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This study describes the experiences of cancer caregivers and compares these experiences with patients' assessment of cancer's toll on their caregiver. Participants (16 patient-caregiver dyads) were recruited from a NCI cancer center of excellence in the northeastern United States. Patients were in treatment for ovarian (n = 7), uterine (n = 2), or endometrial (n = 7) cancers. Caregivers included 7 women and 9 men who described themselves as spouse/partner (n = 7), adult child (n = 4), sister (n = 2), parent (n = 1), nephew (n = 1), and friend (n = 1). Participants completed semi-structured individual interviews that focused on perceptions of caregiver burden or the impact of the patient's diagnosis on the caregiver specifically. Data were coded inductively to identify themes present within participants' responses. This process included open and axial coding. Two overarching themes emerged: (1) patient-caregiver agreement and (2) patient-caregiver disagreement. Patient-caregiver agreement included two subthemes: (1) weight gain and (2) weight loss. Patient-caregiver disagreement consisted of two subthemes: (1) differing perspectives of quantity and quality of caregiving provided and (2) withholding of caregiver concerns. Overall, there was 56% agreement between patient and caregiver responses. The results may inform intervention development to address patient-caregiver communication, cancer caregiver needs, and ultimately improve caregiver quality of life.

Health care providers routinely advise cancer patients to involve support persons in oncology care to fulfill critical support roles. This qualitative descriptive study explored alignment of triadic perceptions of support person involvement in oncology treatment visits and cancer-related care from the perspectives of patients with gynecologic cancer ( n = 18), regular visit-attending support people ( n = 16), and health care providers ( n = 10), including oncologists, nurses, and medical assistants. Semi-structured interviews ( N = 44) captured perceptions of facilitation and interference of support persons' roles within and outside appointments with oncology providers. Thematic analyses revealed alignment and divergence regarding support persons' instrumental, informational, and emotional support behaviors. Perspectives aligned regarding what support functions companions provide. However, patients and support persons emphasized the significance of instrumental followed by informational and emotional support, whereas oncology providers highlighted informational, followed by emotional and instrumental support. Discussion provides insight into each role’s perspective in the triad.

PURPOSE To examine patients' with gynecologic cancer and supporters' reports of sharing and withholding cancer-related information during oncology visits, with a focus on navigating communication encounters more effectively. PARTICIPANTS A SETTING 18 women who were recently diagnosed with gynecologic cancer and their supporters (N = 16) were recruited from the Rutgers Cancer Institute of New Jersey in New Brunswick. METHODOLOGIC APPROACH Data were collected via audio-recorded semistructured interviews and analyzed to determine the types of information that patients and supporters share or withhold during oncology visits. FINDINGS Thematic analyses revealed two major themes. IMPLICATIONS FOR NURSING Probing patients and supporters separately on topics that they may not feel comfortable discussing can help nurses to identify unaddressed concerns and better assist patients and their supporters during oncology visits.

Adolescent-produced anti-substance use messaging is an increasingly popular and effective prevention strategy. However, little is known about the content of these messages and the production elements adolescents use to bring that content to life. In this article, we present a content analysis of 95 anti-substance use messages developed by 4-H club members across nine U.S. states as part of their participation in the media literacy program REAL media. Posters and videos were content-analyzed for target substance, prevention goal, message form, message content, persuasion strategies, and production elements. Results of the content analysis revealed that combustible tobacco (smoking) was the most popular target substance in the sample among the choices of alcohol, marijuana, e-cigarettes, and chewing tobacco. More youth developed messages with the goal of preventing substance use, rather than stopping current use. Slogans were used in the majority of messages, and nearly all messages took an informational form, rather than narrative or statistical form. Persuasion strategies covered in the curriculum, including fun with the group, unexpected, style, and endorsement were scantily used. Finally, results showed that production value was high in this sample, reflected by the extensive use of color and variety of fonts and font sizes. Implications for future media literacy interventions and research are discussed.

Although no tobacco products are safe, tobacco companies in the United States may request regulatory authorization to make certain &ldquo, modified risk tobacco product&rdquo, (MRTP) claims in their marketing. However, few qualitative studies have explored consumer perceptions and understanding of comparative risk messages and wordings. We examined consumer perceptions of statements indicating reduced risks and exposure to chemicals from snus and e-cigarettes relative to smoking. We conducted 12 focus groups with adult smokers (ages 21&ndash, 66) and young adult (YA) non-smokers (ages 18&ndash, 25) (n = 57) in the USA in 2019. Participants shared reactions to modified risk and exposure messages and message variations. Participants largely understood claims, including language about &ldquo, switching completely.&rdquo, However, participants expressed desire for more message specificity, evidence, risk reduction reasons, and statistics/quantitative information. Claim believability and acceptance was also limited by existing negative product beliefs and experiences, negative media reports, and skepticism about message source. YAs did not express product interest based on message exposure. Some YAs suggested the included &ldquo, smoker&rdquo, language made the messages less interesting/relevant. Given existing proposals for and use of MRTP messages, additional research on their wording, framing, delivery, and effects may help inform regulatory or organizational decisions about such messages, optimize potential benefits, and mitigate unintended consequences.

This study aimed to elucidate whether gynecologic cancer patients and their support persons have certain expectancies for emotion and whether these expectancies, if they exist, affect cancer-related communication. Semi-structured interviews ( N = 34) were conducted separately with 18 patients and one of their support persons ( n = 16). Thematic analysis revealed a subset of patients and support persons expected patients to not have any negative emotions, which patients also reported they perceived from support persons, and that these expectancies could affect cancer-related communication. These results have implications and can facilitate appropriate recommendations for how cancer patients and support persons co-manage patients’ emotions.

Background The primary aim of this study was to evaluate the short-term effects of testing an e-learning program to reduce adolescent substance use and abuse. Early initiation of substance use is linked to a variety of negative outcomes, thus effective intervention programs are needed. One approach is to use media literacy to capitalize on adolescents’ immersion with media in a variety of forms. We developed, implemented, and tested an engaging substance use prevention program by collaborating with a youth-oriented community partner (4-H). Methods 639 middle adolescents from nine U.S. states participated in an RCT of REAL media. Participants completed a series of online surveys and were randomized to use an online substance prevention program (REAL media) or serve as control (delayed program use). Self-report surveys were administered at three points in time. This short-term evaluation uses data from the pretest (Time 1) and short-term posttest three-month surveys, which measured demographics, self-efficacy to counterargue, and injunctive and descriptive substance use norms. Results Participants who completed the REAL media program reported increased self-efficacy to counterargue and decreased positive injunctive norms compared to control participants who did not complete the program. No significant differences were observed for descriptive norms. Conclusions We found support for the REAL media program in changing key predictors of youth substance use demonstrating (1) the efficacy of media literacy interventions targeting adolescents and (2) that e-learning substance use prevention efforts can be adapted for and implemented through community organizations.

This article describes formative research (a pilot study, interviews, and focus groups) conducted as part of a feasibility test of 2 versions (Analysis vs. Planning) of a brief media literacy intervention titled Youth Message Development (YMD). The intervention targets high school student alcohol use with activities to understand persuasion strategies, increase counter-arguing, and then apply these new skills to ad analysis or a more engaging ad poster planning activity. Based on the theory of active involvement (Greene, 2013), the Planning curriculum is proposed to be more effective than the Analysis curriculum. Overall, results of the formative research indicated that students (N = 182) and mentors/teachers (N = 53) perceived the YMD Planning curriculum as more interesting, involving, and novel, and these ratings were associated with increased critical thinking about the impact of advertising, lower alcohol use intentions, and fewer positive expectations about the effects of alcohol use. Qualitative feedback indicated a need to supplement alcohol-focused ad stimuli with ads targeting other advertising images, use incentives and competition-based activities to further enhance student motivation, and provide flexibility to enhance the appropriateness of the curriculum to various settings. These concerns led to the development of a revised curriculum and plans for further study.

This study applied the disclosure decision-making model (DD-MM) to explore how individuals plan to disclose nonvisible illness (Study 1), compared to planning to disclose personal information (Study 2). Study 1 showed that perceived stigma from the illness negatively predicted disclosure efficacy; closeness predicted anticipated response (i.e., provision of support) although it did not influence disclosure efficacy; disclosure efficacy led to reduced planning, with planning leading to scheduling. Study 2 demonstrated that when information was considered to be intimate, it negatively influenced disclosure efficacy. Unlike the model with stigma (Study 1), closeness positively predicted both anticipated response and disclosure efficacy. The rest of the hypothesized relationships showed a similar pattern to Study 1: disclosure efficacy reduced planning, which then positively influenced scheduling. Implications of understanding stages of planning for stigmatized information are discussed.

Rates of melanoma and nonmelanoma skin cancers are on the rise in the USA with data revealing disproportionate increase in female young adults. The popularity of intentional skin tanning among U.S. adolescents is attributed to several factors, including prioritization of physical appearance, media images of tanned celebrities, ease of availability of artificial tanning facilities, and more recently, the prevalence and celebration of tanned skin on social media. Pinterest, as the third most popular social media platform, was searched for “pins” about skin tanning. The resultant “pins” were examined to understand the extent and characteristics of skin tanning portrayed on Pinterest. We analyzed pins on Pinterest about skin tanning (n = 501) through a quantitative content analysis. Overall, results indicated an overwhelmingly protanning characteristic of pins about skin tanning on Pinterest, with over 85% of pins promoting tanning behavior. The pins were generally characterized by the portrayal of a female subject (61%) and provided positive reinforcement for tanning (49%). Use of tanning for enhancing appearance was the main positive outcome expectancy portrayed in the pins (35%), and nudity or exposure of skin on arms (32%) and legs (31%) was evident in about a third of pins. With overwhelmingly positive pins promoting tanning, use of female subjects, exhibiting nudity, and appearance enhancement, there seems be to a consistent targeting of female users to accept tanning as a socially acceptable and popular behavior. The findings indicate a need for developing sun protection messages and the leveraging of social media for dissemination of skin cancer prevention and detection messages.

In efforts to better understand the intricate nature of response, we tested a four-dimension structure of response patterns (measured as support, reciprocity, emotional reaction, and avoidance) as well as four single dimension models within the context of couples managing cancer. All models incorporate dyadic data, including both patient and partner perceptions that relational quality influences response patterns, and response patterns influence ongoing disclosure (measured as breadth and depth). Participants were 95 dyads in which one partner had been diagnosed with cancer. We conducted multilevel analyses using an actor-partner interdependence model (APIM). Results supported the four-dimension model as well as individual dimension models. All response types predict within person disclosure. However, only reciprocity predicts the other person’s disclosure, and only patient’s reports of partner reciprocity predict partner disclosure.

The purpose of this survey study was to evaluate a model of body image influences on indoor tanning behavior. Participants were 823 young adult women recruited from a probability-based web panel in the United States. Consistent with our hypothesized model, tanning-related sociocultural experiences were indirectly associated with lifetime indoor tanning use and intentions to tan as mediated through tan surveillance and tan dissatisfaction. In secondary analyses, tan dissatisfaction was positively associated with recent indoor tanning. Findings suggest the need for targeting body image constructs as mechanisms of behavior change in indoor tanning behavioral interventions.

Americans are living longer, and many are managing at least one chronic illness. Having people with whom to disclose health information is a salient component of managing a chronic health condition, such as heart disease. The purpose of this study is to explore differences in elderly patients' health disclosures by target (i.e. disclosing to a partner vs. another person). Elderly patients (age 60) with a diagnosed heart-related condition (n = 273) completed a survey regarding sharing information about their health condition. Results indicated significant differences between the two groups in perceived support; breadth, depth, and frequency of disclosures; and disclosure of psychological/emotional symptoms, physical symptoms, and talk about heart-healthy behaviors. No significant differences were found between the two groups for relationship quality and efficacy. Patients who reported sharing information with a partner reported significantly more health information disclosures compared to patients who reported sharing information with another person.

Objectives To examine construct and predictive utility of an adapted cognitive rationalization scale for tanning-bed use. Methods Current/former tanning-bedusing undergraduate students (N = 216; 87.6% females; 78.4% white) at a large northeastern university participated in a survey. A cognitive rationalization for tanning-bed use scale was adapted. Standardized self-report measures of past tanning-bed use, advantages of tanning, perceived vulnerability to photoaging, tanning-bed use dependence, and tanning-bed use intention were also administered. Results The cognitive rationalization scale exhibited strong construct and predictive validity. Current tanners and tanning-bed-use-dependent participants endorsed rationalizations more strongly than did former tanners and not-tanning-bed-use-dependent participants respectively. Conclusions Findings indicate that cognitive rationalizations help explain discrepancy between inconsistent cognitions.

This paper explores perceived active health information seeking, informal advocacy by a partner or other, cardiac efficacy, and cardiovascular health indicators for patients surveyed while visiting their cardiologist. Participants include 208 patients with a diagnosed heart condition. Variables include predisposing characteristics (e.g., illness severity, demographics), perceived active health information seeking during an office visit, informal advocacy by partner or other, cardiac efficacy, and cardiovascular health indicators (i.e., basal metabolic index (BMI), total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides). Data were analyzed using correlations, t-tests, and structural equation modeling. As hypothesized, perceived active health information seeking during an office visit (positively) and informal advocacy by partner or other (negatively) predicted cardiac efficacy. One path was added from active information seeking to BMI. Cardiac efficacy, in turn, significantly predicted total cholesterol and BMI. The model was also replicated for LDLs but not for HDLs or triglycerides. We discuss implications for cardiac disease management.

A narrative experience can partly depend on how a narrative ends or concludes. This study examined prevention effects of personal drug use narratives varying by type of ending and gender of protagonist. Additionally, the role of transportation in the persuasion process, particularly the association between transportation and cocaine use intentions, both directly and indirectly, through the mediation of anti-drug and pro-drug expectancies was assessed. A total of 500 undergraduate students at a large northern university in the UK participated in the experiment which was a 2 × 2 × 2 mixed design with ending (progressive vs. regressive) and gender of protagonist (male vs. female) as within-participants factors and participant gender (male vs. female) as between-participants factors. The results demonstrated significant main effects for ending, gender of protagonist in the narrative and participant gender, but no interaction effects. Finally, greater transportation was associated with stronger anti-cocaine expectancies, which were further associated with lower cocaine use intentions. Important theoretical and empirical implications are discussed.

This study examined transportation effects of first- and third-person narratives as well as the role of transportation in the persuasion process. In particular, the authors evaluated the role of transportation in affecting cognitive and affective responses. Last, they addressed the relation between (a) cognitive and affective responses and (b) antidrug expectancies. Participants were 500 undergraduate students at a large northern university in the United Kingdom who were randomly assigned to 1 of 2 conditions: first- or third-person narratives on cocaine use. The results demonstrated that there was no difference between first- and third-person narratives in terms of transportation. However, overall, greater transportation was associated with more favorable cognitive responses, and more favorable cognitive response was associated with stronger anticocaine expectancies. In terms of affective responses, results indicated the mediating role of sadness and contentment in the association between transportation and anticocaine expectancies. In particular, increased transportation was associated with greater sadness and lower contentment. Lower sadness and contentment were associated with stronger anticocaine expectancies. Important theoretical and empirical implications are discussed.

This paper explored how sensation seeking contributes to the likelihood of tanning bed use intentions both directly and indirectly through the way it shapes interaction with peers who use tanning beds and attitudes toward tanning bed. Eight hundred and ninety six (n = 896) male and female college students were recruited for the study. Measured variables included sensation seeking, association with friends who use tanning beds, attitudes toward tanning and tanning bed use intentions. Structural equation modeling was performed to test the hypotheses. In general, results supported the proposed hypotheses and documented that sensation seeking is indirectly associated with tanning bed use intentions through the mediation of association with peers who use tanning beds and attitudes toward tanning. The article discusses theoretical and methodological implications of the findings demonstrating the pathways of influence of sensation seeking on tanning bed use intentions.

Introduction: This study explored the association between unsupervised time with peers and adolescent smoking behavior both directly and indirectly through interaction with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers. Methods: A cross-sectional survey was used for the study and included 248 male and female middle school students. Results: Results of structural equation modeling revealed that unsupervised time with peers is associated indirectly with adolescent smoking behavior through the mediation of association with delinquent peers, social expectancies about cigarette smoking, and cigarette offers from peers. Discussion: Interventions designed to motivate adolescents without adult supervision to associate more with friends who engage in prosocial activities may eventually reduce adolescent smoking. Further implications for structured supervised time for students outside of school time are discussed.

This study developed inoculation-driven antismoking interventions aimed at changing attitudes, norms and intentions about smoking to influence smoking behavior in adolescents. This study explored the efficacy of 2 intervention approaches designed to help adolescents to refrain from smoking initiation. Participants were junior high students (6th, 7th, and 8th grade) from schools in the Northeast. Two kinds of experimental workshops and a control group were designed as stimulus material in a repeated measure nonequivalent group experimental design. The 2 intervention workshops developed included: analysis + analysis (where participants discussed and analyzed cigarette and antismoking ads) and analysis + production (where participants discussed, analyzed, and then created their own antismoking ads). The analysis + production workshop was generally more successful than the analysis + analysis workshop and control group in changing participants' behavioral intention to smoke and attitude toward smoking but not subjective norms over time. Implications and directions for future research are discussed.

Indoor tanning beds (IT) that emit artificial ultraviolet (UV) radiation are implicated in an estimated 450,000 cases of non-melanoma skin cancer and 11,300 cases of melanoma each year in the United States, Northern and Western Europe, and Australia (Wehner et al., 2012). In the United States, the increasing popularity of IT over the past 2 decades among young adult women (Robinson, Kim, Rosenbaum, & Ortiz, 2008) has been accompanied by increasing melanoma incidence in this group (Coelho & Hearing, 2010). Nearly 1 in 3 young adult Caucasian women report using IT in the past year (Guy, Berkowitz, Watson, Holman, & Richardson, 2013), making this an important group for melanoma prevention efforts. The 2014 Surgeon General’s Call to Action to Prevent Skin Cancer highlights the need for innovative IT behavioral interventions that address underlying motives for tanning including “the desire to look attractive and healthy and to conform to societal beauty standards” (U.S. Department of Health and Human Services, 2014). Body image theory may provide insights into developing such interventions. Body image theories posit that one’s thoughts and actions related to their appearance are largely socially determined by perceptions of societal beauty standards, or beauty ideals (Stice, 2001; Thompson & Stice, 2001). This beauty ideal is further reinforced by interpersonal experiences. A young woman who internalizes the beauty ideal as her own appearance goal will feel pressured to match her appearance to them. Perceived discrepancies between the internalized ideal and one’s appearance leads to body image dissatisfaction. Appearance-altering behaviors, like IT, become powerfully reinforcing because they help to alleviate body dissatisfaction by aligning one’s appearance more closely with the ideal. The application of body image theory to IT would suggest a young woman’s societal experiences can lead her to form a tan beauty ideal, defined as the belief that being tan is a defining aspect of being an attractive woman. A young women who internalizes a tan ideal will value being tan as important to her own attractiveness, be motivated to use IT, and experience appearance dissatisfaction when she is not tan. Evidence is beginning to emerge that supports an association between body image constructs and IT attitudes and behavior (see review by Thompson, Ata, Roehrig, & Chait, 2012). The desire to possess the same tan as favored celebrities, a marker of tan ideal internalization, is linked to IT among young adults (Cafri, et al., 2008). Also consistent with internalization, IT users monitor, evaluate, and compare their tan to their desired or ideal tan level (Cafri et al., 2008; Gillen & Markey, 2012; Prichard, Kneebone, Hutchinson, & Wilson, 2014). Appearance monitoring influences IT intentions through increasing body dissatisfaction (Stapleton, Turrisi, Todaro, & Robinson, 2009). Skin tone dissatisfaction, defined as perceived discrepancy between one's current and ideal tan, is associated with tan ideal internalization and tanning behavior among adolescent girls (Pritchard, et al., 2014). Body image investment in IT may explain why some users think the short-term appearance benefits and self-confidence gained with IT are more important than or worth the risks (Banerjee, Hay, & Greene, 2013; Cafri, Thompson, Jacobsen, & Hillhouse, 2009). This study describes the pilot test of a web-based IT intervention informed by body image theory-guided interventions designed to prevent disordered eating among young women. The intervention targets an IT user’s perceptions of the benefits and value of tanning and addresses the role of body image in IT. The intervention was targeted to young women as they report the highest rates of IT. The intervention included persuasive techniques informed by non-clinical cognitive behavioral interventions that engage participants in reflection and cognitive restructuring of beliefs (Heinicke, Paxton, McLean, & Wertheim, 2007; Stewart, Carter, Drinkwater, Hainsworth, & Fairburn, 2001; Stice, Rohde, Durant, & Shaw, 2012). Psychoeducational content was designed to engage participants in reflecting on how their IT behavior may be influenced by their societal experiences related to tanning, the internalization of the value that a tanned appearance is an ideal body image, and resulting dissatisfaction. Restructuring IT-related beliefs involved thought exercises that presented tan ideal counter perspectives, including evidence against a tan beauty ideal as well as alternative viewpoints about the personal and social benefits of tanning. Participants were also encouraged to consider strategies for counteracting body dissatisfaction and plans for reducing their IT. Several IT interventions with evidence of efficacy target perceptions of the short-term appearance benefits of IT through raising awareness of the negative appearance effects of IT (e.g., premature skin aging and wrinkling) (Hillhouse, Turrisi, Stapleton, & Robinson, 2008; Gibbons, Gerrard, Lane, Mahler, & Kulik, 2005; Greene & Brinn, 2003). This intervention shares important key features with these and other skin cancer intervention approaches (Jackson & Aiken, 2006; Lazovich et al., 2013; Mahler, Kulik, Butler, Gerrard, & Gibbons, 2008; Pagoto, Schneider, Oleski, Bodenlos, & Ma, 2010) including reframing perceptions of tanning benefits, targeting normative perceptions regarding the attractiveness of tanning, and promoting healthy alternatives to tanning. Innovative aspects of this intervention include the web-based format and the use of thought exercises to target central body image constructs including perceptions of a tan ideal, tan ideal internalization, and perceptions of the role of dissatisfaction in IT. The first study aim was to describe the acceptability of the intervention as determined by participants’ intervention evaluations. The second aim was to report the preliminary behavioral outcomes measured on a 6-week intervention follow-up assessment. The study hypothesis was that intervention participants would report less IT and a lower likelihood of using IT in the future at follow-up compared to control participants. We also examined whether rates of sunburns, a marker of IT and other risky UV exposure, were lower among intervention participants.

People living with HIV/AIDS must make decisions about how, where, when, what, and to whom to disclose their HIV status. This study explores their perceptions of benefits and drawbacks of various HIV disclosure strategies. The authors interviewed 53 people living with HIV/AIDS from a large AIDS service organization in a northeastern U.S. state and used a combination of deductive and inductive coding to analyze disclosure strategies and advantages and disadvantages of disclosure strategies. Deductive codes consisted of eight strategies subsumed under three broad categories: mode (face-to-face, non-face-to-face, and third-party disclosure), context (setting, bringing a companion, and planning a time), and content (practicing and incremental disclosure). Inductive coding identified benefits and drawbacks for enacting each specific disclosure strategy. The discussion focuses on theoretical explanations for the reasons for and against disclosure strategy enactment and the utility of these findings for practical interventions concerning HIV disclosure practices and decision making.

This study explores the prevalence of AIDS and cancer stigma as influenced by attitude toward homosexuality, religiosity, authoritarianism, and androgyny. This study used a quasi-experimental survey design (N = 485) to examine attitude toward people with AIDS and cancer, and interaction with people with AIDS and cancer. Negative attitudes toward homosexuality, high religious intensity and ideology, high authoritarianism, and low expressive emerged as factors related to more negative attitudes toward people with AIDS and unwillingness to interact with people with AIDS. Attitudes toward people with cancer were generally not related to the variables. Findings explore how to campaign efforts to reduce existing negative attitudes toward AIDS and homosexuality, given that gay men with AIDS are especially stigmatized. Implications and directions for future research are discussed, especially for interventions.

Understanding the effect of messages and other influences on health decision-making has the potential to decrease risky behavior such as tanning bed use. This study explores the effect of type of evidence, self-assessments of risk for skin cancer, and personality factors on intention to use and use of tanning beds among Caucasian female college students. Specifically, it targeted the perceived susceptibility component of the Health Belief Model and its impact on intention to tan as well as changes in actual tanning behavior. College students (N=141) in the southeast United States read randomly assigned messages and self-assessments, filled out surveys, and were later contacted for a follow-up telephone survey. The statistical message was rated higher on information value and also resulted in decreased intention to tan, decreased tanning behavior, and increased perceived susceptibility to skin cancer. The narrative message, in contrast, increased perceptions of realism and also worked to decrease intentions to tan. Additionally, the self-assessment manipulation resulted in increased susceptibility and decreased intention to tan and post tanning behavior. Personality factors explained small portions of variance. Key limitations and directions for future research are also addressed.

Current research about violence in intimate relationships suggests that at least two qualitatively distinct types of violence exist. This new knowledge challenges the dominant conceptualization of intimate violence as solely a manifestation of patriarchal male dominance. Following a review of the research and analysis of illustrative clinical examples, a conceptual framework is presented that assists couple therapists in answering three salient questions: What type of violence am I most likely to be working with? How can I assess the differences between types of violence? And how might I proceed with treatment for different types of violence?

The purpose of the present study was to apply Berg and Upchurch’s developmental-conceptual model toward a better understanding of how couples cope with chronic illness. Specifically, a model was hypothesized in which proximal factors (relational quality), dyadic appraisal (illness interference), and dyadic coping (partner support) influence adjustment (health condition management). The study was cross-sectional and included 308 dyads in which one partner has a chronic health condition. The actor partner interdependence model shows how congruence and noncongruence in relational quality, dyadic appraisal, and dyadic coping influence dyadic adjustment.

This study is grounded in theories of information management. Patients with a diagnosed heart-related condition ( N = 253) completed a survey regarding their perceptions of sharing/not sharing information with a partner about their health condition. Data were analyzed using descriptive and inferential statistics. Results indicated that although most patients reported sharing “everything” with their partner, others reported not sharing certain topics such as health issues and physical symptoms/ailments. In addition, patients who reported sharing everything with a partner reported significantly greater communication efficacy, and breadth, depth, and frequency of communication about a heart-related condition compared with those who reported not sharing certain topics. Finally, as hypothesized, there were no significant group differences in terms of sharing specific physical and psychological health information. We discuss the findings and implications of the study for nursing practice.

Involvement in creating anti-alcohol advertisements generates enthusiasm among adolescents, however, little is known about the messages adolescents develop for these activities. In this paper, we present a content analysis of 72 print alcohol counter-advertisements created by high school (age 14–17 years old) and college (18–25 years old) students. The posters were content analyzed for poster message content, persuasion strategies, and production components, and we compared high school and college student posters. All of the posters used a slogan to highlight the main point/message of the ad and counter-arguments/consequences to support the slogans. The most frequently depicted consequences were negative consequences of alcohol use followed by negative-positive consequence comparison. Persuasion strategies were sparingly used in advertisements and included having fun/one of the gang, humor/unexpected, glamour/sex appeal, and endorsement. Finally, posters displayed a number of production techniques including depicting people, clear setting, multiple colors, different font sizes, and object placement. College and high school student constructed posters were similar on many features (for instance, posters displayed similar frequency of utilization of slogans, negative consequences and positive-negative consequence comparisons), but were different on the use of positive consequences of not using alcohol and before-after comparisons. Implications for teaching media literacy and involving adolescents and youth in developing alcohol prevention messages are discussed.

Tanning bed use is a popular behavior among American youth1 despite evidence of increased risk of melanoma.2 Current interventions to reduce tanning bed use3 have not been very successful with resistant tanners, characterized by engagement in tanning bed use for appearance enhancement despite being knowledgeable about harmful effects of their behavior.

Illness affects millions of Americans each year, and the disclosure of health conditions can facilitate access to social support, in addition to other physical and physiological benefits. This article tests the Disclosure Decision-Making Model (DD-MM; Greene, 2009 ) to predict factors that influence the likelihood of disclosing (and past disclosure of) nonvisible physical or mental health-related information. One hundred eighty-seven (n = 187) people were recruited for a study to report on both disclosing and not disclosing a nonvisible health condition. Measured variables included information assessment, relational quality, anticipated reactions (support, relational consequences), confidence in response, disclosure efficacy, and disclosure (likelihood of disclosure and depth of disclosure). Structural equation modeling results supported many of the proposed hypotheses, with a great deal of similarity across models. Specifically, assessing information predicted efficacy, and to some extent relational outcomes. Closeness was related to response overall and to efficacy in one model. Response predicted outcome overall and likelihood of disclosure in one model. Finally, efficacy predicted likelihood of disclosure and depth of disclosure. The article discusses the implications of the findings for understanding information, relationship assessments, and efficacy in disclosing health diagnoses.

This study is framed in Greene's (2009) health disclosure decision-making model (DD-MM) and explores the role of prognosis and symptom uncertainty in patterns of disclosure in a close relationship. Toward this end, an uncertainty and disclosure model is hypothesized in which prognosis and symptom uncertainty and relational quality are expected to predict perceived partner support, communication efficacy, and the depth, breadth, and frequency of disclosure to a partner about a chronic health condition. Patients with diagnosed heart-related conditions visiting a private medical office were recruited to complete anonymous surveys. Results indicated that (1) the key mechanisms identified in the DD-MM are associated with the depth, breadth, and frequency of disclosure to a partner about a health condition, and (2) uncertainty plays a prominent role in people's communication with their partner about the heart-related condition. The findings and implications of the study are discussed.

Objective: The authors examined factors predicting college students' use of tanning beds. Participants and Methods: Undergraduate students (N = 745) at a large Northeastern university participated in the study by answering a survey measuring tanning behavior and other psychosocial variables, including sensation seeking, self-esteem, tanning image beliefs, and friends' tanning bed use. Results: All 3 systems from problem behavior theory predicted past tanning bed use and intention to use tanning beds. The authors observed a positive association between sensation seeking and intention to use tanning beds. Tanning image beliefs were positively associated with both past tanning behavior and intention to use tanning beds. Conclusions: Interventions focusing on friend and acquaintance social network influences may be more effective than health-risk campaigns in reducing tanning bed use.

Summary Taylor and Lobel's (1989) model of social comparison processes under threat predicts that upward affiliation (a social activity) may be useful to improve the skills and to find inspiration in coping with HIV, whereas downward evaluation (a cognitive activity) may assist someone to feel better by comparing oneself to a less fortunate person. Participants with HIV were randomly assigned, using a 3 × 3 factorial design, to read one of nine vignettes about someone whose HIV medical prognosis and psychological adjustment were described as good, poor or unspecified. Participants desired upward affiliation with a target doing well physically, but they wanted to avoid a target doing poorly psychologically. Participants also evaluated their own physical condition as better than a target coping poorly physically with HIV. The results may be useful in understanding the impact of various role models in coping with HIV.

To examine the impact of tanned female images on respondents' perceptions of attractiveness, healthiness, and height and weight estimations.A 3 (light, medium, or dark tan) by 2 (male or female respondent) experimental design.Only male respondents perceived the dark-tanned woman as more physically attractive and thinner than both light- and medium-tanned women. Men also perceived the dark-tanned woman as more interpersonally attractive and healthier than the medium-tanned woman.Campaigns targeted at males need to reduce the perceptions that tanned females are healthier, thinner, and more attractive. Educational efforts targeting females need to reduce attraction-based motivations.

Tremendous resources are spent each year developing programs and messages targeting adolescent risk behavior. Adolescents are often reasonably well educated about methods for health promotion such as preventing HIV infection, yet they fail to act accordingly. One widely used individual difference variable, sensation-seeking, has been incorporated in health message design to some extent, but it fails to take development into account. Research on adolescent egocentrism suggests adolescents experience personal fable which can lead to an exaggerated sense of invulnerability. The present study sampled adolescents and college students to examine relative contributions of egocentrism and sensation-seeking to risk-taking behavior. Results indicate a latent factor labeled risk-seeking (primarily indicated by disinhibition and risk-taking personality, and to a lesser degree by invulnerability, experience-seeking, boredom susceptibility, and thrill and adventure-seeking) indeed predicted a latent factor labeled delinquent behavior (primarily indicated by alcohol consumption and delinquency, and to a lesser degree by drug use, drinking and driving, and risky driving). Other results indicate consistently high personal fable combined with high sensation-seeking explained most risk-taking behavior. Implications and directions for future research are discussed.