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The article examines how the role of media in framing moral issues help the public to make attributions about candidate integrity. Three hypothesis are discussed that suggests media coverage of political issues activates certain cognitions, which are then more broadly accessible for use by individuals in evaluating other applicable elements of the political environment. The cognitions activated by media coverage of one issue may subsequently be used by voters to process information about additional issues. The article presents a study that offers insights into priming effects i.e. how the process of priming occurs depends on the degree of inter-connectedness of an individual's mental system. The study concludes that media priming effects may be contingent upon the specific features of an issue and the manner in which media frame issue coverage. The future research should conceptualize priming more broadly to include considerations of both the accessibility of cognitions in short-term memory and the pathways among information in long-term memory.

Reports on a study which focused its research on the mental processes involved, when political issues are presented by the media. How the research was conducted; Details on the way that the media frames political issues; What factors affect the way the issues are viewed; Identification of the groups that data was gathered from.

The mechanisms underlying the formation and sustenance of social capital on the individual level were explored with a structural model composed of the endogenous variables of civic engagement and interpersonal trust. Using the 1995 DDB Needham life style study, analysis of the model permitted an examination of the strength and direction of the causal relationships driving the ‘virtuous circle’ of participation and trust; the demographic. situational/contextual, orientational, and attitudinal factors that are exogenous to these latent variables; and the linkage between these components of social capital and viewing preferences for specific television genres. The results indicate that (1) the direction of the linkage between civic engagement and interpersonal trust is mainly from participating to trusting; and (2) television viewing plays a conditional role in the production of social capital that is dependent on the use of particular genres. [ABSTRACT FROM AUTHOR]

Examines the relationships among media frames, individual interpretations of issues, and voter decision making by building on multidisciplinary research on framing, motivation and decision making. Framing and priming; Motivation and the self; Decision making; Implications for understanding the voting process.

The third person effect hypothesis, which states that individuals exposed to a mass media message will expect the communication to have a greater effect on others than on themselves, may help to explain the growing trend in support of media censorship. It is suggested here that overestimating the effect of media on others may play an important role in the forces underlying a willingness to restrict various types of communication. To examine this relationship, this study focused on the discrepancy between perceived media effects on others and self, and its relation to pro-censorship attitudes within three major topics: the media in general, violence on television, and pornography. The results of this study support the existence of the third-person effect in mass communication. The findings also indicate that as the gap between perceived first-and third-person effects increases, individuals are more likely to manifest pro-censorship attitudes. This relationship remained for all three topics even when a variety of potentially confounding demographic, media use, and attitudinal variables were controlled. The data also suggest that for pornography the effects gap is related to a willingness to act in favor of censoring. [ABSTRACT FROM AUTHOR]

Background: Multiple chronic conditions (MCCs) are common among older adults and expensive to manage. Two-thirds of Medicare beneficiaries have multiple conditions (eg, diabetes and osteoarthritis) and account for more than 90% of Medicare spending. Patients with MCCs also experience lower quality of life and worse medical and psychiatric outcomes than patients without MCCs. In primary care settings, where MCCs are generally treated, care often focuses on laboratory results and medication management, and not quality of life, due in part to time constraints. eHealth systems, which have been shown to improve multiple outcomes, may be able to fill the gap, supplementing primary care and improving these patients' lives. Objective: This study aims to assess the effects of ElderTree (ET), an eHealth intervention for older adults with MCCs, on quality of life and related measures. Methods: In this unblinded study, 346 adults aged 65 years and older with at least 3 of 5 targeted high-risk chronic conditions (hypertension, hyperlipidemia, diabetes, osteoarthritis, and BMI ≥30 kg/m2) were recruited from primary care clinics and randomized in a ratio of 1:1 to one of 2 conditions: usual care (UC) plus laptop computer, internet service, and ET or a control consisting of UC plus laptop and internet but no ET. Patients with ET have access for 12 months and will be followed up for an additional 6 months, for a total of 18 months. The primary outcomes of this study are the differences between the 2 groups with regard to measures of quality of life, psychological well-being, and loneliness. The secondary outcomes are between-group differences in laboratory scores, falls, symptom distress, medication adherence, and crisis and long-term health care use. We will also examine the mediators and moderators of the effects of ET. At baseline and months 6, 12, and 18, patients complete written surveys comprising validated scales selected for good psychometric properties with similar populations; laboratory data are collected from eHealth records; health care use and chronic conditions are collected from health records and patient surveys; and ET use data are collected continuously in system logs. We will use general linear models and linear mixed models to evaluate primary and secondary outcomes over time, with treatment condition as a between-subjects factor. Separate analyses will be conducted for outcomes that are noncontinuous or not correlated with other outcomes. Results: Recruitment was conducted from January 2018 to December 2019, and 346 participants were recruited. The intervention period will end in June 2021. Conclusions: With self-management and motivational strategies, health tracking, educational tools, and peer community and support, ET may help improve outcomes for patients coping with ongoing, complex MCCs. In addition, it may relieve some stress on the primary care system, with potential cost implications. Trial Registration: ClinicalTrials.gov NCT03387735; https://www.clinicaltrials.gov/ct2/show/NCT03387735. International Registered Report Identifier (IRRID): DERR1-10.2196/25175 JMIR Res Protoc 2021;10(2):e25175 doi:10.2196/25175 [ABSTRACT FROM AUTHOR]

Background: The growing epidemic of opioid use disorder (OUD) and associated injection drug use has resulted in a surge of new hepatitis C virus (HCV) infections. Approximately half of the people with HCV infection are unaware of their HCV status. Improving HCV awareness and increasing screening among people with OUD are critical. Addiction-Comprehensive Health Enhancement Support System (A-CHESS) is an evidence-based, smartphone-delivered relapse prevention system that has been implemented among people with OUD who are receiving medications for addiction treatment (MAT) to improve long-term recovery. Objective: We incorporated HCV-related content and functionality into A-CHESS to characterize the HCV care continuum among people in early remission and receiving MAT for OUD and to determine whether incorporating such content and functionality into A-CHESS increases HCV testing. Methods: HCV intervention content, including dissemination of educational information, private messages tailored to individuals' stage of HCV care, and a public discussion forum, was implemented into the A-CHESS platform. Between April 2016 and April 2020, 416 participants with OUD were enrolled in this study. Participants were randomly assigned to receive MAT alone (control arm) or MAT+A-CHESS (experimental arm). Quarterly telephone interviews were conducted from baseline to month 24 to assess risk behaviors and HCV testing history. Cox proportional hazards regression was used to assess whether participants who used A-CHESS were tested for HCV (either antibody [Ab] or RNA testing) at a higher rate than those in the control arm. To assess the effect of A-CHESS on subsets of participants at the highest risk for HCV, additional analyses were performed to examine the effect of the intervention among participants who injected drugs and shared injection equipment. Results: Overall, 44.2% (184/416) of the study participants were HCV Ab positive, 30.3% (126/416) were HCV Ab negative, and 25.5% (106/416) were considered untested at baseline. At month 24, there was no overall difference in HCV testing uptake between the intervention and control participants. However, among the subset of 109 participants who engaged in injection drug use, there was a slight trend toward increased HCV testing uptake among those who used A-CHESS (89% vs 85%; hazard ratio: 1.34; 95% CI 0.87-2.05; P =.18), and a stronger trend was observed when focusing on the subset of 32 participants who reported sharing injection equipment (87% vs 56%; hazard ratio: 2.92; 95% CI 0.959-8.86; P =.06). Conclusions: Incorporating HCV prevention and care information into A-CHESS may increase the uptake of HCV testing while preventing opioid relapse when implemented among populations who engage in high-risk behaviors such as sharing contaminated injection equipment. However, more studies that are powered to detect differences in HCV testing among high-risk groups are needed. Trial Registration: ClinicalTrials.gov NCT02712034; https://clinicaltrials.gov/ct2/show/NCT02712034 International Registered Report Identifier (IRRID): RR2-10.2196/12620 JMIR Mhealth Uhealth 2021;9(2):e23080 doi:10.2196/23080 [ABSTRACT FROM AUTHOR]

Background: Depressive symptoms are the most prevalent mental health concern among older adults (possibly heightened during the COVID-19 pandemic), which raises questions about how such symptoms can be lowered in this population. Existing research shows that offline social connectedness is a protective factor against depression in older adults; however, it is unknown whether web-based social connectedness can have similar effects. Objective: This study investigates whether social connectedness on a support website protects older adults against depressive symptoms over the course of a year, above and beyond the protective effect of offline social connectedness. The secondary aim is to determine whether older adults with increased depressive symptoms are more likely to engage in social connectedness on this website. Thus, we examine depressive symptoms as both an outcome and predictor of web-based social connectedness to fully understand the chain of causality among these variables. Finally, we compare web-based social connectedness with offline social connectedness in their ability to lower depressive symptoms among older adults. Methods: A total of 197 adults aged 65 years or older were given access to a social support website, where they were able to communicate with each other via a discussion forum for a year. Participants' social connectedness on the web-based platform, conceptualized as message production and consumption, was measured using behavioral log data as the number of messages participants wrote and read, respectively, during the first 6 months (t1) and the following 6 months (t2) of the study. Participants self-reported their offline social connectedness as the number of people in their support networks, and they reported their depressive symptoms using the Patient Health Questionnaire-8 both at baseline (t1) and at 12-month follow-up (t2). To ascertain the flow of causality between these variables, we employed a cross-lagged panel design, in which all variables were measured at t1 and t2. Results: After controlling for the effect of offline support networks at t1, web-based message consumption at t1 decreased older adults' depressive symptoms at t2 (β =−.11; P =.02), but web-based message production at t1 did not impact t2 depressive symptoms (β =.12; P =.34). Web-based message consumption had a larger effect (β =−.11; P =.02) than offline support networks (β =−.08; P =.03) in reducing older adults' depressive symptoms over time. Higher baseline depressive symptoms did not predict increased web-based message consumption (β =.12; P =.36) or production (β =.02; P =.43) over time. Conclusions: The more messages older adults read on the web-based forum for the first 6 months of the study, the less depressed they felt at the 1-year follow-up, above and beyond the availability of offline support networks at baseline. This pinpoints the substantial potential of web-based communication to combat depressive symptoms in this vulnerable population. International Registered Report Identifier (IRRID): RR2-10.1186/s13063-015-0713-2 [ABSTRACT FROM AUTHOR]

Despite the fact that social distancing is an effective mean to slow the spread of COVID-19, individuals often fail to practice this behavior. Major US news media provided information to the public about social distancing after COVID-19 was declared a pandemic, potentially spurring this preventative health practice. Using data from a representative sample of US residents, this study aims to understand the relationship between news media attention and social-distancing behavior via three potential mediators: perceived effectiveness of social distancing, perceived susceptibility to COVID-19 infection, and perceived negative consequences of infection. Media trust and social norms concerning social distancing were included as potential moderators of these relationships, along with political ideology. With multiple regression and mediation analyses, we found that news media attention was positively associated with social-distancing behavior during this period. Perceived effectiveness of social distancing mediated this relationship, while perceived susceptibility and negative consequences of COVID-19 did not. Notably, media trust negatively moderated news attention's impact on the perceived effectiveness of social distancing, with the relationship being more pronounced among those who have lower trust in media. Political ideology did not moderate the relationship between news attention and perceived effectiveness. Further, social norms negatively moderated the relationship between perceived effectiveness and social-distancing behavior, with this relationship growing stronger among those uncertain about the adoption of social-distancing norms in their circle. Overall, the study found news media to have an important role in promoting social-distancing behavior when they emphasized safety measures across the ideological spectrum. [ABSTRACT FROM AUTHOR]

Communicating within digital health interventions involves a range of behaviors that may contribute to the management of chronic illnesses in different ways. This study examines whether communication within a smartphone-based application for addiction recovery produces distinct effects depending on 1) the "level" of communication, defined as intraindividual communication (e.g., journal entries to oneself); dyadic communication (e.g., private messaging to other individuals); or network communication (e.g., discussion forum posts to all group members), and 2) whether individuals produce or are exposed to messages. We operationalize these communication levels and behaviors based on system use logs as the number of clicks dedicated to each activity and assess how each category of system use relates to changes in group bonding and substance use after 6 months with the mobile intervention. Our findings show that (1) intraindividual exposure to one's own past posts marginally predicts decreased drug use; (2) dyadic production predicts greater perceived bonding; while dyadic exposure marginally predicts reduced drug use; (3) network production predicts decreased risky drinking. Implications for digital health interventions are discussed. [ABSTRACT FROM AUTHOR]

Scholars have adopted Street's (2003) ecological model of communication in medical encounters to investigate the factors promoting patient participation in health care. However, factors demonstrated in the ecological model were bounded in the context of medical care primarily focusing on health care providers and patients. Social factors, such as patients' relationships and supportive communication with others outside the context of health care remain relatively unexplored. To expand the purview of our understanding of factors that influence patient participation, this research integrated social support literature into the research on physician-patient communication and proposed a model which described a process through which social support can enhance patient participation in health care. The data analyzed in this study were a part of two larger clinical trials in which 661 women with breast cancer were recruited from three cancer institutions in the United States. The results from structural equation modeling analysis from cross-sectional and longitudinal data provided strong evidence for the hypotheses predicting that perceived social support was positively associated with health information competence, which in turn fully mediated the association between social support and patient participation in health care. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: People who inject drugs are at a disproportionate risk for contracting hepatitis C virus (HCV). However, use of HCV prevention and treatment services remains suboptimal among people with substance use disorders due to various health system, societal, and individual barriers. Mobile health applications offer promising strategies to support people in recovery from substance use disorders. We sought to determine whether the Addiction-Comprehensive Health Enhancement Support System (A-CHESS), an existing mobile health application for opioid use disorder, could be adapted to improve HCV screening and treatment. Objective: The goals of this paper are to describe: (1) the components and functionality of an HCV intervention incorporated into the existing A-CHESS system; and (2) how data are collected and will be used to evaluate HCV testing, linkage to care, and treatment. Methods: People with recent opioid use were enrolled in a randomized controlled trial to test whether A-CHESS reduced relapse. We developed and implemented HCV intervention content within the A-CHESS platform to simultaneously evaluate whether A-CHESS improved secondary outcomes related to HCV care. All A-CHESS users received the HCV intervention content, which includes educational information, private messages tailored to an individual's stage of HCV care, and a public discussion forum. Data on patients' HCV risk behaviors and stage of care were collected through quarterly telephone interviews and weekly surveys delivered through A-CHESS. The proportion of people with opioid use disorder who are HCV untested, HCV-negative, HCV antibody-positive, or HCV RNA–positive, as well as linked to care, treated and cured at baseline is described here. The 24-month follow-up is ongoing and will be completed in April 2020. Survey data will then be used to assess whether individuals who received the HCV-enhanced A-CHESS intervention were more likely to reduce risky injection behaviors, receive HCV testing, link to medical care, initiate treatment, and be cured of HCV compared to the control group. Results: Between April 2016 and April 2018, 416 individuals were enrolled and completed the baseline interview. Of these individuals, 207 were then randomly assigned to the control arm and 209 were assigned to the intervention arm. At baseline, 202 individuals (49%) self-reported ever testing HCV antibody-positive. Of those, 179 (89%) reported receiving HCV RNA confirmatory testing, 134 (66%) tested HCV RNA–positive, 125 (62%) were linked to medical care and 27 (13%) were treated and cured of HCV. Of the remaining 214 individuals who had never tested HCV antibody–positive, 129 (31%) had tested HCV antibody–negative within the past year and 85 (20%) had not been tested within the past year. Conclusions: The A-CHESS mobile health system allows for the implementation of a bundle of services as well as the collection of longitudinal data related to drug use and HCV care among people with opioid use disorders. This study will provide preliminary evidence to determine whether HCV-specific services embedded into the A-CHESS program can improve HCV outcomes for people engaged in addiction treatment. Trial Registration: ClinicalTrials.gov NCT02712034; https://clinicaltrials.gov/ct2/show/NCT02712034 International Registered Report Identifier (IRRID): DERR1-10.2196/12620 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]

Objective: This investigation explores how using different e‐health interventions facilitates positive psychosocial changes and how these changes reduce cancer concerns and improve quality of life in breast cancer patients over time. Methods: A total of 326 breast cancer patients were randomly assigned to one of three e‐health interventions: (a) Internet only, (b) the Comprehensive Health Enhancement Support System information and support services (CHESS‐IS), or (c) CHESS with mentor. Proximal health outcomes such as information overload, emotional functioning, and social support were measured alongside distal outcomes like cancer concerns and quality of life. Participants completed surveys at four time points: pretest as a baseline, 6 weeks, 3 months, and 6 months. Results: Both interventions were effective in improving patient health beyond Internet only but they differed in type of change mechanism and clinical benefit. The CHESS‐IS enhanced proximal outcomes at 3 months through improved information competence. The CHESS with mentor intervention reduced breast cancer concerns at 6 months, mediated mainly by emotional‐social competence and emotional functioning. Conclusions: Using e‐health interventions like CHESS can help patients improve cancer information management skills and emotional functioning, contributing to better short‐term health outcomes. Adding a human mentor can enhance the benefits of CHESS use, extending the experience among breast cancer patients. Theoretical, practical, and clinical implications of the study results are discussed. [ABSTRACT FROM AUTHOR]

Beyond a consciousness-raising hashtag, #MeToo has become a transnational movement, crossing the borders of many societies. However, outsized attention has been paid to the manifestations of #MeToo in the US and on Twitter when the reach of this movement was not restricted to a single country, language, or platform. Drawing from the concept of hybridization, we seek to understand how the uses of #MeToo are contextualized across cultures, languages, and social media platforms. By establishing a macroscopic computational approach, we examine the global diffusion of #MeToo as a hybrid communicative process across different language groups (English, Spanish, and Korean) and social media platforms (Twitter, Facebook, and Instagram). Through time-series analysis and comparative descriptions of language groups and platforms, we demonstrate how discourse flows, language characteristics, and actors differ across cultural and platform contexts and how public discourse of #MeToo was reappropriated and re-signified in different parts of the world to localize connective action. [ABSTRACT FROM AUTHOR]

Political polarization surrounding the COVID-19 health crisis has been on the rise since the beginning of the pandemic. We combine prior research on motivated reasoning, selective exposure, and news framing to understand the association between partisan media use and social distancing behavior related to COVID-19. To do so, we collected media content data and national survey data during the onset of the pandemic. We employed structural topic modeling (STM), dependency parsing, word co-occurrence, and manual coding to examine the media coverage. Next, we analyzed survey data collected with a Qualtrics panel from a sample of U.S. residents for factors explaining social distancing behaviors. Results reveal coverage from the right leaning outlets downplayed the virus and highlighted the consequences of lockdowns on the economy. Our survey findings show that even after accounting for a range of demographic, political orientation, and COVID-19 awareness variables, conservative media use was linked, although modestly, with a lower likelihood of social distancing behavior. Our findings echo past research on media framing of pandemics and their association with public attitudes and behavior. [ABSTRACT FROM AUTHOR]

Medication for opioid use disorder (MOUD) improves treatment retention and reduces illicit opioid use. A-CHESS is an evidence-based smartphone intervention shown to improve addiction-related behaviors. The authors tested the efficacy of MOUD alone versus MOUD plus A-CHESS to determine whether the combination further improved outcomes. In an unblinded parallel-group randomized controlled trial, 414 participants recruited from outpatient programs were assigned in a 1:1 ratio to receive either MOUD alone or MOUD+A-CHESS for 16 months and were followed for an additional 8 months. All participants were on methadone, buprenorphine, or injectable naltrexone. The primary outcome was abstinence from illicit opioid use; secondary outcomes were treatment retention, health services use, other substance use, and quality of life; moderators were MOUD type, gender, withdrawal symptom severity, pain severity, and loneliness. Data sources were surveys comprising multiple validated scales, as well as urine screens, every 4 months. There was no difference in abstinence between participants in the MOUD+A-CHESS and MOUD-alone arms across time (odds ratio=1.10, 95% CI=0.90–1.33). However, abstinence was moderated by withdrawal symptom severity (odds ratio=0.95, 95% CI=0.91–1.00) and MOUD type (odds ratio=0.57, 95% CI=0.34–0.97). Among participants without withdrawal symptoms, abstinence rates were higher over time for those in the MOUD+A-CHESS arm than for those in the MOUD-alone arm (odds ratio=1.30, 95% CI=1.01–1.67). Among participants taking methadone, those in the MOUD+A-CHESS arm were more likely to be abstinent over time (b=0.28, SE=0.09) than those in the MOUD-alone arm (b=0.06, SE=0.08), although the two groups did not differ significantly from each other (∆b=0.22, SE=0.11). MOUD+A-CHESS was also associated with greater meeting attendance (odds ratio=1.25, 95% CI=1.05–1.49) and decreased emergency department and urgent care use (odds ratio=0.88, 95% CI=0.78–0.99). Overall, MOUD+A-CHESS did not improve abstinence relative to MOUD alone. However, MOUD+A-CHESS may provide benefits for subsets of patients and may impact treatment utilization. [ABSTRACT FROM AUTHOR]

Objectives: To examine the effects of exchanging treatment information within computer-mediated breast cancer support groups on emotional well-being, and to explore whether this relationship is moderated by health self-efficacy. Methods: Sample: 177 breast cancer patients using an electronic Health (eHealth) program with discussion group. Measure: expression and reception of treatment information; emotional well-being scale (0, 4 months). Analyses: hierarchical regression. Results: Effects of expression and reception of treatment information on emotional well-being were significantly greater for those who have higher health self-efficacy. Conclusions: Results conditionally support prior research finding positive effects of treatment information exchanges among breast cancer patients. Such exchanges had a positive impact on emotional well-being for those with higher health self-efficacy, but they had a negative influence for those with lower health self-efficacy. Practice implications: Given that the association between emotional well-being and exchanging treatment information was moderated by health self-efficacy, clinicians should explain the role of health self-efficacy before encouraging patients to use eHealth systems for treatment exchanges. [Copyright &y& Elsevier]

Historians and cultural theorists have long asserted that a desire to express political concerns often guides consumer behavior, yet such political consumerism has received limited attention from social scientists. Here, the authors explore the relationship of political consumerism with dispositional factors, communication variables, and consumption orientations using data collected from a panel survey conducted in the United States between February 2002 and July 2005. The authors test a theorized model using both cross-sectional and auto-regressive panel analyses. The static and change models reveal that conventional and online news use encourage political consumerism indirectly through their influence on political talk and environmental concerns. However, media use may also have some suppressive effects by reducing the desire to protect others from harmful messages. Results demonstrate how communication practices and consumption orientations work together to influence political consumerism beyond previously delineated factors. Implications for declines in political and civic participation and youth socialization are discussed. [ABSTRACT FROM AUTHOR]

Response efficacy information indicating the effectiveness of a recommended behavior in risk reduction is an important component of health communication. For example, many messages regarding COVID-19 vaccines featured numerical vaccine efficacy rates in preventing infections, hospitalizations, and deaths. While the relationship between disease risk perceptions and fear has been well established, we know less about the psychological factors involved in communicating vaccine efficacy information, such as response efficacy perceptions and hope. This study examines the effects of numerical vaccine efficacy information and message framing on vaccination intentions and their relationship to perceived response efficacy and hope, using a fictitious infectious disease similar to COVID-19. Findings suggest that communicating a high efficacy rate of the vaccine in preventing severe illness increased perceived response efficacy, which in turn boosted vaccination intention directly and indirectly through increasing hope. Also, fear about the virus was positively associated with hope about the vaccine. Implications of using response efficacy information and hope appeals in health communication and vaccination promotion are discussed. [ABSTRACT FROM AUTHOR]

Background: Clinical decision aids may support shared decision-making for screening mammography. To inform shared decision-making between patients and their providers, this study examines how patterns of using an EHR-integrated decision aid and accompanying verbal patient-provider communication predict decision-making satisfaction. Methods: For 51 patient visits during which a mammography decision aid was used, linguistic characteristics of patient-provider verbal communication were extracted from transcribed audio recordings and system logs automatically captured uses of the decision aid. Surveys assessed patients' post-visit decisional satisfaction and its subcomponents. Linear mixed effects models assessed how patients' satisfaction with decision making was related to patterns of verbal communication and navigation of the decision aid. Results: The results indicate that providers' use of quantitative language during the encounter was positively associated with patients' overall satisfaction, feeling informed, and values clarity. Patients' question-asking was negatively associated with overall satisfaction, values clarity, and certainty perception. Where system use data indicated the dyad had cycled through the decision-making process more than once ("looping" back through pages of the decision aid), patients reported improved satisfaction with shared decision making and all subcomponents. Overall satisfaction, perceived support, certainty, and perceived effectiveness of decision-making were lowest when a high number of navigating clicks occurred absent "looping." Conclusions: Linguistic features of patient-provider communication and system use data of a decision aid predict patients' satisfaction with shared decision making. Our findings have implications for the design of decision aid tools and clinician training to support more effective shared decision-making for screening mammography. [ABSTRACT FROM AUTHOR]

Objective: Motivating older adults to follow up with an outpatient clinician after discharge from emergency departments (ED) is beneficial yet challenging. We aimed to answer whether psychological needs for motivation and discrete emotions observed by care transition coaches would predict this behavioral outcome.Methods: Community-dwelling older adults following ED discharge were recruited from three EDs in two U.S. states. We examined home visit notes documented by coaches (N = 725). Retrospective chart reviews of medical records tracked participants' health care utilization for 30 days.Results: Observed knowledge-based competence predicted higher likelihood of outpatient follow-up within 30 days, while observed sadness predicted a lower likelihood of follow-up within seven days following discharge. Moreover, participants who demonstrated happiness were marginally more likely to have an in-person follow-up within seven days, and those who demonstrated knowledge-based competence were more likely to have an electronic follow-up within 30 days.Conclusions: Knowledge-based competence and emotions, as observed and documented in coach notes, can predict older adults' subsequent outpatient follow-up following their ED-discharge.Practice Implications: Intervention programs might encourage coaches to check knowledge-based competence and to observe emotions in addition to delivering the content. Coaches could also customize strategies for patients with different recommended timeframes of follow-up. [ABSTRACT FROM AUTHOR]

The intersection of consumer culture and civic life has long been a topic of academic discussion. This study revisits the relationship between consumption and civic engagement and investigates the moderators of this relationship. Specifically, we focus on news consumption and opinion leadership as intervening factors that condition the way consumption and civic life are interconnected. Our data reveal that both socially conscious consumption and status-oriented consumption are positively related with civic participation. The positive relationships become stronger when news consumption increases or when one’s opinion leadership is strong. Implications for research on consumer culture and civic engagement are discussed. [ABSTRACT FROM PUBLISHER]

Social bots, or algorithmic agents that amplify certain viewpoints and interact with selected actors on social media, may influence online discussion, news attention, or even public opinion through coordinated action. Previous research has documented the presence of bot activities and developed detection algorithms. Yet, how social bots influence attention dynamics of the hybrid media system remains understudied. Leveraging a large collection of both tweets (N  =   1,657,551) and news stories (N  =   50,356) about the early COVID-19 pandemic, we employed bot detection techniques, structural topic modeling, and time series analysis to characterize the temporal associations between the topics Twitter bots tend to amplify and subsequent news coverage across the partisan spectrum. We found that bots represented 8.98% of total accounts, selectively promoted certain topics and predicted coverage aligned with partisan narratives. Our macro-level longitudinal description highlights the role of bots as algorithmic communicators and invites future research to explain micro-level causal mechanisms. [ABSTRACT FROM AUTHOR]

Background: By 2030, the number of US adults age ≥65 will exceed 70 million. Their quality of life has been declared a national priority by the US government. Objective: Assess effects of an eHealth intervention for older adults on quality of life, independence, and related outcomes. Design: Multi-site, 2-arm (1:1), non-blinded randomized clinical trial. Recruitment November 2013 to May 2015; data collection through November 2016. Setting: Three Wisconsin communities (urban, suburban, and rural). Participants: Purposive community-based sample, 390 adults age ≥65 with health challenges. Exclusions: long-term care, inability to get out of bed/chair unassisted. Intervention: Access (vs. no access) to interactive website (ElderTree) designed to improve quality of life, social connection, and independence. Measures: Primary outcome: quality of life (PROMIS Global Health). Secondary: independence (Instrumental Activities of Daily Living); social support (MOS Social Support); depression (Patient Health Questionnaire-8); falls prevention (Falls Behavioral Scale). Moderation: healthcare use (Medical Services Utilization). Both groups completed all measures at baseline, 6, and 12 months. Results: Three hundred ten participants (79%) completed the 12-month survey. There were no main effects of ElderTree over time. Moderation analyses indicated that among participants with high primary care use, ElderTree (vs. control) led to better trajectories for mental quality of life (OR=0.32, 95% CI 0.10–0.54, P=0.005), social support received (OR=0.17, 95% CI 0.05–0.29, P=0.007), social support provided (OR=0.29, 95% CI 0.13–0.45, P<0.001), and depression (OR= −0.20, 95% CI −0.39 to −0.01, P=0.034). Supplemental analyses suggested ElderTree may be more effective among people with multiple (vs. 0 or 1) chronic conditions. Limitations: Once randomized, participants were not blind to the condition; self-reports may be subject to memory bias. Conclusion: Interventions like ET may help improve quality of life and socio-emotional outcomes among older adults with more illness burden. Our next study focuses on this population. Trial Registration: ClinicalTrials.gov; registration ID number: NCT02128789 [ABSTRACT FROM AUTHOR]

This study merges insights from cultivation and uses and gratifications to examine the relationship between environmental concern, five forms of television viewing, and pro-environmental behaviors. This research considers both the direct effects of various forms of television viewing and their potential mediating roles in the relationship between environmental attitudes and behaviors. Analysis of 1999 and 2000 DDB Life Style Study data reveals that television news and nature documentary use are predicted by environmental concern and contribute to pro-environmental behaviors, whereas three forms of entertainment television use are not consistently linked to these variables. Implications for future research are discussed. [ABSTRACT FROM AUTHOR]

In this research note, we provide evidence about burdens people face when voting and who benefits from policies designed to mitigate those burdens. Using pre-and-post 2018 midterm elections panel surveys in Wisconsin, we show that Black voters estimate greater time getting to the polls and Hispanic voters report longer wait times once they are there. Regarding who takes advantage of policies purported to ease these burdens on voting—early voting, voting by mail, and absentee voting—our analysis reveals that that those facing temporal disadvantages are not the groups benefiting from these electoral policy affordances. [ABSTRACT FROM AUTHOR]

A certain social-political geography recurs across European and North American societies: As post-industrialization and mechanization of agriculture have disrupted economies, rural and nonmetropolitan areas are aging and declining in population, leading to widening political and cultural gaps between metropolitan and rural communities. Yet political communication research tends to focus on national or cross-national levels, often emphasizing networked digital media and an implicitly global information order. We contend that geographic place still provides a powerful grounding for individuals' lifeworld experiences, identities, and orientations to political communications and politics. Focusing on the U.S. state of Wisconsin, and presenting data gathered in 2018, this study demonstrates significant, though often small, differences between geographic locations in terms of their patterns of media consumption, political talk, and anti-elite attitudes. Importantly, television news continues to play a major role in citizens' repertoires across locations, suggesting we must continue to pay attention to this broadcast medium. Residents of more metropolitan communities consume significantly more national and international news from prestige sources such as the New York Times, and their talk networks are more cleanly sorted by partisanship. Running against common stereotypes of news media use, residents of small towns and rural areas consume no more conservative media than other citizens, even without controlling for partisanship. Our theoretical model and empirical results call for further attention to the intersections of place and politics in understanding news consumption behaviors and the meanings citizens draw from media content. [ABSTRACT FROM AUTHOR]

Since the 2016 election, the relationship between Trump supporters and Fox News has gained considerable attention. Drawing on interviews with more than 200 people and a representative survey conducted in the state of Wisconsin, we dive deeper into the media habits of Trump supporters using a mixed methods analytical approach. While we do not refute the importance of Fox News in the conservative media ecology, we find that characterizing Trump supporters as isolated in Fox News bubbles obscures the fact that many are news omnivores, or people who consume a wide variety of news. In fact, we find that Trump supporters may have more politically heterogeneous consumption habits than Trump non-supporters. We find that 17% of our survey respondents who support Trump in Wisconsin are regularly exposed to ideologically heterogeneous news media. We also find that like other voters, Trump supporters are disenchanted with the divisive nature of contemporary media and politics. Finally, we analyze the media use of young Trump supporters and find an especially high level of news omnivorousness among them. [ABSTRACT FROM AUTHOR]

Objective: Individuals in recovery for substance use disorders (SUDs) increasingly use online social support forums, necessitating research on how communicating through these forums can affect recovery. This study examines how giving and receiving support within an SUDs recovery forum predict substance use, and considers whether effects vary according to participants' self-efficacy.Methods: We applied content analysis to 3440 messages that were posted by 231 participants in an online SUDs forum. Surveys assessed social support reception and substance use at three timepoints. We assessed relationships between giving and receiving support and substance use (risky drinking days, illicit drug use days), and the interactions between self-efficacy and social support in predicting substance use outcomes.Results: Receiving more emotional support was associated with reduced illicit drug use at 6 and 12 months. For those with low self-efficacy, giving more emotional support predicted less risky drinking at month 12, whereas giving more informational support predicted more risky drinking at month 12.Conclusion: These results suggest conditional benefits of exchanging support in an online SUDs forum, depending upon type of support (informational versus emotional), the participants' role (giver or receiver), and their self-efficacy.Practice Implications: We discuss implications for designing and using peer-to-peer support platforms. [ABSTRACT FROM AUTHOR]

Purpose Despite the growing use of social media by politicians, especially during election campaigns, research on the integration of these media into broader campaign communication strategies remains rare. The purpose of this paper is to ask what the consequences of the transition to social media may be, specifically considering how Senate candidates’ use of a popular social network, Twitter, is related to their messaging via broadcast media in the form of campaign advertising, in terms of content and tone.Design/methodology/approach To address this research question, a unique data set combining every tweet (10,303) and every television ad aired (576,933 ad airings) by candidate campaigns for the US Senate during the 2010 campaign is created. Using these data, tweets and ads are analyzed for their references to issues as well as their overall tone.Findings Findings demonstrate that social messaging often resembles broadcast advertising, but that Twitter nonetheless occupies a unique place in modern campaigns in that its tone tends to be quite different than that of advertisements.Research limitations/implications This sheds light on a larger debate about whether online campaigning has produced a fundamental change in election practices or whether new media simply extend “campaigning as usual.”Originality/value This study uses a novel data set, encompassing the complete universe of ads and tweets distributed by candidates for Senate in 2010. [ABSTRACT FROM AUTHOR]

This study uses national survey data from 1231 parent-children dyads to examine the socialization of political participation among adolescents (ages 12–17). In particular, we expand on existing models of political socialization to account for the incorporation of lifestyle practices into the political repertoires of today’s youth. We found in comparison to future voting intention, which is rooted largely in background characteristics and the direct influence of socialization agents, political consumerism is fostered more indirectly through communication practices. Moreover, we found some meaningful age differences in the associations among key variables in the model. In particular, we observed a shift from a greater emphasis of socialization agents among younger adolescents to a greater emphasis of communication practices, particularly online communication, among older adolescents. We argue, for older adolescents especially, the controllability afforded by interactive digital media plays a critical role in the cultivation of political behaviors that address individual lifestyle concerns. [ABSTRACT FROM AUTHOR]

Discussions about whether citizens can learn and use the information necessary to contribute to democratic governance often focus on debates about heuristics. We argue that the debate over whether heuristics should be used misframes a central issue-the consideration of what forms of decision-making are most likely to operate in different kinds of communication environments. This article examines how people make decisions in contentious political climates, which are characterized by high-information volume, relatively strong partisan commitment, and an affective divide between the opposing camps. Our contribution takes account of the possibility that in contentious environments, political communication offers neither reasoned deliberation nor cues, but rather solidarity signals that engage people's cultural worldviews. We also posit that the use of cultural worldviews for liberals and conservatives is asymmetrical-raising important questions about democracy in a society in which a variety of worldviews have different weights for various individuals and publics. To test our perspective, we analyze public opinion data collected during the time surrounding the recall election of Governor Scott Walker of Wisconsin. [ABSTRACT FROM AUTHOR]

Highlights: [•] Emotional communication competence moderates the benefits of emotional support. [•] Expressing support improves mental well-being for patients with high competence. [•] Expressing support decreases mental well-being for patients with low competence. [•] Receiving support reduces cancer-related concern for patients with high competence. [•] Receiving support increases cancer-related concern for patients with low competence. [Copyright &y& Elsevier]

Abstract: Objectives: To explore how the expression of emotional support in an online breast cancer support group changes over time, and what factors predict this pattern of change. Methods: We conducted growth curve modeling with data collected from 192 participants in an online breast cancer support group within the Comprehensive Health Enhancement Support System (CHESS) during a 24-week intervention period. Results: Individual expression of emotional support tends to increase over time for the first 12 weeks of the intervention, but then decrease slightly with time after that. In addition, we found that age, living situation, comfort level with computer and the Internet, coping strategies were important factors in predicting the changing pattern of expressing emotional support. Conclusions: Expressing emotional support changed in a quadratic trajectory, with a range of factors predicting the changing pattern of expression. Practical implications: These results can provide important information for e-health researchers and physicians in determining the benefits individuals can gain from participation in should CMSS groups as the purpose of cancer treatment. [Copyright &y& Elsevier]

Research on print and broadcast media shows differences in cognitive and affective responses. We extend that research by combining content analysis and survey methods to examine medium differences in the emotional tone of coverage concerning the September 11 terrorist attacks, and audience differences in emotional reactions to the attacks. A computer aided content analysis of national television and newspaper transcripts demonstrates that television news was consistently more emotional than print news. Further, a panel survey found use of television news was more strongly related to positive and negative emotional responses to the attacks than use of newspapers. [ABSTRACT FROM AUTHOR]

Background: The growing epidemic of opioid use disorder (OUD) and associated injection drug use has resulted in a surge of new hepatitis C virus (HCV) infections. Approximately half of the people with HCV infection are unaware of their HCV status. Improving HCV awareness and increasing screening among people with OUD are critical. Addiction-Comprehensive Health Enhancement Support System (A-CHESS) is an evidence-based, smartphone-delivered relapse prevention system that has been implemented among people with OUD who are receiving medications for addiction treatment (MAT) to improve long-term recovery., Objective: We incorporated HCV-related content and functionality into A-CHESS to characterize the HCV care continuum among people in early remission and receiving MAT for OUD and to determine whether incorporating such content and functionality into A-CHESS increases HCV testing., Methods: HCV intervention content, including dissemination of educational information, private messages tailored to individuals' stage of HCV care, and a public discussion forum, was implemented into the A-CHESS platform. Between April 2016 and April 2020, 416 participants with OUD were enrolled in this study. Participants were randomly assigned to receive MAT alone (control arm) or MAT+A-CHESS (experimental arm). Quarterly telephone interviews were conducted from baseline to month 24 to assess risk behaviors and HCV testing history. Cox proportional hazards regression was used to assess whether participants who used A-CHESS were tested for HCV (either antibody [Ab] or RNA testing) at a higher rate than those in the control arm. To assess the effect of A-CHESS on subsets of participants at the highest risk for HCV, additional analyses were performed to examine the effect of the intervention among participants who injected drugs and shared injection equipment., Results: Overall, 44.2% (184/416) of the study participants were HCV Ab positive, 30.3% (126/416) were HCV Ab negative, and 25.5% (106/416) were considered untested at baseline. At month 24, there was no overall difference in HCV testing uptake between the intervention and control participants. However, among the subset of 109 participants who engaged in injection drug use, there was a slight trend toward increased HCV testing uptake among those who used A-CHESS (89% vs 85%; hazard ratio: 1.34; 95% CI 0.87-2.05; P=.18), and a stronger trend was observed when focusing on the subset of 32 participants who reported sharing injection equipment (87% vs 56%; hazard ratio: 2.92; 95% CI 0.959-8.86; P=.06)., Conclusions: Incorporating HCV prevention and care information into A-CHESS may increase the uptake of HCV testing while preventing opioid relapse when implemented among populations who engage in high-risk behaviors such as sharing contaminated injection equipment. However, more studies that are powered to detect differences in HCV testing among high-risk groups are needed., Trial Registration: ClinicalTrials.gov NCT02712034; https://clinicaltrials.gov/ct2/show/NCT02712034., International Registered Report Identifier (irrid): RR2-10.2196/12620., (©Karli R Hochstatter, David H Gustafson Sr, Gina Landucci, Klaren Pe-Romashko, Olivia Cody, Adam Maus, Dhavan V Shah, Ryan P Westergaard. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 22.02.2021.)

Background: Multiple chronic conditions (MCCs) are common among older adults and expensive to manage. Two-thirds of Medicare beneficiaries have multiple conditions (eg, diabetes and osteoarthritis) and account for more than 90% of Medicare spending. Patients with MCCs also experience lower quality of life and worse medical and psychiatric outcomes than patients without MCCs. In primary care settings, where MCCs are generally treated, care often focuses on laboratory results and medication management, and not quality of life, due in part to time constraints. eHealth systems, which have been shown to improve multiple outcomes, may be able to fill the gap, supplementing primary care and improving these patients' lives., Objective: This study aims to assess the effects of ElderTree (ET), an eHealth intervention for older adults with MCCs, on quality of life and related measures., Methods: In this unblinded study, 346 adults aged 65 years and older with at least 3 of 5 targeted high-risk chronic conditions (hypertension, hyperlipidemia, diabetes, osteoarthritis, and BMI ≥30 kg/m2) were recruited from primary care clinics and randomized in a ratio of 1:1 to one of 2 conditions: usual care (UC) plus laptop computer, internet service, and ET or a control consisting of UC plus laptop and internet but no ET. Patients with ET have access for 12 months and will be followed up for an additional 6 months, for a total of 18 months. The primary outcomes of this study are the differences between the 2 groups with regard to measures of quality of life, psychological well-being, and loneliness. The secondary outcomes are between-group differences in laboratory scores, falls, symptom distress, medication adherence, and crisis and long-term health care use. We will also examine the mediators and moderators of the effects of ET. At baseline and months 6, 12, and 18, patients complete written surveys comprising validated scales selected for good psychometric properties with similar populations; laboratory data are collected from eHealth records; health care use and chronic conditions are collected from health records and patient surveys; and ET use data are collected continuously in system logs. We will use general linear models and linear mixed models to evaluate primary and secondary outcomes over time, with treatment condition as a between-subjects factor. Separate analyses will be conducted for outcomes that are noncontinuous or not correlated with other outcomes., Results: Recruitment was conducted from January 2018 to December 2019, and 346 participants were recruited. The intervention period will end in June 2021., Conclusions: With self-management and motivational strategies, health tracking, educational tools, and peer community and support, ET may help improve outcomes for patients coping with ongoing, complex MCCs. In addition, it may relieve some stress on the primary care system, with potential cost implications., Trial Registration: ClinicalTrials.gov NCT03387735; https://www.clinicaltrials.gov/ct2/show/NCT03387735., International Registered Report Identifier (irrid): DERR1-10.2196/25175., (©David H Gustafson Sr, Marie-Louise Mares, Darcie C Johnston, Jane E Mahoney, Randall T Brown, Gina Landucci, Klaren Pe-Romashko, Olivia J Cody, David H Gustafson Jr, Dhavan V Shah. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 19.02.2021.)

People living with HIV (PLWH) and substance use disorder (SUD) are particularly vulnerable to harmful health consequences of the global COVID-19 pandemic. The health and social consequences of the pandemic may exacerbate substance misuse and poor management of HIV among this population. This study compares substance use and HIV care before and during the pandemic using data collected weekly through an opioid relapse prevention and HIV management mobile-health intervention. We found that during the pandemic, PLWH and SUD have increased illicit substance use and contact with other substance-using individuals and decreased their confidence to stay sober and attend recovery meetings. The proportion of people missing their HIV medications also increased, and confidence to attend HIV follow-up appointments decreased. Optimal support for PLWH and SUD is critical during pandemics like COVID-19, as drug-related and HIV antiretroviral therapy (ART) non-adherence risks such as overdose, unsafe sexual behaviors, and transmission of infectious diseases may unfold.

The study examines whether physicians' framing of clinical interactions is related to patient shared decision-making (SDM) satisfaction when using a clinical decision support tool (CDST) concerning mammographic screening. To answer this question, we combined (a) system log data from a CDST, (b) content coding of the physicians' message framing while using the CDST, and (c) a post-visit patient survey to assess SDM satisfaction concerning screening mammography. Results suggest that two types of message frames - consequence frames and numerical frames - moderated the relationship of the CDST on SDM satisfaction. When the CDST displayed low risk of breast cancer for a patient, physicians were able to improve the cognitive aspects of SDM satisfaction by framing the consequences of mammography screening in positive terms. However, when the physician delivered the numerical information in relative, rather than absolute terms, the patient's SDM satisfaction was reduced. Our study advances previous message framing effect research in health communication from experimental settings to clinical encounters. It also discusses the importance of delivering risk-congruent frames in clinical settings.

Although low socio-economic status (SES) persons with diabetes show low levels of physical activity (PA), there is limited knowledge regarding which media is effective in improving their PA. This study aimed to determine the appropriate media for providing PA-related information to persons with diabetes in low SES compared with those in high SES. The data of 770 persons with diabetes in low or high SES were extracted from Multimedia Audience Research Systems 2013, a nationwide cross-sectional study. The relationships among media use for health information (i.e. magazine, television and Internet use), PA, and high and low SES were examined using regression analysis. Additional analysis was conducted to examine whether the above relationships differ by age, which influences the use of media. The relationships of media use for health information with PA levels varied by SES; while television use was associated with increased PA levels, Internet use was associated with decreased PA levels in older, low SES persons with diabetes. The findings indicated that television can be a useful resource to provide PA-related information to low SES persons with diabetes and suggest the significance of choosing appropriate media to provide PA-related information for them., (� The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background: Emotional support has traditionally been conceived as something a breast cancer patient receives. However, this framework may obscure a more complex process, facilitated by the emerging social media environment, which includes the effects of composing and sending messages to others. Accordingly, this study explores the effects of expression and reception of emotional support messages in online groups and the importance of bonding as a mediator influencing the coping strategies of breast cancer patients., Methods: Data were collected as part of two National Cancer Institute-funded randomized clinical trials. Eligible subjects were within 2 months of diagnosis of primary breast cancer or recurrence. Expression and reception of emotionally supportive messages were tracked and coded for 237 breast cancer patients. Analysis resulted from merging 1) computer-aided content analysis of discussion posts, 2) action log analysis of system use, and 3) longitudinal survey data., Results: As expected, perceived bonding was positively related to all four coping strategies (active coping: β = 0.251, P = .000; positive reframing: β = 0.288, P = .000; planning: β = 0.213, P = .006; humor: β = 0.159, P = .009). More importantly, expression (γ = 0.138, P = .027), but not reception (γ = -0.018, P = .741), of emotional support increases perceived bonding, which in turn mediates the effects on patients' positive coping strategies., Conclusions: There is increasing importance for scholars to distinguish the effects of expression from reception to understand the processes involved in producing psychosocial benefits. This study shows that emotional support is more than something cancer patients receive; it is part of an active, complex process that can be facilitated by social media.

Information and communication technologies offer clinicians the opportunity to work with patients to manage chronic conditions, including addiction. The early research on the efficacy of electronic treatment and support tools is promising. Sensors have recently received increased attention as key components of electronic treatment and recovery management systems. Although results of the research are very promising, concerns at the clinical and policy level must be addressed before widespread adoption of these technologies can become practical. First, clinicians must adapt their practices to incorporate a continuing flow of patient information. Second, payment and regulatory systems must make adjustments far beyond what telemedicine and electronic medical records have required. This paper examines potential roles of information and communication technologies as well as process and regulatory challenges.