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Simple Summary: Despite the benefits of stool-based tests for colorectal cancer screening, the return rate is low. In this study, we tested if adding a tailored, one-page educational flyer to the mailed stool kits targeted at rural Midwestern residents in the USA improved the kit return rates. Overall, there was no significant difference in return rate between the groups that did and did not receive the flyer. However, females and older participants were more likely to return the kits compared to males and younger participants. To improve the kit return rates of male and younger participants, future programs should consider how the content and design of the flyer can be more closely tailored to the audience's needs and preferences as well as how the flyer can be combined with other approaches (e.g., reminders). Background/Objectives: Stool-based tests, such as the fecal immunochemical test (FIT), have been widely used for increasing colorectal cancer (CRC) screening. Small media, such as printed materials or flyers, are known to be an effective intervention to increase CRC screening by fecal tests. However, more evidence is needed to determine whether such small media are effective in improving screening uptake of a mailed FIT intervention targeted at rural populations in the USA. Methods: In this randomized study, 1230 FIT kits were mailed from July to December 2022 to rural Nebraskans aged 45–74 who were not up to date on CRC screening. Half of the participants (n = 608) also received a tailored, one-page, gender-specific educational flyer created based on focus groups with rural residents. Logistic regression was used to determine predictors of returning the FIT. Results: Study participants were predominantly female (76%), non-Hispanic White (83%), and within the age group of 55–64 (43%). Overall, 192 (15.6%) kits were returned (16.1% from the flyer group; 15.1% from the no-flyer group). However, we found no significant differences between the flyer and no-flyer groups (Adjusted Odds Ratio [AOR]: 1.21; 95% CI: 0.88–1.66). Females (AOR: 1.78; 95% CI: 1.19–6.14) and the oldest (65–74) age group (AOR: 5.03; 95% CI: 2.78–8.47) were more likely to return FIT kits than males and the youngest (45–54) age group. Conclusions: A tailored educational flyer was not effective in improving the CRC-screening-rate-by-mailed-FIT approach for rural populations. Future research should explore the content, timing, and mode of delivery of educational interventions as well as other multi-component strategies to improve screening rates. Public health officials might also consider developing strategies targeted at males and younger (45–54) age groups. [ABSTRACT FROM AUTHOR]

Opioid-related overdose death continues to be a public health crisis in the United States, reaching a new peak in 2021 with more than 100,000 people dying of drug overdose; 75% of these deaths involved an opioid. Naloxone, often known by the brand name Narcan®, can be easily administered to prevent opioid overdose death. While naloxone is a central harm reduction tool, it has generated controversy as discussions of its use have been framed by longstanding stigmas associated with drug use. Critics have framed it as a "moral hazard" that encourages drug use, stigmatizing its distribution and uptake. Harm reductionists have responded by countering misinformation about drug use and harm reduction and humanizing people who use drugs. Social media platforms have become key sites for these debates. These are digital social spaces in which individuals may fuel stigma and/or build community with others by enacting identities, exchanging knowledge, and bonding over shared experiences. TikTok, a video-based platform, has become an active space for community-building around harm reduction. This article examines the experiences of people who post about naloxone on TikTok. We draw on thematic analyses of semistructured, open-ended interviews with 13 TikTok users who tagged posts with #naloxonesaveslives or #narcansaveslives hashtags from June 2020 to April 2023. Specifically, we explore how these individuals understand and leverage TikTok's association, creative, and interactive affordances as "doors" to build harm reduction community and to educate others about drug use and harm reduction. We also explore how they navigate the "traps" of visibility on TikTok that pose challenges to using the platform for harm reduction activism: stigma, burnout, mental distress, and digital silencing. Finally, we consider the implications of our findings for future research and practice related to digital harm reduction activism. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of the study was to identify barriers and facilitators of colorectal cancer (CRC) screening use among agricultural operators in Nebraska, US. Methods: The concept mapping approach was used to engage participants and enhance the generation of ideas and opinions regarding CRC screening. Two focus groups (seven women and seven men) were conducted. Results: Among women, the cost domain was most agreed upon as important, followed by experiencing symptoms, awareness, and family. Among men, the important concepts related to CRC screening were family and friend support, feeling too young to get CRC, family or personal history of CRC, and lack of awareness of the need to be screened. Some gender differences regarding barriers were observed, such as women were more concerned about the cost of screening while men were far more concerned about the embarrassment associated with CRC screening. Conclusion: These findings will be crucial to developing educational materials to increase knowledge of risk factors for CRC and of CRC screening in the agricultural population. [ABSTRACT FROM AUTHOR]

This study investigated the benefits and challenges of computer-mediated communication use among a sample of young adults who identify with the autism spectrum via semistructured interviews. The interviews revealed that participants enjoyed using computer-mediated communication technologies (e.g. Discord, Facebook, Steam, and Zoom) to fulfill various social gratifications, as found in previous research. They appreciated that computer-mediated communication supports neurodiversity in social communication by altering the communication environment in various ways, such as the inclusion of asynchronous options and decreased sensory input. However, it is noteworthy that several mentioned that computer-mediated communication could not replace in-person interaction because it makes deep social connection difficult. Participants also discussed negative attributes of computer-mediated communication such as promoting social comparison and instant gratification. The findings are inherently valuable to learning more about young adults' use of technology for social communication. In addition, they provide insight into how to integrate technology into the design of interventions to support the development of social connections among individuals who identify with autism. This study investigated the benefits and challenges of online communication use among a sample of young adults who identify on the autism spectrum via semi-structured interviews. The interviews revealed that participants enjoyed using online forms of communication for social purposes. Participants appreciated how this type of communication changes the social environment in ways that support neurodiversity, such as the static nature of the communication context and decreased sensory input. However, some participants noted that online communication could not replace inperson interaction because it makes deep social connection difficult. Participants also discussed negative attributes of online communication such as promoting social comparison and instant gratification. The findings are inherently valuable to learning more about young adults' use of technology for social communication. In addition, this information may provide insight into how to integrate technology into the design of interventions to support the development of social connections among individuals who identify on the autism spectrum. [ABSTRACT FROM AUTHOR]

Background: Antiobesity campaigns blaming individual behaviors for obesity have sparked concern that an emphasis on individual behavior may lead to stigmatization of overweight or obese people. Past studies have shown that perpetuating stigma is not effective for influencing behavior. Purpose: This study examined whether stigmatizing or nonstigmatizing images and text in antiobesity advertisements led to differences in health-related behavioral intentions. Method: Participants in this experiment were 161 American adults. Measures included self-reported body mass index, weight satisfaction, antifat attitudes, and intention to increase healthy behaviors. Results: Images in particular prompted intention to increase healthy behavior, but only among participants who were not overweight or obese. Conclusion: Images and text emphasizing individual responsibility for obesity may influence behavioral intention among those who are not overweight, but they do not seem to be effective at altering behavioral intentions among overweight people, the target audience for many antiobesity messages. Images in antiobesity messages intended to alter behavior are influential and should be selected carefully.

Hispanic/Latinx persons have disproportionately lower breast, cervical, and colorectal cancer screening rates than non-Hispanic White (NHW) persons. This low participation in cancer screening results in late-stage cancer diagnosis among Hispanic persons compared to NHW persons. Mobile health (mHealth) interventions effectively improve cancer screening rates in the general population; however, few reviews about mHealth interventions are tailored to Hispanic populations. This is important to investigate given that Hispanic persons differ from NHW persons with regard to culture, language, and health care utilization. Therefore, in this study, we investigated: (a) What types of mHealth interventions have been undertaken to increase cancer screening rates among Hispanic persons in the United States? (b) How effective have these interventions been? and (c) What features of these interventions help increase cancer screening rates? Searches conducted during December 2020 identified 10 articles published between January 2017 and December 2020 that met our inclusion criteria. The review revealed that mHealth interventions mainly provided education about cancer and cancer screening using videos, PowerPoint slides, and interactive multimedia. mHealth interventions that effectively improved screening behavior were mainly for easy-to-screen cancers like skin and cervical cancer. Finally, reviewed studies did not provide details on how cultural adaptations were made, and it is unclear what specific features of mHealth interventions increase cancer screening rates among Hispanic persons. Future research should identify and evaluate the effects of different components of culturally tailored interventions on cancer screening. Public health practitioners and health care providers should tailor mHealth approaches to their clients or patients and practice environment. [ABSTRACT FROM AUTHOR]

Background: Inspired by research indicating that exposure to humanities correlates with reduced burnout, the Nebraska Medical Orchestra was founded in 2018 as a collaboration between the University of Nebraska Medical Center and the University of Nebraska at Omaha School of Music. Methods: Semistructured interviews about orchestra participants' experiences were conducted with 9 musicians and recorded and transcribed. Transcripts were analyzed using the constant comparative method. Results: The interviews suggested that participants are drawn to the orchestra to pursue a love of music, to be part of an ensemble, and to connect with others in an environment that provides a lighthearted, nonjudgmental, noncompetitive forum in which to create and enjoy music for its own sake. Conclusions: This study has implications for designing arts-based wellness activities for clinicians and scaling them nationwide. Roma Subramanian, PhD an assistant professor in the School of Communication at the University of Nebraska at Omaha, where she is also on the medical humanities faculty. Her research focuses on health communication regarding stigmatized disorders and has been published in peer-reviewed journals such as Health Communication, Health Education & Behavior, Critical Public Health, and the Journal of Visual Communication in Medicine. Matthew J. Brooks, DMA is the director of orchestral activities in music and medicine at the University of Nebraska at Omaha, where he is an assistant professor in the School of Music and a faculty member in medical humanities. He is also courtesy faculty at the University of Nebraska Medical Center, where he is the founding music director of the Nebraska Medical Orchestra. He holds bachelor of music, master of music, and doctor of musical arts degrees. [ABSTRACT FROM AUTHOR]

An analysis of #notokay tweets revealed that tweets constructed a grassroots health activist discourse that made visible the 'invisible' pervasiveness of sexual assault by encouraging women to disclose assault in a digital space of affective solidarity. The campaign captured a multiplicity of embodied assault experiences, dispelled rape myths, and challenged and broadened mainstream conceptualizations of assault. It aimed at transformative change by politicizing the public health issue of sexual violence by highlighting the socioenvironmental determinants of assault – a patriarchal culture that condones and fosters violence against women and does not prioritize women's health. By offering rich qualitative data on the magnitude, characteristics, and consequences of sexual violence via the lived experiences of women shared through tweets, digital health activist campaigns like #notokay have the potential to complement traditional public health surveillance systems of violence against women, and thereby raise the visibility of this issue. [ABSTRACT FROM AUTHOR]

A qualitative framing analysis of a sample of stories on mental illness (N = 177) in The Times of India, India's largest-selling English language broadsheet newspaper, was conducted. Specifically, frames were examined for whether, and if so, how they challenged or perpetuated mental illness stigma. Two predominant frames were identified: people with mental illness are a danger to themselves and others and mental illness can be caused and treated in various ways. Frames had a mix of positive and negative aspects-some that challenged stigma and others that perpetuated it. For example, stories typically attributed mental illness to socioenvironmental, not biological determinants, reflecting a tension between traditional cultural and neurobiological conceptions of mental illness. Such framing could reduce stigma by placing responsibility for recovering from mental illness on the community, not on the individual. However, it could increase stigma by suggesting that mental disorders are not legitimate medical disorders. Also, people with mental illness were rarely quoted, thereby perpetuating stigma by implying, for example, that they are not capable of being interviewed. This study contributes to understanding of how stigma and anti-stigma frames about mental illness are constructed by media in a non-Western sociocultural context. The findings have implications for news coverage of mental illness as well as for the design of anti-stigma interventions in India. [ABSTRACT FROM AUTHOR]

Given the increasingly widespread use of mobile phones in the developing world, the application of this technology for healthcare (also referred to as m-health) has tremendous potential. However, there is a need for more research on factors that influence the sustainable and scalable adoption of m-health in developing countries. To fill this gap, in this study, drawing on the theory of diffusion of innovation, we conducted indepth interviews with 29 health professionals in Sri Lanka to understand their views on the benefits and barriers to adopting m-health. Participants had mixed views on the adoption of this technology. Reasons for m-health adoption included efficiency and usefulness in emergency situations. Barriers to adoption included risks for miscommunication/misinterpretation and lack of systems/policies for implementing m-health technology. With regard to the innovation-decision process, most participants appear to be in the stages of "persuasion" and "decision"; with regard to degree of innovativeness, interviewees comprise a mix of "early adopters" and "laggards." Assuming mobile health apps afford improvements in health outcomes for developing countries, contextual factors in each national setting should inform design and implementation of m-health interventions. [ABSTRACT FROM AUTHOR]

Many Native American communities experience severe health inequalities, including shorter average lifespan and higher rates of chronic illnesses. Journalism that serves Native Americans is a promising channel for heath communication, but only if scholars first understand the particular cultural contexts of indigenous communities. This research contributes to that goal by investigating how journalists serving Native American communities characterize health and the issues they identify with covering determinants of health. In in-depth interviews (N = 24), journalists contrasted how they cover health issues as embedded in cultural context with shallow, more negative coverage by non-Native media organizations. Interviews also revealed a tension between "medical" and "cultural" models of health, contributing to the oversaturation of certain issues, like diabetes, while other health topics are underrepresented. The journalists also expressed how social determinants and histories of oppression shape health inequalities, illuminating the roles of historical trauma and the destruction of indigenous health beliefs and behaviors. Failure to recognize these issues could stymie efforts to communicate about health issues facing Native American audiences. [ABSTRACT FROM AUTHOR]

Cyberbullying has provoked public concern after well-publicized suicides of adolescents. This mixed-methods study investigates the social representation of these suicides. A content analysis of 184 U.S. newspaper articles on death by suicide associated with cyberbullying or aggression found that few articles adhered to guidelines suggested by the World Health Organization and the American Foundation for Suicide Prevention to protect against suicidal behavioral contagion. Few articles made reference to suicide or bullying prevention resources, and most suggested that the suicide had a single cause. Thematic analysis of a subset of articles found that individual deaths by suicide were used as cautionary tales to prompt attention to cyberbullying. This research suggests that newspaper coverage of these events veers from evidence-based guidelines and that more work is needed to determine how best to engage with journalists about the potential consequences of cyberbullying and suicide coverage. [ABSTRACT FROM PUBLISHER]

Using interview methodology, this research examines the role conceptions of US health journalists. Asking journalists from different types of media to define their roles as they relate to public health, inequalities, responsibility and news values reveals the external demands on journalists as well as internal processes that shape professional identity. This paper considers professional and normative role conceptions. Interviews with experienced health journalists revealed that they do not identify with any one of these roles in particular but operate on a spectrum, navigating competing pressures resulting from individual, organizational, and societal influences. Through the process of analyzing and categorizing health journalists’ goals, responsibilities, and ideals, we explore how topics and tasks specific to covering health relate to the democratic functions of the press. The findings of this study advance knowledge about the sociology of newswork and shed light on the professional identities of health journalists. [ABSTRACT FROM AUTHOR]