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BackgroundDigital media technologies provide users with the ability to interact with content and to receive information based on their preferences and engagement. ObjectiveWe used skin cancer and sun protection as a health topic to explore how modality interactivity, interface tools that afford users greater activity, resulting in greater depth and breadth of mentally representing and experiencing mediated content, and message interactivity, the extent to which the system allows users to exchange messages back and forth on health websites, influenced users’ attitudes, knowledge, behavioral intentions, and experience. MethodsWe employed a 2×2 (modality interactivity: high vs low; message interactivity: high vs low) between-subject online experiment for which 4 websites were created. Participants (n=293) were recruited using Amazon Mechanical Turk and randomly assigned into to 1 of 4 conditions. After browsing the website, participants completed an online survey regarding their experience and cognitive perceptions. General linear models and path analysis were used to analyze the data. ResultsBoth modality interactivity (P=.001) and message interactivity (P

BackgroundApproximately 42.5 million adults have been affected by mental illness in the United States in 2013, and 173 million people have been affected by a diagnosable psychiatric disorder in China. An increasing number of people tend to seek health information on the Web, and it is important to understand the factors associated with individuals’ mental health information seeking. Identifying factors associated with mental health information seeking may influence the disease progression of potential patients. The planned risk information seeking model (PRISM) was developed in 2010 by integrating multiple information seeking models including the theory of planned behavior. Few studies have replicated PRISM outside the United States and no previous study has examined mental health as a personal risk in different cultures. ObjectiveThis study aimed to test the planned risk information seeking model (PRISM) in China and the United States with a chronic disease, mental illness, and two additional factors, ie, media use and cultural identity, among college students. MethodsData were collected in both countries using the same online survey through a survey management program (Qualtrics). In China, college instructors distributed the survey link among university students, and it was also posted on a leading social media site called Sina Weibo. In the United States, the data were collected in a college-wide survey pool in a large Northwestern university. ResultsThe final sample size was 235 for the Chinese sample and 241 for the US sample. Media use was significantly associated with mental health information–seeking intentions in the Chinese sample (P

Ecological momentary assessment (EMA), a method that allows for data collection in real-time, may offer benefits for communication research. We conducted two EMA studies on different topics (i.e., alcohol and sexual content in media and social media use, emotions, and tanning) in 2017 and 2018, respectively, and completed in-depth interviews (N = 19 and N = 16) following each study. Participants were open to the method and described potential changes in awareness and behavior, which could contribute to changes in data collected and potentially serve as an unintentional intervention. Researchers should consider the intent of their research and possible unintended effects of the questions posed. [ABSTRACT FROM AUTHOR]

When celebrities, political figures, influencers, or anyone with a large following publicly disclose an illness or die, the news becomes a de facto public health campaign. Until health communicators began studying such disclosures and the effects of the following waves of media coverage, however, it was not known to what extent these events impacted the public. A growing body of research has empirically documented these events and examined the factors that predict which types of audiences are most affected and why. Beyond motivating research opportunities, celebrity and influencer health disclosures or deaths can impact calls to hotlines, views on health-related websites, discussions of related topics on social media, behavioral changes relevant to the disclosure, increased news coverage of celebrity health research, integration of celebrity health narratives into strategic health campaigns, and even policy changes. We provide an overview of research conducted in this area and detail examples of the impact that celebrity health disclosures and studies about those disclosures have had on public discourse and public health. [ABSTRACT FROM AUTHOR]

Objective: While research suggests media use is positively associated with skin-damaging behaviours, especially among US college-aged women, less is known about the role of specific media types in potentially promoting indoor or outdoor tanning. Design: We used an online survey to examine the relationship between demographic variables, entertainment media and social media use, attitudes towards looking like people in the media and indoor tanning and outdoor sunbathing frequency. Setting: US Pacific Northwest. Method: Online survey with a convenience sample of college women (N = 502) in September 2016. Results: Attitudes towards looking like people in media were a significant predictor of frequency of indoor and outdoor tanning, above and beyond demographic variables and media use. Greater magazine use predicted increased indoor tanning and social media use predicted outdoor sunbathing frequency. Greater use of visual-oriented social media platforms like Instagram, SnapChat and Pinterest predicted increased sunbathing. Conclusion: Health communicators should consider specific channels for prevention efforts, particularly social media for targeting sunbathers.

AbstractObjective: During the COVID-19 pandemic, college students were navigating confusing and often conflicting information on social media. Media literacy can help people interpret information online. We developed and tested a text-message media literacy intervention designed for college students. Participants: 267 U.S. college students from a university in the Pacific Northwest. Methods: We used an explanatory mixed methods design with a pretest-posttest field experiment (N = 267) and in-depth interviews (N = 15) to test a text message-based media literacy intervention in April 2020. Results: The intervention influenced media literacy for source and interacted with elaboration to influence media literacy for content and COVID-19 expectancies. Interviews highlighted how media literacy can be bolstered by emphasizing the salience of the role the message source plays in message interpretation. Conclusions: A media literacy text message intervention can prompt college students to consider media literacy related to the source and impact health expectancies. [ABSTRACT FROM AUTHOR]

AbstractObjectiveParticipantsMethodsResultsConclusionsA growing number of U.S. states have legalized cannabis for people 21 and older, but cannabis use and misuse can negatively impact college students’ health and academic achievements. We created a technology-delivered intervention designed to reduce cannabis misuse among college students.College students at one university in Washington state.We tested the intervention in a pretest, post-test lab experiment (N = 64). A person with experience in the cannabis marketing industry voiced the intervention, describing relevant laws, product knowledge, packaging literacy, serving sizes and potency, strategies for reducing misuse and possible harms of using.Participants viewed the intervention as highly credible and useful. The intervention increased participants’ confidence in cannabis product knowledge, confidence in responsible use, and perceptions of health risks.Such an intervention can positively impact participants’ confidence in navigating the legal cannabis landscape while increasing risk perceptions. The use of a credible source with industry experience is beneficial for reaching college students with such information. [ABSTRACT FROM AUTHOR]

Fitspiration content on Instagram often includes images in which women are objectified but may also include captions that aim to positively motivate viewers, such as through messaging about body appreciation. Viewing objectifying content in fitspiration posts may be problematic for young women's mental health, but it's unclear if positive messaging may help to alleviate some of these effects. In this study, we conducted a 2 × 2 online experiment assessing the effects of body appreciation and objectification content present in Instagram fitness posts by influencers on young women (N = 200). The outcome variables were state body appreciation, trait body appreciation, self-esteem, and self-compassion. We found an interaction between the presence and absence of objectification and presence and absence of body appreciation that significantly influenced self-compassion and body appreciation. The interaction suggests that self-compassion and state body appreciation are higher in the presence of body appreciation messaging, although there were not main effects for just viewing objectifying images or body appreciation captions. This means that just body appreciation or just objectification may not affect state body appreciation and self-compassion, but the two together have an effect. Our findings suggest that body appreciation captions may serve as a protective factor for self-compassion and state body appreciation when young women view Instagram fitspiration posts that include sexual objectification. Health communicators could encourage influencers to include body appreciation content in their fitspiration posts to help improve self-compassion among viewers, and interventions could work to promote body appreciation among young women to encourage self-compassion. [ABSTRACT FROM AUTHOR]

Objectives: Text message-based interventions may provide sexual health information to young people through a number of service types, from sending information on a regularly scheduled timeline, to providing an automated menu, to allowing young people to connect directly with health educators. While such service types exist, it is not clear which features young adults feel are most effective at allowing them to engage with sexual health information. Design: This study used a mixed-methods design (survey and focus groups) to assess perceptions of three types of sexual health text message services with young adults, a population particularly at risk of negative sexual health outcomes. Setting: College students from the US Pacific Northwest participated in the project. Method: Participants heard about three sexual health text message services, completed questionnaires and discussed each type. Focus groups were gender-separated. Results: Participants reported that services that allowed them to connect with a health educator would be highly useful, but automated services would be beneficial in bringing new topics to their attention. Participants perceived the purpose of the service types as different and felt each could be a useful resource, depending on the situation. Regardless of service type, participants wanted to personalise their experience. Participants wanted messages tailored to them and options to interact with the systems, from influencing topic selection to message timing. Conclusion: Each of the service types can be useful for young adults. Young adults perceive services that provide the opportunity to tailor information and interact with the system as beneficial.

Young adults are disproportionately affected by negative sexual health outcomes, such as sexually transmitted infections. One strategy for reducing such negative outcomes involves the use of comprehensive sexual health education. As comprehensive sexual health education programmes are adopted, there is a need to evaluate the messaging approaches that might best connect with young people. Sex-positive approaches, which describe sex as a healthy practice and personal choice, are becoming popular, but whether this strategy works has not been tested from a message design perspective. This study examines the reactions of young adults to sex-positive or sex-negative messages, framed as a gain or loss, designed for a text message-based intervention. Participants quantitatively evaluated 24 messages on their mobile phones. Gain frames were preferred over loss frames, and sex-positive messages were rated as more believable and persuasive. An interaction between the two concepts was also found. Results highlight how sex-positive messages that focus on the benefits of certain behaviours tend to resonate better with young adults. Implications for health educators and practitioners are discussed.

Health and fitness content intended to inspire people to live healthy lives (e.g. "fitspiration") has been linked to negative body image among girls and young women. Fitness influencers purport wanting to motivate healthy behaviors. This study seeks to examine the presence of strategies known to positively influence health behaviors (e.g. attitudes, self-efficacy) as well as of content known to have a negative influence (e.g. objectification) among fitness influencers. We conducted a content analysis (N = 441) of a random sample of one year of posts from four Instagram fitness influencers popular with girls and young women in the United States. The main analysis consisted of codes related to objectification, health promotion strategies, health-related content, and social engagement (i.e., likes). We found that fitness influencers included content that conveyed constructs previously found to positively influence health behaviors (e.g., attitudes and self-efficacy), but objectification was frequently present, in more than half of the posts. Additionally, we found that the presence of objectification in posts was negatively associated with likes, a form of social endorsement. We suggest health communicators aim to work in tandem with fitness influencers to include content that may motivate positive health behaviors and improve media literacy and that influencers aim to reduce the amount of objectifying content included in their posts. Our findings shed light on content being conveyed and possible insights into the negative effects associated with viewing such content. [ABSTRACT FROM AUTHOR]

Objective: Condom distribution programmes are an important means of preventing sexually transmitted infections (STIs); yet little research has examined their perceived and actual impact on college campuses. Design: Quantitative, cross-sectional study. Setting: Large public university in the Southeastern USA. Method: Approximately 2 months after a campus-wide condom distribution programme began, we utilised intercept surveys with 355 students (68% women; 43% racial/ethnic minorities) to examine their perceptions of the availability, accessibility and acceptability of condoms, and their perceptions and use of the newly installed condom dispensers. Results: Students perceived condoms to be available and accessible on campus after implementation of the condom dispensers. Students had heard about the dispensers from other people (36%), through social media (18%) and the campus newspaper (15%). Most students (71%) had seen the dispensers. Almost one in four students (23%) had taken a condom from the dispensers; among those who were sexually active during the 2 months that the dispensers were available, 33% had used them. More than one-third of students (37%)--and 53% of sexually active students--indicated intentions to use the dispensers in the next 6 months. Multiple regression analysis controlling for age, gender and race revealed that prior condom use, attitudes about the dispensers and comfort with the dispensers were significant predictors of sexually active students' intentions to use the dispensers (p < 0.001). Objective: Condom distribution programmes are an important means of preventing sexually transmitted infections (STIs); yet little research has examined their perceived and actual impact on college campuses. Design: Quantitative, cross-sectional study. Setting: Large public university in the Southeastern USA. Method: Approximately 2 months after a campus-wide condom distribution programme began, we utilised intercept surveys with 355 students (68% women; 43% racial/ethnic minorities) to examine their perceptions of the availability, accessibility and acceptability of condoms, and their perceptions and use of the newly installed condom dispensers. Results: Students perceived condoms to be available and accessible on campus after implementation of the condom dispensers. Students had heard about the dispensers from other people (36%), through social media (18%) and the campus newspaper (15%). Most students (71%) had seen the dispensers. Almost one in four students (23%) had taken a condom from the dispensers; among those who were sexually active during the 2 months that the dispensers were available, 33% had used them. More than one-third of students (37%)--and 53% of sexually active students--indicated intentions to use the dispensers in the next 6 months. Multiple regression analysis controlling for age, gender and race revealed that prior condom use, attitudes about the dispensers and comfort with the dispensers were significant predictors of sexually active students' intentions to use the dispensers (p < 001). Conclusion: Overall, results indicate that over a short time period, this condom distribution programme was successful in reaching students and providing free condoms. Implications for implementing condom distribution programmes on college campuses as well as future directions for research are discussed.

Objective: The goal of this study was to take an in-depth look at why college students do (or do not) seek health information, and how they seek information when they do. Design: Qualitative content analysis of responses to an open-ended prompt embedded in a survey about health information seeking behaviours. Setting: Nearly 700 (N?=?697) college students at a public university in the Southeastern USA responded to an open-ended prompt to discuss health information seeking. Method: Two coders used constant-comparative method to identify themes within the data set. Results: Students in the sample were motivated to seek health information by personal relevance, emotions, identity and media coverage. When they did seek such information, they relied heavily on the Internet. Many respondents reported not seeking health information due to perceptions of low personal risk, third person perceptions that they knew more than others and/or a fatalistic view of their future health. Conclusion: College students seek health information largely based on perceptions of relevance. Health professionals wanting to motivate this population to educate themselves about health issues may wish to focus on making relevance salient as well as understanding both cognitive and affective motivations to seek or avoid seeking.

Text messaging services are becoming an increasingly popular way to provide sexual health information to teens, but little is known about who uses such services. This study assessed whether teens at a greater risk for negative sexual health outcomes use a sexual health text message service. A text message service that connects teens with sexual health educators was promoted in six public schools in one state in the Southeast. Students (n = 2,125) in four schools completed an online questionnaire assessing personal risk factors associated with negative sexual health outcomes and use of the text message service. Text message service users (n = 144) were more likely to have had sex, to have been in a relationship, and to come from a lower socioeconomic status background. Users also felt less connected to their schools and were slightly older than nonservice users. When all variables were entered into a logistic regression, only sexual experience was associated with service use. Sexual health text message services are designed to provide information to teens in an effort to prevent negative sexual outcomes. Such services seem to be reaching youth with increased risk of teen pregnancy and sexually transmitted disease acquisition. This study provides evidence that teens most likely to benefit are also those most likely to use a sexual health text message service.

Sexual health text message services are becoming an increasingly popular way to reach young people with sexual health information. A variety of service types exist: some send automated messages on a set schedule; others provide personalized responses to individual questions. Young people's perceptions of interactivity, which is often based on system responsiveness, may vary. This study examines perceptions of interactivity for users of a two-way text message service that connects young people directly with a health educator and examines the relationship between perceived interactivity and attitudes toward the service, service satisfaction, and repeated service use. Data from 131 users in the southeastern U.S.A. were analysed. Perceived interactivity was associated with positive attitudes, user satisfaction and repeat use. Data suggest that for sexual health information seeking, young people may view a program as more useful if they perceive it is interactive. Services that provide a back-and-forth dialog between health educators and users may be perceived as interactive, and those perceptions of interactivity can influence attitudes toward the service as well as behaviors, such as using the service repeatedly. Since such services offer accurate and timely health information, repeated use allows for the additional exchange of health information and educational opportunities.

Background: Important tools in preventing the spread of COVID-19 include contract tracing and adherence to isolation guidelines after a positive diagnosis of COVID-19. This is especially relevant among college students who are often away from support systems at home, living in high-density housing, and may not experience serious symptoms from COVID-19 while still contagious. Objective: As text message-based interventions have been found effective in addressing health behaviors among young adults, we conducted formative research to explore how text messaging could support students in adhering to isolation guidelines. Participants: A convenience sample of college students (n = 104) at one university. Methods: An online survey gathered students' perceptions of helpful components to include in a text message-based intervention. Results: Students expressed interest in receiving text messages with support, encouragement, and resources during their time in isolation following a COVID-19 diagnosis. Conclusions: Based on the results, we developed a text message-based intervention designed to provide motivation, support, distraction, and information on resources. [ABSTRACT FROM AUTHOR]

Introduction: Cannabis messaging on digital media may include sexualised portrayals. We examined whether exposure to and perceptions of cannabis posts that included sexual objectification impacted two types of sex‐related cannabis expectancies—sexual risk and sexual enhancement—and whether body appreciation moderated these relationships. Methods: We conducted an online experiment with college students in Washington state. Participants viewed three brand‐generated cannabis Instagram posts that either included sexually objectified women or recreational appeals (e.g., sitting by a firepit). We conducted regressions, using the PROCESS macro, to examine the hypothesized model and potential mediation and moderation. Results: Exposure to sexualised advertisements was associated with increased perceptions of cannabis sex enhancement scripts (b = 0.34, p < 0.01), which was associated with increased cannabis sex enhancement expectancies (b = 0.34, p < 0.001) and decreased cannabis sexual risk expectancies (b = −0.16, p < 0.001); exposure to such advertisements were also associated with increased perceptions of cannabis sexual risk scripts (b = 0.61, p < 0.001), which was associated with increased cannabis sexual risk expectancies (b = 0.53, p < 0.001). Body appreciation was associated with increased cannabis sex enhancement expectancies (b = 0.13, p < 0.01) and moderated the relationship between exposure to sexualised ads and cannabis sex enhancement expectancies (b = −0.21, p < 0.01). Discussion and Conclusions: Practitioners may want to consider how to increase critical consumption of cannabis content on digital media. Researchers should consider the possible role of body appreciation as it relates to cannabis and sex enhancement expectancies. [ABSTRACT FROM AUTHOR]

Content analyses have documented that posts about cannabis are increasingly common on social media. The relationship between the cannabis-related content to which teens and college students are exposed on social media and how such content may be associated with intentions to use and use of cannabis is less known, however. We conducted an online survey with teens (N = 350) who lived in Washington state using online survey panel participants in June 2018 and with college students (N = 966) in a Washington state-wide university system in February and March 2019. Participants in both samples reported seeing both pro-cannabis and anti-cannabis messages on social media platforms. Exposure to pro-cannabis messages on social media was associated with an increased intention to use cannabis. Exposure to anti-cannabis messages on social media was indirectly associated with decreased intentions to use cannabis through negative outcome beliefs of cannabis use and, among college students, through perceived norms. Among college students specifically, exposure to pro-cannabis messages on social media was also associated with more frequent cannabis use. Health communicators could focus anti-cannabis messaging on negative outcome beliefs among teens and college students as well as norms among college students to potentially influence constructs associated with intentions and use. [ABSTRACT FROM AUTHOR]

Young people have questions about sex and development but may have trouble getting answers to them. Text messaging services can serve as a resource. This study analysed 1351 text messages sent to a sexual health text message service designed for young people in North Carolina to determine the types of questions asked of a confidential, accurate source of information. The majority of texts sought information about sexual health topics (89%). A smaller proportion asked for advice (7%) or reassurance (4%) that the sender was developing normally. Questions mainly asked about sexual acts (33.9%), unplanned pregnancy (20.2%), contraception (13.7%), physical or sexual development (12.9%) and sexually transmitted diseases (10.8%). Findings suggest that a confidential and accurate sexual health text message service could be an important resource for young people, especially if they seek advice before engaging in risky sexual behaviour. (Contains 2 tables.)

Given the vast amounts of COVID-19-related messages flooding mediated and interpersonal communication channels during the global pandemic, celebrity COVID-19 disclosures offer rare opportunities to cut through message fatigue and apathy and garner the attention of wide swaths of the public. We conducted a convergent mixed method analysis of audience responses to actor Tom Hanks' March 11, 2020 disclosure of his COVID-19 diagnosis via social media. We collected our data within 24 hours of his announcement, allowing us to quickly capture emotional and cognitive responses to the announcement and to assess both demographic and psychosocial differences in types of people who heard the news in this time frame and those who had not. In our study, 587 participants had heard the news of Hanks' disclosure while 95 had not. Participants who had heard responded to an open-ended prompt asking if the disclosure affected them at all. Those who had not heard were funneled into a field intervention to test how random assignment to seeing Hanks' disclosure post or not would affect audiences' COVID-19-related emotions, cognitions, and willingness to enact prevention behaviors. The results of this mixed methods study revealed differences in responses to Hanks' disclosure based on health information source trust and involvement with Hanks as well as effects of the intervention on efficacy for dealing with COVID-19. We discuss implications for health communication theory and crafting messages that can effectively build off the attentional inertia generated by celebrity illness disclosures to encourage prevention efforts. [ABSTRACT FROM AUTHOR]