Cancer Information Overload Across Time: Evidence from Two Longitudinal Studies.

A majority of U.S. adults report feeling overwhelmed by the amount of available cancer information, termed cancer information overload (CIO). Research has demonstrated CIO is prevalent and negatively related to health behaviors, but no study to date has examined this disposition across time. Two longitudinal studies - a colonoscopy intervention among older U.S. adults (N = 237) and an HPV vaccination intervention among young U.S. women (N = 411) - were utilized to examine CIO stability across time and its relationship to prevention intentions and indifference. CIO increased indifference for non-adherent individuals but had no effect on intentions. CIO was stable in study 1 but not study 2, suggesting CIO stabilizes across the life course. Results also support a five-item measure of CIO.

Developing skin cancer education materials for darker skin populations: crowdsourced design, message targeting, and acral lentiginous melanoma.

Despite decreased susceptibility, darker skin individuals who develop melanoma have worse survival. This disparity in melanoma mortality is the largest for any cancer, and partly driven by a lack of patient education materials targeted to darker skin populations in whom acral lentiginous melanoma (ALM) is the most common subtype. To address this communication disparity, the current study reports a multi-phase design process that leverages crowdsourcing and message testing to develop ALM-focused patient education materials for darker skin populations. Crowdsourced design was utilized to develop a pool of designs (phase 1), the pool was narrowed and thematically analyzed (phase 2), and select designs were evaluated via a message experiment (N = 1877). For darker skin populations, designs that depicted people enhanced knowledge of ALM through message memorability. The current study engages melanoma disparities by providing ALM patient education materials for darker skin populations vetted via a multi-phase process.

Does it matter if a story character lives or dies?: a message experiment comparing survivor and death narratives.

OBJECTIVE: In narratives, characters often face threats where they either live (survivor narratives) or die (death narratives). Both outcomes have the potential to persuade, and are frequently utilised in mass communication campaigns, yet more research is needed examining the relative effectiveness and underlying mechanisms of each strategy. DESIGN: U.S. adults (N = 1010) were randomly assigned to a 2 (survivor, death) × 2 (non-foreshadowed, foreshadowed) × 2 (within-study replication: narrative 1, narrative 2) between-participants experiment with melanoma stories as stimuli. MAIN OUTCOME MEASURES: Intentions to engage in sun safe behaviour and skin self-examination behaviour were assessed in the pre- and posttest, and then transformed into change scores. RESULTS: Death narratives increased sun safe behaviour intentions. Consistent with the entertainment overcoming resistance model, foreshadowed death narratives were found to increase sun safe behaviour intentions via increased transportation and decreased counterarguing. CONCLUSION: Compared to survivor narratives, death narratives increase intentions to engage in sun safe behaviour. The findings offer support for character death as a key feature of narrative persuasion, and narrative transportation and counterarguing as important mediational pathways.

Revisiting nutrition backlash: Psychometric properties and discriminant validity of the nutrition backlash scale.

OBJECTIVES: Nutrition backlash is a disposition defined by negative feelings about dietary recommendations. Past research has measured nutrition backlash using the nutrition backlash scale (NBS) and found that it is negatively related to the consumption of fruits and vegetables. The aim of this study was to examine several aspects of the NBS, including factor structure, discriminant validity, and relationship to demographic characteristics and health behaviors. METHODS: Adults were recruited to participate in two studies. Study 1 (N = 480) included measures of nutritional backlash, information overload, worry, fatalism, and nutrition-related behaviors. Study 2 (N = 399) was a follow-up that examined the factor structure of the NBS in a separate sample. RESULTS: In study 1, a six-item version of the NBS was found to be a good fit for the data and discriminant from overload, worry, and fatalism. NBS was higher for those with less education, non-white participants, and men. Individuals with higher backlash were less likely to look at nutritional labels and to use sunscreen. Study 2 confirmed the factor structure from study 1. CONCLUSIONS: A six-item version of the NBS was found to be reliable, discriminant from related measures, higher in underserved groups (less-educated, non-white, and male participants), and related to nutrition label use.

Do ultraviolet photos increase sun safe behavior expectations via fear? A randomized controlled trial in a sample of U.S. adults.

Ultraviolet (UV) photos reveal the world in a different light spectrum, including damage that is caused by UV light. In the context of skin cancer control, UV photos have the potential to communicate fear because they reveal underlying skin damage. U.S. adults (N = 2219) were assigned to a 5 (visual: UV skin damage, sun exposure, sunburn, photoaging, and mole removal) × 3 (replication: three examples of each visual condition) × 4 (efficacy: no efficacy, text only, visual, visual + text) randomized controlled trial. Compared to all other visual conditions combined, UV skin damage visuals generated greater fear which triggered increased sun safe behavior expectations. Compared with other visual conditions separately, only mole removal visuals produced equivalent fear as UV skin damage visuals. Visual efficacy conditions appeared to nullify rather than magnify the indirect path through fear. The results suggest one way UV images impact sun safe behavioral expectations is via fear and that researchers should continue to examine the position of fear in fear appeal theories.