The role of fear and disgust in predicting the effectiveness of television advertisements that graphically depict the health harms of smoking.

INTRODUCTION: Antismoking television advertisements that depict the graphic health harms of smoking are increasingly considered best practices, as exemplified by the Centers for Disease Control and Prevention's current national campaign. Evaluation of responses to these widely used advertisements is important to determine advertisements that are most effective and their mechanisms of action. Our study tested the hypothesis that advertisements rated highest in fear- and disgust-eliciting imagery would be rated as the most effective. METHODS: Our laboratory study included 144 women and men aged 18 to 33; 84% were current nonsmokers. All participants viewed 6 antismoking television advertisements that depicted the health harms of smoking; they rated their responses of fear and disgust and the effectiveness of the advertisements. We used multilevel modeling to test the effects of the following in predicting effectiveness: fear, disgust, the fear-disgust interaction, the advertisement, and the participant's sex and smoking status. Follow-up analyses examined differences in ratings of fear, disgust, and effectiveness. RESULTS: Advertisement, fear, disgust, and the fear-disgust interaction were each significant predictors of effectiveness. Smoking status and sex were not significant predictors. The 3 advertisements that elicited the highest ratings of fear and disgust were rated the most effective. CONCLUSION: Our findings support the hypothesis that antismoking advertisements of health harms that elicit the greatest responses of fear or disgust are the most effective. When advertisements elicit high ratings of both fear and disgust, advertisements with graphic imagery are effective, whereas advertisements without graphic imagery are not.

Telephone-based motivational interviewing to promote physical activity and stage of change progression in older adults.

This study examined the efficacy of motivational interviewing (MI) for increasing physical activity in aging adults. Eighty-six participants aged 55 years and older were randomly assigned to receive either four weekly sessions of telephone-based MI for increasing physical activity, or a healthy activity living guide (information only control). Changes from baseline weekly caloric expenditure from physical activity, self-efficacy for physical activity, and stage of change for physical activity were compared across groups at posttreatment and six months follow-up. Results indicated that MI participants had higher weekly caloric expenditures from physical activity at posttreatment, but not at six months follow-up; higher self-efficacy for physical activity at six months follow-up; and demonstrated greater stage of change progression across assessments. These findings support the use of telephone-based MI for increasing physical activity in older adults in the short-term. Future studies will need to determine if follow-up booster sessions increase long-term efficacy.

Relationships between health behaviors and weight status in American Indian and white rural children.

PURPOSE: Preventing obesity in childhood is an increasingly important public health goal. Prevention efforts can be improved by better understanding relationships between health behaviors and overweight and obesity. This study examined such relationships in young American Indian and white children living in the rural United States. METHODS: Self-report measures of diet, screen time (passive and active), and physical activity were combined with cardiovascular fitness in cross-sectional analyses to predict weight categories based on body mass index percentiles in 306 American Indian and white children (aged 8-9 years) from a rural area in the upper Midwestern United States. FINDINGS: Multinomial logistic regression models were statistically significant for girls (χ2 [20] = 42.73, P < .01), boys (χ2 [20] = 50.44, P < .001), American Indian (χ2 [20] = 36.67, P < .05), and white children (χ2 [20] = 55.99, P < .001). Obesity was associated with poorer cardiovascular fitness in girls (OR = 0.82), boys (OR = 0.83), American Indian (OR = 0.79), and white children (OR = 0.85), and with passive screen time in girls (OR = 1.69), boys (OR = 2.1), and white children (OR = 1.81). Overweight was associated with passive screen time (OR = 2.24) and inversely with active screen time (OR = 0.54), but only in boys. CONCLUSIONS: Logistic regression models were more successful at predicting obesity than overweight in all groups of participants. Poorer cardiovascular fitness showed the strongest and most consistent association with obesity, but passive screen time was also a significant and important contributor to the prediction of obesity in most prediction models. Prediction models were similar in girls, boys, American Indian, and white children.

Lower but not higher doses of transdermal nicotine facilitate cognitive performance in smokers on gender non-preferred tasks.

One of the most widely used treatments for smoking cessation is nicotine replacement therapy (NRT). There is some evidence that smokers experience abstinence-induced deficits in cognitive function, which are attenuated by NRTs. Additionally it's been suggested that the degree of reversal of cognitive deficits may depend on the NRT dose and the smoker's gender. In the present placebo-controlled study we investigated effects of three doses of transdermal nicotine (7 mg, 14 mg and 21 mg) on cognitive performance of 48 male and 48 female smokers after overnight abstinence and 6h of patch application. Cognitive tasks used in the study included the Conners' CPT, emotional Stroop, mental arithmetic, and verbal recall of affective prose passages. The results showed greater probability of attentional problems in the male sample compared to females as identified by the Conners' CPT. Within gender women showed improved performance in the 7 mg and 14 mg conditions on several measures of the Conners' CPT, and faster hit reaction time on the emotional Stroop test compared to women in the placebo and 21 mg of nicotine groups. Conversely, males showed a moderate overall advantage on the mental arithmetic task and were differentially sensitive to nicotine treatment on the prose recall task, on which the greatest improvement in recall of affective material was observed for the 14 mg group compared to the 21 mg group. The results are explained on the basis of an inverted U-shaped relationship between nicotinic stimulation and cognitive performance as well as greater sensitivity to nicotine dose manipulation on gender non-preferred cognitive tasks.

Carbohydrate antigens in nipple aspirate fluid predict the presence of atypia and cancer in women requiring diagnostic breast biopsy.

BACKGROUND: The goal of this prospective study was to determine (a) concentrations of the carbohydrate biomarkers Thomsen Friedenreich (TF) antigen and its precursor, Tn antigen, in nipple discharge (ND) collected from women requiring biopsy because of a suspicious breast lesion; and (b) if concentration levels predicted pathologic diagnosis. METHODS: Adult women requiring biopsy to exclude breast cancer were enrolled and ND obtained. The samples from 124 women were analyzed using an anti-TF and anti-Tn monoclonal antibodies in direct immunoassay. RESULTS: The highest median concentration in ND for TF and Tn was in women with ductal carcinoma in situ (DCIS). TF was higher in women with 1) cancer (DCIS or invasive) vs. either no cancer (atypia or benign pathology, p = .048), or benign pathology (p = .018); and 2) abnormal (atypia or cancer) versus benign pathology (p = .016); and was more predictive of atypia or cancer in post- compared to premenopausal women. Tn was not predictive of disease. High TF concentration and age were independent predictors of disease, correctly classifying either cancer or abnormal vs. benign pathology 83% of the time in postmenopausal women. CONCLUSIONS: TF concentrations in ND were higher in women with precancer and cancer compared to women with benign disease, and TF was an independent predictor of breast atypia and cancer. TF may prove useful in early breast cancer detection.

Assessing health status, behavioral risks, and health disparities in American Indians living on the northern plains of the U.S.

OBJECTIVE: We assessed health status and behavioral risks in American Indians (AIs) from rural, northern plains reservation communities. METHODS: AI interviewers from the communities administered the core and optional modules of the Behavioral Risk Factor Surveillance System (BRFSS) to 404 AI adults randomly selected from housing lists from four AI tribal communities located on the northern plains of the U.S. The BRFSS interview assessed several health functioning areas including medical conditions, preventive screenings, and behavioral risks. We measured health disparities by comparing the AI sample data with a northern plains statewide (North Dakota) sample and a U.S. national sample. We compared outcomes with BRFSS statewide (North Dakota) and U.S. national data from telephone-based interviews. RESULTS: AI participants showed a significantly greater prevalence of diabetes, coronary heart disease, myocardial infarction, smoking, obesity, and heavy alcohol use than either the regional or national samples. They also reported being less likely to engage in leisure-time physical activity and to have had age-appropriate preventive screenings for several diseases including colorectal cancer, prostate cancer, breast cancer, and cardiovascular disease. CONCLUSIONS: Face-to-face interviews conducted by AI community members are an effective means of gathering health information about AIs living in rural, reservation communities. AIs living in these communities on the northern plains have a much higher prevalence of many health-risk behaviors and some medical conditions than are found in the general population. Improved health-care access, better preventive screenings, and culturally appropriate community-based health promotion programs and policies should be examined as possible ways to reduce health disparities.

Confirmed recall and perceived effectiveness of tobacco countermarketing media in rural youth.

This study was the first to examine rural youth's responses to ten television and radio tobacco countermarketing ads aired during a 13-week field campaign conducted in a U.S. Northern Plains state. A post-campaign survey of 391 girls and boys aged 12-17 years and including 58 American Indian youth provided information about their confirmed recall (CR) of the ads; and for recalled ads, their ratings of the ads' perceived effectiveness (PE). Results were that controlling for age and smoking risk, both American Indian and white girls and boys had the highest CR for the television ad Artery and for the radio ad ABC. Artery shows fatty deposits being squeezed from a deceased smoker's aorta, and ABC presents a former smoker speaking through his electro-larynx. Among the television ads, PE ratings were highest for the ad Artery in both boys and girls. Among the radio ads, boys rated ABC highest, whereas girls rated Joe DoBoer highest-an ad that discusses mouth lesions that developed from using smokeless tobacco. An analysis of race/ethnicity differences in PE for the ad Artery and ABC indicated American Indian and white youth considered these ads equally effective. These findings indicate certain TV and radio ads depicting graphic health harms from tobacco-especially the TV ad Artery and the radio ad ABC-are highly recalled and perceived as effective by both American Indian and white girls and boys from a rural region. Future research is needed to better understand which individual- and media-level factors increase the likelihood that anti-tobacco ads will be effective in reducing youth tobacco use.

Correlates of overweight and obesity in american Indian children.

OBJECTIVE: To identify risk factors that may contribute to the development and/or maintenance of overweight and obesity in American Indian children. METHODS: The sample consisted of 291 tribally enrolled American Indian children. Body mass index (BMI) was measured by a tribal program and children completed self-report measures during health class. Hierarchical multiple regression analyses were conducted for 232 children and included three blocks of predictor variables (diet and physical activity, weight-related attitudes, and psychosocial variables). RESULTS: Thirty-three percent of children were obese and 20% were overweight. Diet and physical activity (7.6%) and weight-related attitudes (31.9%) made significant contributions, explaining 39.5% of the variance in BMI. CONCLUSIONS: Greater BMI scores were related to healthier food choice intentions, more hours of television viewing, greater body dissatisfaction, higher negative attitudes toward body size, and more weight loss attempts.

Predicting responses to sexually aggressive stories: the role of consent, interest in sexual aggression, and overall sexual interest.

Measures of interest in sexual aggression and overall sexual interest were used to predict men s responses to consensual and nonconsensual stories that contained forceful sexual content. College males (N = 108) listened to these stories and completed questionnaires assessing self-reported sexual arousal and desire, their perceptions of the woman s enjoyment and sexual desire in the stories, their likelihood of acting like the man in the stories, and how likely they would be to read similar stories. Multiple regression analyses revealed that overall sexual interest variables were significant predictors of responses to both consensual and nonconsensual stories, while interest in sexual aggression predicted responses to only the nonconsensual story. The present study highlights the importance of considering overall sexual interest measures in sexual aggression research.

A multi-center evaluation of the McGill Pain Questionnaire: results from more than 1700 chronic pain patients.

We argue that the conflicting results reported in previous studies examining the factor structure of the McGill Pain Questionnaire Pain Rating Index (PRI) can be explained by differences in the patient samples and statistical analyses used across studies. In an effort to clarify the factor structure of the PRI, 3 different factor models were compared using confirmatory factor analysis in 2 samples of low-back pain patients (N = 1372) and in a third sample of patients suffering from other chronic pain problems (N = 423). A 4-factor model, similar to those obtained in previous studies where multiple criteria were used to determine the number of factors extracted, best explained covariation among PRI subclasses. However, relatively high interfactor correlations (approximately two-thirds of the variance explained by the best fitting factor structure was common variance) cast doubt on the discriminant validity of PRI subscales; examination of relationships between the PRI and MMPI subscales also failed to provide evidence of the discriminant validity or clinical utility of PRI subscales. Reducing the information from the 10 PRI sensory subclasses to a single subscale score may seriously limit the usefulness of the PRI. Alternate methods of using PRI data are suggested.