Disparities in knowledge of mouth or throat cancer among rural Floridians.

OBJECTIVE: The aim of this study was to examine risk factors for reduced mouth or throat cancer (MTC) knowledge using a sample of rural North Floridian adults. METHODS: Telephone interviews were conducted across rural census tracts throughout North Florida in 2009-2010, using a survey adapted for cultural appropriateness. The sample consisted of 2,393 individuals (1,059 males and 1,334 females; 1,681 whites and 712 blacks). FINDINGS: Only 9% of the study respondents indicated they had not heard of MTC; however, only 12% endorsed knowing "a lot." Higher education levels and health literacy indicated they had more MTC knowledge. Among female participants, whites had more knowledge than blacks (OR = 1.9). Among black participants, males had more knowledge than females (OR = 1.7). Conversely, greater concern with MTC was associated with lower education levels, health literacy, and financial status, but higher depression scores. Awareness that excessive sun exposure is a risk factor for MTC was lower than for earlier studies using more urban samples. CONCLUSIONS: This study adds to the literature on MTC knowledge and concern because this sample was drawn exclusively from rural populations in North Florida, a group with the highest MTC morbidity and mortality. An unanticipated finding was that blacks were more concerned than their white rural counterparts. This study was also the first to report that depression was associated with increased concern about MTC. The goal is to persuade at-risk groups to obtain MTC screenings with the goal of reducing disparities in MTC whenever they occur.

Examining predictors of physical activity among inactive middle-aged women: an application of the health action process approach.

This study tested several relationships predicted by the Health Action Process Approach (HAPA) in a sample of 175 generally healthy, inactive, middle-aged women (40-65 yrs old) over a 12 week period. Participants' physical activity, risk perceptions, outcome expectancies, action self-efficacy and intention were measured at baseline. Planning and maintenance self-efficacy were measured 4 weeks later. Physical activity behaviour was measured 12 weeks after baseline. The HAPA relationships were examined using a structural equation model. The data fit the model well and revealed several significant relationships. Action self-efficacy was the best predictor of intention. Maintenance self-efficacy was the best predictor of planning and behaviour. Contrary to the tenets of HAPA and to past research, planning did not predict behaviour. Overall, HAPA provides a useful framework for identifying determinants of physical activity intentions and behaviour within a group of inactive, middle-aged women.

A Review of Acculturation Measures and Their Utility in Studies Promoting Latino Health.

The authors reviewed the acculturation literature with the goal of identifying measures used to assess acculturation in Hispanic populations in the context of studies of health knowledge, attitudes, and behavior change. Twenty-six acculturation measures were identified and summarized. As the Hispanic population continues to grow in the United States, there is a need to develop rigorous acculturation measures that include health indicators. Findings suggest that multidimensional acculturation scales are robust measurement tools when assessing nationality, cultural awareness, media and language preferences, and health status. Furthermore, aspects of Hispanic cultural lifestyle, such as beliefs about nutrition and physical activity, affect health care utilization, treatment, and prevention. Health communication researchers should consider aspects of cultural values and beliefs, and their impact on health status, for future research and health promotion interventions.

Media as social influence: racial differences in the effects of peers and media on adolescent alcohol cognitions and consumption.

Racial differences in the effects of peer and media influence on adolescents' alcohol cognitions and consumption were examined in a large-scale panel study. With regard to peer influence, results from cross-lagged panel analyses indicated that the relation between perceived peer drinking and own drinking was significant for both Black and White adolescents, but it was stronger for the White adolescents. With regard to media influence, structural modeling analyses indicated that exposure to drinking in movies was associated with more alcohol consumption 8 months and 16 months later. These effects were mediated by increases in the favorability of the adolescents' drinker prototypes, their willingness to drink, and their tendency to affiliate with friends who were drinking. Multiple group analyses indicated that, once again, the effects (both direct and indirect) were much stronger for White adolescents than for Black adolescents. The results suggest media influence works in a similar manner to social influence and that Whites may be more susceptible to both types of influence.

From willingness to intention: experience moderates the shift from reactive to reasoned behavior.

Three studies compared the predictive validity of three proximal antecedents to risk behavior: behavioral intention (BI), behavioral expectation (BE), and behavioral willingness (BW). In Study 1, BW was the only significant predictor of change in substance use in early adolescence (age 13), whereas only BI was significant in middle adolescence (age 16). In Study 2, BW was a better predictor of change in smoking among young adolescents than was BE, but BE became predominant by middle adolescence. By late adolescence, previous behavior surpassed both BE and BW. When only smoking initiation was examined, BW was a better predictor than was BE. In Study 3, BI, BW, and BE independently predicted class skipping. However, BI was a better predictor for students more experienced with the behavior, whereas BW was superior for less experienced students. The findings provide evidence of a developmental shift from more reactive to more reasoned processing, as experience with the behavior increases.

The impact of parenting on risk cognitions and risk behavior: a study of mediation and moderation in a panel of African American adolescents.

Hypotheses concerning the extent to which adolescents' cognitions mediate the relation between parenting behaviors and adolescent substance use were examined in a panel of African American adolescents (N = 714, M age at Time 1 = 10.51 years) and their primary caregivers. A nested-model approach indicated that effective parenting (i.e., monitoring of the child's activities, communication about substances, and parental warmth) was related to adolescent substance use more than 5 years later. The parenting behaviors protected the adolescent from subsequent alcohol, tobacco, and marijuana use through associations with two cognitive elements from the prototype/willingness model: favorable risk images (prototypes) and behavioral willingness. Additional analyses indicated that these protective effects were strongest among families residing in high-risk neighborhoods.

Families and risk: prospective analyses of familial and social influences on adolescent substance use.

Parental, peer, and older siblings' contributions to adolescents' substance use were investigated with 2 waves of panel data from 225 African American families. Structural equation modeling showed that older siblings' behavioral willingness (BW) to use substances at Time 1 (T1) predicted target adolescents' Time 2 (T2) use, controlling for other T1 variables. Regression analyses revealed an interaction between targets' and siblings' BW, such that targets were more likely to use at T2 if both they and their siblings reported BW at T1. This interaction was stronger for families living in high-risk neighborhoods. Finally, siblings' willingness buffered the impact of peer use on targets' later use: Low sibling BW was associated with less evidence of peer influence.