Examining the Psychological Mechanisms Underlying Nostalgia Appeals: A Comparative Experiment of Nostalgia and Regret.

Obesity rates remain high among U.S. adults, especially rural residents. Research has shown that nostalgia appeals effectively promote several healthy behaviors. However, the psychological mechanisms underlying nostalgia appeals remain unclear. This study examined the effects of nostalgia appeals on intention to increase exercise and shed light on how nostalgia affected persuasive outcomes. We anticipated that nostalgia appeals would persuade people by enhancing self-esteem and reducing anger and counterarguing. To illuminate the mechanisms underlying the effects of nostalgia, a between-subject experiment (nostalgia appeal vs. regret appeal vs. irrelevant message vs. neutral persuasive message) was conducted among overweight or obese rural Michiganders (N = 507). Results showed that relative to the regret appeal, the nostalgia appeal led to higher state self-esteem, less anger, and less counterarguing. There was no significant difference in attitude or behavioral intention between the nostalgia appeal, regret appeal, and neutral persuasive message. We demonstrated that enhancing self-esteem was the key mechanism by which the nostalgia appeal persuaded the target audience.

The Role of Collective Group Orientation and Social Norms on Physical Distancing Behaviors for Disease Prevention.

To reduce the impact of communicable diseases like COVID-19, collective action is required and likely to be susceptible to normative influence as well as whether people are more or less collectively oriented. We extend the theory of normative social behavior (TNSB) to account for group orientation and predict the relationships between social norms and physical distancing behaviors. Using a rolling cross-sectional design during 17 weeks of the pandemic, a national sample of US residents from 20 states (N = 8,778) participated in the study. The findings show that perceived descriptive norms, injunctive norms, and group orientation are significantly associated with physical distancing. The descriptive norm-behavior relationship and injunctive norm-behavior relationship are moderated by group orientation and the other predicted moderators in the TNSB. The findings extend the TNSB and highlight the need to understand social norms and group orientation in formative research for health communication campaigns designed to promote prevention behaviors.

The effects of moral norms and anticipated guilt on COVID19 prevention behaviors.

Studies have shown that older adolescents have a low perceived personal risk of COVID-19, and yet their ability and willingness to engage in COVID-19 prevention behaviors is imperative for community health. Thus, health communication scholars need to consider alternative psycho-social predictors of prevention behaviors that will assist in protecting others in a pandemic. Based on Schwartz's Norms Activation Model (NAM; Schwartz, 1977), we examined the relationship between moral norms and COVID-19 prevention behaviors (mask wearing and physical distancing). We predicted that anticipated guilt would mediate the relationship between moral norms and intention to engage in prevention behaviors, and that collective orientation would strengthen the association between moral norms and anticipated guilt. We tested predictions with data from a cross-sectional survey with a probability-based sample of college students at a large land grant university. These data indicated that moral norms were associated with behavioral intention, and this relationship was mediated by anticipated guilt. Collective orientation was found to moderate the relationship between moral norms and anticipated guilt in the context of physical distancing but not mask wearing. These findings suggest that making moral norms salient when designing an intervention is an effective strategy for older adolescents. Supplementary information: The online version contains supplementary material available at 10.1007/s12144-023-04477-5.

Predicting Breastfeeding Intentions: A Test and Extension of the Theory of Normative Social Behavior with African American Social Identity.

Breastfeeding is a health promoting social behavior but statistics suggest a persistent disparity of lower rates among African American mothers. The Theory of Normative Social Behavior (TNSB) explains when and how norms influence behaviors, but has produced inconsistent results with respect to proposed moderators group identity and injunctive norms (IN), limiting its predictive value in diverse cultural groups. Cultural norms are one of many influences on breastfeeding behaviors, yet little is known about their mechanisms of influence. The TNSB has not been tested in the breastfeeding context or within an exclusively African American cultural group. Given this knowledge gap, a survey of 528 African American mothers in the Washington, D.C. area was conducted to test the moderating effects of IN and subjective norms (SN) and social identity on the descriptive norms (DN) to intentions relationship as predicted by the TNSB. Structural equation modeling was used to show that when controlling for education and breastfeeding history, norms significantly predicted 26.4% of the variance in breastfeeding intentions. SN and DN interacted negatively to enhance breastfeeding intentions. Latent profile analysis using ethnic pride, collectivism, and religiosity scales detected four profiles of African American social identity. Social identity profile membership was a significant moderator on the DN to intentions pathway in the structural equation model. Profiles with the highest ethnic pride were significantly influenced by DN to intend to breastfeed. Implications from this study for public health intervention and communication messaging are discussed.

Rumour spread and control during the West African Ebola epidemic in Liberia.

The severity of the 2014-15 West African Ebola epidemic in Liberia was coupled with widespread misunderstanding of the virus among citizens and the proliferation of rumours. Rumour control during outbreaks is imperative to reduce the public's fears about a disease. In Liberia, a tracker system was developed to detect rumours as quickly as possible through SMS (short message service) text messaging. This study focused on assessing rumour circulation in newspapers and on radio and rumour control over time. It relied on a content analysis of SMS messages from the 'DeySay' tracker, print and audio communications of newspapers, and radio programmes, in the time frame between January 2014 and March 2015. The findings show that more rumours appeared in newspapers but were more likely to be overtly characterised as such on the radio. DeySay accurately predicted rumours before they appeared on the radio and in newspapers, supporting its usefulness in future health epidemics.

Improving African American women's engagement in clinical research: A systematic review of barriers to participation in clinical trials.

BACKGROUND: Despite multiple efforts, African American women continue to be inadequately represented in clinical research while being overrepresented in disease, producing research results with limited generalizability to this specific population. Our understanding of the barriers to participation in clinical trials among racial/ethnic minority patients in general has evolved, but few studies have examined the reasoning behind African American women's decision to not participate in clinical trials. OBJECTIVE: The primary aim was to conduct a systematic review to identify the barriers reported by African American women regarding participation in clinical research to help explain the low levels of enrollment. We also suggest strategies that can be implemented by the research community to lessen the effect of those barriers. METHODS: Searches were conducted through MEDLINE, SCOPUS, Web of Science, and Google Scholar. Following a set of eligibility criteria, a total of 18 peer-reviewed journal articles were selected and analyzed to render categories and themes. RESULTS: Across studies aimed at examining their unique perspective, the reasons mentioned by African American women for not participating in clinical research were grouped in three broad categories: 1) weak relationship with the medical and research community, 2) high cost to participation, and 3) personal and "out-of-reach" circumstances. Reasons pertaining to participants' relationship with physicians/researchers were most salient. DISCUSSION: A targeted and comprehensive understanding of the barriers impacting African American women's decision to participate in clinical research informs population-specific recruitment and research strategies for future studies. Additional studies assessing barriers to clinical trial research participation that intentionally report on disaggregated data by not only race/ethnicity but also sex are essential to improving the risk/benefit profile for a wide range of prevention and treatment efforts. This improved understanding of the differences between subgroups within minority populations has implications for bolstering culturally sensitive messages to enhance the engagement of minority communities in clinical trial research.

Reversing the Antibiotic Resistance "Yelp Effect" Through the Use of Emotionally Framed Responses to Negative Reviews of Providers: Questionnaire Study.

BACKGROUND: The overuse of antibiotics has rapidly made antimicrobial resistance a global public health challenge. There is an emerging trend where providers who perceive that their patients expect antibiotics are more likely to prescribe antibiotics unprompted or upon request. Particularly, health care providers have expressed concern that dissatisfied patients will provide disparaging online reviews, therefore threatening the reputation of the practice. To better deal with the negative reviews and inform patients, some health care staff directly respond to patients' online feedback. Engaging with patients' online reviews gives providers an opportunity to prevent reputational damage and improve patients' understanding of the antibiotic resistance problem. OBJECTIVE: We aim to test the effectiveness of different response strategies to the negative patient online reviews on the readers' perceptions of the health care provider and their perceptions related to antibiotics resistance. METHODS: Two experiments were conducted to examine the impact of message tactics (apologizing, inducing fear or guilt) that can be employed by health care providers when responding to patients' negative online feedback related to not receiving an antibiotic. RESULTS: Overall, our results demonstrated positive impacts of responding to patients' online reviews. In study 1, we found apologetic messaging and use of emotional appeals in the response were effective in making readers feel more favorable toward the message. Readers also expressed a greater credibility perception toward the provider and willingness to visit the clinic when emotional appeals were used. Findings from study 2 largely supported the effectiveness of a fear-based response in improving the readers' credibility perceptions and willingness to visit the clinic. The fear-inducing information was particularly effective among parent readers. CONCLUSIONS: This paper demonstrated that a strategic response to online patient complaints could prevent reputational damage and minimize the potential negative impacts of the review. The results also glean insight into the step toward developing a novel intervention-crafting a persuasive response to patients' negative feedback that can help improve the understanding of antibiotic resistance problems.

Speaking of Values: Value-Expressive Communication and Exercise Intentions.

This study introduces the concept of value-expressive communication and examines its relationship with behavioral intent. Value-expressive communication is conceptualized as the verbal output of a value-expressive attitude. Value-expressive communication about exercise is examined in relationship to strength of religious faith, exercise attitudes, communication frequency, and intentions to exercise among a sample of self-identified Christians. The data indicate a significant interaction between value-expressive communication and communication frequency explains significant variance in exercise intentions. Interact to and exercise attitudes is significantly associated with intentions to exercise. Suggestions for using value-expressive communication in health communication research and practice are discussed.

Questioning the Yelp Effect: Mixed Methods Analysis of Web-Based Reviews of Urgent Cares.

BACKGROUND: Providers of on-demand care, such as those in urgent care centers, may prescribe antibiotics unnecessarily because they fear receiving negative reviews on web-based platforms from unsatisfied patients-the so-called Yelp effect. This effect is hypothesized to be a significant driver of inappropriate antibiotic prescribing, which exacerbates antibiotic resistance. OBJECTIVE: In this study, we aimed to determine the frequency with which patients left negative reviews on web-based platforms after they expected to receive antibiotics in an urgent care setting but did not. METHODS: We obtained a list of 8662 urgent care facilities from the Yelp application programming interface. By using this list, we automatically collected 481,825 web-based reviews from Google Maps between January 21 and February 10, 2019. We used machine learning algorithms to summarize the contents of these reviews. Additionally, 200 randomly sampled reviews were analyzed by 4 annotators to verify the types of messages present and whether they were consistent with the Yelp effect. RESULTS: We collected 481,825 reviews, of which 1696 (95% CI 1240-2152) exhibited the Yelp effect. Negative reviews primarily identified operations issues regarding wait times, rude staff, billing, and communication. CONCLUSIONS: Urgent care patients rarely express expectations for antibiotics in negative web-based reviews. Thus, our findings do not support an association between a lack of antibiotic prescriptions and negative web-based reviews. Rather, patients' dissatisfaction with urgent care was most strongly linked to operations issues that were not related to the clinical management plan.

Using a Community-Based Participatory Mixed Methods Research Approach to Develop, Evaluate, and Refine a Nutrition Intervention to Replace Sugary Drinks with Filtered Tap Water among Predominantly Central-American Immigrant Families with Infants and Toddlers: The Water Up @Home Pilot Evaluation Study.

Descriptions of the implementation of community-based participatory mixed-methods research (CBPMMR) in all phases of the engagement approach are limited. This manuscript describes the explicit integration of mixed-methods in four stages of CBPR: (1) connecting and diagnosing, (2) prescribing-implementing, (3) evaluating, and (4) disseminating and refining an intervention that aimed to motivate Latino parents (predominantly Central American in the US) of infants and toddlers to replace sugary drinks with filtered tap water. CBPMMR allowed for co-learning that led to the identification of preliminary behavioral outcomes, insights into potential mechanisms of behavior change, and revisions to the intervention design, implementation and evaluation.

Too stringent or too Lenient: Antecedents and consequences of perceived stringency of COVID-19 policies in the United States.

In the United States, federal and local governments have attempted to contain the spread of Coronavirus Disease 2019 (COVID-19) by implementing a variety of policies such as stay-at-home orders and mask mandates. Perceptions can influence behaviors; therefore, it is important to understand how people perceive the stringency of COVID-19 policies, what factors shape perceived policy stringency, and whether and how policy perceptions impact the practice of prevention behaviors. With rolling-cross sectional survey data collected in the US from June to October 2020 and other external sources of data, the study examines the impact of objective risk of the pandemic, information seeking, and political ideology at the individual and the state levels on perceived policy stringency, and the impact of perceived policy stringency on prevention behaviors such as mask wearing and social distancing. The findings reveal that objective risk and political ideology are significantly associated with perceived policy stringency. The perceived policy stringency has negative associations with prevention behaviors. The findings provide important implications for the development process of compulsory public health policies during the pandemic.

Breastfeeding in Context: African American Women's Normative Referents, Salient Identities, and Perceived Social Norms.

The purpose of this study was to describe social norms and salient social identities related to breastfeeding intentions among African American mothers in Washington, D.C. Five focus groups were held with 30 mothers who gave birth to a child between 2016 and 2019. Two coders conducted pragmatic thematic analysis. This study demonstrated that women hold different identities relevant to making infant feeding decisions, with mother being primary and race/ethnicity, age, and relationship status factoring into how they define themselves. Mothers drew their perceptions of what is common and accepted from family, friends, the "Black community," and what they perceived visually in their geographic area and heard from their health care providers. Mothers believed breastfeeding to be increasing in popularity and acceptability in African American communities in Washington, D.C., but not yet the most common or accepted mode of feeding, with some variability by socioeconomic status group. Implications for public health communication and social marketing are discussed.

Racism and Resistance: A Qualitative Study of Bias As a Barrier to Breastfeeding.

Background: Nearly 75% of Black non-Hispanic babies born in 2016 ever breastfed. However, Black mothers still experience barriers to breastfeeding, perpetuating disparities in exclusivity and duration. Subjects and Methods: Using data collected from five focus groups with Black mothers (N = 30) in Washington, District of Columbia during summer 2019, we critically examine the influence of institutionalized and personally mediated racism on breastfeeding. We also explore the counter-narratives Black women use to resist oppression and deal with these barriers. Results: Themes surrounding institutionalized racism included historic exploitation, institutions pushing formula, and lack of economic and employment supports. Themes regarding how personally mediated racism manifested included health care interactions and shaming/stigma while feeding in public. At each level examined, themes of resistance were also identified. Themes of resistance to institutionalized racism were economic empowerment and institutions protecting breastfeeding. Themes of resistance to personally mediated biases were rejecting health provider bias and building community. Conclusions: There are opportunities for health providers and systems to break down barriers to breastfeeding for Black women. These include changes in clinical training and practice as well as clinicians leveraging their position and lending their voices in advocacy efforts.

Raising a Red Flag on Dating Violence: Evaluation of a Low-Resource, College-Based Bystander Behavior Intervention Program.

Encouraging bystanders to intervene safely and effectively in situations that could escalate to violence-known as bystander behavior programs-is a growing yet largely untested strategy to prevent dating violence. Using a quasi-experimental design, we evaluate a low-resource, low-intensity intervention aimed at preventing dating violence among college students. The integrated behavioral model (IBM) was used to guide the evaluation. We also assess which IBM variables were most strongly associated with bystander behaviors. Participants were drawn from two Virginia colleges that predominantly train females in the health profession sciences. The intervention group ( n = 329) participated in a university-wide bystander behavior intervention consisting of a 30-min presentation on dating violence at new-student orientation and a week-long "red flag" social marketing campaign on campus to raise awareness of dating violence. Controlling for changes at the comparison university, results showed an increase in bystander behaviors, such as encouraging a friend who may be in an abusive relationship to get help, after the intervention and adjusting for potential confounders (increase of 1.41 bystander behaviors, p = .04). However, no significant changes were found for bystander intentions, self-efficacy, social norms, or attitudes related to dating violence from pre- to post-intervention. Self-efficacy had a direct relationship with bystander behaviors. Results suggest that low-resource interventions have a modest effect on increasing bystander behaviors. However, higher resource interventions likely are needed for a larger impact, especially among students who already demonstrate strong baseline intentions to intervene and prevent dating violence.

The Relationship Between Advertising-Induced Anger and Self-efficacy on Persuasive Outcomes: A Test of the Anger Activism Model Using the Truth Campaign.

Turner's Anger Activism Model (AAM) contends anger and efficacy interact in a unique way to determine message responses to campaign materials. This study tested the AAM using responses to 2 truth antismoking advertisements collected in August-October 2014 via an online, cross-sectional survey of 15- to 21-year-olds. Those aware of each of the truth advertisements (n = 319 for each) were organized into 4 anger/efficacy groups. Analysis of variance and regressions were conducted to understand group differences in message-related cognitions (persuasiveness, receptivity, conversation). Message cognitions were highest among the high anger/high efficacy group and lowest among the low anger/low efficacy group.

Do Sexual Assault Bystander Interventions Change Men's Intentions? Applying the Theory of Normative Social Behavior to Predicting Bystander Outcomes.

The high prevalence of sexual assault on college campuses has led to the implementation of health communication programs to prevent sexual assault. A few novel programs focus on primary prevention by targeting social norms related to gender and masculinity among men through bystander intervention. Guided by the theory of normative social behavior, this study sought to examine the relative effect of campaigns communicating positive versus negative injunctive norms and the interaction between exposure to such campaign messages and perceived descriptive norms and relevant cognitive moderators (e.g., outcome expectations, injunctive norms, group identity, ego involvement) among men. A 2 (high/low descriptive norms) × 2 (high/low moderator) × 3 (public service announcement) independent groups quasi-experimental design (N = 332) was used. Results indicated that messages communicating positive injunctive norms were most effective among men who were least likely to engage in bystander intervention. Furthermore, descriptive norms played a significant role in behavioral intentions, such that those with stronger norms were more likely to report intentions to engage in bystander behaviors in the future. Similarly, the moderators of aspiration, injunctive norms, social approval, and ego involvement had a significant positive effect on behavioral intentions. These findings have important implications for future message design strategy and audience segmentation.

Predicting visual attention to nutrition information on food products: the influence of motivation and ability.

Obesity is linked to numerous diseases including heart disease, diabetes, and cancer. To address this issue, food and beverage manufacturers as well as health organizations have developed nutrition symbols and logos to be placed on the front of food packages to guide consumers to more healthful food choices. In 2010, the U.S. Food and Drug Administration requested information on the extent to which consumers notice, use, and understand front-of-package nutrition symbols. In response, this study used eye-tracking technology to explore the degree to which people pay visual attention to the information contained in food nutrition labels and front-of-package nutrition symbols. Results indicate that people with motivation to shop for healthful foods spent significantly more time looking at all available nutrition information compared to people with motivation to shop for products on the basis of taste. Implications of these results for message design, food labeling, and public policy are discussed.

Predicting psychological ripple effects: the role of cultural identity, in-group/out-group identification, and attributions of blame in crisis communication.

Incidents of intentional food contamination can produce ripple effects in consumers such as reduced trust and increased anxiety. In their postcrisis communication, food companies often direct the blame at the perpetrator in an effort to mitigate potential losses and regain consumer trust. The attempt to placate consumers may, in itself, potentially create psychological ripple effects in message readers. This study examined the interacting influence of two message characteristics: identity of the perpetrator of the crime (in-group/out-group membership), and the attribution of blame (reason why the perpetrator committed the crime), with message receiver characteristic (cultural identity) on psychological ripple effects such as blame, trust, anxiety, and future purchase intention. Results indicated that although group membership of the perpetrator was not significant in predicting outcomes for the organization, the attribution communicated in the message was. American message receivers blamed the organization more and trusted it less when personal dispositional attributions were made about the perpetrator. Asian message receivers blamed the organization more and trusted it less when situational attributions were made about the perpetrator. Lowered trust in the company and increased anxiety correlated with lower purchase intent for both American and Asian message receivers. Implications for crisis message design are discussed.