COVID-19 Vaccine-Related Beliefs and Behaviors Among Patients With and Survivors of Hematologic Malignancies.

PURPOSE: Patients with and survivors of hematologic malignancies are particularly vulnerable to COVID-19 disease and complications. This study examined patients' vaccination attitudes and behaviors and their correlates. METHODS: A two-wave survey was fielded in December 2020 and June 2021 among hematologic malignancy patients and survivors (N = 2,272). Demographic characteristics, intent to get vaccinated, vaccination status, attitudes toward vaccination, and level of trust in specific sources of information about COVID-19 vaccines were assessed. Descriptive statistics were calculated, and linear probability models were estimated to examine binary outcomes and their correlates. RESULTS: In December 2020, before COVID-19 vaccines were available, 73% stated they were likely or very likely to get vaccinated if an FDA-approved vaccine became available; however, in June 2021 over 90% reported being vaccinated. Being younger, unmarried, trusting local faith leaders, and not having a bachelor's degree or more were negatively associated with getting vaccinated. Among those hesitant in December 2020, those who expressed a distrust of vaccines in general were least likely to get vaccinated. Being vaccinated in June 2021 was positively associated with the degree to which respondents trust their oncologist, federal agencies, and pharmaceutical companies. Oncologists and primary care physicians were reported as the most trusted sources for information about vaccines. DISCUSSION: COVID-19 vaccine hesitancy remains a public policy concern even now, as additional boosters are recommended among vulnerable populations. Our findings suggest that patient trust in their treating physicians can play a critical role in promoting individual patient and public health goals.

A communication matrix intervention to increase adoption of federal government safety recommendations.

A 3-year, multichannel intervention project assessed adoption of federal government workplace safety testing methods among 3 randomly drawn samples of industrial hygienists. A communication matrix (McGuire, 1985, 1989) framework focusing on stages of reception, processing, and response was used to create, implement, and evaluate the intervention. Participants were interviewed by phone during 3 waves: baseline, immediately following year 1 of the intervention, and immediately following year 2 of the intervention. Results indicate a gain in reception over the course of the intervention. Increases in attitudes, control beliefs, intentions, and self-reported behavior were found between baseline and the 1st year of the intervention, and were maintained (although not increased) during the 2nd year of the intervention. Strengths and weaknesses of the intervention are viewed through the scope of the communication matrix.

An examination of antecedents to coal miners' hearing protection behaviors: a test of the theory of planned behavior.

PROBLEM: The National Institute for Occupational Safety and Health's [NIOSH] National Occupational Research Agenda (DHHS Publication No. 96-115) reports that approximately 50% of miners will experience hearing loss by age 50, compared to only 9% of the general population. The present investigation examines three antecedents believed to be associated with miner's use of hearing protection. METHOD: A posttest-delayed-posttest-control group field research design was employed to assess antecedents toward wearing hearing protection. RESULTS: Following the initial posttest, miners' attitudes and subjective norms were antecedents to intentions to wear hearing protection devices. Also, intentions toward wearing hearing protection predicted hearing protection behaviors. Approximately six weeks later, miners' attitudes and perceived behavioral control were each significant predictors of intentions to wear hearing protection and again, intentions were positively associated with hearing protection behaviors. IMPACT ON INDUSTRY: Our results indicate that appeals to normative influences may be the most effective antecedent to employ when persuading coal miners to wear hearing protection. However, messages designed to impact attitudes and perceived behavioral control were also effective.

Formative field experiments of a NIOSH alert to reduce the risks to firefighters from structural collapse: applying the cascade framework.

The authors report two field experiments aimed at testing the impact of government safety recommendations. Using a cascade framework from the Communication Matrix (McGuire, 1985, 1989), the study tested effects of reminder cards, message format, argument quality, and mailer types on indicators of reception, processing, and response. Systematic combinations of these variables were mailed to randomly selected firefighting units in the United States. Fire chiefs were contacted by phone to complete a survey within the next month (Experiment 1, N = 2,000, 44% completion; Experiment 2, N = 600; 77% completion). Results showed highest reception rates ( asymptotically equal to 50%) with one reminder card and the standard government low-graphics format and that greater reception produced stronger intentions. Processing was stronger with the standard government low-graphics format, and processing was correlated with more positive attitudes and intentions. Response indexes were favorable (>4 on -point scale) under all conditions. Outcomes are interpreted within the framework of a communication cascade model.

The cost-effectiveness of 1% or less media campaigns promoting low-fat milk consumption.

INTRODUCTION: The purpose of our study was to compare the cost-effectiveness of four strategies using components of 1% Or Less to promote population-based behavior change. 1% Or Less is a mass-media campaign that encourages switching from high-fat (whole or 2%) to low-fat (1% or skim) milk. Using a quasi-experimental design, campaigns were previously conducted in four West Virginia communities using different combinations of 1) paid advertising, 2) media relations, and 3) community-based educational activities. Telephone surveys and supermarket milk sales data were used to measure the campaigns' effectiveness. METHODS: Using data from the previously completed studies, we analyzed the cost of each campaign. We then calculated the cost per person exposed to the campaign and cost per person who switched from high- to low-fat milk. RESULTS: The combination of paid advertising and media relations was the most cost-effective campaign, with a cost of 0.57 dollars per person to elicit a switch from high- to low-fat milk, and the combination of media relations and community-based educational activities was the least cost-effective campaign, with a cost of 11.85 dollars per person to elicit a switch. CONCLUSION: Population-based campaigns using a combination of paid advertising and media relations strategies can be a cost-effective way to promote a behavior change in a community.

Using the theory of planned behavior and a stage model of persuasion to evaluate a safety message for firefighters.

A field study was conducted to evaluate the effectiveness of a National Institute for Occupational Safety and Health (NIOSH) health and safety message targeted at firefighters and to examine predictors of safety intentions among this group. This project examined: (a) the ability of the theory of planned behavior (TPB) to predict behavioral intentions for firefighters receiving a NIOSH occupational safety and health message; and (b) the use of a persuasion output matrix to assess message impact. A message about firefighting safety was nationally distributed to 36,000 fire chiefs, from which 781 were randomly selected to complete a survey assessing message impact and behavioral intentions. Results indicate message impact was weakest at the exposure, recall, and action stages of persuasion output. The TPB variables were found to significantly predict safety intentions.

"If we didn't use humor, we'd cry": humorous coping communication in health care settings.

Folkman and Lazarus's transactional theory of emotion and coping was used to explain how humor influences job satisfaction among health care providers. One hundred forty-two nurses completed measures of humor orientation (HO), coping efficacy, job satisfaction, and open-ended questions about their use of humor to relieve job tensions. This produced 9 categories of producing humor and 8 types of work situations identified in which humor was used to cope. Nurses (21.4%) reported using humor the most often during "patient care" situations (e.g., providing medicines, moving patients, physical therapy, and so on). More than one third (38.66%) of the nurses reported using "word-play/language" as a humorous coping strategy. Higher HO was associated with higher ratings of humor effectiveness, greater self-perceived coping efficacy, and higher emotional expressivity. Path analysis demonstrated that, as the transactional theory would predict, trait HO influences job satisfaction through its effect on heightened coping efficacy. Study limitations include the use of self-report methods and the limited number of responses to the open-ended items. Subsequent research in this area should attempt to validate the categories identified in this study and determine the most effective means of coping. Researchers also should explore differences in health care providers' coping communication based on gender, years of experience, and profession.

Using persuasive messages to encourage voluntary hearing protection among coal miners.

INTRODUCTION: This longitudinal field study was designed to encourage Appalachian coal miners in West Virginia and Pennsylvania to engage in hearing-protection behaviors. METHOD: Participants were mailed postcards that featured either a positive, negative, or neutral message on the outside of the postcard and a message encouraging hearing protection behaviors on the inside. The first posttest measurement of the effectiveness of the persuasive messages was conducted about a week after the postcards were mailed. The delayed posttest measurement was conducted six weeks later. RESULTS: Responses from 307 coal miners revealed that the positive or neutral messages generated significantly more self-reported hearing protection behaviors than the negative message. Identical results were obtained in a delayed posttest assessment of miners' self-reported hearing protection behaviors. The positive message was also more effective than either the neutral or negative message in preventing defensive mechanisms from emerging over time. IMPACT ON INDUSTRY: Positive and neutral messages were convincingly more successful than negative messages in facilitating self-reported hearing protection behaviors among coal miners. Similarly, the positive messages kept defensive processes at bay.

The message changes belief and the rest is theory: the "1% or less" milk campaign and reasoned action.

BACKGROUND: Theory-based approaches to public health interventions are useful for designing, implementing, and evaluating research. This paper describes and presents data to support the theoretical force behind the "1% or less" nutrition intervention studies. METHODS: Using the Theory of Reasoned Action (TRA), high-fat (whole and 2%) milk users were targeted. Supermarket milk sale data were collected, and randomly selected intervention and comparison community residents were surveyed via telephone to assess milk use. TRA constructs were used in the surveys that were conducted immediately before and after a 6-week mass media campaign. Campaign messages were aimed at changing behavioral rather than normative beliefs. RESULTS: We found significant and predicted changes in intervention participants on intention, attitude, and behavioral beliefs, but not subjective norm outcomes. A path model showed support that TRA variables mediated significant changes in self-reported milk use. CONCLUSIONS: The analysis further validates the TRAs and supports a template using both the Principle of Compatibility and TRA to aid development and implementation of messages for effective behavior change field interventions.