The Effects of Safe Zone Badges in Physicians' Online Biographies: Evidence from an Experimental Study.

Earning digital badges to showcase a person's expertise or knowledge are becoming increasingly popular. A healthcare provider's displaying of a Safe Zone badge within their online profile may offer prospective patients a cue as to the kind of care they might receive if they selected that particular provider. Prior research indicates LGBTQ+ individuals are looking for these types of cues within providers' biographies to make their selections. A between subjects, 2 (Safe Zone badge present/absent) x 2 (male/female doctor) online experiment was conducted (n = 658). Results revealed a main effect for the presence of the Safe Zone badge. Participants had greater anticipated satisfaction, liking, were more likely to view the provider as approachable, and were more willing to schedule an appointment with the provider displaying a Safe Zone badge.

College student gratitude: A silver lining while evaluating a yearlong bathroom stall messaging campaign.

OBJECTIVE: Mental health concerns of college students are on the rise, prompting a need for communication campaigns to address ways to assist students. The current campaign utilized weekly bathroom stall messaging to address five key themes developed by a university's mental wellness task force.Participants: Undergraduate students at a large Midwestern university.Methods: A survey at pre and post-campaign implementation.Results: No significant shifts in attitudes, and only one significant behavioral increase (i.e., reaching out to academic advisers), were revealed. One silver lining was that college students were found to express gratitude to someone new a median of 5 times per month. Gratitude tended to be displayed most recently to those in their social circles, and primarily for receiving instrumental support.Conclusions: Narrowing the focus of future mental wellness campaigns is recommended. Additional recommendations for developing future mental wellness campaigns are also addressed.

The Effect of Physician Immediacy on Patient Liking for Physician, Motivation, and Recall.

Guided by the fostering relationships function of patient-centered communication (PCC), the present study utilized a 2 (high/low nonverbal immediacy) x 2 (high/low verbal immediacy) between-subjects experimental design to determine whether physician verbal and nonverbal immediacy influenced participant liking for physician, motivation to process a health message, and recall of the health message. An actor physician delivered a 3-4 minute video-recorded message, diagnosing U.S. adult participants, serving as analogue patients, with a health issue. The results indicated main effects for physician verbal immediacy and nonverbal immediacy on participant liking for physician and motivation such that participants had greater liking for the physician and motivation to do what the physician requested when the physician demonstrated greater verbal and nonverbal immediacy. However, physician verbal and nonverbal immediacy did not influence participants' recall. Physicians should consider displaying verbal and nonverbal immediacy to create a positive impression among patients, and to motivate patients to take steps to improve their health.

Patients' Perceptions of Health Care Providers' Dismissive Communication.

Some patients experience negative interactions with health care providers, such as when they perceive that their concerns are ignored by providers. The present study, guided by patient-centered communication, examined health care provider communication behaviors that resulted in patients feeling dismissed, and whether there were differences in providers who dismissed being perceived as (dis)similar to the patients in gender, race/ethnicity, or age. U.S. adults claiming they felt dismissed by a provider were asked to recall demographic information they perceived about the provider and what the provider said that was dismissive. Responses were coded for emergent themes. Results revealed that younger, female, and non-White participants most frequently reported being dismissed by a dissimilar provider. Patients felt dismissed when they perceived that providers were rude or did not take action, provided poor information, did not believe patients, rushed the visit, or were uninformed. Providers may want to avoid these behaviors and could consider obtaining training in supportive communication behaviors such as providing validation to patients and listening to patients in order to enhance patient satisfaction. Patients can also receive communication training to take a more active role in their medical encounters by learning to effectively ask questions, express preferences, and speak up for themselves.

When Doctors Swear, Do Patients Care? Two Experiments Examining Physicians Cursing in the Presence of Patients.

Swearing in everyday conversation has become more normalized in recent years; but less certain, however, is how accepting Americans are when a doctor swears in their presence. Two online experiments (Study 1: n = 497; Study 2: n = 1,224) were conducted with US participants to investigate the impact of a doctor swearing in the course of examining a patient's infected wound (i.e., "You've got a lot of nasty [shit/stuff] in there that we're going to want to flush out"), or swearing when dropping papers in a patient's presence while varying the intensity of a swear (i.e., "[Shit!/Damn!/Whoops!]"), with or without an apology (i.e., "I'm sorry"). Overall findings reveal a main effect for swearing, with a swearing doctor generally seen as less likable, and in Study 1, less trustworthy, approachable, and less of an expert. However, the majority of participants exposed to a swearing doctor still said they would visit that physician again. Open-ended responses from these participants revealed that they perceived a swearing doctor as more human. Results from Study 2 also found that if a doctor swore, the negative impact was lessened if the doctor apologized immediately after cursing. While results from these studies indicate it is wise for doctors to refrain from swearing, most participants were still willing to make a future appointment with a cursing doctor.

Examining Variation in Emotional Distress among Individuals with a Cancer Diagnosis.

This study examined whether emotional distress among U.S. adults diagnosed with cancer was influenced by death rates, survival rates, and new cases based on cancer type and individual-level variables (health efficacy, perceived health, and use of information and communication technologies and social media for health-related reasons). Health Information National Trends Survey 5 data from cycle 1 and cycle 2 were used to examine emotional distress among individuals who had experienced 1 of 17 different types of cancer diagnoses. A multilevel model and follow-up one-way ANOVA indicated a small statistically significant difference in emotional distress across cancer types. To investigate the influence of individual-level variables on emotional distress, a hierarchical regression analysis indicated that, after controlling for perceived health and health efficacy, using social media in a greater number of health-related ways significantly predicted greater emotional distress, while using information and communication technologies in a greater number of health-related ways did not.

Healthcare Provider Analogies as Memorable Messages.

Healthcare providers must explain medical information to patients in a way that patients can understand. Provider use of analogies is one strategy that may help patients better understand medical information. The present study, guided by a memorable message framework, investigated whether participants remembered any analogies used by their healthcare providers, and included a content analysis of the function the analogies served, the types of analogies participants remembered, and the body systems associated with the health issues that were described. Almost one-quarter of participants recalled an analogy used by a provider. The most frequently recalled analogies functioned to describe health conditions or phenomena, followed by elements of the body, and treatments or something external to the body. Analogies were most frequently used to describe health issues associated with the cardiovascular system, musculoskeletal system, digestive system, dental, eye, or skin issues, or the nervous system. The analogies were categorized as mechanical, a feeling or experience, random object, structure, food, nature, war/battle, or medical/body. Provider analogies may be a type of memorable message for some patients. Providers could consider using suitable analogies to explain health issues when communicating with patients, and be trained in effective use of analogies.

Evaluating a Health Literacy Communication Training for Medical Students: Using Plain Language.

Medical students tend to use technical terminology without explanation when communicating with patients, and do not feel confident interacting with patients who have low health literacy (LHL). The present study consisted of an evaluation of a brief health literacy training for first-year medical students seeking to enhance their knowledge of health literacy, self-efficacy in communicating with patients who have LHL, and clear communication skills. The training was guided by patient-centered communication, social cognitive theory, and the universal precautions approach to health literacy, and developed and delivered by communication scholars. Results indicated that medical students had increased health literacy knowledge, confidence in communicating with patients who have LHL, and found the training to be useful. Medical student interactions with standardized patients from the cohort who received the training were compared with the previous year's cohort who did not receive the training. Analysis of transcripts of interactions after the training indicated no significant differences in medical students' use of examples. Health literacy trainings should be incorporated into the medical student curriculum, taught in collaboration with communication scholars, and be given more frequently throughout the medical school career to reinforce utilization of clear communication strategies.

Online information seeking behaviors of breast cancer patients before and after diagnosis: From website discovery to improving website information.

Despite the internet being a common place breast cancer patients seek information, navigating this Wild West of content can be challenging. The present study analyzed open-ended data from breast cancer survivors (n = 77) regarding their online information seeking behaviors when looking for breast cancer information to help inform the creation of improved online educational materials. Participants were asked what prompted them to seek information, which websites and search terms they used both before and after diagnosis, what information was useful, what misinformation was found, and what they would like to see improved. Results indicated symptoms, tests, or diagnoses prompt women to seek breast cancer information online, and that many different search terms and websites are used. More search terms and websites were utilized after diagnosis compared to before diagnosis, but the most common search terms and websites did not change much from before to after diagnosis. Cancer specific and general medical websites were the most popular. The most useful information related to treatment, obtaining information from other breast cancer survivors, statistics, and positively-valenced information. Though misinformation was not reported by many participants, some mentioned outdated survival rates, inaccurate information about alternative treatments, and other breast cancer patients' experiences that did not align with their own. Participants desired improvements in treatment information, more factual information, a guide, and information that is easy to understand. Creation of a guide and use of search engine optimization to help breast cancer patients navigate this online information could be beneficial.

The Buffering Effect of Health Care Provider Video Biographies When Viewed in Combination With Negative Reviews: "You Can't Fake Nice".

BACKGROUND: Patients seek information from numerous sources before choosing a primary care provider; two of the most popular sources are providers' own online biographies and patient rating websites. However, prior research has generally only examined how these sources influence patients' decisions in isolation. OBJECTIVE: This study aimed to determine how primary care providers' online biographies and online patient ratings interact to affect patients' decision making, especially in the face of negative reviews. METHODS: An 8-condition online experiment (n=866) was conducted, manipulating patient ratings and the timing of viewing a provider's online biographical video (pre- or postrating viewing). RESULTS: When participants were shown a short video introduction of a provider after reading predominantly negative reviews a positive expectancy violation occurred, which was also related to more positive perceptions of the provider. When exposed to all negative reviews, 43% of participants indicated they would still choose to make an appointment with the provider, with many indicating that the video provided the evidence needed to help make up their own minds. CONCLUSIONS: These findings are especially relevant to health care organizations seeking to combat a recent rise in fake patient reviews. Providing patients with realistic expectations of the care that clinicians can offer via their own online biographical videos can help counteract negative patient comments online.

Preventive/office visit patient knowledge and their insurance information gathering perceptions.

OBJECTIVES: To better understand patients' levels of health literacy regarding what constitutes no-cost preventive visits versus possibly costly office visits and their ease of obtaining information about coverage and costs from providers and health insurance companies. STUDY DESIGN: A cross-sectional online survey of 866 participants aged 18 to 82 years from 49 states. METHODS: Participants' knowledge of preventive versus office visits was assessed through a series of true/false questions. Participants rated their ease of obtaining information from health insurance providers and doctors about costs and coverage. They also described phone calls with their health insurance companies via an open-ended question. Logistic regression was used to predict how the ease of obtaining information is related to being erroneously charged for a medical visit. RESULTS: About two-thirds of participants were unable to answer all knowledge questions correctly regarding the differences between preventive and office visits. Participants reporting a greater ease of obtaining information from health insurance providers were less likely to indicate being erroneously charged for medical visits. About 15% rated their calls with insurance companies as negative. CONCLUSIONS: Many Americans have limited health literacy regarding what constitutes a preventive care visit. Support must continue to educate the population about preventive care visits and improve the ease of obtaining information from health insurance companies about preventive coverage.

Hashtag Health: College Health on Social Media and Students' Motivations to Follow, Interact, and Share Their Social Media Content.

Social media are advocated as a prime channel through which to reach college students with health-related information. However, how well are colleges and universities utilizing social media as it was intended-a means to be truly social and not just promotional? Social media can only be effective if students actually follow, interact, and share the content being produced. The following study completed a census of student health center Facebook accounts in the United States as well as investigated students' motivations to follow, interact with, and share health-related content. Facebook pages were found for about 20% of student health centers, and about two thirds posted content within the past 14 days. However, their median number of "likes" was between 191 and 496 despite being in existence for an average of 6 years. Additionally, the majority of these centers' most recent posts were promotional, instead of trying to socially engage with their followers. Students indicated that they would be likely to follow, interact, or share social media content from college health accounts if they were incentivized to do so, if they thought the content could be relevant to them, or if they simply knew that the account existed. Unless more attention is given to growing their followings, resources used by student health organizations to consistently post content might be better placed elsewhere. Recommendations for increasing engagement with students are discussed.

Addressing Health Disparities in America: Analysis of Community Health Improvement Plans.

BACKGROUND: Healthy People 2020 has made achieving health equity one of its overarching goals; another goal is increasing the number of accredited local agencies that have Community Health Improvement Plans (CHIPs). Community Health Improvement Plans are meant to serve agencies as guiding documents for multiple years. OBJECTIVES: This study investigates the prevalence with which health disparities are addressed within CHIPs and the specific health disparities targeted by these objectives. METHODS: Researchers analyzed 4,094 objectives from CHIPs of 280 local Public Health Accreditation Board (PHAB)-accredited and nonaccredited public health agencies in the United States. RESULTS: Despite the PHAB's focus on addressing health equity, not all PHAB-accredited agencies addressed health disparities (85.4% of CHIPs analyzed). However, more accredited than nonaccredited agencies (73.9%) contained at least one objective focused on health disparities. DISCUSSION: Findings indicate that if health equity is truly a goal of national initiatives, agencies' planning documents (e.g., CHIPs) can do a better job addressing commonly ignored populations.

Epigeneti-What? Approaches on Translating Research for Primary Breast Cancer Prevention.

In fiscal year 2017, the National Cancer Institute devoted more than a half billion dollars to breast cancer research. Since 2012, the total investment has been more than $3 billion. Despite this significant investment, breast cancer still has no known immediate causes as it generally develops over the life course. Therefore, research is unable to provide the public any sort of magic bullet, or conclusive link between certain environmental exposures and the development of breast cancer later in life. What research is only able to report are likelihoods-possible links-things people might want to consider avoiding or doing in their everyday lives to reduce their future risks of developing breast cancer. This abundance of rigorously performed, albeit causally inconclusive, research focused on "plausible" links poses a challenge for health communicators who are tasked with seeking to find ways to translate this science into advice that people can act upon today. However, if society must wait for the science to provide 100% conclusive evidence before anyone ever takes action, how many lives could have been saved in the interim? Therefore, we advocate a two-pronged approach to translating scientific findings regarding environmental exposures and breast cancer prevention: a bottom-up approach-focused on informing the lay public and individuals, while simultaneously performing a top-down approach-focused on influencing policymakers. The current perspective analyzes the strengths and weaknesses to both of these approaches, and encourages scientists to work closely with health communicators to develop theoretically-driven strategies to drive positive changes over time.