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.

Physicians Disclosing Religion in Online Biographies: Patient Perceptions and Decision-Making in the United States.

The inclusion of personal information about a healthcare provider is becoming more prevalent within online biographies as a means to help patients make more informed decisions about their future care. While many physicians indicate they are religious, and that spiritual well-being is an important part of one's overall health, what is unclear is what impact this sort of disclosure within an online biography might have on a prospective patient's perceptions of that provider. The current study took the form of a 2 (gender of provider: man; woman) × 2 (religion disclosure: yes; no) × 2 (activity: singing in choir; playing on softball team) between-subjects experiment. Participants (n = 551) in the USA were randomly assigned to view one of the eight biography conditions and then asked to rate their perceptions of the physician, and whether they would choose to make a future appointment with that physician. While there were no differences in perceptions (e.g., liking, trustworthiness), more participants who viewed a biography with a religion disclosure indicated an unwillingness to make a future appointment with that physician. A moderated mediation analysis revealed that this effect is only significant for participants with low levels of religiosity and is explained by these participants feeling less similar to an explicitly religious physician. Open-ended responses justifying their decisions found that religion disclosure played a much larger role in not choosing the physician (20% of responses) than for choosing the physician (3% of responses). However, participants wanting a physician of a different gender was the most cited reason for not wanting to select the provider (27.5% of responses). Recommendations for physicians contemplating adding an item about religion within their online biographies are discussed.

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.

Mindfulness messages on napkins: The efficacy of dining hall napkins as a messaging channel.

OBJECTIVE: To assess the efficacy of utilizing dining hall napkins as a novel health messaging strategy to promote mindfulness. PARTICIPANTS: Undergraduate students at a large Midwestern university.Methods: Utilizing a place-based promotional strategy, mindfulness messages were printed on over 8-million napkins at dining halls. Surveys (N = 573) were used to measure message viewership, and attitudes toward mindfulness. RESULTS: While only a few small significant effects for students who read the messaging were found (e.g., increases in self-efficacy for keeping ones phone out of sight while speaking with someone), napkins appeared to be a successful channel for reaching students. About 97% of students who dined in-person indicated they saw the napkin messaging. Additionally, students were more likely to read the napkin messaging when dining in-person rather than when they took their food "to-go." CONCLUSION: Future research should continue to test napkins' efficacy as a messaging channel for health messaging for college students.

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.

The state of health communication research: A content analysis of articles published in Journal of Health Communication and Health Communication (2010-2019).

This study presents data from a content analysis of original research articles published in Journal of Health Communication (JOHC) andHealth Communication (HC) from 2010 to 2019. The authors coded 2,050 articles using categories that identified health topics, theory, population characteristics, and methods used in each study. Distinctions between the published research in JOHCand HCare highlighted. Across both journals, articles are primarily conducted within the United States, most frequently use college student samples, often lack explicit theoretical frameworks, heavily rely on online survey methods, and most commonly use quantitative methodologies. The most frequently utilized theory across both journals wasSocial Cognitive Theory and the most studied health topic were behaviors related to smoking, tobacco, and e-cigarette use. The journals were significantly different in several areas, with HC containing more articles explicitly guided by theory and publishing more qualitative research, while JOHC had more racial diversity in its study samples. Results are discussed in terms of their implications for future research. Increased diversity in methodology and samples, as well as increased use of theory and continued use of interdisciplinary collaborations among researchers will allow for expanding and enhancing health communication knowledge going forward.

The Missed Opportunity of Primary Care Providers' Online Biographies: a Content Analysis of US Health Systems in 2020.

BACKGROUND: Prospective patients are increasingly going to health systems' online directories to find their next primary care providers (PCP), making this channel of communication important to assess to determine if it is meeting patients' needs. When seeking a new PCP, patients want to know not only educational credentials but also providers' communication traits, and personal information to showcase providers as real people. Offering this information, to help patients find providers best suited to meet their needs, is a key attribute of patient-centered care. OBJECTIVE: To analyze whether health systems' online PCP biographies are including the information prospective patients deem important when selecting a PCP. DESIGN: Using the AHRQ's Compendium of US Health Systems, 523 health systems' PCP biographies were content analyzed (n = 5004 biographies) from December 2019 to March 2020. MAIN MEASURES: Forty-eight unique pieces of information were coded for either their presence or absence (e.g., education, photo, languages spoken, insurance accepted, patient reviews, philosophy of care, video provided, personal hobbies/interests). Providers' alphabetic credentials (e.g., MD, DO, APRN) were also documented. KEY RESULTS: The majority of biographies stated the provider's medical education (83.6%) and included a photo (81.4%). However, information patients also desire (e.g., communication traits and personal information) were less prevalent. Only 33.7% listed languages spoken, 18.2% offered patient reviews, 14.4% had personal hobbies/interests, and 10.6% included a video. There were also 192 unique alphabetic credential combinations listed next to providers' names. Two health systems clearly included information within biographies to help prospective patients understand what these credentials meant. CONCLUSIONS: Health systems could make simple changes to their providers' online biographies in order to help patients make more informed decisions of PCPs. Doing so may decrease doctor shopping, and also lead to a greater likelihood of developing longer-term relationships with PCPs.

The Diminishing Returns for Longer Healthcare Provider Video Biographies: A Thin Slice Examination of Patient Decision-Making.

The consumer-centric nature of the current healthcare landscape in the United States is forcing healthcare organizations to innovate novel ways to help patients more efficiently and effectively select their healthcare providers to improve the patient experience. One way organizations are doing this is by providing introductory videos of their providers online to help patients informatively shop for new providers. However, producing videos - especially lengthy ones - for all providers within an organization can be both time consuming and expensive, with costs inevitably trickling down to patients. Framed by the concepts of thin slicing from the psychological sciences, and uncertainty reduction from the communication sciences, the primary purpose of this 12-condition online experiment (n = 1,310) was to determine the optimal length of healthcare providers' introductory biographical videos in-terms of patients' ease of selection, and the impact that video length can have on patients' provider perceptions. Results reveal that introductory videos of around 46-seconds, as well as shorter videos with supplemental text, provide similar results on dependent variables such as selection ease, patient satisfaction, and trust, as do longer videos. Additional recommendations for applying these findings within healthcare organizations are discussed.

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.

The Utility of Healthcare Providers' Online Biographies for First-Time Patients: A Year-Long Study within a Clinical Setting.

Despite recommendations to provide patient-centered care (i.e., empowering patients to take a greater role in their care), healthcare systems still lag behind in helping patients make arguably one of their most important decisions - their initial selection of a primary care provider. While prior highly-controlled, theoretically-guided, experimental research has tested how various presentations of provider information may impact patients' decision-making processes, no studies to date have taken the next step to actually roll out improvements to providers' online information in a real-world healthcare organization and assess their effects. Over the course of a year, the current study made improvements to the website of a health clinic (i.e., adding biographies of primary care providers, & including short video introductions). Post-consultation questionnaires completed by first-time patients revealed patients who naturally viewed online biographies prior to setting appointments indicated less uncertainty - which was mediated through increases in perceived similarity - and were more likely to purposely select their providers. Patients who purposely selected their providers also reported greater patient satisfaction, and were more likely to choose providers with whom they perceived greater similarity. Similarity and patient satisfaction were also positively related. Overall, findings indicate online provider biographies can help patients become more purposive participants in their care, which can lead to greater patient satisfaction.

Exploring the Effects of Source Credibility and Message Framing on STI Screening Intentions: An Application of Prospect and Protection Motivation Theory.

Roughly half of all new sexually transmitted infections (STI) occur in adolescent and college-aged populations. College students tend to underestimate their personal risks of contracting STIs. Consequently, many college students do not engage in protective behaviors that would reduce STI transmission rates. This study examined the effect of source credibility (high vs. low) and message framing (positive vs. negative) on college students' behavioral intentions to get screened for STIs via a 2 × 2 experiment (n = 207). Further, drawing on both Prospect Theory and Protection Motivation Theory, the study tested whether coping and threat appraisals mediated the effects of source credibility and message framing on behavioral intentions. Results reveal that both highly credible sources and negatively framed messages influenced behavioral intentions to screen for STIs. However, the interaction term of source credibility by message frame was not significant. Mediation models suggested that efficacy perceptions partially explained the effect of source credibility on behavioral intentions, but not for the effect of message framing. Perceptions of severity and susceptibility did not mediate the effect of either source credibility or message framing. Practical and theoretical implications of the results are discussed.

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.

Concise Consent Forms Appreciated-Still Not Comprehended: Applying Revised Common Rule Guidelines in Online Studies.

As informed consent documents have historically gotten lengthier, recent revisions to federal Common Rule guidelines now require consent forms that are "concise" and presented in ways that "facilitate comprehension." The current research sought to apply these guidelines by developing a consent process for an online study that was only 71 words and also allowed participants a choice to either continue directly to the study or learn more about the study to which they were consenting. All participants (100%, N = 429) decided to continue directly to the study, choosing to forgo additional information about the study and the institutional review board (IRB) approval process. Participants indicated they liked this streamlined consent process, even though on average they only comprehended about half of the information this streamlined process contained. A plurality of participants indicated they would like to see this style of streamlined consent continued in future online studies. However, if we want to continue referring to informed consent as informed, future research should be welcomed and supported by IRBs to seek ways to apply the newest Common Rule guidelines while increasing comprehension; otherwise, informed consent will likely always remain an oxymoron.

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.