Let's (not) talk about sexual health: How sexual communication apprehension with healthcare providers and peer communication influence intentions to protect sexual health.

OBJECTIVE: This study examined how patients' clinical and peer interactions may affect their communication apprehension with healthcare providers, a major communication barrier to sexual health protective behaviors (SHPB). METHODS: Between January 2022 and February 2023, we conducted an online survey with 310 participants recruited through snowball sampling. Using structural equation modeling (SEM), we explored relationships among patient-provider interactions, peer communication about sex, communication apprehension with providers, and SHPB intentions. RESULTS: Significant predictors of SHPB intentions included lower communication apprehension and more peer communication. Communication apprehension was a significant mediator in paths from peer communication and three types of patient-provider communication to SHPB intentions. CONCLUSIONS: Our study indicates the need to address communication barriers to increase patients' SHPB intentions. Active patient involvement and patient-centered communication may open up discussions about sex in the clinical setting. Peer interactions, informed by scientific guidance, may reduce patients' apprehension, leading to better health outcomes. PRACTICE IMPLICATIONS: Communication interventions are needed to promote collaborative patient-provider environments and peer sexual communication. Active involvement and evidence-based discussions can help patients navigate difficult conversations (e.g., like sex), improving SHPB.

Collaborative Care and Healthcare Usage in Families with Pediatric Patients During COVID-19: A Secondary Analysis of National Survey of Children's Health (NSCH) Data.

One of the most detrimental side effects of the COVID-19 pandemic is the needed but not received care. Forgone health care affects the general public, but particularly children with special care needs. Previous research focused on non-modifiable factors, such as demographic background and insurance coverage. Based on Politi and Street's model of collaborative decision-making, we explored how two modifiable communication factors contributed to the prevention of forgone pediatric care during the COVID-19 pandemic. Using a nationally representative sample (n = 10845) from the 2020 National Survey of Children's Health (NSCH) survey, we found that health-care providers' family-centered communication and shared decision-making may reduce the possibility of forgone care through improved satisfaction with providers' communication. For children with mental health needs, providers' family-centered communication may also stimulate family's capacity to openly communicate, leading to better involvement in care and timely health care seeking. This helps to address COVID-related uncertainty, prevent higher health-care expenditures, and reduce negative health outcomes.

How Family Sex Talks Can Increase Daughters' Intentions to Engage in Sexual Health Protective Behavior: Mediating Roles of Parents' Direct and Indirect Sexual Communication.

The family environment is essential but underused for promoting sexual and reproductive health protective behaviors (SHPB). However, previous literature had no consistent findings regarding how families can efficiently provide sex education and what aspects of family communication may facilitate SHPB. Based on family communication patterns theory (FCPT) and new research that segments family conformity orientation into four sub-dimensions (i.e., respecting parental authority, experiencing parental control, adopting parents' values, and questioning parents' beliefs), we explored the roles that family communication patterns (FCP) and parents' (direct and indirect) sexual communication play in influencing adult daughters' intentions to engage in SHPB. Using survey data from 234 female participants, path analysis suggested that daughters' SHPB intentions were associated with more direct and indirect sexual communication, higher conversation orientation, higher parental control, and less adoption of parental values. Also, parents' direct sexual communication mediated the impact of conversation orientation on SHPB intentions. Additionally, parents' indirect sexual communication mediated the path from parental value adoption to SHPB intentions, mitigating the negative direct impact of parental value adoption. Theoretical and practical implications are discussed.

A Dual-Process Model of Promoting Employee Mental Health in Crises: Impacts of Leadership Health Support and Organizational Leaders' Crisis Communication in COVID-19.

This study examined how organizations may promote their employees' mental health in difficult times. Drawing from organizational crisis communication and organizational health promotion research, it proposed and tested a dual-process model that links leadership health support, an essential dimension of organizational health culture, with organizational leaders' crisis communication (i.e. use of ethical-base responses) and workers' self-care awareness and perceived stress in a crisis. Through a survey of 502 full-time U.S. employees conducted during COVID-19, we found that organizational leaders' use of ethical-base responses predicted employees' enhanced self-care awareness and decreased stress levels. Further, leadership health support provided a double-buffer effect to sustain employee mental health by directly bolstering employees' self-care awareness and organizational leaders' use of ethical-base responses. The findings of this study bridge the gaps in organizational health promotion and crisis communication literature and offer practical suggestions for organizations seeking to foster employees' mental health challenges during crises.

How communicative environments affect college students' mental health help-seeking during COVID-19: a cross-sectional study.

Objective: This study explores how interpersonal communication environments (eg family, patient-provider, and online communication environments) affect college students' mental help-seeking during COVID-19. Methods: Based on Social Cognitive Theory, we conducted a cross-sectional survey assessing participants' mental help-seeking attitudes, self-stigma, self-efficacy, and readiness, as well as their communication experiences with their families, healthcare providers, and online environments. Four hundred fifty-six student participants were recruited. Structural equation modeling was used to explore relationships among the assessed variables. Results: About one-third of the participants (N = 137) had signs of mental distress, and most of them (N = 71) did not intend to seek help soon. Patient-centered communication experiences with healthcare providers were associated with reduced help-seeking stigma, whereas online and family communication predicted help-seeking readiness through changes in attitude, self-stigma, and self-efficacy. Conclusions: This study's results help identify risk factors of help-seeking reluctance. It suggests that communicative environments affect help-seeking by influencing individual predictors. This study may inform interventions targeting college students' use of mental health services during health crises like COVID-19.

Information-Seeking Behavior for COVID-19 Boosters in China: A Cross-Sectional Survey.

As China launches its second COVID-19 booster campaign and races to bring new vaccine technologies to protect against severe COVID-19 infections, there is limited research on how Chinese residents search for vaccine-related information. This study examined the factors influencing Chinese residents' information-seeking behaviors regarding COVID-19 boosters with a sample of 616 respondents with a mean age of 31.53 from a research panel. Structural equation modeling was used to report factors that influenced respondents' seeking intent. The results indicated that seeking-related subjective norms (ß = -0.55, p < 0.001), negative affect (ß = 0.08, p < 0.05), positive affect (ß = 0.18, p < 0.001), and perceived knowledge insufficiency (ß = 0.10, p < 0.001) are strong predictors of one's seeking intent. We also discovered that there was an inverse relationship between risk perception and positive affect (ß = -0.55, p < 0.001) and between negative and positive affect (ß = -0.19, p < 0.01), while all measurements were either directly or indirectly related to information-seeking intent. A few more indirect but important relationships were also included in our discussion. In conclusion, the present study helps understand what motivates Chinese residents to seek COVID-19 booster information when limited information is available.

Factors related to moderate exercise during COVID-19 for overweight and obese individuals: A secondary analysis of HINTS data.

Objective: COVID-19 has exacerbated pre-existing rates of overweight and obesity in the United States. mHealth technologies are gaining in popularity for its potential to reduce obesity, if facilitated by patient-centered communication. This study explores predictors of overweight and obese individuals' exercise levels during COVID-19. Methods: 2191 respondents who visited a doctor in the past year and self-reported being overweight were selected from the 2020 Health Information National Trends Survey (HINTS). Respondents reported their physical activity, beliefs about obesity, health tracking behaviors, and communication with providers during the pandemic. Structural equation modeling was used to explore connections among the variables. Results: Patient-provider (e-)communication was significantly associated with changes in people's obesity-related beliefs and mHealth tracking usage, predicting moderate exercise during the pandemic. Conclusion: The findings illustrate the need for patient-centered communication encounters to include discussions on mHealth technologies and accessible methods of engaging in physical activity.Innovation: This study examined secondary data provided by overweight and obese individuals from the early days of the COVID-19 pandemic; this population may benefit from targeted health interventions using mHealth technologies. Our findings suggest that healthcare providers should engage patients through mHealth technology and seek to improve digital health literacy to progress physical activity nationwide.

Examining Potential Usability and Health Beliefs Among Young Adults Using a Conversational Agent for HPV Vaccine Counseling.

The human papillomavirus (HPV) vaccine is the most effective way to prevent HPV-related cancers. Integrating provider vaccine counseling is crucial to improving HPV vaccine completion rates. Automating the counseling experience through a conversational agent could help improve HPV vaccine coverage and reduce the burden of vaccine counseling for providers. In a previous study, we tested a simulated conversational agent that provided HPV vaccine counseling for parents using the Wizard of OZ protocol. In the current study, we assessed the conversational agent among young college adults (n=24), a population that may have missed the HPV vaccine during their adolescence when vaccination is recommended. We also administered surveys for system and voice usability, and for health beliefs concerning the HPV vaccine. Participants perceived the agent to have high usability that is slightly better or equivalent to other voice interactive interfaces, and there is some evidence that the agent impacted their beliefs concerning the harms, uncertainty, and risk denials for the HPV vaccine. Overall, this study demonstrates the potential for conversational agents to be an impactful tool for health promotion endeavors.