Reproductive Health Experiences Shared on TikTok by Young People: Content Analysis.

BACKGROUND: TikTok is a popular social media platform that allows users to create and share content through short videos. It has become a place for everyday users, especially Generation Z users, to share experiences about their reproductive health. Owing to its growing popularity and easy accessibility, TikTok can help raise awareness for reproductive health issues as well as help destigmatize these conversations. OBJECTIVE: We aimed to identify and understand the visual, audio, and written components of content that TikTok users create about their reproductive health experiences. METHODS: A sampling framework was implemented to narrow down the analytic data set. The top 6 videos from each targeted hashtag (eg, #BirthControl, #MyBodyMyChoice, and #LoveYourself) were extracted biweekly for 16 weeks (July-November 2020). During data collection, we noted video characteristics such as captioning, music, likes, and cited sources. Qualitative content analysis was performed on the extracted videos. RESULTS: The top videos in each hashtag were consistent over time; for example, only 11 videos appeared in the top 6 category for #BirthControl throughout the data collection. Most videos fell into 2 primary categories: personal experiences and informational content. Among the personal experiences, people shared stories (eg, intrauterine device removal experiences), crafts (eg, painting their pill case), or humor (eg, celebrations of the arrival of their period). Dancing and demonstrations were commonly used in informational content. CONCLUSIONS: TikTok is used to share messages on myriad reproductive health topics. Understanding users' exposure provides important insights into their beliefs and knowledge of sexual and reproductive health. The study findings can be used to generate valuable information for teenagers and young adults, their health care providers, and their communities. Producing health messages that are both meaningful and accessible will contribute to the cocreation of critical health information for professional and personal use.

Demand of and Access to Health Messages Through Mass Media in the Rural Community of Eastern Ethiopia: A Mixed Method Study.

Background: The demand for health-related information has increased dramatically in recent years. Media is crucial in reaching health messages to audiences, especially those who are distant and rural. Therefore, the study aimed to assess demands, access, and factors associated with access to health messages through mass media in the rural community of Kersa District of East Hararghe, Eastern Ethiopia. Methods: A mixed-methods study was conducted from October 15 to November 20, 2020. A quantitative cross-sectional and a qualitative phenomenological study design were applied. A total of 578 participants were included by using a systematic sampling technique. Collected data were entered into Epidata version 3.1 and analyzed using SPSS version 22.0. A multivariate logistic regression analysis model was used and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p <0.05. For qualitative, six-focused group discussions (FGDs) were used and then analyzed thematically. Results: Overall, the demand of and access to health messages through mass media was 32.5% (95% CI=28.5-34.2%) and 26.6% (95% CI=24.6-28.7%), respectively. Factors such as having electric services (AOR=2.36, 95% CI=2.13-5.41), having a mobile phone (AOR=4.56, 95% CI=4.32-8.73), exposure to TV (AOR=4.73, 95% CI=1.03-11.62), and exposure to social media and printed media (AOR=5.24, 95% CI=1.07-15.63), a preference for programs such as news, current affairs, entertainment, health and educational were 2.37, 9.47, 4.75 and 7.55 times more likely to access health messages (AOR=2.37, 95% CI=1.00-5.61; AOR=9.47, 95% CI=3.54-25.34; AOR=4.75, 95% CI=1.23-18.38; and AOR=7.55, 95% CI=3.12-8.66, respectively). Qualitative findings, participants demand for health messages from health workers, radio, and the main source for accessing the message was the radio. Conclusion: Approximately one in every three and one in every four rural communities in the study area had demand, and access to health messages through mass media, respectively. As a result, all stakeholders should emphasize and strengthen expanding methods of reaching health messages using mass media.

Community Health Worker Use of Smart Devices for Health Promotion: Scoping Review.

BACKGROUND: Community health workers (CHWs) have become essential to the promotion of healthy behaviors, yet their work is complicated by challenges both within and beyond their control. These challenges include resistance to the change of existing behaviors, disbelief of health messages, limited community health literacy, insufficient CHW communication skills and knowledge, lack of community interest and respect for CHWs, and CHWs' lack of adequate supplies. The rising penetration of "smart" technology (eg, smartphones and tablets) in low- and middle-income countries facilitates the use of portable electronic devices in the field. OBJECTIVE: This scoping review examines to what extent mobile health in the form of smart devices may enhance the delivery of public health messages in CHW-client interactions, thereby addressing the aforementioned challenges and inducing client behavior change. METHODS: We conducted a structured search of the PubMed and LILACS databases using subject heading terms in 4 categories: technology user, technology device, use of technology, and outcome. Eligibility criteria included publication since January 2007, CHWs delivering a health message aided by a smart device, and face-to-face communication between CHWs and clients. Eligible studies were analyzed qualitatively using a modified version of the Partners in Health conceptual framework. RESULTS: We identified 12 eligible studies, 10 (83%) of which used qualitative or mixed methods approaches. We found that smart devices mitigate challenges encountered by CHWs by improving their knowledge, motivation, and creativity (eg, through self-made videos); their status within the community; and the credibility of their health messages. The technology stimulated interest in both CHWs and clients-and sometimes even in bystanders and neighbors. Media content produced locally or reflecting local customs was strongly embraced. Yet, the effect of smart devices on the quality of CHW-client interactions was inconclusive. Interactions suffered as CHWs were tempted to replace educational conversations with clients by passively watching video content. Furthermore, a series of technical difficulties experienced especially by older and less educated CHWs compromised some of the advantages brought about by mobile devices. Adequate CHW training ameliorated these difficulties. Only 1 study (8%) considered client health behavior change as an end point, thus revealing a major research gap. CONCLUSIONS: Smart mobile devices may augment CHWs' field performance and enhance face-to-face interactions with clients, yet they also generate new challenges. The available evidence is scarce, mostly qualitative, and focused on a limited range of health outcomes. Future research should include larger-scale interventions across a wide range of health outcomes and feature client health behavior change as an end point.

Development of a rating scale for measuring resistance to persuasive health messages.

BACKGROUND: Pretesting is the key to understanding how the intended audience will react to the message. Resistant reactions affect message processing or can lead to undesirable boomerang effects. The objective of this study was to develop a rating scale for measuring active (reactance) and passive (disengagement) resistance to persuasive health messages. METHODS: Six candidate items (3 items for disengagement and 3 items for reactance) were generated based on literature review. A web-based survey was conducted among Japanese adults aged 25-64 years to verify the reliability and validity of the 6-item resistance scale. Participants were asked to rate one of the advance care planning (ACP) promotion messages. All scale items were scored on a 1-to-5 point Likert scale and they were averaged to produce the resistance score. RESULTS: Explanatory factor analysis revealed a two-factor solution that agreed with the disengagement and reactance domains, respectively. Correlation coefficients between each set of items ranged between 0.30-0.69. Cronbach alpha (0.86) indicated satisfactory internal consistency of the set of items. Confirmatory factor analysis showed a good fit of the two-factor model with CFI = 0.998, SRMR = 0.011, and RMSEA = 0.041. The resistance score showed a moderate positive correlation with negative emotional responses (displeasure γ = 0.55, anger γ = 0.53) and was significantly inversely related to the persuasiveness score (γ = -0.50). Multivariable logistic regression analysis showed that the odds ratio for ACP intention per 1-point increase in the resistance score was 0.47 (95% confidence interval 0.40-0.56) with adjustment for the persuasiveness score. CONCLUSION: The 6-item resistance scale exhibited adequate reliability and validity for measuring audience resistance when applied to the ACP promotion messages in Japanese people. The scale will be useful for pretesting health messages to make them more acceptable to the intended audience. TRIAL REGISTRATION: Not applicable; this is not a report of intervention trial.

How to inform college students about meningitis B vaccine? Comparative effectiveness of an online theory-based text and video intervention.

Objective The purpose of this study was to compare the effect of text and video formats of an online theory-based Meningitis B (MenB) health message intervention on college students. Participants: College freshmen and transfer students admitted at a Southern U.S. University. Methods: In a 2-arm randomized study, knowledge, perceptions, and intention to receive the vaccine were compared pre- and post-intervention. Results: Post intervention, participants in both the written and video interventions had significantly higher scores of knowledge, perceptions, and intentions. Upon comparing the change in scores pre- to post-intervention between both text and video groups, no significant differences were found between both groups. Conclusions: This study, a first in using a theory-based MenB online education intervention and questionnaire to compare text and video formats, suggests that both text and video formats are equally effective in raising young adults' awareness about the MenB vaccine.

Public Health Implications of Adapting HIV Pre-exposure Prophylaxis Programs for Virtual Service Delivery in the Context of the COVID-19 Pandemic: Systematic Review.

BACKGROUND: The novel coronavirus disease COVID-19 caused by SARS-CoV-2 threatens to disrupt global progress toward HIV epidemic control. Opportunities exist to leverage ongoing public health responses to mitigate the impacts of COVID-19 on HIV services, and novel approaches to care provision might help address both epidemics. OBJECTIVE: As the COVID-19 pandemic continues, novel approaches to maintain comprehensive HIV prevention service delivery are needed. The aim of this study was to summarize the related literature to highlight adaptations that could address potential COVID-19-related service interruptions. METHODS: We performed a systematic review and searched six databases, OVID/Medline, Scopus, Cochrane Library, CINAHL, PsycINFO, and Embase, for studies published between January 1, 2010, and October 26, 2021, related to recent technology-based interventions for virtual service delivery. Search terms included "telemedicine," "telehealth," "mobile health," "eHealth," "mHealth," "telecommunication," "social media," "mobile device," and "internet," among others. Of the 6685 abstracts identified, 1259 focused on HIV virtual service delivery, 120 of which were relevant for HIV prevention efforts; 48 pertained to pre-exposure prophylaxis (PrEP) and 19 of these focused on evaluations of interventions for the virtual service delivery of PrEP. Of the 16 systematic reviews identified, three were specific to PrEP. All 35 papers were reviewed for outcomes of efficacy, feasibility, and/or acceptability. Limitations included heterogeneity of the studies' methodological approaches and outcomes; thus, a meta-analysis was not performed. We considered the evidence-based interventions found in our review and developed a virtual service delivery model for HIV prevention interventions. We also considered how this platform could be leveraged for COVID-19 prevention and care. RESULTS: We summarize 19 studies of virtual service delivery of PrEP and 16 relevant reviews. Examples of technology-based interventions that were effective, feasible, and/or acceptable for PrEP service delivery include: use of SMS, internet, and smartphone apps such as iText (50% [95% CI 16%-71%] reduction in discontinuation of PrEP) and PrEPmate (OR 2.62, 95% CI 1.24-5.5.4); telehealth and eHealth platforms for virtual visits such as PrEPTECH and IowaTelePrEP; and platforms for training of health care workers such as Extension for Community Healthcare Outcomes (ECHO). We suggest a virtual service delivery model for PrEP that can be leveraged for COVID-19 using the internet and social media for demand creation, community-based self-testing, telehealth platforms for risk assessment and follow-up, applications for support groups and adherence/appointment reminders, and applications for monitoring. CONCLUSIONS: Innovations in the virtual service provision of PrEP occurred before COVID-19 but have new relevance during the COVID-19 pandemic. The innovations we describe might strengthen HIV prevention service delivery during the COVID-19 pandemic and in the long run by engaging traditionally hard-to-reach populations, reducing stigma, and creating a more accessible health care platform. These virtual service delivery platforms can mitigate the impacts of the COVID-19 pandemic on HIV services, which can be leveraged to facilitate COVID-19 pandemic control now and for future responses.

Development of a rating scale for measuring resistance to persuasive health messages

BACKGROUND@#Pretesting is the key to understanding how the intended audience will react to the message. Resistant reactions affect message processing or can lead to undesirable boomerang effects. The objective of this study was to develop a rating scale for measuring active (reactance) and passive (disengagement) resistance to persuasive health messages.@*METHODS@#Six candidate items (3 items for disengagement and 3 items for reactance) were generated based on literature review. A web-based survey was conducted among Japanese adults aged 25-64 years to verify the reliability and validity of the 6-item resistance scale. Participants were asked to rate one of the advance care planning (ACP) promotion messages. All scale items were scored on a 1-to-5 point Likert scale and they were averaged to produce the resistance score.@*RESULTS@#Explanatory factor analysis revealed a two-factor solution that agreed with the disengagement and reactance domains, respectively. Correlation coefficients between each set of items ranged between 0.30-0.69. Cronbach alpha (0.86) indicated satisfactory internal consistency of the set of items. Confirmatory factor analysis showed a good fit of the two-factor model with CFI = 0.998, SRMR = 0.011, and RMSEA = 0.041. The resistance score showed a moderate positive correlation with negative emotional responses (displeasure γ = 0.55, anger γ = 0.53) and was significantly inversely related to the persuasiveness score (γ = -0.50). Multivariable logistic regression analysis showed that the odds ratio for ACP intention per 1-point increase in the resistance score was 0.47 (95% confidence interval 0.40-0.56) with adjustment for the persuasiveness score.@*CONCLUSION@#The 6-item resistance scale exhibited adequate reliability and validity for measuring audience resistance when applied to the ACP promotion messages in Japanese people. The scale will be useful for pretesting health messages to make them more acceptable to the intended audience.@*TRIAL REGISTRATION@#Not applicable; this is not a report of intervention trial.

Understanding self-affirmation effects: The moderating role of self-esteem.

OBJECTIVES: Whether people benefit from self-affirmation in overcoming resistance to health messages may depend on their level of self-esteem. However, extant theories offer rival hypotheses about the role of self-esteem. We pitted these hypotheses against each other, building on the argument that how self-esteem shapes self-affirmation effects may depend on how and when people self-affirm. DESIGN: A 3 (Self-affirmation type: value essay, attribute scale, control task) by 2 (Timing: pre-message, post-message) plus 1 (message-only) experimental, between-subjects design. METHODS: Participants (N = 422) completed a value essay, an attribute scale, a control task, or no task, either before or after reading a message about health risks of excessive drinking. Participants then completed defensiveness and message acceptance measures. RESULTS: Self-esteem moderated self-affirmation effects across different types and timing of self-affirmation. While participants with relatively high self-esteem consistently benefited from self-affirmation, participants with relatively low self-esteem experienced adverse effects from self-affirmation. Self-affirmed participants with high self-esteem showed lower psychological discomfort, lower personal risk discounting, and higher message acceptance than unaffirmed participants, while self-affirmed participants with low self-esteem showed higher psychological discomfort, higher personal risk discounting, and lower message acceptance than unaffirmed participants. CONCLUSIONS: These findings support the proposition that self-esteem serves as affirmational resources, which implies that self-affirmation interventions to reduce defensiveness to health messages may be beneficial for people with high self-esteem but less so for people with lower self-esteem. Similar to much other self-esteem research, self-esteem was negatively skewed, which warrants caution in generalization of the findings across all levels of self-esteem.

Influence of Knowledge and Attitude on Lifestyle Practices Among Seventh-Day Adventists in Metro Manila, Philippines.

This cross-sectional study examined the influence of knowledge and attitude on lifestyle practices (KAP) of the five dimensions of the Adventist Health Message (AHM5D). A sample of 1442 respondents was drawn from seven Seventh-day Adventist Churches in Metro Manila, Philippines. Hierarchical multiple regression showed that the social dimension of knowledge and the physical, spiritual, and social dimensions of attitude, significantly influenced the practices of AHM5D (ß = - .056, p = .037; ß = .236, p < .001; ß = .211, p < .001; ß = .145, p < .001, respectively), with r2 = .334. These findings suggest more effective interventions in the AHM5D promotion.

Behavioral economics informed message content in text message reminders to improve cervical screening participation: Two pragmatic randomized controlled trials.

The objective of the reported research was to assess the impact of text message (SMS) reminders and their content on cervical screening rates. Women invited for cervical screening in Northwest London from February-October 2015 were eligible. 3133 women aged 24-29 (Study 1) were randomized (1, 1) to 'no SMS' (control), or a primary care physician (PCP) endorsed SMS (SMS-PCP). 11,405 women aged 30-64 (Study 2), were randomized (1, 1:1:1:1:1:1) to either: no SMS, an SMS without manipulation (SMS), the SMS-PCP, an SMS with a total or proportionate social norm (SMS-SNT or SMS-SNP), or an SMS with a gain-framed or loss-framed message (SMS-GF and SMS-LF). The primary outcome was participation at 18 weeks. In Study 1 participation was significantly higher in the SMS-PCP arm (31.4%) compared to control (26.4%, aOR, 1.29, 95%CI: 1.09-1·51; p = 0.002). In Study 2 participation was highest in the SMS-PCP (38.4%) and SMS (38.1%) arms compared to control (34.4%), (aOR: 1.19, 95%CI: 1.03-1.38; p = 0.02 and aOR: 1.18, 95%CI: 1.02-1.37; p = 0.03, respectively). The results demonstrate that behavioral SMSs improve cervical screening participation. The message content plays an important role in the impact of SMS. The results from this trial have already been used to designing effective policy for cervical cancer screening. The NHS Cervical Screening Programme started running a London-wide screening SMS campaign which was based on the cervical screening trial described here. According to figures published by Public Health England, after six months attendance increased by 4.8%, which is the equivalent of 13,400 more women being screened at 18 weeks.

Goal-Framing and Temporal-Framing: Effects on the Acceptance of Childhood Simple Obesity Prevention Messages among Preschool Children's Caregivers in China.

A range of intervention models are available for childhood obesity prevention; however, few studies have examined the effectiveness of intervention messages. This study developed childhood simple obesity prevention messages on the basis of goal-framing and temporal-framing effects to improve message acceptance among the caregivers of preschool children and explored associated factors. A cross-sectional study was conducted among 592 caregivers of preschool children in urban kindergartens in China during March to April 2019. The framing messages were developed based on prospect theory and construal level theory. The majority (48.4%) of caregivers found the gain-framed, present-oriented message most salient for acceptance. We found that gender, education background, theme, and the use of negative words have impacts on goal-framing effects; and previous participation in a health related intervention, career category, and the theme have impacts on temporal-framing effects (p < 0.001). Goal-framing effects and temporal-framing effects can influence each other (p < 0.001). The findings suggest that the gain-framed, present-oriented message could be considered a strategy to improve the acceptance of information by caregivers. When framing a message, subtle differences like using negative words might affect the exertion of framing effects.

Developing a Mass Media Campaign to Promote Mammography Awareness in African American Women in the Nation's Capital.

This study developed and examined the reach and impact of a culturally appropriate mass media campaign pilot, designed to increase awareness about the importance of mammography screening and the available community mammography services for low-income African American women ages 40 and above. We conducted formative research using focus groups to inform campaign development, resulting in five emergent themes-good breast health, holistic views of healthiness, cancer fatalism, fear of mammogram machines, and mammogram affordability. The campaign targeted specific low-income African American communities in the District of Columbia via print ads in Metro stations and on buses, print ads in the Washington Informer, and online ads on a local TV network website. Data were collected before, during, and after campaign implementation to assess reach and impact. Reach was measured by number of impressions (number of people exposed to the campaign), while impact was assessed via online ad click-through rates, website use and referrals, and mammography center calls. The campaign was successful in reaching the target audience, with a total combined reach from all media of 9,479,386 impressions. In addition, the mammography center received significant increases in new website visitors (1482 during the campaign, compared to 24 during the preceding period) as well as 97 calls to the dedicated phone line. Further research involving a more long-term investment in terms of funding and campaign run time, coupled with a more robust evaluation, is needed to assess if culturally appropriate mass media campaigns can generate increased mammography screening rates and decrease breast-cancer-related mortality.

Associations between narrative transportation, risk perception and behaviour intentions following narrative messages about skin cancer.

OBJECTIVE: Narrative messages may be an effective strategy to increase risk perceptions and motivate preventive behaviours related to cancer. The aim of this research was to examine associations between narrative transportation (i.e. psychological absorption into a narrative), risk perceptions, and intentions following narrative messages about skin cancer. DESIGN: In two studies, women who reported indoor tanning read first-person narrative messages about skin cancer. We examined associations between narrative transportation and the women's responses to the narratives, including risk perceptions for skin cancer and behaviour intentions to reduce risk. Associations between transportation, knowledge and worry were also examined. RESULTS: Greater transportation was associated with higher intentions to perform skin self-examination, talk to one's doctor about skin cancer, and look for more information. Greater transportation was also associated with higher gut feelings of risk and higher worry about skin cancer, but not deliberative risk perceptions or knowledge from the message. Additional analyses showed that after controlling for risk perception and worry, transportation had unique associations with some behaviour intentions. CONCLUSION: Findings suggest that narrative transportation may be an important component to the persuasion of cancer narratives. Future research should explore ideas such as the role of the experiential system in narratives' influence.

Perceived effectiveness rating scales applied to insomnia help-seeking messages for middle-aged Japanese people: a validity and reliability study.

BACKGROUND: Communicating health messages is an important way to influence people's behaviors towards health issues. Providers need to incorporate audience's perspective to design more persuasive messages. This study aimed to develop rating scales for measuring audience's perception of effectiveness of health messages in Japanese people. METHODS: The comprehensibility scale including five items and the persuasiveness scale including seven items were designed based on literature review. A cross-sectional web-based survey was conducted among Japanese adults aged 35-45 years to assess the reliability and validity of the scales. Participants were asked to rate a text message that encouraged help-seeking intention for insomnia. All scale items were scored on a 1-to-5 point Likert scale, and they were averaged to produce an overall score for each scale. RESULTS: Explanatory factor analysis revealed a two-factor solution that agreed with the comprehensibility and persuasiveness scales, respectively. Correlation coefficients between each set of items ranged between 0.63-0.87 for the comprehensibility scale and 0.37-0.76 for the persuasiveness scale. Cronbach alpha (0.88) indicated satisfactory internal consistency of the set of items. The mean (SD) of the comprehensibility and persuasiveness scores were 3.70 (0.82) and 3.15 (0.61), respectively, without ceiling or floor effects. These scores were significantly associated with intended future use of the message. The proportion of participants who reported a positive help-seeking intention for insomnia was significantly higher in the higher score groups for both scales. Multiple logistic regression analysis showed that the comprehensibility and persuasiveness scores were significantly associated with the help-seeking intention for insomnia. CONCLUSION: The proposed rating scales exhibited adequate reliability and validity for measuring the comprehensibility and persuasiveness of insomnia health-seeking message in middle-aged Japanese people. Further studies are needed to confirm the generalizability of the results, but these scales may be useful for pretesting a health message with audience members to make it more acceptable and persuasive to the intended audience. TRIAL REGISTRATION: Not applicable; this is not a report of intervention trial.

Survivors' perceptions of public health messages during an Ebola crisis in Liberia and Sierra Leone: An exploratory study.

The outbreak of Ebola virus disease in Guinea, Liberia, and Sierra Leone was the largest epidemic of Ebola ever recorded. The healthcare workforce was diminished and exhausted as the region emerged from civil war. Few qualitative, descriptive studies have been conducted to date that concentrate on the voices of Ebola survivors and their perceptions of health messages. In this study, we employed an interpretive, qualitative design to explore participant experiences. Twenty five survivors who had recovered from Ebola were recruited from three villages in Liberia and Sierra Leone in August 2015. Data were collected using semistructured interviews. Data analysis revealed four themes: (i) degrees of mistrust; (ii) messages conflicting with life and culture; (iii) seeing is believing; and (iv) recovery inspires hope. The findings were explored in the context of the relevant literature. The themes highlight the need to develop culturally-appropriate messages, underpinned by a sound understanding of the community and a willingness to work with the culture and trusted leaders.

Denial of a sleep deprivation message: situational and dispositional influences on message rejection.

Two studies investigated situational and dispositional influences on rejection of a sleep deprivation warning message for young adults. The hassle of protection (Study 1) and the self-relevance of the problem (Study 2) were manipulated; the disposition to use denial (threat orientation) for warning messages was measured. In both studies, it was found that both dispositional denial and the situational manipulation (more protection-hassle or self-relevance) showed at least one denial effect by reducing perceived susceptibility, perceived severity, or credibility. Indirect (mediational) effects were tested with the bootstrap method. In Study 1, judgments of credibility and severity mediated the effects of the hassle manipulation and denial orientation on message outcomes. In Study 2, credibility mediated the effects of the self-relevance manipulation and denial orientation on message outcomes of intentions to change and priority given to sleep. These studies show that both situational and dispositional sources of denial work in similar ways by lowering key message judgments and that the lower judgments lead to less priority given to a health risk and lower intentions to protect oneself.

Positive messages enhance older adults' motivation and recognition memory for physical activity programmes.

Although physical activity is an effective way to cope with ageing-related impairments, few older people are motivated to turn their sedentary lifestyle into an active one. Recent evidence suggests that walking can be more effectively promoted in older adults with positive messages about the benefits of walking than with negative messages about the risks of inactivity. This study examined motivation and memory as the supposed mechanisms underlying the greater effectiveness of positively framed compared to negatively framed messages for promoting activity. Older adults (N = 53, age 60-87 years) were introduced to six physical activity programmes that were randomly paired with either positively framed or negatively framed messages. Participants indicated how motivated they were to participate in each programme by providing ratings on attractiveness, suitability, capability and intention. They also completed surprise free recall and recognition tests. Respondents felt more motivated to participate in physical activity programmes paired with positively framed messages than in those with negatively framed ones. They also had better recognition memory for positively framed than negatively framed messages, and misremembered negatively framed messages to be positively framed. Findings support the notion that socioemotional selectivity theory-a theory of age-related changes in motivation-is a useful basis for health intervention design.

Health messages to promote fruit and vegetable consumption at different stages: A match-mismatch design.

OBJECTIVE: To examine the effectiveness of matching health messages promoting fruit and vegetable intake to the Health Action Process Approach stages of change. DESIGN: In a randomised controlled trial, 205 undergraduate students (non-intenders n = 123; intenders n = 82) were exposed to one of three health messages, targeted at non-intenders, intenders and controls. MAIN OUTCOME MEASURES: Three longitudinal assessments of stage, fruit and vegetable intake, and social-cognitive determinants were obtained. RESULTS: Stage-specific effects of the interventions were confirmed. For self-efficacy, a stage by health message crossover interaction emerged, with both non-intenders and intenders in the matched conditions scoring higher in self-efficacy. Furthermore, in line with predictions, non-intenders in the matched condition showed higher risk perception, outcome expectancies, intention, and stage progression immediately after message exposure, and lower levels of action planning and coping planning a week later in the mismatched condition, but for these outcomes no differences across conditions were obtained among intenders. Multiple mediation analyses confirmed the facilitating role of self-efficacy and behavioural intention among non-intenders. CONCLUSIONS: Stages should be considered when designing health messages, although more interactive interventions for intenders and extended measurement time frames may be required.

Hypertensive patients' readiness to use of mobile phones and other information technological modes for improving their compliance to doctors' advice in Karachi.

OBJECTIVE: To determine the use of information technology (IT) & electronic media for improving compliance rate to doctors' advice in hypertensive patients in Karachi. METHODS: Total 400 persons (200 males & 200 females) were randomly selected in six districts of Karachi. Data was collected through a pretested questionnaire. Following was sample criteria: age above 15 years, living in Karachi and ambulatory. Persons admitted in a hospital, individuals who were doing some physical activity during survey e.g. exercise, labor work etc., individual in stressed condition, non-cooperative individuals - not willing to get BP checked and fill questionnaire, and pregnant women were excluded. Those who did not sign the consent form were also excluded. SPSS was used for data analysis and descriptive statistics was employed for sensitivity analysis. RESULTS: For healthcare awareness, people look for health programs on radio and TV channels. Short Message Service (SMS) and phone are highly appreciated by patients for reminders. To increase compliance to doctors' advice, less educated people prefer phone calls over SMS whereas educated individuals favor SMS. Although price of medicine has not emerged as a major contributing factor for non-compliance, discount on medicinal products is highly appreciated by the patients. CONCLUSION: The study concludes that there is a widespread awareness of high blood pressure in the sample population of Karachi e.g. 72.5%. People consider reminder message system i.e. Calls and Short Messaging Service (SMS) would help them in improving compliance to doctors' advice.

Health in arts: are arts settings better than sports settings for promoting anti-smoking messages?

AIM: Tobacco smoking is a leading cause of preventable mortality and morbidity. Since 1991, the Western Australian Health Promotion Foundation (Healthway) has sponsored the arts and sport in exchange for cigarette smoke-free events, smoke-free policies and the promotion of anti-smoking messages (e.g. Quit, Smoke Free or Smarter than Smoking). As health promoters often look for innovative and effective settings to advocate health, and as the approach of sponsoring the arts to promote health to the general population is uncommon, the purpose of this study was to evaluate the effectiveness of 'health in arts' by measuring the cognitive impact (message awareness, comprehension, acceptance and intention) of promoting anti-smoking messages at arts events, and comparing findings to sports events, a more traditional health promotion setting. METHOD: A secondary analysis of the 2004-2009 Healthway Sponsorship Monitor data was conducted. A total of 12 arts events (n = 592 respondents) and 9 sports events (n = 420 respondents) sponsored by Healthway to promote an anti-smoking message were evaluated. The study was cross-sectional in design. Participants were residents of Western Australia aged 15 years or above and attended events as part of an audience or as a spectator. Descriptive and regression analyses were conducted. RESULTS: After adjustment for demographic variables, smoking status and clustering, arts events were found to be as effective in promoting anti-smoking message awareness, comprehension and acceptance and twice as effective on intention to act (p = .03) compared with sports events. CONCLUSION: This study provides evidence of the effectiveness of arts sponsorship to promote health to the general population, that is, health in arts. Promoting an anti-smoking message in arts settings was as, or more, effective than in sports settings. Results suggest that the arts should be utilised to communicate and reinforce anti-smoking messages to the general population. The suitability of the arts to promote other types of health messages should be investigated further.