Testing the Effects of Certain versus Hypothetical Language in Health Risk Messages.
Ontology highlight
ABSTRACT:
SUBMITTER: Katz SJ
PROVIDER: S-EPMC7269152 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Publications
Testing the Effects of Certain versus Hypothetical Language in Health Risk Messages.
Katz Sherri Jean SJ Byrne Sahara S Mathios Alan D AD Avery Rosemary J RJ Dorf Michael C MC Safi Amelia Greiner AG Niederdeppe Jeff J
Communication monographs 20190718 1
This paper tests how the certainty or hypotheticality conveyed through language can be harnessed to enhance the effectiveness of targeted messaging about health risks. We conducted two experiments with adult smokers (<i>n</i> = 317) and middle school youth (<i>n</i> = 321) from low-income communities in the context of pictorial cigarette warning labels. We manipulated hypotheticality of risk through verb modality: 1. non-modal <i>(present tense, e.g., smoking causes cancer)</i>, and modal/hypoth ...[more]
Similar Datasets
Project description:BackgroundHealth messages on e-cigarette packs emphasise nicotine addiction or harms using similar wording to warnings on cigarette packs. These may not be appropriate for e-cigarettes which constitute a reduced risk alternative for smokers. This research aimed to (1) develop and test a selection of relative risk messages for e-cigarette products; (2) compare these to the two current EU Tobacco Products Directive (TPD) nicotine addiction messages; and (3) explore differences between smokers, non-smokers and dual users.MethodTwenty-six messages focusing on either harm-reduction or cessation were developed and rated by multidisciplinary experts for accuracy, persuasiveness and clarity. The eight highest ranking messages were compared alongside the TPD messages in a sample of 983 European residents (316 smokers, 327 non-smokers, 340 dual users) on understandability, believability and convincingness.ResultsOn all three constructs combined, the two TPD messages rated the highest, closely followed by four relative risk messages "Completely switching to e-cigarettes lowers your risk of smoking related diseases", "Use of this product is much less harmful than smoking", "Completely switching to e-cigarettes is a healthier alternative to smoking", and "This product presents substantially lower risks to health than cigarettes" which did not differ statistically from the TPD messages. Non-smokers rated TPD1 significantly higher overall than dual users. Dual users rated "This product is a safer alternative to smoking" significantly higher than non-smokers. Messages did not differ on understandability.ConclusionsThese alternative messages provide a useful resource for future research and for policy makers considering updating e-cigarette product labelling.
| S-EPMC8424813 | biostudies-literature
Project description:IntroductionHealth agencies are grappling with communicating risks of electronic cigarettes (e-cigarettes) compared with combusted cigarettes. This study examined smokers' responses to two types of comparative risk messages with one type incorporating more negative antismoking elements in the design.MethodsIn an online experiment, 1400 US adult (18+ years) current smokers and recent quitters were randomised to view one of three comparative risk messages about e-cigarettes (CR messages), one of three comparative risk messages that included more negative antismoking elements in the design (CR- messages) or a control message. Selection of outcomes was guided by the antismoking message impact framework. Multivariate analyses of covariance and logistic regression models analysed effects of messages on message evaluations, e-cigarette-related and cigarette-related beliefs and behavioural intentions.ResultsBoth CR and CR- messages decreased smokers' intentions to smoke cigarettes, increased intentions to switch to e-cigarettes completely and increased perceptions that e-cigarettes are less harmful than combusted cigarettes. Neither message type increased dual use intentions relative to exclusive e-cigarettes use or smoking cessation. CR messages decreased perceived absolute risks of e-cigarettes and self-exempting beliefs about smoking, whereas CR- versus CR messages produced higher self-efficacy to quit smoking.ConclusionComparative risk communication might encourage smokers to switch to lower-harm tobacco products. Comparative risk messages with more negative antismoking elements in the design might be particularly effective, because they led to higher self-efficacy to quit smoking. Regulatory agencies may consider using comparative risk messages with more negative antismoking elements to educate the public about lower risk of e-cigarettes.
| S-EPMC6374208 | biostudies-literature
Project description:Patients experiencing mental health crises often seek help through messaging-based platforms, but may face long wait times due to limited message triage capacity. Here we build and deploy a machine-learning-enabled system to improve response times to crisis messages in a large, national telehealth provider network. We train a two-stage natural language processing (NLP) system with key word filtering followed by logistic regression on 721 electronic medical record chat messages, of which 32% are potential crises (suicidal/homicidal ideation, domestic violence, or non-suicidal self-injury). Model performance is evaluated on a retrospective test set (4/1/21-4/1/22, N = 481) and a prospective test set (10/1/22-10/31/22, N = 102,471). In the retrospective test set, the model has an AUC of 0.82 (95% CI: 0.78-0.86), sensitivity of 0.99 (95% CI: 0.96-1.00), and PPV of 0.35 (95% CI: 0.309-0.4). In the prospective test set, the model has an AUC of 0.98 (95% CI: 0.966-0.984), sensitivity of 0.98 (95% CI: 0.96-0.99), and PPV of 0.66 (95% CI: 0.626-0.692). The daily median time from message receipt to crisis specialist triage ranges from 8 to 13 min, compared to 9 h before the deployment of the system. We demonstrate that a NLP-based machine learning model can reliably identify potential crisis chat messages in a telehealth setting. Our system integrates into existing clinical workflows, suggesting that with appropriate training, humans can successfully leverage ML systems to facilitate triage of crisis messages.
| S-EPMC10663535 | biostudies-literature
Project description:BackgroundNearly 1 in 5 people living with HIV in the United States are unaware they are infected. Therefore, it is important to develop and evaluate health communication messages that clinicians can use to encourage HIV testing.MethodsThe objective was to evaluate health communication messages designed to increase HIV testing rates among women and evaluate possible moderators of message effect. We used a randomized four-arm clinical trial conducted at urban community outpatient health clinics involving 1,919 female patients, 18 to 64 years old. The four health message intervention groups were: i) information-only control; ii) one-sided message describing the advantages of HIV testing; iii) two-sided message acknowledging a superficial objection to testing (i.e., a 20 minute wait for results) followed by a description of the advantages of testing; and iv) two-sided message acknowledging a serious objection (i.e., fear of testing positive for HIV) followed by a description of the advantages of testing. The main outcome was acceptance of an oral rapid HIV test.ResultsParticipants were randomized to receive the control message (n = 483), one-sided message (n = 480), two-sided message with a superficial objection (n = 481), or two-sided message with a serious objection (n = 475). The overall rate of HIV test acceptance was 83%. The two-sided message groups were not significantly different from the controls. The one-sided message group, however, had a lower rate of testing (80%) than the controls (86%) (OR, 0.66; 95% CI, 0.47-0.93; P = 0.018). "Perceived obstacles to HIV testing" moderated this effect, indicating that the decrease in HIV test acceptance for the one-sided message group was only statistically significant for those who had reported high levels of obstacles to HIV testing (OR, 0.36; 95% CI, 0.19-0.67; P = 0.001).ConclusionsNone of the messages increased test acceptance. The one-sided message decreased acceptance and this effect was particularly true for women with greater perceived obstacles to testing, the very group one would most want to persuade. This finding suggests that efforts to persuade those who are reluctant to get tested, in some circumstances, may have unanticipated negative effects. Other approaches to messaging around HIV testing should be investigated, particularly with diverse, behaviorally high-risk populations.Trial registrationClinicaltrials.gov Identifier: NCT00771537. Registration date: October 10. 2008.
| S-EPMC4243315 | biostudies-literature
Project description:AimsMental health-related stigma is a major challenge associated with the huge mental health treatment gap. It has remained unclear what kind of educational content is effective in reducing the stigma. Whether biomedical messages (BMM) about mental illness are effective or harmful in decreasing stigma is controversial. To investigate whether BMM can improve practically useful knowledge of mental illness, comparably to recommended messages (RCM) advocated by experts, of types such as 'recovery-oriented', 'social inclusion/human rights' and 'high prevalence of mental illnesses' through a randomised controlled trial (RCT).MethodThis study is an individual-level RCT with a parallel-group design over 1 year, conducted in Tokyo, Japan. A total of 179 participants (males n = 80, mean age = 21.9 years and s.d. = 7.8) were recruited in high schools and universities, and through a commercial internet advertisement in June and July 2017, without any indication that the study appertained to mental health. Participants were allocated to the BMM and RCM groups. They underwent a 10-min intervention, and completed self-report questionnaires during baseline, post-test, 1-month follow-up and 1-year follow-up surveys. The primary outcome measures were practically useful knowledge of mental illness at the post-test survey using the Mental Illness and Disorder Understanding Scale (MIDUS). Analysis was conducted in October 2018.ResultsBoth groups demonstrated improved MIDUS score in the post-test survey, and showed similar intervention effects (F(1, 177) = 160.5, p < 0.001, η2 = 0.48). The effect of the interventions continued until the 1-year follow-up survey (B [95% CI] = -2.56 [-4.27, -0.85], p < 0.01), and showed no difference between groups. The reported adverse effect that BMM increase stigma was not confirmed.ConclusionsBMM may have a positive impact on stigma, comparable to RCM. These findings may encourage reconsideration of the content of messages about mental health, as it is indicated that combining BMM and RCM might contribute to an effective anti-stigma programme.
| S-EPMC8061129 | biostudies-literature
Project description:Limited health literacy is a barrier to optimal healthcare delivery and outcomes. Current measures requiring patients to self-report limitations are time-consuming and may be considered intrusive by some. This makes widespread classification of patient health literacy challenging. The objective of this study was to develop and validate "literacy profiles" as automated indicators of patients' health literacy to facilitate a non-intrusive, economic and more comprehensive characterization of health literacy among a health care delivery system's membership. To this end, three literacy profiles were generated based on natural language processing (combining computational linguistics and machine learning) using a sample of 283,216 secure messages sent from 6,941 patients to their primary care physicians. All patients were participants in Kaiser Permanente Northern California's DISTANCE Study. Performance of the three literacy profiles were compared against a gold standard of patient self-reported health literacy. Associations were analyzed between each literacy profile and patient demographics, health outcomes and healthcare utilization. T-tests were used for numeric data such as A1C, Charlson comorbidity index and healthcare utilization rates, and chi-square tests for categorical data such as sex, race, poor adherence and severe hypoglycemia. Literacy profiles varied in their test characteristics, with C-statistics ranging from 0.61-0.74. Relations between literacy profiles and health outcomes revealed patterns consistent with previous health literacy research: patients identified via literacy profiles indicative of limited health literacy: (a) were older and more likely of minority status; (b) had poorer medication adherence and glycemic control; and (c) exhibited higher rates of hypoglycemia, comorbidities and healthcare utilization. This represents the first successful attempt to employ natural language processing to estimate health literacy. Literacy profiles can offer an automated and economical way to identify patients with limited health literacy and greater vulnerability to poor health outcomes.
| S-EPMC6386302 | biostudies-literature
Project description:IntroductionYoung adults in the military are aggressively targeted by tobacco companies and are at high risk of tobacco use. Existing antismoking advertisements developed for the general population might be effective in educating young adults in the military. This study evaluated the effects of different themes of existing antismoking advertisements on perceived harm and intentions to use cigarettes and other tobacco products among Air Force trainees.MethodsIn a pretest-post-test experiment, 782 Airmen were randomised to view antismoking advertisements in 1 of 6 conditions: anti-industry, health effects+anti-industry, sexual health, secondhand smoke, environment+anti-industry or control. We assessed the effect of different conditions on changes in perceived harm and intentions to use cigarettes, electronic cigarettes, smokeless tobacco, hookah and cigarillos from pretest to post-test with multivariable linear regression models (perceived harm) and zero-inflated Poisson regression model (intentions).ResultsAntismoking advertisements increased perceived harm of various tobacco products and reduced intentions to use. Advertisements featuring negative effects of tobacco on health and sexual performance coupled with revealing tobacco industry manipulations had the most consistent pattern of effects on perceived harm and intentions.ConclusionsAntismoking advertisements produced for the general public might also be effective with a young adult military population and could have spillover effects on perceptions of harm and intentions to use other tobacco products besides cigarettes. Existing antismoking advertising may be a cost-effective tool to educate young adults in the military.
| S-EPMC4837096 | biostudies-literature
Project description:BackgroundExisting initiatives to promote healthy eating remain largely ineffective as individuals struggle to adhere to dietary recommendations. Therefore, challenging the strategies currently used is of significant importance. Recent studies have indicated the potential of an approach oriented towards eating pleasure to promote the consumption of healthy foods.ObjectivesThe aim of this study was to compare perceptions and the potential effect of pleasure-oriented and health-oriented messages promoting healthy eating among French-Canadians.MethodsTwo leaflets similar in all respects, except for the message orientation (pleasure or health), were developed. Perceived message orientation and effectiveness, perceptions towards healthy eating as well as emotions, attitude towards healthy eating, and intention to eat healthily were evaluated. A total of 100 adults (50% women; mean ± SD age 45.1 ± 13.0 y) were randomly assigned to read 1 of the 2 leaflets (pleasure: n = 50; health: n = 50). Questionnaires were completed online and data were also collected at a visit made to the Institute of Nutrition and Functional Foods.ResultsThe difference in message orientation (pleasure compared with health) was well perceived by participants (P ≤ 0.01). The pleasure-oriented message was successful in inducing the perception that eating healthy can be pleasurable (pre- compared with post-reading; P = 0.01). Perceived message effectiveness and induced emotions in response to reading were similar between leaflets. Both messages significantly improved global attitude towards healthy eating (P ≤ 0.01) and increased intention to eat healthily (P < 0.001). Additional analyses showed that the affective attitude towards healthy eating increased more after reading the pleasure leaflet than the health leaflet (P = 0.05), whereas the health message tended to improve cognitive attitude more than the pleasure leaflet (P = 0.06).ConclusionsThese findings suggest that the leaflets would be appropriate to promote healthy eating through 2 distinct approaches (health and pleasure paradigms) and propose that different effects on attitude could be observed from these 2 approaches.
| S-EPMC6470394 | biostudies-literature
Project description:ImportanceVirtual patient-physician communications have increased since 2020 and negatively impacted primary care physician (PCP) well-being. Generative artificial intelligence (GenAI) drafts of patient messages could potentially reduce health care professional (HCP) workload and improve communication quality, but only if the drafts are considered useful.ObjectivesTo assess PCPs' perceptions of GenAI drafts and to examine linguistic characteristics associated with equity and perceived empathy.Design, setting, and participantsThis cross-sectional quality improvement study tested the hypothesis that PCPs' ratings of GenAI drafts (created using the electronic health record [EHR] standard prompts) would be equivalent to HCP-generated responses on 3 dimensions. The study was conducted at NYU Langone Health using private patient-HCP communications at 3 internal medicine practices piloting GenAI.ExposuresRandomly assigned patient messages coupled with either an HCP message or the draft GenAI response.Main outcomes and measuresPCPs rated responses' information content quality (eg, relevance), using a Likert scale, communication quality (eg, verbosity), using a Likert scale, and whether they would use the draft or start anew (usable vs unusable). Branching logic further probed for empathy, personalization, and professionalism of responses. Computational linguistics methods assessed content differences in HCP vs GenAI responses, focusing on equity and empathy.ResultsA total of 16 PCPs (8 [50.0%] female) reviewed 344 messages (175 GenAI drafted; 169 HCP drafted). Both GenAI and HCP responses were rated favorably. GenAI responses were rated higher for communication style than HCP responses (mean [SD], 3.70 [1.15] vs 3.38 [1.20]; P = .01, U = 12 568.5) but were similar to HCPs on information content (mean [SD], 3.53 [1.26] vs 3.41 [1.27]; P = .37; U = 13 981.0) and usable draft proportion (mean [SD], 0.69 [0.48] vs 0.65 [0.47], P = .49, t = -0.6842). Usable GenAI responses were considered more empathetic than usable HCP responses (32 of 86 [37.2%] vs 13 of 79 [16.5%]; difference, 125.5%), possibly attributable to more subjective (mean [SD], 0.54 [0.16] vs 0.31 [0.23]; P < .001; difference, 74.2%) and positive (mean [SD] polarity, 0.21 [0.14] vs 0.13 [0.25]; P = .02; difference, 61.5%) language; they were also numerically longer (mean [SD] word count, 90.5 [32.0] vs 65.4 [62.6]; difference, 38.4%), but the difference was not statistically significant (P = .07) and more linguistically complex (mean [SD] score, 125.2 [47.8] vs 95.4 [58.8]; P = .002; difference, 31.2%).ConclusionsIn this cross-sectional study of PCP perceptions of an EHR-integrated GenAI chatbot, GenAI was found to communicate information better and with more empathy than HCPs, highlighting its potential to enhance patient-HCP communication. However, GenAI drafts were less readable than HCPs', a significant concern for patients with low health or English literacy.
| S-EPMC11252893 | biostudies-literature
Project description:This study examined racial oral health disparities among Non-Hispanic Whites, Non-Hispanic Blacks, and Hispanics. For Hispanics, this study also examined the role of language in oral health disparities between English-speaking Hispanics and Spanish-speaking Hispanics. This study included 12, 307 adults older than 20 from the National Health and Nutrition Examination Survey (NHANES) 2011-2016. Oral health is measured by self-rated oral health, the frequencies of dentist visits, and the number of missed teeth. Exposures of interest referred to social gradients, which include education, annual family income, foreign born, and citizenship. Covariates included age, gender, and marital status. Ordinal logistic regression models were used to estimates the effects of social gradients on self-rated oral health and dentist visits. Negative binomial regression model was applied to estimate the effects of social gradients on the number of missed teeth. Overall, Spanish-speaking Hispanics presented the most disadvantaged social gradients and the worst oral health results. Non-Hispanic Blacks and English-speaking Hispanics reported disadvantaged oral health status when compared to Non-Hispanic Whites. Foreign-born, higher education levels and annual family income play protective role on oral health outcomes, while respondents who do not have citizenship are at higher risk of self-rated fair/poor oral health and dentist visits.
| S-EPMC6658987 | biostudies-literature