Tobacco cues in India: An ecological momentary assessment

Funding for Open Access provided by the UMD Libraries Open Access Publishing Fund.Background: Tobacco use in India is a major health concern; however, little is known about the influence of tobacco-related social and environmental cues on tobacco use. This study uses ecological momentary assessment (EMA) to examine real-time tobacco use and exposure to social and environmental cues. Methods: In Hyderabad and Kolkata, participants were recruited, and an EMA application was installed on their mobile phones. Momentary prompts (MP) were randomly used to collect real-time information and end-of-day (EOD) prompts gathered retrospective information on daily basis. Besides personal tobacco use, the surveys asked about exposure to social (e.g., presence of others using tobacco) and environmental cues (e.g., visual and olfactory stimuli). Using the data aggregation approach, bivariate and multivariate analyses were performed to examine the association of tobacco use and cue exposure. Moderating roles of participants’ socio-demographic characteristics were also tested to gain an in-depth understanding of the relationship. Results: Among the 205 participants, around a third (MP, 33.7 %; EOD, 37.6 %) used tobacco at least once during the study period. Tobacco-related social and environmental cues related were commonly reported. In the bivariate models, tobacco use was associated with gender, age, and all the examined social and environmental cues except for seeing restrictions on tobacco use. In the multivariate models, tobacco use was associated with age, gender, seeing others using tobacco, and seeing restrictions on tobacco use. Seeing others in one’s immediate group using tobacco was the strongest predictor of tobacco use in both MP and EOD assessments. Gender and age did not moderate the relationship between cue exposure and tobacco use, although males reported higher tobacco use and cue exposure in general. Conclusions: This research provides data on the ubiquity of social and environmental tobacco cues in India. The EMA approach was feasible and informative. Future cessation interventions and advocacy efforts should address the high prevalence of tobacco use and exposure to pro-tobacco use cues especially among Indian males. Health education campaigns for promoting tobacco use restrictions in private places as well as changing the norms of tobacco use in social settings are recommended

“It’s Got to Be on This Page”: Age and Cognitive Style in a Study of Online Health Information Seeking

Funding for Open Access provided by the UMD Libraries Open Access Publishing Fund.Background: The extensive availability of online health information offers the public opportunities to become independently informed about their care, but what affects the successful retrieval and understanding of accurate and detailed information? We have limited knowledge about the ways individuals use the Internet and the personal characteristics that affect online health literacy. Objective: This study examined the extent to which age and cognitive style predicted success in searching for online health information, controlling for differences in education, daily Internet use, and general health literacy. Methods: The Online Health Study (OHS) was conducted at Johns Hopkins School of Public Health and Stanford University School of Medicine from April 2009 to June 2010. The OHS was designed to explore the factors associated with success in obtaining health information across different age groups. A total of 346 men and women aged 35 years and older of diverse racial and ethnic backgrounds participated in the study. Participants were evaluated for success in searching online for answers to health-related tasks/questions on nutrition, cancer, alternative medicine, vaccinations, medical equipment, and genetic testing. Results: Cognitive style, in terms of context sensitivity, was associated with less success in obtaining online health information, with tasks involving visual judgment most affected. In addition, better health literacy was positively associated with overall success in online health seeking, specifically for tasks requiring prior health knowledge. The oldest searchers were disadvantaged even after controlling for education, Internet use, general health literacy, and cognitive style, especially when spatial tasks such as mapping were involved. Conclusions: The increasing availability of online health information provides opportunities to improve patient education and knowledge, but effective use of these resources depends on online health literacy. Greater support for those who are in the oldest cohorts and for design of interfaces that support users with different cognitive styles may be required in an age of shared medical decision making

Young children’s perceptions of health warning labels on cigarette packages: a study in six countries

AIM: Health warning labels on cigarette packages are one way to reach youth thinking about initiating tobacco use. The purpose of this study was to examine awareness and understanding of current health warning labels among 5 and 6 year old children. SUBJECTS AND METHODS: Researchers conducted one-on-one interviews with urban and rural 5 and 6 year olds from Brazil, China, India, Nigeria, Pakistan, and Russia. RESULTS: Among the 2,423 participating children, 62 % were unaware of the health warnings currently featured on cigarette packages, with the lowest levels of awareness in India and the highest levels in Brazil. When shown the messages, the same percentage of participating children (62 %) showed no level of message understanding. CONCLUSION: While youth are receiving social and informational messages promoting tobacco use, health warning labels featured on cigarette packages are not effectively reaching young children with anti-smoking messages

Cleaner, Happier, Healthier: Sesame Workshop’s Water, Sanitation, and Hygiene Intervention among Low-Income Groups in Bangladesh and India

This article evaluates a pilot intervention of Sesame Workshop’s “Cleaner, Happier, Healthier” media program promoting water, sanitation, and hygiene (WASH) knowledge, attitudes, and behaviors among vulnerable children and their families in impoverished areas of Bangladesh (n = 240) and India (n = 258). Raya, a new Muppet® was developed and introduced, advocating for healthier WASH behaviors. As part of the intervention, two approaches to health messaging were developed framing WASH as a personal behavior (the “me” intervention) or a social endeavor (the “we” intervention). In each country a three-armed approach employed groups focused on the “me” and “we” interventions and a comparison group. Both the “me” and “we” groups improved in WASH measures over the comparison group; however, there were limited differences between the “me” and “we” groups. Target behaviors, such as using the latrine, wearing shoes, and handwashing, improved when examining change before and after the intervention, and the intervention was predictive of positive knowledge, attitude, and behavior change. Results of this work are limited due to lack of a randomized control trial but suggest that participants who received the “Cleaner, Healthier, Happier” interventions will be more prone to engage in healthier hygiene behaviors

Emotions, Strategies, and Health: Examining the Impact of an Educational Program on Tanzanian Preschool Children

Around the world, well-produced television programming can engage vulnerable, hard-to-reach audiences by offering informal education and enrichment. Akili and Me is an animated children’s educational program available in Sub-Saharan Africa that provides age and culturally appropriate lessons. In 2018, the producers created socio-emotional and health content. This study examines the relationship between children’s exposure to the new Akili and Me content and socio-emotional and health outcomes. Participants included low-income school children (mean age 5.32 years, SD = 0.82) from Arusha, Tanzania. Researchers conducted one-on-one baseline and post-intervention surveys with each participant. Over 12 weeks, the children attended afterschool sessions with screenings of Akili and Me, with distinct content screened on different days. The research team recorded children’s attendance and assessed children’s receptivity to the program through character identification. Using MLM regression models with data from 411 participants from 10 public schools, the analyses showed that a greater exposure and receptivity to Akili and Me predicted improved outcomes scores on the socio-emotional and health outcomes, controlling for sex, age, baseline scores, and general media receptivity (non-Akili and Me characters). Contributing to the literature on educational media, this study shows that exposure to an animated program can teach vulnerable preschool children socio-emotional and health content