Searching from the heart: The interplay between emotions and customization in online health information seeking

The prospect of a threat to one's health or an opportunity for improved health can spark emotional reactions--the fear of an illness or the hope of a healthier life. People are increasingly turning to the Internet to search for information related to such health issues. However, the dizzying amount of online health information--some of it of dubious quality--makes the task of finding trustworthy and relevant health information difficult. One way to address this dilemma is to utilize technology's ability to provide users with customized content based on their unique desires and preferences. Grounded in the literatures on emotions, health information seeking, and customization, one approach to improving the efficiency and effectiveness of the health information seeking process would be to craft customized search engine results based on the user's situational emotion state. Further customizing of health search results based on dispositional aspects of the user's identity--in addition to the situational emotion--is a conceptually promising approach to improving the health information seeking process. This dissertation examined the relationship between types of emotional experiences and health information seeking as well as the interplay of emotion states and customization in the health information seeking process. The results revealed that discrete emotions have an important impact on multiple steps in the health information seeking process, from search query generation to post-search cognitions, attitudes, and behaviors. Additionally, the results indicate that customizing health-related search results based on situational factors may not be as effective as customizing search results based on dispositional aspects of a user's identity. Theoretical, methodological, and public health implications are discussed and directions for future research in this domain are offered.Doctor of Philosoph

Development and Validation of the Comprehensive Indoor Tanning Expectations Scale

IMPORTANCE: Strong links between indoor tanning behavior and skin cancer have been demonstrated across several studies. Understanding the complex belief systems that underlie indoor tanning in young women is a crucial first step in developing interventions to deter this behavior. OBJECTIVES: To develop and validate a comprehensive, multidimensional, theory-based outcome expectations measure to advance an understanding of the sets of beliefs that underlie indoor tanning behavior among young women. DESIGN, SETTING, AND PARTICIPANTS: Cross-sectional study comprising a web-based survey of 11 sororities at a large university in the southeastern United States. Study participants (n = 706) were aged 18 to 25 years; 45.3% had tanned indoors in their lifetime and 30.3% in the past year. MAIN OUTCOMES AND MEASURES: Intention to tan indoors, frequency of indoor tanning behavior in the past year, and indoor tanner type (nontanner, former tanner, or current tanner). RESULTS: A comprehensive scale assessing indoor tanning outcome expectations was developed. In total, 6 positive outcome expectations factors and 5 negative outcome expectations factors were identified. These subscales were reliable (coefficient α range, 0.86-0.95) and were significantly (mostly at P < .001) correlated with a set of established measures, including appearance motivation, indoor tanning attitudes and norms, and intention to tan indoors. Examination of subscales across the 3 indoor tanning groups also revealed significant (P < .001) differences on all 11 subscales. Current tanners had the most positive and least negative perceptions about indoor tanning, while nontanners had the most negative and least positive perceptions. Former tanners tended to fall in between these 2 groups. The 2 subscales with the largest differences across the groups were mood enhancement (positive outcome expectation) and psychological/physical discomfort (negative outcome expectation). Multiple linear regression analyses demonstrated several outcome expectations subscales to be significantly associated with intention to tan indoors and frequency of indoor tanning behavior. CONCLUSIONS AND RELEVANCE: Results suggest that the Comprehensive Indoor Tanning Expectations (CITE) Scale provides a reliable and valid assessment of the complex sets of beliefs that underlie indoor tanning, including positive (motivational) and negative (deterrent) beliefs. This new scale may further advance research on indoor tanning beliefs and can guide health communications to prevent and deter indoor tanning behavior

A Closer Look at Descriptive Norms and Indoor Tanning: Investigating the Intermediary Role of Positive and Negative Outcome Expectations

Indoor tanning is a risky behavior that dramatically increases skin cancer risk. Researchers from multiple disciplines aim to better understand this behavior to develop interventions and messages to curtail it. As such, we investigated the role of social norms and outcome expectations as predictors of tanning behavior as part of a larger test of constructs included in the Theory of Normative Social Behavior. In addition to offering additional empirical results to support theoretical claims for the importance of social norms and outcome expectations in predicting health behaviors, we offer indoor tanning-specific operationalizations in a conditional process model with the aim of assessing how content-specific measurements predict indoor tanning intentions. Results of a survey of adult indoor tanners from across the U.S. (N = 262) highlight when and how descriptive norms influence tanning intentions through the mediating roles of anticipatory socialization, injunctive norms, and health threat, and through the moderating role of mood-based tanning motivations. Implications for theory building as well as for intervention and message design are discussed

Mental Health and Its Predictors during the Early Months of the COVID-19 Pandemic Experience in the United States

To date, there has been relatively little published research on the mental health impacts of COVID-19 for the general public at the beginning of the U.S.&rsquo; experience of the pandemic, or the factors associated with stress, anxiety, depression, and post-traumatic growth during this time. The current study provides a longitudinal examination of the predictors of self-reported stress, anxiety, depression, and post-traumatic growth for U.S. residents between April and May, 2020, including the influence of demographic, psychosocial, and behavioral factors on these outcomes. The findings indicate that, generally, the early months of the U.S. COVID-19 experience were characterized by a modest negative impact on mental health. Younger adults, people with pre-existing health conditions, and those experiencing greater perceived risk, higher levels of rumination, higher levels of co-rumination, greater social strain, or less social support reported worse mental health. Positive mental health was associated with the adoption of coping strategies, especially those that were forward-looking, and with greater adherence to national health-protection guidelines. The findings are discussed with regard to the current status of health-protective measures and mental health in the U.S., especially as these impact future management of the on-going pandemic

Stories to Prevent Cancer: A Pilot Study Using Cancer Survivor Narratives to Increase Human Papillomavirus Vaccine Intentions

Introduction Human papillomavirus (HPV) vaccination rates are lower than other recommended adolescent vaccines. Cancer survivor narratives are used to promote cancer prevention and control, but little is known about their impact on adolescent HPV vaccination. Objective This pilot study explored the feasibility and effects of a video education intervention using a cancer survivor narrative to improve parents’ attitudes toward and intentions to get the HPV vaccine. Methods This study utilized a one-group design; participants completed a pre-intervention survey, watched the video before attending their sons’ wellness visits, and completed a post-intervention survey within one week of their appointment. Using the narrative persuasion framework, we developed a 4-minute video of a local HPV-related cancer survivor to promote the HPV vaccine as cancer prevention. We recruited 37 participants between June and October 2020. Participants were parents of males ages 9-17 who had not yet initiated HPV vaccination. Results After the video, more parents agreed that HPV vaccination is safe (pre: 66% vs. post: 82%; P = .045) and that their child’s chances of getting HPV-related cancer in the future are high (pre: 24% vs. post: 46%; P = .014). Overall, 91% of parents felt the cancer survivor story helped them understand the risks of HPV cancers, and 52% said the story influenced their decision to start HPV vaccination for their child. Conclusions Our findings suggest that cancer survivor narratives influence parents’ vaccine opinions and understanding of their child’s risk of HPV infection, leading to increased parental intent to get the HPV vaccine for their adolescent males