An Investigation into the Portrayal of Organ Donation on Grey's Anatomy Seasons 1 Through 15

The current project sought to extend prior research examining organ donation portrayals on Grey's Anatomy by examining the first fifteen seasons. Guided by the health belief model, content analysis revealed more attention was given to benefits of donation than barriers. Contrary to previous research, more attention was given to refuting rather than promoting commonly cited myths. The results also address attention to the health threat as well as Grey's Anatomy's representation of self-efficacy in registering to be an organ donor. Finally, proportion tests revealed significant differences between the types of organs transplanted on Grey's Anatomy compared to organs transplanted in the United States. The results are discussed with an emphasis on portrayal trends throughout Season 1 through 15 as well as the theoretical and practical implications of our findings.

"Saving Students' Lives": Instructor Sharing of Run-Hide-Fight® Emergency Preparedness Materials

When emergency situations occur, it is essential that individuals can effectively respond to keep themselves and others safe. One attempt at increasing individuals' readiness for an emergency is the Run-Hide-Fight® campaign, which has been adopted by several higher education institutions in the United States. This study explores the dissemination of this campaign by instructors at a large Midwestern university in the United States. We generally find support for the reasoned action perspective, with attitudes, norms, and perceived behavioral control influencing intentions to share the emergency preparedness video with students. Through open-ended responses provided by the instructors, we identify four main themes surrounding video dissemination. First, most instructors felt comfortable sharing the video, believing it would be useful in preparing students for an emergency. Second, some instructors voiced concerns about the negative emotional effects the video may have on students. Third, instructors generally appreciated the brief and effective delivery of the message, though some were concerned about dramatizing emergencies. Finally, instructors suggested ways of improving the video, such as including more specific guidance on how to behave in an emergency situation. Practically, these findings suggest that universities should consider their emergency preparedness information dissemination strategy to maximize credibility, minimize message fatigue, and reach more students. Theoretically, this study affirms the tenets of reasoned action and suggests alternative theoretical approaches for future scholarship.

Can Happiness and Sadness Overcome Organ Donation Barriers Following Exposure to Radio Ads?

Concerns related to bodily integrity, medical mistrust, superstition, and disgust with respect to organ transplantation remain commonly cited barriers among African American, Caucasian, and Hispanic non-donors. The current study examined two narrative strategies for mitigating these barriers by eliciting feelings of happiness or sadness. African American, Caucasian, and Hispanic non-donors (N = 576) were randomly assigned to a radio ad that communicated either a recipient narrative or a waiting list narrative. As expected, the recipient narrative elicited greater feelings of happiness whereas the waiting list narrative aroused greater feelings of sadness. Moderated mediation analyses revealed models in which happiness, not sadness, was the mediator, such that the narrative frame was associated with ad persuasiveness. Additionally, only medical mistrust interacted with happiness to predict ad persuasiveness The results are discussed with an emphasis on message design strategies to employ among reluctant adult African American, Caucasian, and Hispanic potential donors.

An evaluation of the license to save lives program to promote organ, eye, and tissue donation among teenagers

As the number of designated organ donors continues to lag behind the number of waiting list patients, teenagers remain a promising demographic of potential organ donors. The current study enlisted Michigan and Ohio driver education students to participate in an online digital learning intervention, License to Save Lives (LTSL). Students were randomly assigned to either an interactive or noninteractive LTSL intervention. Across both states, the pretest-posttest design revealed greater knowledge among students following exposure to either the interactive or noninteractive LTSL program. No attitudinal or behavioral differences emerged between the interactive and noninteractive conditions. Michigan (39.82%) and Ohio (58.10%) students registered to be organ donors at a respectable rate. The results are discussed with an emphasis on feasibility and sustainability as well as the promise for digital games to promote organ donation knowledge, attitude, and registration among teenagers.

A Reasoned Action Approach to Limiting Excessive Social Media Usage Among Adults

The literature on social media suggests a link between use and negative mental health consequences. Numerous theoretical perspectives have attempted to explain the underlying mechanisms for this relationship but are lacking a clear explanation for why some individuals may be negatively impacted by their social media use. Despite a plethora of research on this relationship, minimal research has examined the act of limiting social media use as a promotional behavior. This study takes a fresh approach by investigating attitudinal components that predict intentions to limit social media use via the reasoned action approach. US adults (N = 298) participated in an online survey on excessive social media use. Attitudes, perceived norms, and perceived behavioral control were significant predictors of intentions to limit social media use. In addition, perceived behavioral control was hypothesized to moderate both the attitude to intention and norm to intention relationships in that these associations would be stronger for those with higher control beliefs. Results showed that strong control beliefs strengthened the attitudes to intentions relationship but weakened the norm to intention relationship. Future practical and research directions are discussed to promote limiting social media use and further investigate the negative mental health outcomes of excessive social media.

A Test of Autonomy Restoration Postscripts to Mitigate Psychological Reactance to an Opt-Out Organ Donor Registry in the United States

The organ shortage continues to present problems around the world including the United States. In response, some countries have switched from an opt-in organ donor registry to an opt-out registry. The United States currently utilizes an opt-in registry where an individual is not considered an organ donor until they register their intentions. In the current study, U.S. adults were randomly assigned to a 2 (message valence: promotional, refutational) x 2 (autonomy restoration postscript: present, not present) x 2 (social proof: high likes, low likes) posttest only control group design evaluating social media message regarding an opt-out organ donor registry for implementation in the U.S. Results revealed an interaction between message valence and autonomy on freedom threat perceptions toward the message. Consistent with psychological reactance theory, freedom threat perceptions were positively associated with reactance, which in turn was positively associated with an intention to sign a petition and call a representative to voice disapproval of the opt-out organ donor registry. The discussion is focused on pragmatic recommendations for organ donor practitioners and advocates as well as the theoretical contributions to reactance theory.

Raising Concussion Awareness among Amateur Athletes: An Examination of the Centers for Disease Control and Prevention's (CDC) Heads Up Campaign

Attention to concussion prevention and management has grown in recent years due to the potentially long-term, debilitating effects a head injury can have on an individual. Although multiple campaigns have been designed to target this issue, there remains a need to evaluate the persuasive principles used to advocate for safety measures and protocols, specifically within youth sports. With this in mind, we applied the health belief model (HBM) in our content analysis of the Centers for Disease Control and Prevention's (CDC) Heads Up concussion awareness campaign. Campaign videos (N = 35) were coded for threat severity, threat susceptibility, benefits, barriers, self-efficacy, and cues to action. The majority of videos communicated the seriousness of concussions and attempts to communicate concussion susceptibility were driven by personal stories, rather than facts and statistics demonstrating concussion prevalence. Less than half of the videos communicated the benefits of following concussion protocols and only a third of the messages described barriers to following recommended protocols. The majority of videos aimed to elevate self-efficacy among athletes and parents, but not coaches, by focusing on identifying symptoms and concussion avoidance. The implications for concussion prevention and management among athletes, parents, and coaches are discussed.

State mask mandates and psychological reactance theory: The role of political partisanship and COVID-19 risk in mask adoption and resistance

RATIONALE

Psychological reactance theory was applied to examine the implications of state-level mask mandates in the United States during the COVID-19 pandemic. We evaluated the role of political partisanship and COVID-19 risk on changes in self-reported mask wearing before and after the imposition and removal of state mask mandates.

METHOD

Secondary data from several sources were aggregated about self-reported mask wearing behavior, state mandates, COVID-19 infection rates, and state-level political partisanship. Difference-in-differences tests were performed using logistic regression to evaluate whether change in mask wearing behavior following the imposition or removal of a mandate was greater in states based on state-level political partisanship and COVID-19 infection rates.

RESULTS

Although mask adoption generally increased following mandates, the amount of increase was smaller in more Republican states compared to more Democratic states. Mask wearing generally decreased following the removal of mandates, with greater decreases when COVID-19 infection rates were lower.

CONCLUSION

The results collectively offer insights about the nuanced role of contextual factors in the adoption and resistance to masks following state mask mandates. Partisanship was important in responses to the imposition of state mask mandates and COVID-19 risk played a critical role in responses to mandate removal.

Psychological Reactance Theory and COVID-19 Vaccine Mandates: The Roles of Threat Magnitude and Direction of Threat

The current study examines psychological reactance theory (PRT), focusing on the role of threat directness and threat magnitude in the context of a COVID-19 vaccine mandate. Students on two college campuses in the United States (N = 374) were informed that their university or the other university (i.e., threat directness manipulation) was considering a vaccinate mandate for the following semester that would or would not include sanctions for noncompliance (i.e., threat magnitude manipulation). Participants experienced significantly greater freedom threat perceptions when the mandate included sanctions compared to when it did not, but freedom threat perception did not differ when the mandate was on their own campus as to the other campus. An interaction effect was also observed in which perceived freedom threat and reactance was greatest among participants receiving an indirect (as opposed to direct) threat with sanctions. Findings are discussed with an emphasis on the theoretical contribution to PRT along with the practical implications for vaccine mandates.

Message Fatigue and Resistance to Anti-Binge Drinking Messages: Examining the Mediating Roles of Inattention and Reactance

OBJECTIVE

The current study examined message fatigue as a theoretical explanation for college students' resistance to anti-binge drinking messaging. Specifically, inattention and psychological reactance were examined as mediators bridging the message fatigue and perceived message effectiveness relationship.

METHOD

University students (N = 783, 60% female) were recruited by the university's SONA sampling system to participate in an online Qualtrics survey where they read a message discouraging binge drinking.

RESULTS

In line with our predictions, structural equation modeling revealed that message fatigue was positively associated with both inattention and reactance (as mediated by freedom threat). In turn, inattention, but not reactance, was negatively associated with perceived message effectiveness.

CONCLUSIONS

The current findings suggest that there may be deleterious consequences of message fatigue when discouraging binge drinking. The current results also highlight the importance of pilot testing anti-binge drinking messages for message fatigue during formative research to avoid triggering maladaptive outcomes.

An examination of teenagers' beliefs toward organ donor registration

Teenagers represent a promising target population for organ donor registration efforts, as in the US teenagers age 15-17 may register their intent for organ donation, which later translates to consent at age 18. However, teenagers constitute a relatively understudied population in the organ donation literature. A sample of teenagers (N = 466) ranging in age from 13 to 19 was recruited from driver's education schools in Ohio and Michigan in order to learn more about their perceived reasons for and against registering as an organ donor. A coding scheme was developed, and responses were coded by two trained coders. In line with previous work in adult samples, our results revealed the three most common reasons for registering were prosocial benefits, rational arguments, and personal experience. In contrast to previous work among adults, the two most common reasons for not registering were bodily integrity and religious reasons. Several novel beliefs among teenagers that were both supportive and non-supportive of organ donor registration were identified. Findings from the current study are discussed with an emphasis on implications for practitioners working to promote organ donor registration among teenage audiences.

An application of the theory of normative social behavior to bystander intervention for sexual assault

Objective: Given the high prevalence of sexual assault on U.S. college campuses, the current study examines predictors of college students' intentions to intervene to prevent sexual assault through the lens of the theory of normative social behavior (TNSB). Participants: One hundred eighty-six undergraduate students age 18-25 were recruited from an introductory course at a large Midwestern university. Methods: Data were collected through an online survey during the 2015-2016 academic year. Results: Results indicated that descriptive norms, injunctive norms, and outcome expectations had direct positive effects on behavioral intention. However, no direct effect of group identity on intention was found. In addition to these main effects, an interaction between descriptive and injunctive norms was also observed. Conclusions: The results of the current study speak to theoretical questions surrounding the nature of TNSB variables, as well as several practical implications for coordinated efforts to promote bystander intervention on college campuses.

An evaluation of a motor vehicle facility campaign with an established statewide donor registry: A test of sustainable, evidence-based intervention strategies

Increasing organ donor registration enrollment inside motor vehicle facilities (MVF) is a common approach in the United States. From this research, a formula for what works has emerged within the literature including the presence of an interpersonal component, video messages, and point-of-decision materials. These intervention components have demonstrated effectiveness at increasing registrations in relatively new statewide registries; however, their effectiveness in MVFs with a mature registry remains understudied. The current study examined the effectiveness of an online MVF clerk intervention and the other examined the effectiveness of a multi-message, phase MVF intervention aimed at increasing organ donation registrations. The results revealed that MVF clerks garnered increased knowledge and greater comfort in communicating about organ donation with patrons after the intervention. Moreover, the intervention revealed that clerk talk effectiveness was positively associated with organ donation registration among MVF customers. Against expectations, recall of video messages was negatively associated with new registrations. Exposure to the brochure, counter mat, and poster donation messages was not associated with organ donation registration. An emphasis on the strengths and shortcomings of using MVFs as intervention sites for organ donation registration promotion are discussed.

An Application of the Reasoned Action Approach to Bystander Intervention for Sexual Assault

The high prevalence of sexual assault in US college campuses has led to a widespread implementation of bystander intervention programs aimed at preventing sexual assault. The current study examines predictors of college students' intentions to engage in bystander intervention through the theoretical lens of the reasoned action approach. An online survey with college students (N = 186) was conducted at a large Midwestern university. Our results indicated experiential attitudes, instrumental attitudes, descriptive norms, autonomy, and capacity, each positively associated with participants' intentions to intervene to stop a sexual assault. Against expectations, injunctive norms were unrelated to bystander intervention intentions. Finally, in addition to these main effects, an experiential attitude by autonomy interaction was also observed. The results are discussed with a focus on the theoretical and practical implications of our findings.

An evaluation of a college campus emergency preparedness intervention

INTRODUCTION

Given the range of emergencies that beset postsecondary institutions, university administrators must take a multimodal approach to prepare campus stakeholders for safety threats. One such strategy is emergency preparedness communication.

METHODS

In the present investigation, we tested the efficacy of a professionally produced video that uses the federally endorsed slogan, Run-Hide-Fight(r). Undergraduate students participated in a quasi-experiment with a pretest-posttest-delayed posttest control group design.

RESULTS

Using the theory of planned behavior as our guiding framework, we found that video exposure increased attitudes, perceived norms, perceived behavioral control, intentions, as well as knowledge of recommended behavioral responses. Favorable attitudes and injunctive norms positively predicted intentions at the initial and delayed posttests. Importantly, the video's effects on most of the outcomes endured two weeks after video exposure.

CONCLUSIONS

A brief emergency preparedness video using the Run-Hide-Fight(r) theme can have immediate and lingering effects on psychosocial predictors of appropriate emergency response behaviors.

PRACTICAL APPLICATIONS

Administrators at higher education institutions should consider showing emergency preparedness messages to increase the likelihood that stakeholders will take appropriate action in case of a campus threat. In particular, these messages should aim to promote favorable attitudes toward appropriate response behaviors and instill beliefs that appropriate responses ought to be performed.

Examining Mechanisms Underlying Fear-Control in the Extended Parallel Process Model

This investigation sought to advance the extended parallel process model in important ways by testing associations among the strengths of efficacy and threat appeals with fear as well as two outcomes of fear-control processing, psychological reactance and message minimization. Within the context of print ads admonishing against noise-induced hearing loss (NIHL) and the fictitious Trepidosis virus, partial support was found for the additive model with no support for the multiplicative model. High efficacy appeals mitigated freedom threat perceptions across both contexts. Fear was positively associated with both freedom threat perceptions within the NIHL context and favorable attitudes for both NIHL and Trepidosis virus contexts. In line with psychological reactance theory, a freedom threat was positively associated with psychological reactance. Reactance, in turn, was positively associated with message minimization. The models supported reactance preceding message minimization across both message contexts. Both the theoretical and practical implications are discussed with an emphasis on future research opportunities within the fear-appeal literature.

Source and Message Framing Considerations for Recruiting Mature Adults as Organ Donors Through Direct Mail Campaigns

Context:

Mature adults represent an important audience segment for organ donation practitioners. Despite their potential impact as organ donors, compared to other age demographics, their registration rates are much lower.

Objective:

The objective of the current campaign was to determine the most effective source and message strategy to promote organ and tissue donation among mature adults.

Methods:

A 2 (states: Illinois and Iowa) by 2 (sources: government agency and organ procurement organization [OPO]) by 3 (taglines: Any age is the right age to share the gift of life, Don’t rule yourself out, and Don’t rule yourself out: Any age is the right age to share the gift of life) between-subjects design was used to test the effectiveness of direct mailings promoting organ donation to mature adults.

Results:

Across both Illinois and Iowa, the results revealed that greater organ donation registration rates emerged following exposure to direct mail authored by a state official such as the Illinois Secretary of State or the Iowa Department of Public Health compared to local OPOs.

Conclusions:

Overall, the findings speak to the effectiveness of direct mail marketing campaign’s ability to register potential organ donors. Moreover, the results reveal that it is more important who sends the message as opposed to what the message states.

Does Donor Status, Race, and Biological Sex Predict Organ Donor Registration Barriers?

PURPOSE

The purpose of the current study was to examine differences among bodily integrity, disgust, medical mistrust, and superstition among African Americans, Caucasians, and Latinos; females and males; and registered organ donors and non-registered potential donors.

METHODS

A random digit dialing phone survey was utilized to garner information pertaining to organ donation beliefs among African American (n = 200), Caucasian (n = 200), and Latino (n = 200) Chicago residents. More specifically, participants responded to measures of bodily integrity, disgust, medical mistrust, and superstition, organ donor registration status, among others.

RESULTS

The results indicated that African American and Latino participants were less likely to be registered organ donors than Caucasians (p < .001). In general, females maintained fewer barriers than males with respect to bodily integrity (p < .05), disgust (p = .01), and superstition (p = .01). With respect to organ donation barriers, bodily integrity (p < .0001) emerged as a central concern among those surveyed.

CONCLUSION

This study highlights the significance of audience segmentation when promoting posthumous organ and tissue donation. Specifically, the results stress the importance of constructing distinct messages to non-registered potential donors compared to messages delivered to registered donors. Moreover, different barriers surfaced among females and males as well as among African American, Caucasian, and Latino residents. It is clear that a one size fits all approach will likely not work when promoting organ and tissue donation.

Community College Students' Health Insurance Enrollment, Maintenance, and Talking With Parents Intentions: An Application of the Reasoned Action Approach

A primary objective of health care reform is to provide affordable and quality health insurance to individuals. Currently, promotional efforts have been moderately successful in registering older, more mature adults yet comparatively less successful in registering younger adults. With this challenge in mind, we conducted extensive formative research to better understand the attitudes, subjective norms, and perceived behavioral control of community college students. More specifically, we examined how each relates to their intentions to enroll in a health insurance plan, maintain their current health insurance plan, and talk with their parents about their parents having health insurance. In doing so, we relied on the revised reasoned action approach advanced by Fishbein and his associates (Fishbein & Ajzen, 2010; Yzer, 2012, 2013). Results showed that the constructs predicted intentions to enroll in health insurance for those with no insurance and for those with government-sponsored insurance and intentions to maintain insurance for those currently insured. Our study demonstrates the applicability of the revised reasoned action framework within this context and is discussed with an emphasis on the practical and theoretical contributions.

An examination of three theoretical models to explain the organ donation attitude--registration discrepancy among mature adults

An inconsistency in the research indicates positive attitudes toward organ donation do not map reliably onto organ donor registrations. Various models have sought to explain this inconsistency and the current analysis formally compared three models: the Bystander Intervention Model (BIM), the Organ Donor Model (ODM), and Vested Interest Theory (VIT). Mature (N = 688) adults between the ages of 50 to 64 years completed surveys related to organ donation. Results revealed that VIT accounted for the most variance in organ donation registrations followed by the BIM and ODM. The discussion emphasizes the importance of employing theories to explain a phenomenon as well as the practical implications of the findings.

Examining the Principles of Influence on Safer Sex Communication During Casual and Committed Sexual Encounters

Teens and young people are at risk for contracting sexually transmitted infections. Understanding how relationship context may moderate the effectiveness of safer sex communication strategies among this demographic is important information for practitioners striving to promote safer sex behaviors. In this study, focus groups (N = 9) with college students were conducted and analyzed to examine the relation between 6 principles of influence (authority, consistency, liking, reciprocity, scarcity, and social proof) and safer sex communication during committed and casual sexual encounters. Results revealed that with the exceptions of social proof and consistency, the principles of influence were endorsed more frequently for casual than committed sexual encounters. For casual sexual encounters, the principles of authority, reciprocity, and scarcity arose as influential principles. For committed sexual encounters, the principles of consistency, liking, and reciprocity arose as influential principles. These results are discussed with an emphasis on the theoretical and practical implications.

An examination of the relationship between health information use and health orientation in Korean mothers: focusing on the type of health information

The present study explores the relationship between mothers' health information use and health orientation regarding their children's health. Given that the online mothering community (i.e., parenting websites) is currently an important source of parenting information for mothers of young children, the present study distinguishes between informal online health information provided by mothering communities and formal online health information provided by health-related websites to test for differences. An online survey of 533 Korean mothers of children between the ages of 0 and 3 years revealed that the frequency of health-related website use (i.e., formal information) was associated with mothers' health consciousness and their health information orientation toward their children's health. The frequency of mothering community use (i.e., informal information) was associated with health information orientation, but not with health consciousness. Mass media use and contact with a health care professional for health information were not related to health consciousness or health information orientation. However, mothers' education level moderated the relationship between interpersonal communication and health consciousness, and between print media use and health information orientation. Results are discussed with an emphasis on the theoretical and practical implications of our findings.

An examination of the principles of influence on condom use decision making during casual sex encounters

Cialdini's (1984) principles of influence were employed to inform the decision-making process with respect to using condoms during casual sex. In the current study, focus groups (n = 9) were conducted to understand the relationship between the six principles of influence (authority, consistency, liking, reciprocity, scarcity, and social proof) and condom use in casual sex relationships. Results revealed that authority, consistency, and social proof were endorsed often as influencing condom use. Gender differences in the endorsement of the principles were also observed. The results speak to how these principles of influence aide the condom decision-making process during these often spontaneous sexual encounters and are discussed with an emphasis on the theoretical and practical implications for using these principles in future health campaigns.

Perceived message sensation value and psychological reactance: a test of the dominant thought disruption hypothesis

The present study tests to see whether perceived message sensation value reduces psychological reactance within the context of anti-marijuana ads for television. After controlling for sensation seeking, biological sex, and marijuana use, the results indicate that message novelty is negatively associated with a freedom threat, whereas dramatic impact and emotional arousal were not associated with the antecedent to reactance. Results support the use of novel messages in future ads while at the same time offer an explanation to the challenges involved in creating effective anti-marijuana ads. Overall, the results provide partial support for the dominant thought disruption hypothesis and are discussed with an emphasis on the theoretical and practical implications for health communication researchers and practitioners.

What is the truth? An application of the Extended Parallel Process Model to televised truth® ads

The purpose of this study was to analyze television ads in the truth® campaign using the Extended Parallel Process Model (EPPM) as a framework. Among the ads (n = 86) analyzed, results revealed a heavy reliance on severity messages, modest attention to susceptibility messages, and no inclusion of recommended response messages in the form of self-efficacy and response efficacy. The reliance on emphasizing the health threat, without incorporating recommended response messages, is discussed with respect to the likelihood of galvanizing maladaptive responses such as psychological reactance, denial, and defensive avoidance resulting from exposure to these ads. Additionally, the unintended outcomes for secondary audiences including but not limited to stigma are considered. Implications and suggestions for practitioners and theorists are explored.

Understanding the effectiveness of the entertainment-education strategy: an investigation of how audience involvement, message processing, and message design influence health information recall

A growing body of evidence suggests that entertainment-education (EE) is a promising health communication strategy. The purpose of this study was to identify some of the factors that facilitate and hinder audience involvement with EE messages. Using confirmatory factor analysis, the authors introduce a construct they call experiential involvement, which describes the experience of being cognitively and emotionally involved with EE messages and is a product of transportation into an EE text and identification with EE characters. Using an experimental design, the authors also investigated how reports of experiential involvement and health information recall varied depending on the degree to which the educational content was well integrated with the narrative content in EE messages. Findings indicated that integration significantly influenced health information recall. Results indicated that experiential involvement and the perception that the health topic in EE messages was personally relevant predicted participants' systematic processing of the information in EE messages. Contrary to expectation, personal relevance did not predict experiential involvement, and systematic message processing was negatively related to health information recall. Implications for the construction of EE messages and the study of the EE strategy are discussed.

Perceptions about organ donation among African American, Hispanic, and white high school students

We applied the Health Belief Model (HBM) to better understand perceptions of organ donation among African American, Hispanic, and White high school students. We conducted 14 focus groups with 18-year-old students to identify strategies to reach this audience when promoting the First-Person Consent Registry (FPCR) for organ donation. We found that African American, Hispanic, and White high school students are largely unaware of the need for organ donors, and are unfamiliar with how to join the FPCR. Participants identified more barriers to joining the FPCR than benefits. Two aspects of self-efficacy emerged related to joining the FPCR: decisional and task efficacy. Overall, few differences were found with respect to organ donation myths across the three ethnic groups. The results are discussed, with an emphasis on how the findings compare and contrast with previous organ donation research. We focus on message design and dissemination strategies for practitioners targeting 18-year-old high school students with organ donation promotional materials.

Message framing and medium considerations for recruiting newly eligible teen organ donor registrants

In response to the current organ shortage-and in an effort to increase the number of registered donors-the present campaign employed a direct-mail marketing strategy that registered 6908 individuals in the state's First-Person Consent Registry (FPCR). In evaluating the most effective of three mailers, 18-year-old individuals (N = 139,356) were randomly assigned to receive: (a) a letter from the Secretary of State (SoS); (b) a brochure from the SoS or (c) both. As hypothesized, the results revealed that exposure to the SoS letter only resulted in a greater registration rate than exposure to the SoS brochure only. Results also revealed that exposure to both the SoS letter and SoS brochure resulted in a greater registration rate than exposure to the SoS brochure only. No difference in registration rate emerged between exposure to the SoS letter and SoS brochure compared to exposure to the SoS letter only. Our results speak to the effectiveness of utilizing personalized direct-mail marketing strategies to promote organ donation with an emphasis on the practical implications of our findings for organ donation practitioners.

Family communication patterns moderate the relationship between psychological reactance and willingness to talk about organ donation

Considerable research has investigated how psychological reactance affects individuals' responses to health promotion messages, but little is known about how family processes might moderate the reactance process. In this study, 301 participants were exposed to a persuasive message about organ donation. The moderating role of family communication patterns in the reactance process was tested using hierarchical regression. We found that family conversation orientation had a direct effect on willingness to talk with family members about being an organ donor and that family conformity orientation and family conversation orientation each interacted with reactance to predict willingness to communicate with family about donation. Theoretically, these results extend psychological reactance theory by considering how interpersonal factors affect the reactance process. Practically, the findings suggest that for optimal impact, family processes should be considered in the design of messages promoting organ donation.

A formative evaluation of shared family mealtime for parents of toddlers and young children

Shared family mealtime offers numerous health benefits for young children. Unfortunately, only a few studies examine the benefits and barriers to eating together as a family. The present study seeks to fill this gap in the literature by applying the health belief model to understand parents' perceptions about the challenges of preparing and executing family mealtime for toddlers and young children. Six focus groups were conducted with parents of toddlers and/or young children (n = 24). Results revealed that parents identified several benefits to shared family mealtime, including good teaching moments for their children, enhanced family connectedness, and encouraging nutritious meals. Parents also identified barriers to eating together as a family, including child behavioral issues, scheduling difficulties, and ill-prepared husbands. The risks associated with not eating together as a family were seldom mentioned; however, parents highlighted several issues related to self-efficacy, such as difficulty in selecting meals and challenges with cooking. Potential cues to action include print materials encouraging parents by emphasizing the benefits of eating together as a family. Results are discussed with an emphasis on message design strategies for health practitioners interested in advocating this important yet under-studied phenomenon.

A close examination of trait reactance and issue involvement as moderators of psychological reactance theory

This study used psychological reactance theory (PRT) to investigate (a) the effectiveness of 2 message features (freedom-threatening language and character frame) and (b) the role of trait reactance and issue involvement as moderators of a perceived freedom threat. Within the context of organ donation, the results indicated no differences for character frame among the donor, recipient, or waiting list narratives. However, freedom-threatening language was positively associated with a perceived freedom threat. In turn, a perceived freedom threat was positively associated with state reactance, which was inversely, albeit nonsignificantly, associated with organ donation attitudes. Attitudes predicted intentions to be an organ donor. Results also revealed that trait reactance was positively associated with a perceived freedom threat. Although not associated with a freedom threat, issue involvement was positively associated with organ donation attitudes and intent to be a donor. Additionally, a trait reactance by issue involvement by freedom-threatening language interaction predicted a perceived freedom threat. Results are discussed with an emphasis on these moderators in PRT.

What is the best measure of psychological reactance? An empirical test of two measures

This study examines two measures of psychological reactance. In search of identifying the best measure, each is compared vis-à-vis the other with respect to reliability and validity by placing each in a nomothetic network with a freedom threat, attitude, motivation, and source appraisal. The results are discussed with an emphasis on future practices regarding the best approach to measure psychological reactance.

The use of gain- or loss-frame messages and efficacy appeals to dissuade excessive alcohol consumption among college students: a test of psychological reactance theory

The present study applies psychological reactance theory (PRT) to examine the effectiveness of a 2 (frame: gain, loss) x 2 (efficacy: present, not present) experiment to determine best practices in dissuading excessive alcohol consumption among college students. Results from the structural model revealed no association between a perceived threat to choose and message frame or efficacy appeals. As anticipated, a perceived threat to freedom was positively associated with state reactance, which in turn was positively associated with a boomerang effect and negatively associated with favorable source appraisal. State reactance was not associated with favorable attitudes toward preventing the overconsumption of alcohol. In addition to main effects, interactions between message frame and efficacy appeal with four person factors (participant age, trait reactance, perceived health risk, and alcohol consumption) were examined. Individuals perceiving health risk to be low would benefit from gain-frame messages, whereas loss-frame messages would be most effective for heavy drinkers. Finally, when communicating to underage drinkers, our results support using efficacy appeals when accompanied by a loss-frame message.

Sensation seeking and psychological reactance as health risk predictors for an emerging adult population

Two personality traits, sensation seeking (SS) and psychological reactance (PR), were examined as predictors of health risk behaviors within an emerging adult population. Results using items from the Youth Risk Behavior Surveillance System (YRBS) survey developed by the Centers for Disease Control and Prevention (CDC) indicate both personality traits are predictive of risky substance use behaviors, but only PR was found to be predictive of risky sexual activity. Furthermore, a significant interaction involving PR and sex emerged concerning alcohol use. Results emphasize the importance of considering SS and PR as critical personality variables when designing and evaluating health risk messages and campaigns targeting adolescent and emerging adult populations.

Applying the health belief model to examine news coverage regarding steroids in sports by ABC, CBS, and NBC between March 1990 and May 2008

The investigation described here examined ABC, CBS, and NBC news coverage of steroids in sports between March 1990 and May 2008. Employing a framing analysis guided by the health belief model (HBM), coverage of the barriers and benefits of using steroids is reported. Overall, the trend by these three news affiliates was to emphasize the illegality of using steroids, whereas considerably less coverage was devoted to the health costs, in terms of both severity and susceptibility, of using steroids. Furthermore, of the health costs reported, the specific consequences of steroid use varied considerably. The results are reported across four timeframes: 1990-2008, 1990-1996, 1997-2002, and 2003-2008.

The utility of anger in promoting clean indoor air policies

This investigation examined antecedents associated with support for clean indoor air policies. Participants (N = 550) living in a Midwestern county (population = 62,223) were randomly sampled. Results suggest that beliefs in the health risks associated with secondhand smoke are positively associated with favorable attitudes toward clean indoor air policies, whereas trait reactance is negatively associated with these attitudes. Findings also indicate that risks and trait reactance are indirectly associated with support for clean indoor air policies, mediated through anger arousal toward exposure to secondhand smoke. In addition, regression analyses revealed that health risks, trait reactance, and smoking status explained a significant amount of variance regarding anger toward exposure to secondhand smoke, but only health risks and smoking status accounted for a significant amount of variance toward clean indoor air attitudes. Finally, the Smoking Status x Health Risks interaction was supported for anger toward exposure to secondhand smoke and favorable attitudes toward clean indoor air policies. Our findings suggest the incorporation of anger appeals when promoting clean indoor air policies.

A 15-year review of ABC, CBS, and NBC news coverage of organ donation: implications for organ donation campaigns

This content analysis represents news coverage of organ donation from January 1990 to December 2005. Specifically, ABC, CBS, and NBC news broadcasts were examined to gain a greater understanding of organ donation coverage on TV. Overall this investigation revealed that organ donation received modest coverage (N = 1,507). Although the majority of coverage was positive, attention to the need for organs and the process of becoming a potential organ donor received modest exposure. In addition, non-living donor and living-donor donations received approximately equal coverage. Results are discussed with a focus on message design for practitioners and advocates of organ donation.

Examining antecedents of clean indoor air policy support: implications for campaigns promoting clean indoor air

This investigation sought to examine the association between knowledge of the risks associated with environmental tobacco smoke and voter support for clean indoor air policies. In doing so, 2 antecedents were employed to enhance understanding of this relationship: attitudes and subjective norms. In addition, differences between nonsmokers and smokers were assessed across the aforementioned variables. The study sampled participants (N = 550) living in the Appalachian foothills as a means of conducting formative research prior to developing messages promoting clean indoor air policies. The study controlled for tobacco usage, age, biological sex, and income. Results revealed that awareness of risk is a good predictor of attitudes and social norms, and in return, attitudes and social norms are good predictors of support for clean indoor air policies. In addition, results reveal that nonsmokers maintain a significantly stronger belief in the dangers associated with environmental tobacco smoke, as well as more favorable attitudes, subjective norms, and support for clean indoor air policies when compared with smokers. These findings are discussed with a focus on message design strategies for practitioners and academics with interests in promoting clean indoor air policies.

Examining the use of forceful language when designing exercise persuasive messages for adults: a test of conceptualizing reactance arousal as a two-step process

This investigation tests a conceptualization of reactance as a two-step process. This conceptualization was recently tested with college students, but research testing this conceptualization among primarily adult samples does not currently exist. Psychological reactance theory (PRT) states that individuals exposed to a threat or elimination of a freedom will experience reactance and subsequently be motivated to restore the freedom. Specifically, it is hypothesized that individuals will perceive persuasive messages containing forceful language as a threat to their personal freedom, which will be followed by reactance, manifested in a latent variable composed of anger and negative cognitions. This hypothesis was tested within the context of persuasive messages aimed at encouraging members (N = 247) to participate in weight lifting or group exercise programs at a health and fitness center. Results support conceptualizing reactance as a 2-step process. In addition, results indicate that a primarily adult sample responds unfavorably to forceful persuasive messages advocating the aforementioned exercise activities. In finding support for conceptualizing reactance as a two-step process, we encourage health campaigners and PRT researchers to employ this measure to provide consistency to future PRT studies.

An examination of antecedents to coal miners' hearing protection behaviors: a test of the theory of planned behavior

PROBLEM

The National Institute for Occupational Safety and Health's [NIOSH] National Occupational Research Agenda (DHHS Publication No. 96-115) reports that approximately 50% of miners will experience hearing loss by age 50, compared to only 9% of the general population. The present investigation examines three antecedents believed to be associated with miner's use of hearing protection.

METHOD

A posttest-delayed-posttest-control group field research design was employed to assess antecedents toward wearing hearing protection.

RESULTS

Following the initial posttest, miners' attitudes and subjective norms were antecedents to intentions to wear hearing protection devices. Also, intentions toward wearing hearing protection predicted hearing protection behaviors. Approximately six weeks later, miners' attitudes and perceived behavioral control were each significant predictors of intentions to wear hearing protection and again, intentions were positively associated with hearing protection behaviors.

IMPACT ON INDUSTRY

Our results indicate that appeals to normative influences may be the most effective antecedent to employ when persuading coal miners to wear hearing protection. However, messages designed to impact attitudes and perceived behavioral control were also effective.

Examining the association between media coverage of organ donation and organ transplantation rates

Research addressing the organ shortage in the USA has examined multiple factors influencing one's decision to become an organ donor. One of these research lines addresses media coverage of organ donation. The present investigation seeks to advance this research line by examining the association between organ donation media coverage and organ transplantation rates. A content analysis spanning January 1990 to December 2005 of three television networks reveals an overall positive association between coverage and transplantation rates. The implications of our findings are discussed along with recommendations for practitioners and advocates alike.

Authoritative parenting and issue involvement as indicators of ad recall: an empirical investigation of anti-drug ads for parents

This investigation explores the role of authoritative parenting and issue involvement in regard to the recall of parental anti-drug ads encouraging child monitoring. In addition, the study tested whether issue involvement mediates the association between authoritative parenting and recall of parental anti-drug television ads among parents (N = 185) with adolescents in Grades 6, 7, and 8. The results indicate that (a) authoritative parenting is positively associated with favorable attitudes toward monitoring children and issue involvement regarding adolescent drug use, (b) issue involvement is associated with ad recall, (c) issue involvement mediates the relationship between authoritative parenting and ad recall, (d) ad recall is not associated with favorable attitudes toward parental monitoring, and (e) favorable attitudes regarding parental monitoring are positively associated with intentions to engage in monitoring within the next 6 months.

Parent ads in the National Youth Anti-Drug Media Campaign

The National Youth Anti-Drug Media Campaign aims not only to reduce drug use by teens and preteens, but also to arm parents with knowledge about specific parenting practices known to reduce the risk of teen drug use. Among the documented successes of the campaign to date was a small, but direct effect on some parenting practices, including parent-child discussions about drug use. To reach a deeper understanding about the substance of the parental ads, we content analyzed the message strategies employed in the campaign's parent ads over the inaugural 5 years of the campaign. Each ad was coded for its major theme, minor subtheme, and featured drug. Among seven possible major themes, the parental anti-drug ads largely featured four: enhance the risk of their child's drug use, encourage monitoring practices, promote parent-child discussions about drug use, or advocate positive involvement behaviors. Moreover, most parental messages addressed marijuana use or addressed drug use in general. Marijuana and inhalant ads largely were risk based, while general drug messages focused on monitoring, parent-child discussions or positive involvement practices.

Using persuasive messages to encourage voluntary hearing protection among coal miners

INTRODUCTION

This longitudinal field study was designed to encourage Appalachian coal miners in West Virginia and Pennsylvania to engage in hearing-protection behaviors.

METHOD

Participants were mailed postcards that featured either a positive, negative, or neutral message on the outside of the postcard and a message encouraging hearing protection behaviors on the inside. The first posttest measurement of the effectiveness of the persuasive messages was conducted about a week after the postcards were mailed. The delayed posttest measurement was conducted six weeks later.

RESULTS

Responses from 307 coal miners revealed that the positive or neutral messages generated significantly more self-reported hearing protection behaviors than the negative message. Identical results were obtained in a delayed posttest assessment of miners' self-reported hearing protection behaviors. The positive message was also more effective than either the neutral or negative message in preventing defensive mechanisms from emerging over time.

IMPACT ON INDUSTRY

Positive and neutral messages were convincingly more successful than negative messages in facilitating self-reported hearing protection behaviors among coal miners. Similarly, the positive messages kept defensive processes at bay.

Authoritative parenting and drug-prevention practices: implications for antidrug ads for parents

This research employed the theory of reasoned action to investigate the role of authoritative parenting in 3 drug-prevention behaviors: (a) parental monitoring, (b) parent-child discussions, and (c) awareness of the child's environment. A phone survey of 158 parents of adolescents in 7th, 9th, and 11th grades revealed that authoritative parenting was correlated with parenting practices that reduce the likelihood of adolescent drug use, including discussing family rules about drugs, discussing strategies to avoid drugs, discussing those in trouble with drugs, parental monitoring, knowing the child's plans for the coming day, and personally knowing the child's friends well. Additionally, authoritative parenting moderated the attitude-behavioral intention relation for parental monitoring and awareness of the child's environment, with the weakest relation detected for low-authoritative parents. The utility of these findings in helping design and target antidrug messages for parents more effectively is discussed.