Informed Decision Making on the Uptake of Evidence-Based Smoking Cessation Assistance by Individuals Motivated to Quit Smoking

Evidence-based cessation assistance increases cessation rates. Activating preferences during decision making could improve effectiveness further. Decision aids (DAs) facilitate deciding by taking preferences into account. To develop effective DAs, potential end users' (i.e., individuals motivated to quit) needs and experts' viewpoints should be considered. Therefore, the aim of this needs assessment was: (1) To explore end users' needs and (2) to obtain consensus among smoking cessation counsellors and scientific experts to develop a self-administered DA to support end users in choosing cessation assistance. Data was gathered via two approaches: (1) twenty semi-structured interviews with potential end users and (2) two three-round Delphi studies with 61 counsellors and 44 scientific experts. Interview data and the first Delphi rounds were analysed qualitatively, the other Delphi rounds were analysed quantitatively. Potential end users acquired information in different ways, e.g., via own experiences. Important characteristics to decide between tools varied, however effectiveness and costs were commonly reported. Experts reached consensus on 38 and 40 statements, e.g., tools should be appropriate for users' addiction level. Although some trends emerged, due to the variation among stakeholders, a 'one size fits all'-approach is undesirable. This heterogeneity should be considered, e.g., by enabling users to customise the DA.

How do Hematologists Communicate with Patients Suffering from Chronic Lymphocytic Leukemia?

Chronic Lymphocytic Leukemia (CLL) is a chronic hematologic malignancy with great heterogeneity and unpredictable clinical course. The European Research Initiative on CLL (ERIC), in the context of its CLL Patient Empowerment Program, conducted a study exploring hematologists’ experience of communication. Thirty semi-structured interviews were conducted with hematologists caring for CLL patients in Greece. Inductive thematic qualitative analysis was employed revealing 3 major themes: (i) disclosure of information encompassing ‘negotiating the level of disclosure’, ‘the power of cultural perceptions’, ‘fear of being held culpable’, ‘fear of patients’ and own emotions’; (ii) medical-decision making which described ‘balancing autonomy and beneficence’, ‘considering patients’ preferences’ and ‘adhering to practice guidelines’; (iii) emotional support which included ‘assessment of emotional distress’, ‘identifying and regulating patients’ emotions’ and ‘maintaining a supportive relationship’. In conclusion, physicians are aware of the importance of communication and its potential impact on CLL patients. They use a wide range of communication strategies which serve the diversity of communication goals they must achieve. However, the majority have not received formal education on patient interactions. Present findings highlight the need for specific communication protocols, guidance and training that will empower physicians to overcome challenges, inherent to the nature of CLL.

Beyond Medical Pluralism

Medical pluralism does not only mean the presence of multiple therapies but also the variety of health discourses and norms. By analysing the rhetoric of active participants in the Estonian health field, we portray the diverse discourses in defining and positioning complementary and alternative medicine (CAM) in relation to biomedicine (BM). On a scale of attitudes, five different positions of CAM and BM emerge. Both ends of the spectrum dominantly represent a system-level view characterized by distinct categories, opposition, and labelling. In between, integrative positions focus more on an individual’s personal needs by combining and “taking the best out of” all available knowledge systems. The presence of these competing discourses poses several challenges for health communication. Meanings offered by CAM-related health approaches are increasingly visible and influential as unlicensed health workers and laypeople contribute more to public communication due to the openness of social media. On the other hand, critics of CAM and proponents of scientific thinking have mobilized to set boundaries to defend the authoritative position of scientific medicine. Our analysis suggests that using system-level categories supports polarization, which could lead people to seek alternative explanations based on their individual experiences, and thus feeding distrust towards medicine and doctors.

Trading Data for Health

mHealth apps are growing in popularity among smartphone users. Such apps often contain social features that enable users to compare their behavior with others but to function, mHealth apps require users to share health information which is considered a threat to individuals’ privacy. Building on social comparison theory and research on privacy decision-making, we investigate the effects of users’ social comparison orientation and privacy attitudes as well as the potential mediating effect of health information disclosure on users’ intention to use a dietary app. Relying on a PLS-based structural-equation model in a sample of N = 528 participants, our study supports claims of a positive effect of social comparison orientation on intention to use a mHealth app. Further, the negative effect of privacy attitude and the positive mediation of information disclosure were supported as well. The study also demonstrated that findings were stable when the context of information disclosure is changed.

Social Aspects of Health Communication – Towards a Research Agenda

Health and health-related behaviours are embedded in social contexts in various ways which comprise both risks and opportunities for health communication. We propose a research agenda on social aspects of health communication and introduce the articles of the present special issue. Owing to the complexity of individuals’ social contexts, the research agenda addresses questions lying at the individual, interpersonal, and societal levels. The issue’s articles cover different and highly relevant questions of this research agenda, ranging from stigmatisation to impression management to collective action and from experimental designs to qualitative interviews and netnography. In sum, the articles demonstrate not only the diversity but also the relevance of academic research on social aspects of health communication. We expect that this topic will continue gaining importance, given the ongoing digitalisation of the media environment and the increasing interconnectedness of producers and users, doctors and patients, and experts and laypersons.

The Influence of Social Support and Characteristics of the Stigmatisers on Stigmatising Attitudes Towards People With Mental Illness

The stigmatisation of people with mental illness has severe negative consequences for affected individuals. As research in the context of exemplification theory (Zillmann & Brosius, 2000) shows, single-case descriptions of affected individuals (i.e., exemplars) have the potential to either strengthen or reduce stigmatising attitudes towards people with mental illness, in general. We examine the role of depicting social support for exemplars with mental illness (i.e., depression), exemplars’ age and sex as well as characteristics of the potential stigmatisers (e.g., sex, relationship status) in generalised stigma-related attitudes towards people with mental illness. A 2 × 2 × 2 online survey experiment with 854 participants was conducted. Univariate ANOVAs yielded main effects and complex interaction patterns of participants’ sex and relationship status, as well as combinations of exemplar characteristics. Overall, our results confirm the influence that single-case descriptions can have upon generalised stigma-related attitudes towards people with mental illness. They underline the potential of depicting social support for exemplars with mental illness as well as the consideration of potential stigmatisers’ sex and relationship status for (de-)stigmatisation and give starting points for future research in the field of health and anti-stigma-communication.

The Onset of Habituation Effects

While extraordinary events like pandemics may prompt an increase in information-seeking behaviour, such trends are unlikely to be sustainable. Over time, issue fatigue/overdose is expected to set in. This study employed generalised additive mixed models (GAMMs) to determine whether attention to TV news corresponded with real-world developments. We sought to predict news use in Germany during the first wave of the COVID-19 pandemic based on disease occurrence next to two well-established predictors of news use (total TV use and day of the week). The association of key events with news use was also assessed. Initially, news use increased with disease occurrence. However, as the pandemic progressed, the linkage between the two variables weakened considerably, suggesting the onset of a habituation effect. Some support emerged for the idea that key events increased news use. Overall, our results are more in line with the explanation provided by agenda-setting theory and various information-seeking models than with the notion of coping through information avoidance. Thus, how the pandemic progresses appears to be a good predictor of news use at the aggregate level, although its predictive power decreases over time.

Sick for Information?

During a pandemic outbreak, timely and accurate information that matches the information needs of the public is vital to inform the public. In April 2020, 977 individuals completed a questionnaire that measured the Dutch public’s health information needs and media consumption during the early stages of the coronavirus outbreak. Results show that respondents sought information about prevention of contamination, (the severity of) symptoms, treatment, and vaccination. News outlets, both online and offline, were the most preferred sources for information. Older people were more likely to search for information in traditional media, such as on TV, in newspapers, and on the radio. Younger people more often used news websites to find information. Respondents with lower levels of education obtained information via TV more frequently than respondents with higher levels of education, who in turn used newspapers more frequently. This study, guided by the Risk Information Seeking and Processing (RISP) model, was conducted during the early stages of the pandemic in the Netherlands to provide information that public health officials and governments can use to optimise information provision during pandemics. Presently, news media have the highest degree of coverage and impact and should thus be used first to convey reliable information.

Sensible Use(rs) and the Construction of Self-Identity in Research Interviews

As a much-used data collection method in qualitative research, interviewing is a primary way to make sense of social life. However, critics point out that interviews are often used uncritically and unreflectively, without considering epistemological foundations and self-presentation efforts by interviewees. By way of a two-step, theory-driven qualitative thematic analysis, this study examines how Belgian middle-aged and older adults (51-79 years old) construct their self-identity in research interviews as sensible internet users with regards to online health information (OHI) and their motivations for doing so. The findings are underpinned by a theoretical framework which enhances impression management (IM) theory with the third-person effect (TPE). The study finds that respondents engage in various IM behaviours, including instances of the TPE, to maximise positive impressions and minimise negative impressions. Through IM, interviewees 1) respond to critical questions; 2) proactively demonstrate knowledge, accomplishments, and positive outcomes; 3) compare and distance oneself from others; and 4) communicate limitations and offer external explanations. The findings contribute to the scant literature on IM in research interviews and among older adults and carry various implications for the field of health communication and beyond, such as the importance of critically reflecting on interviewing and going beyond the face value of the data.

Influence of Animation- Versus Text-Based Delivery of a Web-Based Computer-Tailored Smoking Cessation Intervention on User Perceptions

Computer-tailored (CT) digital health interventions have shown to be effective in obtaining behaviour change. Yet, user perceptions of these interventions are often unsatisfactory. Traditional CT interventions rely mostly on text-based feedback messages. A way of presenting feedback messages in a more engaging manner may be the use of narrated animations instead of text. The goal of this study was to assess the effect of manipulating the mode of delivery (animation vs. text) in a smoking cessation intervention on user perceptions among smokers and non-smokers. Smokers and non-smokers (N = 181) were randomized into either the animation or text condition. Participants in the animation condition assessed the intervention as more effective (ηp2 = .035), more trustworthy (ηp2 = .048), more enjoyable (ηp2 = .022), more aesthetic (ηp2 = .233), and more engaging (ηp2 = .043) compared to participants in the text condition. Participants that received animations compared to text messages also reported to actively trust the intervention more (ηp2 = .039) and graded the intervention better (ηp2 = .056). These findings suggest that animation-based interventions are superior to text-based interventions with respect to user perceptions.