Tough talks COVID-19 (TT-C) digital health intervention: multistate randomized controlled trial.

During the COVID-19 pandemic, rapid changes in variant virulence, limited personal protective equipment availability, and diminished hospital capacity necessitated aggressive vaccine distribution. To promote COVID-19 vaccination to historically underserved populations, the National Institutes of Health funded a small group of clinical trials, including the Tough Talks for COVID-19 vaccine (TT-C) digital health intervention (DHI) randomized controlled trial (RCT). Black young adults, 18-29 years, who were unvaccinated or insufficiently vaccinated against COVID-19 were recruited via social media in Alabama, Georgia, and North Carolina and randomized to the intervention or standard of care control (N = 360).

Evaluating concurrency and gaps between self-report and vaccine card data for COVID-19 vaccination.

We compared self-reported vaccination to vaccine card data to assess concurrency in a sample of Black young adults in Georgia, Alabama, and North Carolina. We described vaccine card versus self-reported data over time and examined discrepancies in reporting between these two sources. Results indicated strong currency suggesting collection of self-reported data may be an acceptable proxy to requiring official vaccine documentation.

Greater Improvements in Vaccination Outcomes Among Black Young Adults With Vaccine-Resistant Attitudes in the United States South Following a Digital Health Intervention: Latent Profile Analysis of a Randomized Control Trial.

Background: Negative attitudes toward vaccines and suboptimal vaccination rates among African American and Black (Black) Americans have been well documented, due to a history of medical racism and human rights violations in the United States. However, digital health interventions (DHI) have been shown to address racial disparities in several health outcomes, such as cardiovascular disease, HIV, and maternal health. The Tough Talks COVID (TT-C) study was a randomized controlled trial of a DHI designed to empower Black young adults in the United States South to make informed, autonomous decisions about COVID-19 vaccine uptake by addressing structural barriers and misinformation about vaccines.

Relationships Between Vaccine Knowledge, Hesitancy, and Conspiracy Beliefs on COVID-19, Influenza, and HPV Vaccination.

Introduction: The COVID-19 pandemic highlighted the centuries old issue of vaccine hesitancy and exposed healthcare inequities harming Black young adults. Despite vaccines being able to reduce COVID-19, human papillomavirus (HPV), and influenza morbidity and mortality, they are underutilized. An examination of socio-behavioral factors to understand motivators and barriers to vaccine uptake within Black communities is necessary to improve preventative health.

Advocating, Unlearning, Tearing It All Down? How BIPOC Young Adults with Mental Health Concerns Perceive and Engage with the Media.

The COVID-19 pandemic has increased the salience of issues related to social justice, mental health, and health equity. During this time, the media have been instrumental in amplifying social movements but also in spreading mis/disinformation, violence, and hatred. Among communities who have been affected heavily during this time are Black, Indigenous, and People of Color (BIPOC) young adults who have a mental illness/significant mental health concerns.

Tough Talks COVID-19 Digital Health Intervention for Vaccine Hesitancy Among Black Young Adults: Protocol for a Hybrid Type 1 Effectiveness Implementation Randomized Controlled Trial.

Background: Interventions for increasing the uptake of COVID-19 vaccination among Black young adults are central to ending the pandemic. Black young adults experience harms from structural forces, such as racism and stigma, that reduce receptivity to traditional public health messaging due to skepticism and distrust. As such, Black young adults continue to represent a priority population on which to focus efforts for promoting COVID-19 vaccine uptake.

Exploring Motivations for COVID-19 Vaccination Among Black Young Adults in 3 Southern US States: Cross-sectional Study.

Background: Few studies have focused on attitudes toward COVID-19 vaccination among Black or African American young adults (BYA) in the Southern United States, despite high levels of infection in this population.

Objective: To understand this gap, we conducted an online survey to explore beliefs and experiences related to COVID-19 vaccination among BYA (aged 18-29 years) in 3 southern states.

Methods: We recruited 150 BYA to participate in an online survey as formative research for an intervention to address vaccine hesitancy in Alabama, Georgia, and North Carolina from September 22, 2021, to November 18, 2021.

Acknowledgment Correction of: Impact of Game-Inspired Infographics on User Engagement and Information Processing in an eHealth Program.

[This corrects the article DOI: 10.2196/jmir.5976.

Impact of Game-Inspired Infographics on User Engagement and Information Processing in an eHealth Program.

Background: Online interventions providing individual health behavior assessment should deliver feedback in a way that is both understandable and engaging. This study focused on the potential for infographics inspired by the aesthetics of game design to contribute to these goals.

Objective: We conducted formative research to test game-inspired infographics against more traditional displays (eg, text-only, column chart) for conveying a behavioral goal and an individual's behavior relative to the goal.

Cancer Survivors Who Play Recreational Computer Games: Motivations for Playing and Associations with Beneficial Psychological Outcomes.

Objective: Playing recreational videogames is a common activity, yet little is known about its role in the lives of people who are coping with serious illness. These individuals may experience depression and isolation and may turn to games to help alleviate negative experiences and support well-being. We explored these possibilities in the context of cancer survivors.

Identity as a Moderator and Mediator of Communication Effects: Evidence and Implications for Message Design.

Advertisements, movies, and other forms of media content have potential to change behaviors and antecedent psychological states by appealing to identity. However, the mechanisms that are responsible for persuasive effects of such content have not been adequately specified. A recently proposed model of communication effects (the prism model) advances the study of mechanisms and argues that identity can serve as both a moderator and mediator of communication effects on behavior-relevant outcomes.

How Does Gameplaying Support Values and Psychological Well-Being Among Cancer Survivors?

Objective: This qualitative study examined the extent to which playing recreational computer games and videogames is perceived by cancer survivors as supporting personal values. Values serve as behavioral guides and may thus impact health outcomes; therefore activities that have the potential to support values deserve further attention so their role in promoting health may be better understood.

Materials And Methods: We asked a sample of survivors who play recreational games (n = 73) open-ended questions about the types of recreational games they play, about something they really value in life, and the extent to which playing games supports the value.

How does a risk-oriented "future-self" influence behavior? A structural-equation-modeling approach with marijuana-related outcomes.

A study was conducted to examine the influence of a risk-oriented future self on self-reported marijuana use among college students. Drawing on theoretical work on possible selves, it was hypothesized that the extent to which a future self is viewed as risk-oriented will be associated with reported marijuana use and that effects of a risk-oriented future self on use would be partially mediated by risk-oriented attitudes and perceived attractiveness of users. Analysis of data from an online survey of college students supported hypotheses, with the additional finding that the effect of user attractiveness on use is mediated by attitudes.

Comparing effects of "my anti-drug" and "above the influence" on campaign evaluations and marijuana-related perceptions.

Two national campaigns--My Anti-Drug and Above the Influence--have been implemented to prevent youth substance use. Although Above the Influence was conceptualized as a major shift in messaging from My Anti-Drug, no studies have reported head-to-head tests of message effects on behavior-relevant outcomes. An experiment was conducted in which participants viewed ads from one of the campaigns and answered questions about ad appeal and emotional tone; campaign appeal; and marijuana-related beliefs.

The Belief that Alcohol Use is Inconsistent with Personal Autonomy: A Promotive Factor for Younger Adolescents.

This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40 schools were analyzed using a structural equation model.

Effects of adverts from a drug and alcohol prevention campaign on willingness to engage in alcohol-related risky behaviors.

Behavioral willingness is conceptualized as a pathway to behavior that is non-deliberative, yet traditional measures require thoughtful deliberation to complete. This study explored non-deliberative measures of alcohol-related willingness to complement recent work on marijuana-related willingness. The study also examined whether adverts from a field-tested drug and alcohol prevention campaign may have operated by influencing alcohol-related willingness.

Characterizing drug non-users as distinctive in prevention messages: implications of optimal distinctiveness theory.

Optimal distinctiveness theory (ODT) posits that highly valued groups are those that can simultaneously satisfy needs to belong and to be different. The success of drug-prevention messages with a social-identity theme should therefore depend on the extent to which the group is portrayed as capable of meeting these needs. Specifically, messages that portray non-users as a large and undifferentiated majority may not be as successful as messages that emphasize uniqueness of non-users.

The effects of drug-prevention messages on the accessibility of identity-related constructs.

Recent theoretical work has posited that the self-system guides behavior via currently activated self-concepts. The authors adopted this framework to the study of drug-prevention messages by examining the extent to which messages can alter the accessibility of views of self and of drugs that would support nonuse. Participants were exposed to 1 of 3 print-ad conditions: autonomy-themed prevention messages (treatment), health-information themed prevention messages (comparison), and informational consumer ads (control).

Assessing media campaigns linking marijuana non-use with autonomy and aspirations: "Be Under Your Own Influence" and ONDCP's "Above the Influence".

Two media-based interventions designed to reduce adolescent marijuana use ran concurrently from 2005 to 2009. Both interventions used similar message strategies, emphasizing marijuana's inconsistency with personal aspirations and autonomy. "Be Under Your Own Influence" was a randomized community and school trial replicating and extending a successful earlier intervention of the same name (Slater et al.

Smoking correlates among Hispanic and non-Hispanic white adolescents in the US southwest.

We examined smoking correlates among Hispanic and white students in 6-12th grades in small communities in three states in the southwestern United States. Data were collected in 2002 from 8,479 participants, who completed surveys measuring a wide range of potential smoking correlates from individual, family, and peer domains. Logistic regression analyses showed that peer factors were the most robust correlates across both ethnicities and grade groups.

Examining marijuana user and non-user prototypes in formative research for prevention campaigns.

We report on research-both quantitative and qualitative-conducted to explore perceptions of prototypes of marijuana users, as well as the extent to which self-prototype congruence predicted marijuana use intention. Results of a survey of undergraduates (N = 139) showed that prototypes of users and non-users differed in terms of key attributes, and that a greater match between one's self and user prototype would be associated with greater intention to use marijuana. In addition, exploratory analysis showed that males had higher ratings of user prototype social attractiveness compared to females overall, with the most pronounced differences between non-White males and non-White females.

Media influence on alcohol-control policy support in the U.S. adult population: the intervening role of issue concern and risk judgments.

Data from a national random-digit dial survey (N = 1,272) were analyzed to examine the influence of news media use on alcohol-control policy support, and to test whether risk judgments and concern about alcohol-related risks mediated effects of news media use variables on support for various types of alcohol-control public policies. In so doing, we test the proposition that perceptions influenced by routine coverage of events such as crime or accidents may in part explain news effects on public policy support in the domain of health policy. Analyses indicated that the (positive) influence of attention to news about crime and accidents on support for increasing enforcement of existing alcohol control laws and militing marketing of alcohol products was mediated by concern about risks of alcohol-related injuries and by perceptions of the alcohol-attributable fraction of homicides and unintended injury fatalities.

Tobacco counteradvertisements aimed at bicultural Mexican American youth: the impact of language and theme.

The growing population of Mexican American youth and the increasing smoking rates in this population present a considerable public health challenge. Tobacco counteradvertisements have demonstrated their ability to shape attitudes, behavior, and public policy, but little is known about the most effective ways to adapt messages aimed at this audience. To explore key variables that can affect success, a study was conducted with 249 Mexican American middle-school youth from a U.

Using community readiness key informant assessments in a randomized group prevention trial: impact of a participatory community-media intervention.

This study examines the role of key informant community readiness assessments in a randomized group trial testing the impact of a participatory community-media intervention (which was also complemented by in-school efforts). These assessments were used to help match communities in random assignment, as a source of formative data about the community, as the basis for a coalition-building workshop, and as an evaluation tool, with a follow-up set of surveys approximately 2 years after the baseline survey. Results of the nested, random effects analysis indicated that the intervention influenced community knowledge of efforts and (at marginally significant levels) improved prevention leadership quality and community climate supportive of prevention efforts.