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Papers by Don Chaney

International Journal of Environmental Research and Public Health, 2020

The use of social media in public health education has been increasing due to its ability to remo... more The use of social media in public health education has been increasing due to its ability to remove physical barriers that traditionally impede access to healthcare support and resources. As health promotion becomes more deeply rooted in Internet-based programming, health education specialists are tasked with becoming more competent in computer-mediated contexts that optimize both online and offline consumer health experiences. Generating a better understanding of the benefits and drawbacks to using social media in the field is important, since health education specialists continue to weigh its advantages against potential concerns and barriers to use. Accordingly, this Special Issue aims to explore social media as a translational health promotion tool by bridging principles of health education and health communication that examine (1) the method with which social media users access, negotiate, and create health information that is both actionable and impactful for diverse audiences...

Journal of Medical Internet Research, 2019

Background: Despite the relatively high prevalence of low health literacy among individuals livin... more Background: Despite the relatively high prevalence of low health literacy among individuals living with chronic obstructive pulmonary disease (COPD), limited empirical attention has been paid to the cognitive and health literacy-related skills that can uniquely influence patients' health-related quality of life (HRQoL) outcomes. Objective: The aim of this study was to examine how health literacy, electronic health (eHealth) literacy, and COPD knowledge are associated with both generic and lung-specific HRQoL in people living with COPD. Methods: Adults from the COPD Foundation's National Research Registry (n=174) completed a cross-sectional Web-based survey that assessed sociodemographic characteristics, comorbidity status, COPD knowledge, health literacy, eHealth literacy, and generic/lung-specific HRQoL. Hierarchical linear regression models were tested to examine the roles of health literacy and eHealth literacy on generic (model 1) and lung-specific (model 2) HRQoL, after accounting for socioeconomic and comorbidity covariates. Spearman rank correlations examined associations between ordinal HRQoL items and statistically significant hierarchical predictor variables. Results: After adjusting for confounding factors, health literacy, eHealth literacy, and COPD knowledge accounted for an additional 9% of variance in generic HRQoL (total adjusted R 2 =21%; F 9,164 =6.09, P<.001). Health literacy (b=.08, SE 0.02, 95% CI 0.04-0.12) was the only predictor positively associated with generic HRQoL (P<.001). Adding health literacy, eHealth literacy, and COPD knowledge as predictors explained an additional 7.40% of variance in lung-specific HRQoL (total adjusted R 2 =26.4%; F 8,161 =8.59, P<.001). Following adjustment for covariates, both health literacy (b=2.63, SE 0.84, 95% CI 0.96-4.29, P<.001) and eHealth literacy (b=1.41, SE 0.67, 95% CI 0.09-2.73, P<.001) were positively associated with lung-specific HRQoL. Health literacy was positively associated with most lung-specific HRQoL indicators (ie, cough frequency, chest tightness, activity limitation at home, confidence leaving home, sleep quality, and energy level), whereas eHealth literacy was positively associated with 5 of 8 (60%) lung-specific HRQoL indicators. Upon controlling for confounders, COPD knowledge (b=−.56, SE 0.29, 95% CI −1.22 to −0.004, P<.05) was inversely associated with lung-specific HRQoL.

Journal of Medical Internet Research, 2017

Background: Only a handful of studies have examined reliability and validity evidence of scores p... more Background: Only a handful of studies have examined reliability and validity evidence of scores produced by the 8-item eHealth literacy Scale (eHEALS) among older adults. Older adults are generally more comfortable responding to survey items when asked by a real person rather than by completing self-administered paper-and-pencil or online questionnaires. However, no studies have explored the psychometrics of this scale when administered to older adults over the telephone. Objective: The objective of our study was to examine the reliability and internal structure of eHEALS data collected from older adults aged 50 years or older responding to items over the telephone. Methods: Respondents (N=283) completed eHEALS as part of a cross-sectional landline telephone survey. Exploratory structural equation modeling (E-SEM) analyses examined model fit of eHEALS scores with 1-, 2-, and 3-factor structures. Subsequent analyses based on the partial credit model explored the internal structure of eHEALS data. Results: Compared with 1-and 2-factor models, the 3-factor eHEALS structure showed the best global E-SEM model fit indices (root mean square error of approximation=.07; comparative fit index=1.0; Tucker-Lewis index=1.0). Nonetheless, the 3 factors were highly correlated (r range .36 to .65). Item analyses revealed that eHEALS items 2 through 5 were overfit to a minor degree (mean square infit/outfit values <1.0; t statistics less than-2.0), but the internal structure of Likert scale response options functioned as expected. Overfitting eHEALS items (2-5) displayed a similar degree of information for respondents at similar points on the latent continuum. Test information curves suggested that eHEALS may capture more information about older adults at the higher end of the latent continuum (ie, those with high eHealth literacy) than at the lower end of the continuum (ie, those with low eHealth literacy). Item reliability (value=.92) and item separation (value=11.31) estimates indicated that eHEALS responses were reliable and stable. Conclusions: Results support administering eHEALS over the telephone when surveying older adults regarding their use of the Internet for health information. eHEALS scores best captured 3 factors (or subscales) to measure eHealth literacy in older adults; however, statistically significant correlations between these 3 factors suggest an overarching unidimensional structure with 3 underlying dimensions. As older adults continue to use the Internet more frequently to find and evaluate health information, it will be important to consider modifying the original eHEALS to adequately measure societal shifts in online health information seeking among aging populations.

American Journal of Health Education, 2017

Background-College students actively seek online health information and use Instagram, an image-a... more Background-College students actively seek online health information and use Instagram, an image-and video-based social networking website, to build social networks grounded in trust and behavioral norms (social capital), which have the potential to prevent chronic disease. Purpose-This study aimed to: (1) examine how intensity of Instagram use moderates the relationship between eHealth Literacy and online social capital in college students, and (2) discuss how Instagram can be used as a social awareness platform for chronic disease prevention among college students.

ISRN Public Health, 2012

Chronic obstructive pulmonary disease (COPD) causes progressive airflow limitation which results ... more Chronic obstructive pulmonary disease (COPD) causes progressive airflow limitation which results in prolonged episodes of coughing and shortness of breath. COPD self-management education (COPDSME) programs attempt to enhance patient self-efficacy for managing symptoms. The purpose of this paper was to conduct a critical literature review that identified peer-reviewed articles assessing the effects of COPDSME on self-efficacy outcomes. Seven articles were located after an exhaustive search. Most studies () reported statistically significant improvements in self-efficacy following intervention. Almost all of the studies tested interventions that drew upon at least 2 recommended sources of efficacy information. Two studies specifically noted increased self-efficacy for controlling physical exertion following COPDSME. Within the reviewed studies, the content within each educational treatment varied widely and showed a lack of standardization, and the types of instruments used to assess ...

Internet-delivered surveys regarding public health and health education issues inherently raise e... more Internet-delivered surveys regarding public health and health education issues inherently raise ethical issues regarding anonymity, privacy, the informed consent process, and the security of collected data. Within recent years internet connectivity has moved from desktop computers to a range of devices including mobile laptops, tablet computers, and 'smart' phones; providing participants in internet-delivered studies many options regarding the time, place, and device used to access a survey. Understanding how participants access a survey has ramifications for the study design. While self-report items could assess how participants access a study, individuals may not readily know technological specifications of their devices and self-report bias must be considered. As an alternative, commercial survey software programs include a question type that can collect a participant's browser type, browser version, operating system type, screen resolution, flash version, java suppor...

For many young adults, the undergraduate years include substantial dietary changes. These changes... more For many young adults, the undergraduate years include substantial dietary changes. These changes, combined with a barrage of advertising to college students have increased attention to obesity-related marketing campaigns on American college campuses. This study evaluated college students' perceptions of obesity-related messages and images produced by various state and national organizations. All images incorporated in the study materials were obtained through publically accessible websites. To narrow this study's scope, inclusion criteria necessitated a clearly delineated image and message related to obesity, healthy eating, or physical activity. Data were collected from 390 distance education students at a large southeastern university in the fall of 2012. Survey items asked participants to rank 16 images and messages as: helpful, important, credible, informative, stigmatizing, motivating, useful, or appropriate on a likert scale (1 Strongly Disagree- 5 Strongly Agree). Ad...

Background: There are four types of intimate partner violence, recongized by the Center for Disea... more Background: There are four types of intimate partner violence, recongized by the Center for Disease Control and Prevention (CDC). These include physical violence, sexual violence, threats of physical or sexual violence, psychological or emotional violence. These types of violence occur among individuals all of sexes, ages, race, and sexual orientation. Intimate partner violence represents an on-going and costly public health concern. Methods: Data were collected cross three semesters in 2012 using a 30 items online-delivered survey among undergradaute students in a introductory online health education course. Analysis: Descriptive statistics were conducted, along with ANOVA correlations to examine the relationships between demographic variables, past intimate partner violence experiences, and firearm accessibility. Results: Of the 787 respondents, 170 communicated accessiblity to firearm within or near their current home. Of the 170 respondents, a majority were females (68.8%), hete...

Background: Approximately 20.5 million females between the ages of 12 and 26 exhibit disordered e... more Background: Approximately 20.5 million females between the ages of 12 and 26 exhibit disordered eating behaviors with 85% of onset occurring by age 20. Previous research explored the relationship between females' disordered eating behaviors and their objectification experiences though Objectification Theory. This study examines the relationship between disordered eating and objectification experiences among a sample of undergraduate females. Methods: Data were collected across three semesters in 2012, through an online survey comprised of items from the Eating Attitudes Test (EAT-26) and the Objectified Body Consciousness Scale (OBCS), distributed to distance education introductory health course students. Investigators conducted descriptive statistics, correlations, and linear regression analyses. Results: Of the 592 female respondents, most were white (70.0%), heterosexual (95.2%), single or dating without a steady partner (59.8%), and either of junior or senior classification ...

Journal of Medical Internet Research, 2015

Background: Baby boomers and older adults, a subset of the population at high risk for chronic di... more Background: Baby boomers and older adults, a subset of the population at high risk for chronic disease, social isolation, and poor health outcomes, are increasingly utilizing the Internet and social media (Web 2.0) to locate and evaluate health information. However, among these older populations, little is known about what factors influence their eHealth literacy and use of Web 2.0 for health information. Objective: The intent of the study was to explore the extent to which sociodemographic, social determinants, and electronic device use influences eHealth literacy and use of Web 2.0 for health information among baby boomers and older adults. Methods: A random sample of baby boomers and older adults (n=283, mean 67.46 years, SD 9.98) participated in a cross-sectional, telephone survey that included the eHealth literacy scale (eHEALS) and items from the Health Information National Trends Survey (HINTS) assessing electronic device use and use of Web 2.0 for health information. An independent samples t test compared eHealth literacy among users and non-users of Web 2.0 for health information. Multiple linear and logistic regression analyses were conducted to determine associations between sociodemographic, social determinants, and electronic device use on self-reported eHealth literacy and use of Web 2.0 for seeking and sharing health information. Results: Almost 90% of older Web 2.0 users (90/101, 89.1%) reported using popular Web 2.0 websites, such as Facebook and Twitter, to find and share health information. Respondents reporting use of Web 2.0 reported greater eHealth literacy (mean 30.38, SD 5.45, n=101) than those who did not use Web 2.0 (mean 28.31, SD 5.79, n=182), t 217.60 =−2.98, P=.003. Younger age (b=−0.10), more education (b=0.48), and use of more electronic devices (b=1.26) were significantly associated with greater eHealth literacy (R 2 =.17, R 2 adj =.14, F 9,229 =5.277, P<.001). Women were nearly three times more likely than men to use Web 2.0 for health information (OR 2.63, Wald= 8.09, df=1, P=.004). Finally, more education predicted greater use of Web 2.0 for health information, with college graduates (OR 2.57, Wald= 3.86, df =1, P=.049) and post graduates (OR 7.105, Wald= 4.278, df=1, P=.04) nearly 2 to 7 times more likely than non-high school graduates to use Web 2.0 for health information. Conclusions: Being younger and possessing more education was associated with greater eHealth literacy among baby boomers and older adults. Females and those highly educated, particularly at the post graduate level, reported greater use of Web 2.0 for health information. More in-depth surveys and interviews among more diverse groups of baby boomers and older adult populations will likely yield a better understanding regarding how current Web-based health information seeking and sharing behaviors influence health-related decision making.

JMIR Research Protocols, 2015

Telemedicine and e-Health, 2014

Purpose: Because of limited accessibility to pulmonary rehabilitation programs, patients with chr... more Purpose: Because of limited accessibility to pulmonary rehabilitation programs, patients with chronic obstructive pulmonary disease (COPD) are infrequently provided with patient education resources. To help educate patients with COPD on how to live a better life with diminished breathing capacity, we developed a novel social media resource center containing COPD respiratory therapy and education videos called ''COPDFlix.'' Methodology: A heuristic evaluation of COPDFlix was conducted as part of a larger study to determine whether the prototype was successful in adhering to formal Web site usability guidelines for older adults. A purposive sample of three experts, with expertise in Web design and health communications technology, was recruited (a) to identify usability violations and (b) to propose solutions to improve the functionality of the COPDFlix prototype. Each expert evaluated 18 heuristics in four categories of task-based criteria (i.e., interaction and navigation, information architecture, presentation design, and information design). Seventy-six subcriteria across these four categories were assessed. Quantitative ratings and qualitative comments from each expert were compiled into a single master list, noting the violated heuristic and type/location of problem(s). Results: Sixty-one usability violations were identified across the 18 heuristics. Evaluators rated the majority of heuristic subcriteria as either a ''minor hindrance'' (n = 32) or ''no problem'' (n = 132). Moreover, only 2 of the 18 heuristic categories were noted as ''major'' violations, with mean severity scores of ‡ 3. Conclusions: Mixed-methods data analysis helped the multidisciplinary research team to categorize and prioritize usability problems and solutions, leading to 26 discrete design modifications within the COPDFlix prototype.

Quality & Quantity, 2012

Web-based surveys are a salient tool in the repertoire of social and behavioral scientists. The i... more Web-based surveys are a salient tool in the repertoire of social and behavioral scientists. The increase in web-based surveys is understandable considering the distinct advantages offered, including: (a) lower costs and reduced labor time, (b) ability to directly transfer data into statistical packages (reducing coding errors), (c) customization options enabling more attractive presentation, (d) ability to reduce respondent burden by embedding skip patterns, and (e) access to larger sample sizes in different geographic regions. It is important to note, however, that administering web-based surveys also introduces distinct sources of error (e.g., coverage, sampling and non-response). Regardless of format (e.g., paper-and-pencil or web-based), specific, prescribed steps must be followed when constructing an instrument in order to reduce survey error and lend credence to the data collected before subsequent analysis is performed. One of those crucial stages integral to the pretesting process is cognitive interviewing. Cognitive interviewing is a qualitative process, encompassing two main techniques: think aloud interviewing and verbal probing. Collectively, these two methods seek to (a) produce information on what the respondent is thinking while answering the questions, (b) the cognitive processes used to answer the questions, and (c) how the respondent answers the questions. The purpose of this article is to provide a practical guide outlining how Camtasia, a screen video capture software, can aide and inform the cognitive interview process.

Psychological Reports, 2007

The purpose of this study was to test the hypothesis that individuals reporting healthy lifestyle... more The purpose of this study was to test the hypothesis that individuals reporting healthy lifestyle behaviors would also report better self-rated mental health. Logistic regression analyses were conducted utilizing SUDAAN on the Behavioral Risk Factor Surveillance Survey data set. This descriptive analysis suggests that persons reporting poor mental health were more likely to report unhealthy lifestyle behaviors. This set of findings encourages careful design of experimental studies of empirically based associations of mental health and life style, using psychometrically sound measures. Then public health programs focused on change of health-related behaviors might be more suitably devised.

Journal of School Health, 2011

Health Promotion Practice, 2009

What exactly is health education? Professionals with advanced degrees in health education have mo... more What exactly is health education? Professionals with advanced degrees in health education have most likely encountered questions such as these either during introductory coursework or from those inquiring about the field. These queries can prove quite perplexing when asked by individuals who are unaware of the health education profession. Because the act of marketing health education is crucial to the sustainability of the field, the purpose of this article is to (a) explore the issue of describing and promoting health education, (b) establish ideas that can facilitate the provision of coordinated marketing efforts, and (c) offer marketing management and implementation principles that can assist in marketing both health education and health educators. Based on this discussion, the authors suggest building mainstream consensus in regards to marketing message development and implementation to better position health education.

Health Education & Behavior, 2013

Journal of medical Internet research, 2011

eHealth literacy refers to the ability of individuals to seek, find, understand, and appraise hea... more eHealth literacy refers to the ability of individuals to seek, find, understand, and appraise health information from electronic resources and apply such knowledge to addressing or solving a health problem. While the current generation of college students has access to a multitude of health information on the Internet, access alone does not ensure that students are skilled at conducting Internet searches for health information. Ensuring that college students have the knowledge and skills necessary to conduct advanced eHealth searches is an important responsibility particularly for the medical education community. It is unclear if college students, especially those in the medical and health professions, need customized eHealth literacy training for finding, interpreting, and evaluating health- and medical-related information available on the Internet.

Chronic Respiratory Disease, 2014

The aim of the present study is to conduct a social media content analysis of chronic obstructive... more The aim of the present study is to conduct a social media content analysis of chronic obstructive pulmonary disease (COPD) patient education videos on YouTube. A systematic search protocol was used to locate 223 videos. Two independent coders evaluated each video to determine topics covered, media source(s) of posted videos, information quality as measured by HONcode guidelines for posting trustworthy health information on the Internet, and viewer exposure/engagement metrics. Over half the videos ( n = 113, 50.7%) included information on medication management, with far fewer videos on smoking cessation ( n = 40, 17.9%). Most videos were posted by a health agency or organization ( n = 128, 57.4%), and the majority of videos were rated as high quality ( n = 154, 69.1%). HONcode adherence differed by media source (Fisher’s exact test = 20.52, p = 0.01), however with user-generated content receiving the lowest quality scores. Overall level of user engagement as measured by number of “li...