Meghan Moran | Johns Hopkins Bloomberg School of Public Health (original) (raw)

Papers by Meghan Moran

ABSTRACT Background: Latina women have the highest incidence of cervical cancer of any major raci... more ABSTRACT Background: Latina women have the highest incidence of cervical cancer of any major racial/ethnic group in the United States. Interpersonal discussion is an important predictor of perceived efficacy of cancer screening. Purpose: This study examines the relationship of Latina’s social networks to compliance with cervical cancer screening guidelines. Method: We recruited 1600 Hispanic women aged 21-50 for a face-to-face survey at clinics and community sites based on their compliance with Pap test guidelines. The survey asked participants to name up to five people with whom they spoke about women’s health issues. For each member of their social network, women identified their relationship, whether they talked about Pap tests, and where their conversational partner lived. Results: Participants most commonly talked about women’s health with their partners, mothers, sisters and female friends. 64% of the people Latinas reported talking to about women’s health lived in their household or neighborhood. After controlling for age, education, insurance status, and whether a medical professional had encouraged the participant to get a Pap test, talking with a husband/boyfriend/partner (OR = 1.40), mother (OR = 1.62), or female friend (OR = 1.25) was related to Pap test compliance. Additionally, the higher the proportion of conversational partners who lived in the household or neighborhood, the greater the likelihood of following Pap test guidelines (OR = 1.41). Conclusions: These results suggest that it may prove beneficial to incorporate local family members and friends when advising patients on cervical cancer prevention activities.

Background: Considerable evidence indicates that the peer group with which an adolescent identifi... more Background: Considerable evidence indicates that the peer group with which an adolescent identifies is associated with risk behaviors including substance use, unhealthful dieting and risky sexual behavior. The current study advances this research by providing comprehensive profiles of reported problematic addiction to 21 behaviors by peer group. Methods: Four hundred forty-six youth aged 12-15, randomly selected from a nationally representative sample, were surveyed online. Peer group identification was measured by having participants indicate their level of identification with 11 groups; factor analysis produced three factors (deviant, academic, elite). Reported addiction was measured by asking participants whether they have ever been addicted to each of 21 behaviors (yes/no). Logistic regression analysis (controlling for age, ethnicity, socio-economic status and gender) produced profiles of addictive behavior based on peer group identification. Results: Deviants reported being add...

Background: Cigarette smoking is a health behavior that often begins in adolescence, yet has heal... more Background: Cigarette smoking is a health behavior that often begins in adolescence, yet has health effects throughout the lifetime. Although rates of smoking among teens are declining, an estimated 18.7% of high school seniors smoked in the past 30 days, with over half of those youth reporting daily smoking. Thus, it is crucial that health promotion and education research continue to identify ways to increase the effectiveness of anti-smoking communication materials. Because the peer group with which an adolescent identifies is linked to smoking behavior, this study evaluates the extent to which peer group identity-targeting increased adolescent positive response to anti-smoking ads. Methods: An online survey was given to 446 youth aged 12-15, randomly selected from a nationally representative sample. Participants indicated which of 11 peer groups they most identified with and were then randomly assigned to view an ad which either did or did not target that group. Participants then...

Background: Korean women suffer disproportionately from cervical cancer. However, less than half ... more Background: Korean women suffer disproportionately from cervical cancer. However, less than half get a Pap test according to recommendations. With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervical cancer is both a curable and preventable disease. Purpose: To understand how a culture specific narrative, different from ones own, may transcend cultural boundaries; and impact Korean women's knowledge, attitudes and prevention behaviors regarding cervical cancer screening and the use of the HPV vaccine. Methods: A transdisciplinary team at the University of Southern California conducted two focus groups with English-speaking Korean American women between the ages of 25 and 45. Participant responses were video-taped, transcribed and content analysis was conducted to gauge acceptance and identify themes between the narrative and non-narrative focus groups. Results: Women in the narrative focus group reported being distracted by Spanish words occasional...

Background: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervi... more Background: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervical cancer is both a curable and preventable disease. Yet in 2010, cervical cancer took 4,210 lives in the United States. The current research examines whether narratives or stories may be a better way to deliver vital health information than more traditional non-narrative formats. Purpose: Investigate the relative impact of health messages provided in a narrative or non-narrative format on women's knowledge, attitudes, and prevention behaviors concerning the use of the HPV vaccine and Pap test. Methods: A transdisciplinary team at the University of Southern California conducted eight focus groups with English-speaking Hispanic, African American, Korean American, and Caucasian women. Participant responses were video-taped, transcribed and content analysis was conducted to gauge acceptance and identify themes between the narrative (N=4) and non-narrative (N=4) focus groups. Results: A...

Background: Compared to white women, Latinas are at higher risk for cervical cancer. Risk is part... more Background: Compared to white women, Latinas are at higher risk for cervical cancer. Risk is particularly high for Latinas with less than a high school education (currently over half of Latinas living in Los Angeles). Thus, determining barriers to cervical cancer screening among Latinas is crucial to reducing cervical cancer health disparities. Method: Latinas aged 21-50 were recruited for a face-to-face survey in Los Angeles clinics and community sites. Participants were categorized as compliant with current Pap test screening guidelines (N = 500) or not (never had a Pap test or no Pap test within the previous 3 years; N = 250). The survey included questions about barriers to medical care, self-efficacy to be screened, descriptive norms about how commonly other Latinas get cervical cancer screenings, and intentions to be screened in future. Results: Hierarchical regression and logistic regression were used to analyze the data. After controlling for age, education, and insurance sta...

BACKGROUND: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervi... more BACKGROUND: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervical cancer is both a curable and preventable disease. But less than half of Korean women get a regular Pap test or follow guidelines for screening. Moreover, although a vaccine to prevent common strains of HPV is available for males and females ages 9 to 26, little is known regarding acceptance of the HPV vaccine in the Korean population. PURPOSE: This study describes Korean women's knowledge, attitudes, beliefs and perceived barriers to cervical cancer screening; attitudes toward vaccines in general, and toward having their daughter or son vaccinated against HPV. METHODS: Over 50 in depth telephone interviews using random digit dialing were conducted with English-speaking Korean American women, ages of 25 to 45. RESULTS: Analysis show that Korean women generally lack information regarding Pap tests, are uncertain about the connection between HPV and cervical cancer, and are unclear ...

Background: Although pap tests can detect and prevent cervical cancer, many women are not regular... more Background: Although pap tests can detect and prevent cervical cancer, many women are not regularly tested. Descriptive social norms the perception of how common it is for others to engage in a particular behavior have been found to be an important predictor of cervical cancer screening and prevention behaviors. Objective: To compare the effectiveness of a narrative (story-based) and a non-narrative (fact-based featuring doctors and patients) film, each containing the same facts regarding cervical cancer, on women's perceptions of social norms regarding Pap testing and use of the HPV vaccine. Methods: Over 1,000 women aged 25-45 of Hispanic, African-American, Korean and European descent were administered a pre-test telephone survey and then mailed a film of the narrative or non-narrative educational materials (randomly assigned). Women were re-contacted one to two weeks and then six months later to participate in a post-test and follow-up survey. Results: The narrative film was ...

Background: Although narrative has been the primary form of communication throughout history, hea... more Background: Although narrative has been the primary form of communication throughout history, health promotion has all but ignored narrative when conveying health-related information. The need for more effective health communication prompted the development of two films for use in a study that evaluates the relative impact of narrative vs. non-narrative cervical cancer educational materials. Purpose: Detail the participatory process of working with an interdisciplinary team of scholars, medical experts, filmmakers, Promotores, and other community members to develop two films. Methods: The participatory approach included eight formative focus groups with women at risk for cervical cancer, two interviews with community doctors, three interviews with experts and seven interviews with Promotores. As a result of these discussions, 18 cervical cancer-related facts were developed and approved by health experts. Two film scripts were developed, the narrative The Tamale Lesson and the non-na...

There is considerable misinformation regarding the safety and efficacy of vaccines. As a result, ... more There is considerable misinformation regarding the safety and efficacy of vaccines. As a result, a significant number of parents refuse vaccination for their children or do not follow recommended vaccination schedules. This anti-vaccine sentiment is often accompanied by outbreaks of vaccine-preventable diseases. This study examines the association between sources of health information and anti-vaccine beliefs. Latina women (N=727) were recruited in clinics and community settings. Participants were asked items measuring vaccine-related beliefs, sources of health information and the extent of their connection to local health storytelling networks. Analyses controlled for socio-economic status and health insurance status. Latinas who reported brochures, flyers or pamphlets as a top source of health information had slightly more positive vaccination attitudes than those who did not. Other traditional sources of health information (e.g. TV, newspapers) were not associated with anti-vacci...

Journal of Health Communication

Nicotine & Tobacco Research, 2015

This study examined the impact of warning labels conveying the potential harms and addictiveness ... more This study examined the impact of warning labels conveying the potential harms and addictiveness of Swedish snus and the potential reduced harms of Swedish snus among young adult non-smokers and smokers. A convenience sample of young adults aged 18-30 residing in the US (n = 517, 56% male, 33% smokers) participated in an online experiment. Participants completed baseline measures and were randomized to 1 of 5 experimental conditions where they viewed a Swedish snus ad with warning labels that varied by condition: (1) Control - no warning; (2) Addiction - warning conveying the addictiveness of snus; (3) Harm - warning communicating the potential harms of snus; (4) Harm Reduction - warning conveying the potential reduced harms of snus compared with cigarettes; (5) Harm Reduction Switch - warning communicating the potential reduced harms of snus when switching completely from cigarettes to snus. Outcomes measured included perceived harms and addictiveness of snus, thoughts about not using snus, and intentions to use snus. Participants in the Harm Reduction and Harm Reduction Switch conditions perceived snus to be less harmful than cigarettes compared with the Control, Addiction, and Harm conditions. Non-smokers in the Harm Reduction condition reported fewer thoughts about not using snus than non-smokers in the Harm condition. Warnings conveying the potential reduced harms of Swedish snus compared with cigarettes generate perceptions that snus is less harmful than cigarettes and produce fewer thoughts about not using snus among non-smokers. Such perceptions have been associated with snus use in prior studies.

The power and perseverance of a narrative has been recognized and utilized for thousands of years... more The power and perseverance of a narrative has been recognized and utilized for thousands of years. Yet in crafting health messages Western medicine all but ignores the use of narrative. To empirically test the impact of narratives in producing knowledge, attitude and behavior change (compared to non-fiction, non-narrative formats) we produced two 11-minute films both containing the same 15 facts regarding cervical cancer prevention (via HPV vaccine), detection (via Pap tests) and treatment. The narrative, Tamale Lesson, conveys the information via a Mexican-American family's preparation for their youngest daughter's Quinceaera (15th birthday). A random sample of 1000 women (Mexican-American, European-American, African-American & Korean-American) between the ages of 25-45 were surveyed at three time points: (1) a pretest before viewing either the narrative or the non-narrative film; (2) a post-test two weeks after viewing; and (3) a six-month follow-up survey. Analysis reveal...

Background: Limited research exists regarding the association between Spanish-language mass media... more Background: Limited research exists regarding the association between Spanish-language mass media exposure and body image or self-esteem for Latinas. The present study investigates the influence of Sin Senos No Hay Paraso (a Telemundo telenovela concerning plastic surgery) and other Spanish-language mass media for a sample of Latinas. Methods: Latinas (N=437)recruited through Telemundo.com self-administered a Spanish survey addressing demographics, sociocultural and community factors, body image, self-esteem, attitudes towards and experience with plastic surgery, as well as exposure to Spanish-language media, including the telenovela. Factor analysis informed the creation of indices for mass media exposure, sociocultural factors, and body image. Multivariate regression identified predictors to body image and Rosenberg self-esteem scores. Results: Multivariate logistic regression identified perceived comfort of asking health care providers questions (OR = 2.84; p = 0.03), frequent vi...

American journal of public health, Jan 23, 2015

We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrativ... more We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrative film in conveying the same health information. We used a random digit dial procedure to survey the cervical cancer-related knowledge, attitudes, and behavior of non-Hispanic White, Mexican American, and African American women, aged 25 to 45 years, living in Los Angeles, California, from 2011 to 2012. Participants (n = 704) were randomly assigned to view either a narrative or nonnarrative film containing the same information about how cervical cancer could be prevented or detected, and they were re-contacted 2 weeks and 6 months later. At 2 weeks, both films produced a significant increase in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At 6 months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Papanicolaou (Pap) tests, but women who saw the narrative were signific...

Background: Cervical cancer ranks second in terms of prevalence and mortality among female cancer... more Background: Cervical cancer ranks second in terms of prevalence and mortality among female cancers in Panama, where HPV is highly prevalent (>50%). Few qualitative studies have investigated cultural beliefs and knowledge of cervical cancer and HPV among Panamanian women and the role these views may play in screening behaviors. Objective: Describe knowledge, attitudes, and beliefs related to cervical cancer, HPV, and the HPV vaccine among women in Panama City, Panama. Methods: We employed a mixed-methods approach with quantitative survey data and qualitative focus group data. Women aged 18-65 from inner-city Panama completed a verbal survey. Focus group data (collection currently underway, 2-4 groups anticipated) will further explore emergent themes, including: beliefs, perceived risk, and emotions related to cervical cancer, HPV, and the HPV vaccine. Results: Within our quantitative survey, 24.78% (n= 28/113) and 17.70% (n= 20/113) of respondents felt they were personally at risk...

Background: In 2008, Panama became the first country in Latin America to offer the HPV vaccine at... more Background: In 2008, Panama became the first country in Latin America to offer the HPV vaccine at no cost to 10 year-old girls as part of their national immunization program. Although reported coverage rate is >80% among the intended population, no studies have been published on perception and knowledge of the HPV vaccine among women in Panama. Methods: Women aged 18-65 with no previous history of cervical cancer were recruited in waiting rooms of three geographically distinct community health clinics in Panama City. Participants completed a 54 question verbal survey in Spanish. Results: A total of 345 women responded (92% response rate). Although 93.3% of respondents had heard of HPV, knowledge of the illness was limited and only 60.2% of respondents had heard of the HPV vaccine. After a brief orientation about the vaccine 95% of women reported that they would have their daughters vaccinated. Conclusion: Despite gaps in knowledge, coverage of the HPV vaccine and acceptability am...

Background: Maternal stress plays a significant role in the development and progression of cervic... more Background: Maternal stress plays a significant role in the development and progression of cervical cancer. We examined whether being overwhelmed with “too much to deal with” impacts being up-to-date with Pap-testing, having one’s daughter vaccinated against HPV and self-efficacy to engage in these behaviors. Using a place-based framework, we examined whether characteristics of one’s neighborhood, such as presence of health resources, moderate the effects of being overwhelmed. Methods: We conducted a clinic/community-based survey Latina mothers (N=1010) living in one of 24 Los Angeles neighborhoods. We examined the direct effect of “having too much to deal with” and the moderating effect of neighborhood characteristics on the cervical cancer-related outcomes. Results: Over one-third (37.3%) of participants reported “having too much to deal with” prevented them from seeking health care. Women who felt overwhelmed were significantly less likely to be up-to-date with their Pap test (OR...

Background: Maternal stress has been found to be a key factor in family decision-making related t... more Background: Maternal stress has been found to be a key factor in family decision-making related to children and mother's own health (Harrison, 2005). This study examines the role of maternal stress in cervical cancer screening (Pap tests) and child HPV vaccination. Methods: A RDD survey measuring life stress, self-efficacy, behavioral intentions and behaviors regarding Pap tests and HPV vaccination for sons and daughters was administered in Los Angeles (N=843) to Mexican-American, Korean-American, African-American, and Non-Hispanic-White women. Results: Findings from this study show there were no significant differences across ethnicity. Having too much to deal with was associated with a decreased likelihood of having a Pap test in the past two years (OR=.358, p

ABSTRACT Background: Latina women have the highest incidence of cervical cancer of any major raci... more ABSTRACT Background: Latina women have the highest incidence of cervical cancer of any major racial/ethnic group in the United States. Interpersonal discussion is an important predictor of perceived efficacy of cancer screening. Purpose: This study examines the relationship of Latina’s social networks to compliance with cervical cancer screening guidelines. Method: We recruited 1600 Hispanic women aged 21-50 for a face-to-face survey at clinics and community sites based on their compliance with Pap test guidelines. The survey asked participants to name up to five people with whom they spoke about women’s health issues. For each member of their social network, women identified their relationship, whether they talked about Pap tests, and where their conversational partner lived. Results: Participants most commonly talked about women’s health with their partners, mothers, sisters and female friends. 64% of the people Latinas reported talking to about women’s health lived in their household or neighborhood. After controlling for age, education, insurance status, and whether a medical professional had encouraged the participant to get a Pap test, talking with a husband/boyfriend/partner (OR = 1.40), mother (OR = 1.62), or female friend (OR = 1.25) was related to Pap test compliance. Additionally, the higher the proportion of conversational partners who lived in the household or neighborhood, the greater the likelihood of following Pap test guidelines (OR = 1.41). Conclusions: These results suggest that it may prove beneficial to incorporate local family members and friends when advising patients on cervical cancer prevention activities.

Background: Considerable evidence indicates that the peer group with which an adolescent identifi... more Background: Considerable evidence indicates that the peer group with which an adolescent identifies is associated with risk behaviors including substance use, unhealthful dieting and risky sexual behavior. The current study advances this research by providing comprehensive profiles of reported problematic addiction to 21 behaviors by peer group. Methods: Four hundred forty-six youth aged 12-15, randomly selected from a nationally representative sample, were surveyed online. Peer group identification was measured by having participants indicate their level of identification with 11 groups; factor analysis produced three factors (deviant, academic, elite). Reported addiction was measured by asking participants whether they have ever been addicted to each of 21 behaviors (yes/no). Logistic regression analysis (controlling for age, ethnicity, socio-economic status and gender) produced profiles of addictive behavior based on peer group identification. Results: Deviants reported being add...

Background: Cigarette smoking is a health behavior that often begins in adolescence, yet has heal... more Background: Cigarette smoking is a health behavior that often begins in adolescence, yet has health effects throughout the lifetime. Although rates of smoking among teens are declining, an estimated 18.7% of high school seniors smoked in the past 30 days, with over half of those youth reporting daily smoking. Thus, it is crucial that health promotion and education research continue to identify ways to increase the effectiveness of anti-smoking communication materials. Because the peer group with which an adolescent identifies is linked to smoking behavior, this study evaluates the extent to which peer group identity-targeting increased adolescent positive response to anti-smoking ads. Methods: An online survey was given to 446 youth aged 12-15, randomly selected from a nationally representative sample. Participants indicated which of 11 peer groups they most identified with and were then randomly assigned to view an ad which either did or did not target that group. Participants then...

Background: Korean women suffer disproportionately from cervical cancer. However, less than half ... more Background: Korean women suffer disproportionately from cervical cancer. However, less than half get a Pap test according to recommendations. With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervical cancer is both a curable and preventable disease. Purpose: To understand how a culture specific narrative, different from ones own, may transcend cultural boundaries; and impact Korean women's knowledge, attitudes and prevention behaviors regarding cervical cancer screening and the use of the HPV vaccine. Methods: A transdisciplinary team at the University of Southern California conducted two focus groups with English-speaking Korean American women between the ages of 25 and 45. Participant responses were video-taped, transcribed and content analysis was conducted to gauge acceptance and identify themes between the narrative and non-narrative focus groups. Results: Women in the narrative focus group reported being distracted by Spanish words occasional...

Background: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervi... more Background: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervical cancer is both a curable and preventable disease. Yet in 2010, cervical cancer took 4,210 lives in the United States. The current research examines whether narratives or stories may be a better way to deliver vital health information than more traditional non-narrative formats. Purpose: Investigate the relative impact of health messages provided in a narrative or non-narrative format on women's knowledge, attitudes, and prevention behaviors concerning the use of the HPV vaccine and Pap test. Methods: A transdisciplinary team at the University of Southern California conducted eight focus groups with English-speaking Hispanic, African American, Korean American, and Caucasian women. Participant responses were video-taped, transcribed and content analysis was conducted to gauge acceptance and identify themes between the narrative (N=4) and non-narrative (N=4) focus groups. Results: A...

Background: Compared to white women, Latinas are at higher risk for cervical cancer. Risk is part... more Background: Compared to white women, Latinas are at higher risk for cervical cancer. Risk is particularly high for Latinas with less than a high school education (currently over half of Latinas living in Los Angeles). Thus, determining barriers to cervical cancer screening among Latinas is crucial to reducing cervical cancer health disparities. Method: Latinas aged 21-50 were recruited for a face-to-face survey in Los Angeles clinics and community sites. Participants were categorized as compliant with current Pap test screening guidelines (N = 500) or not (never had a Pap test or no Pap test within the previous 3 years; N = 250). The survey included questions about barriers to medical care, self-efficacy to be screened, descriptive norms about how commonly other Latinas get cervical cancer screenings, and intentions to be screened in future. Results: Hierarchical regression and logistic regression were used to analyze the data. After controlling for age, education, and insurance sta...

BACKGROUND: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervi... more BACKGROUND: With early detection and the advent of the Human Papilloma Virus (HPV) vaccine, cervical cancer is both a curable and preventable disease. But less than half of Korean women get a regular Pap test or follow guidelines for screening. Moreover, although a vaccine to prevent common strains of HPV is available for males and females ages 9 to 26, little is known regarding acceptance of the HPV vaccine in the Korean population. PURPOSE: This study describes Korean women's knowledge, attitudes, beliefs and perceived barriers to cervical cancer screening; attitudes toward vaccines in general, and toward having their daughter or son vaccinated against HPV. METHODS: Over 50 in depth telephone interviews using random digit dialing were conducted with English-speaking Korean American women, ages of 25 to 45. RESULTS: Analysis show that Korean women generally lack information regarding Pap tests, are uncertain about the connection between HPV and cervical cancer, and are unclear ...

Background: Although pap tests can detect and prevent cervical cancer, many women are not regular... more Background: Although pap tests can detect and prevent cervical cancer, many women are not regularly tested. Descriptive social norms the perception of how common it is for others to engage in a particular behavior have been found to be an important predictor of cervical cancer screening and prevention behaviors. Objective: To compare the effectiveness of a narrative (story-based) and a non-narrative (fact-based featuring doctors and patients) film, each containing the same facts regarding cervical cancer, on women's perceptions of social norms regarding Pap testing and use of the HPV vaccine. Methods: Over 1,000 women aged 25-45 of Hispanic, African-American, Korean and European descent were administered a pre-test telephone survey and then mailed a film of the narrative or non-narrative educational materials (randomly assigned). Women were re-contacted one to two weeks and then six months later to participate in a post-test and follow-up survey. Results: The narrative film was ...

Background: Although narrative has been the primary form of communication throughout history, hea... more Background: Although narrative has been the primary form of communication throughout history, health promotion has all but ignored narrative when conveying health-related information. The need for more effective health communication prompted the development of two films for use in a study that evaluates the relative impact of narrative vs. non-narrative cervical cancer educational materials. Purpose: Detail the participatory process of working with an interdisciplinary team of scholars, medical experts, filmmakers, Promotores, and other community members to develop two films. Methods: The participatory approach included eight formative focus groups with women at risk for cervical cancer, two interviews with community doctors, three interviews with experts and seven interviews with Promotores. As a result of these discussions, 18 cervical cancer-related facts were developed and approved by health experts. Two film scripts were developed, the narrative The Tamale Lesson and the non-na...

There is considerable misinformation regarding the safety and efficacy of vaccines. As a result, ... more There is considerable misinformation regarding the safety and efficacy of vaccines. As a result, a significant number of parents refuse vaccination for their children or do not follow recommended vaccination schedules. This anti-vaccine sentiment is often accompanied by outbreaks of vaccine-preventable diseases. This study examines the association between sources of health information and anti-vaccine beliefs. Latina women (N=727) were recruited in clinics and community settings. Participants were asked items measuring vaccine-related beliefs, sources of health information and the extent of their connection to local health storytelling networks. Analyses controlled for socio-economic status and health insurance status. Latinas who reported brochures, flyers or pamphlets as a top source of health information had slightly more positive vaccination attitudes than those who did not. Other traditional sources of health information (e.g. TV, newspapers) were not associated with anti-vacci...

Journal of Health Communication

Nicotine & Tobacco Research, 2015

This study examined the impact of warning labels conveying the potential harms and addictiveness ... more This study examined the impact of warning labels conveying the potential harms and addictiveness of Swedish snus and the potential reduced harms of Swedish snus among young adult non-smokers and smokers. A convenience sample of young adults aged 18-30 residing in the US (n = 517, 56% male, 33% smokers) participated in an online experiment. Participants completed baseline measures and were randomized to 1 of 5 experimental conditions where they viewed a Swedish snus ad with warning labels that varied by condition: (1) Control - no warning; (2) Addiction - warning conveying the addictiveness of snus; (3) Harm - warning communicating the potential harms of snus; (4) Harm Reduction - warning conveying the potential reduced harms of snus compared with cigarettes; (5) Harm Reduction Switch - warning communicating the potential reduced harms of snus when switching completely from cigarettes to snus. Outcomes measured included perceived harms and addictiveness of snus, thoughts about not using snus, and intentions to use snus. Participants in the Harm Reduction and Harm Reduction Switch conditions perceived snus to be less harmful than cigarettes compared with the Control, Addiction, and Harm conditions. Non-smokers in the Harm Reduction condition reported fewer thoughts about not using snus than non-smokers in the Harm condition. Warnings conveying the potential reduced harms of Swedish snus compared with cigarettes generate perceptions that snus is less harmful than cigarettes and produce fewer thoughts about not using snus among non-smokers. Such perceptions have been associated with snus use in prior studies.

The power and perseverance of a narrative has been recognized and utilized for thousands of years... more The power and perseverance of a narrative has been recognized and utilized for thousands of years. Yet in crafting health messages Western medicine all but ignores the use of narrative. To empirically test the impact of narratives in producing knowledge, attitude and behavior change (compared to non-fiction, non-narrative formats) we produced two 11-minute films both containing the same 15 facts regarding cervical cancer prevention (via HPV vaccine), detection (via Pap tests) and treatment. The narrative, Tamale Lesson, conveys the information via a Mexican-American family's preparation for their youngest daughter's Quinceaera (15th birthday). A random sample of 1000 women (Mexican-American, European-American, African-American & Korean-American) between the ages of 25-45 were surveyed at three time points: (1) a pretest before viewing either the narrative or the non-narrative film; (2) a post-test two weeks after viewing; and (3) a six-month follow-up survey. Analysis reveal...

Background: Limited research exists regarding the association between Spanish-language mass media... more Background: Limited research exists regarding the association between Spanish-language mass media exposure and body image or self-esteem for Latinas. The present study investigates the influence of Sin Senos No Hay Paraso (a Telemundo telenovela concerning plastic surgery) and other Spanish-language mass media for a sample of Latinas. Methods: Latinas (N=437)recruited through Telemundo.com self-administered a Spanish survey addressing demographics, sociocultural and community factors, body image, self-esteem, attitudes towards and experience with plastic surgery, as well as exposure to Spanish-language media, including the telenovela. Factor analysis informed the creation of indices for mass media exposure, sociocultural factors, and body image. Multivariate regression identified predictors to body image and Rosenberg self-esteem scores. Results: Multivariate logistic regression identified perceived comfort of asking health care providers questions (OR = 2.84; p = 0.03), frequent vi...

American journal of public health, Jan 23, 2015

We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrativ... more We compared the relative efficacy of a fictional narrative film to a more traditional nonnarrative film in conveying the same health information. We used a random digit dial procedure to survey the cervical cancer-related knowledge, attitudes, and behavior of non-Hispanic White, Mexican American, and African American women, aged 25 to 45 years, living in Los Angeles, California, from 2011 to 2012. Participants (n = 704) were randomly assigned to view either a narrative or nonnarrative film containing the same information about how cervical cancer could be prevented or detected, and they were re-contacted 2 weeks and 6 months later. At 2 weeks, both films produced a significant increase in cervical cancer-related knowledge and attitudes, but these effects were significantly higher for the narrative film. At 6 months, viewers of both films retained greater than baseline knowledge and more positive attitudes toward Papanicolaou (Pap) tests, but women who saw the narrative were signific...

Background: Cervical cancer ranks second in terms of prevalence and mortality among female cancer... more Background: Cervical cancer ranks second in terms of prevalence and mortality among female cancers in Panama, where HPV is highly prevalent (>50%). Few qualitative studies have investigated cultural beliefs and knowledge of cervical cancer and HPV among Panamanian women and the role these views may play in screening behaviors. Objective: Describe knowledge, attitudes, and beliefs related to cervical cancer, HPV, and the HPV vaccine among women in Panama City, Panama. Methods: We employed a mixed-methods approach with quantitative survey data and qualitative focus group data. Women aged 18-65 from inner-city Panama completed a verbal survey. Focus group data (collection currently underway, 2-4 groups anticipated) will further explore emergent themes, including: beliefs, perceived risk, and emotions related to cervical cancer, HPV, and the HPV vaccine. Results: Within our quantitative survey, 24.78% (n= 28/113) and 17.70% (n= 20/113) of respondents felt they were personally at risk...

Background: In 2008, Panama became the first country in Latin America to offer the HPV vaccine at... more Background: In 2008, Panama became the first country in Latin America to offer the HPV vaccine at no cost to 10 year-old girls as part of their national immunization program. Although reported coverage rate is >80% among the intended population, no studies have been published on perception and knowledge of the HPV vaccine among women in Panama. Methods: Women aged 18-65 with no previous history of cervical cancer were recruited in waiting rooms of three geographically distinct community health clinics in Panama City. Participants completed a 54 question verbal survey in Spanish. Results: A total of 345 women responded (92% response rate). Although 93.3% of respondents had heard of HPV, knowledge of the illness was limited and only 60.2% of respondents had heard of the HPV vaccine. After a brief orientation about the vaccine 95% of women reported that they would have their daughters vaccinated. Conclusion: Despite gaps in knowledge, coverage of the HPV vaccine and acceptability am...

Background: Maternal stress plays a significant role in the development and progression of cervic... more Background: Maternal stress plays a significant role in the development and progression of cervical cancer. We examined whether being overwhelmed with “too much to deal with” impacts being up-to-date with Pap-testing, having one’s daughter vaccinated against HPV and self-efficacy to engage in these behaviors. Using a place-based framework, we examined whether characteristics of one’s neighborhood, such as presence of health resources, moderate the effects of being overwhelmed. Methods: We conducted a clinic/community-based survey Latina mothers (N=1010) living in one of 24 Los Angeles neighborhoods. We examined the direct effect of “having too much to deal with” and the moderating effect of neighborhood characteristics on the cervical cancer-related outcomes. Results: Over one-third (37.3%) of participants reported “having too much to deal with” prevented them from seeking health care. Women who felt overwhelmed were significantly less likely to be up-to-date with their Pap test (OR...

Background: Maternal stress has been found to be a key factor in family decision-making related t... more Background: Maternal stress has been found to be a key factor in family decision-making related to children and mother's own health (Harrison, 2005). This study examines the role of maternal stress in cervical cancer screening (Pap tests) and child HPV vaccination. Methods: A RDD survey measuring life stress, self-efficacy, behavioral intentions and behaviors regarding Pap tests and HPV vaccination for sons and daughters was administered in Los Angeles (N=843) to Mexican-American, Korean-American, African-American, and Non-Hispanic-White women. Results: Findings from this study show there were no significant differences across ethnicity. Having too much to deal with was associated with a decreased likelihood of having a Pap test in the past two years (OR=.358, p