Key Works of our Authors

Doryn D. Chervin, Dr.Ph.:
Coalition models: lessons learned from the CDC's Community Coalition Partnership Programs for the Prevention of Teen Pregnancy.
Journal of Adolescent Health, September 2005 Vol.37 No.3
PURPOSE: To describe the models created by the 13 communities in the Centers for Disease Control and Prevention's Community Coalition Partnership Program (CCPP), and the relationship between key organizational features of the coalitions and the perception by coalition members of interim and community-wide outcomes. METHODS: This study relied on three sources of data: interviews conducted on site with a sample of coalition staff, evaluators, and members (n = 364); a written survey administered after the site visit to those interviewed (n = 216) asking about perceived outcomes and changes between the beginning and end of the project; and a coalition member survey mailed to all coalition members at all sites (n = 341) focusing on perceptions of coalition functioning, outcomes, and satisfaction. RESULTS: A variety of coalition models were developed. Respondents were positive in their assessments of how their coalitions operated even though few were sustained. The coalitions for which members perceived more positive outcomes were better established at the outset of the grant, led by paid staff, and had an area-wide focus, a steering committee, and a hub that was not a community-based organization. Coalitions composed primarily of neighborhood members were difficult to maintain. CONCLUSIONS: Despite members' high ratings, by the end of the funding period most coalitions were no longer functioning. It may be that coalitions are useful but not as permanent structures in communities. Grassroots and individual members not affiliated with an agency may require meaningful incentives to sustain participation. Because maturity of the coalition at the start of the project was a good predictor of sustainability, time should be spent verifying the stage of coalition development before funding.

Community capacity building in CDC's Community Coalition Partnership Programs for the Prevention of Teen Pregnancy.
Journal of Adolescent Health, September 2005 Vol.37 No.3
PURPOSE: To describe lessons learned from the Centers for Disease Control and Prevention's Community Coalition Partnership Program (CCPP) about building a community's capacity to prevent teen pregnancy through strengthening of partnerships, mobilization of community resources, and changes in the number and quality of community programs. METHODS: A multi-component post-test-only evaluation. In-person interviews (n = 364) were conducted with a sample of CCPP project staff, evaluators, and community and agency members from each of the 13 CCPP communities. RESULTS: All partnerships reported that new groups worked together to address teen pregnancy prevention; however, more time, effort, and resources than anticipated were spent engaging these groups and strengthening their partnerships. Respondents reported increases in community awareness of the problem of teen pregnancy and the willingness to discuss the issue. As a result of partnerships' activities, knowledge and skills related to addressing teen pregnancy improved among partnership members, but respondents were concerned that the broader community did not share these gains. To a lesser extent, respondents reported that partners worked together to reduce duplication and fill gaps in services either through increased collaboration and/or differentiation of activities. Respondents from most of the partnerships also reported new programs were developed as a result of the project; however, in several partnerships, only a few programs were developed in their community. Many respondents doubted whether the limited mobilization of resources during the program would translate into increased agency and community capacity. CONCLUSIONS: Overall, increased partner skills, program improvements, and new programs did not appear to be sufficient to affect community capacity. Research is needed to identify the pathways between changes in community capacity and in individual-level behavior that might result in the avoidance or reduction of teen pregnancy.

Celeste M. Condit, PhD:
How lay people respond to messages about genetics, health, and race.
Clinical Genetics, August 2005, Vol.68 No.2
There is a growing movement in medical genetics to develop, implement, and promote a model of race-based medicine. Although race-based medicine may become a widely disseminated standard of care, messages that advocate race-based selection for diagnosing, screening and prescribing drugs may exacerbate health disparities. These messages are present in clinical genetic counseling sessions, mass media, and everyday talk. Messages promoting linkages among genes, race, and health and messages emphasizing genetic causation may promote both general racism and genetically based racism. This mini-review examines research in three areas: studies that address the effects of these messages about genetics on levels of genetic determinism and genetic discrimination; studies that address the effects of these messages on attitudes about race; and, studies of the impacts of race-specific genetic messages on recipients. Following an integration of this research, this mini-review suggests that the current literature appears fragmented because of methodological and measurement issues and offers strategies for future research. Finally, the authors offer a path model to help organize future research examining the effects of messages about genetics on socioculturally based racism, genetically based racism, and unaccounted for racism. Research in this area is needed to understand and mitigate the negative attitudinal effects of messages that link genes, race, and health and/or emphasize genetic causation.

Risk Comprehension and Judgments of Statistical Evidentiary Appeals When a Picture is Not Worth a Thousand Words.
Human Communication Research, July 2005 Vol.31 No.3
Too little theory and research has considered the effects of communicating statistics in various forms on comprehension, perceptions of evidence quality, or evaluations of message persuasiveness. In a considered extension of Subjective Message Construct Theory (Morley, 1987), we advance a rationale relating evidence form to the formation of impressions of evidence. We compare visual versus verbal representations of statistical evidence associated with multivariate relationships in a community-based field experiment (N = 206). Verbal forms were found to be better comprehended than visual forms and contributed to enhanced understanding when compared to an attention control condition. Comprehension was found to mediate the effect of statistical evidence form on perceptions of evidence quality, while comprehension and perceptions of evidence quality moderated judgments of message persuasiveness. In addition to the effects of evidence form on subjective impressions of statistical evidence, we advance perceiver characteristics as another realm in which persuaders may identify persistent patterns associated with comprehension and judgments of statistical evidence. Numeracy skills, race, and gender emerge as characteristics with merit in this regard. Nonsignificant findings associated with perceiver characteristics were found. Finally, we consider the results for evidence form and perceiver characteristics on comprehension and judgments of statistical evidence for their theoretic and pragmatic importance.

The meaning and effects of discourse about genetics: methodological variations in studies of discourse and social change.
Discourse and Society, July 2004, Vol. 5
Studies seeking to explore the implications of the discourse of medical genetics using four different methodologies are overviewed. Research on genetics discourse using critical methods, audience studies, persuasion studies and institutional studies suggest results that are at odds with one another. Rather than selecting one approach based on a preference for the methodology itself or the results it provides, a clearer picture of how genetic discourse may function is provided by integrating the findings of the various methods.

The role of "genetics" in popular understandings of race in the United States.
Public Understanding of Science, 2004, Vol. 13
The increase in public representation of the science-based concept "genetics" in the mass media might be expected to have a major impact on public understanding of the concept of "race." A model of lay understandings of the role of genetics in the contemporary United States is offered based on focus group research, random digit dial surveys, and community based surveys. That model indicates that lay people identify primarily by physical features, but these identifications are categorized into a variety of groupings that may be regional, national, or linguistic. Although they believe that physical appearance is caused largely by genetics, and therefore that race has a genetic basis, they do not uniformly conclude, however, that all perceived racial characteristics are genetically based. Instead, they vary in the extent to which they attribute differences to cultural, personal, and genetic factors.

Genetic Research and Health Disparities
Journal of the American Medical Association, June 23/30 2004 Vol.291 No.24
Alleviating health disparities in the United States is a goal with broad support. Medical research undertaken to achieve this goal typically adopts the well-established perspective that racial discrimination and poverty are the major contributors to unequal health status. However, the suggestion is increasingly made that genetic research also has a significant role to play in alleviating this problem, which likely overstates the importance of genetics as a factor in health disparities. Overemphasis on genetics as a major explanatory factor in health disparities could lead researchers to miss factors that contribute to disparities more substantially and may also reinforce racial stereotyping, which may contribute to disparities in the first place. Arguments that promote genetics research as a way to help alleviate health disparities are augmented by several factors, including research funding initiatives and the distinct demographic patterns of health disparities in the United States.

Vicki S. Freimuth, PhD:
African Americans' views on research and the Tuskegee Syphilis Study.
Social Science and Medicine, March 2001 Vol.52 No.5
The participation of African Americans in clinical and public health research is essential. However, for a multitude of reasons, participation is low in many research studies. This article reviews the literature that substantiates barriers to participation and the legacy of past abuses of human subjects through research. The article then reports the results of seven focus groups with 60 African Americans in Los Angeles, Chicago, Washington, DC, and Atlanta during the winter of 1997. In order to improve recruitment and retention in research, the focus group study examined knowledge of and attitudes toward medical research, knowledge of the Tuskegee Syphilis Study, and reactions to the Home Box Office production, Miss Evers' Boys, a fictionalized version of the Tuskegee Study, that premiered in February, 1997. The study found that accurate knowledge about research was limited; lack of understanding and trust of informed consent procedures was problematic; and distrust of researchers posed a substantial barrier to recruitment. Additionally, the study found that, in general, participants believed that research was important, but they clearly distinguished between types of research they would be willing to consider participating in and their motivations for doing so.

Communicating the Threat of Emerging Infections to the Public
Emerging Infectious Disease, July/August 2000 Vol.6 No.4
Communication theory and techniques, aided by the electronic revolution, provide new opportunities and challenges for the effective transfer of laboratory, epidemiologic, surveillance, and other public health data to the public who funds them. We review the applicability of communication theory, particularly the audience-source-message-channel meta-model, to emerging infectious disease issues. Emergence of new infectious organisms, microbial resistance to therapeutic drugs, and increased emphasis on prevention have expanded the role of communication as a vital component of public health practice. In the absence of cure, as in AIDS and many other public health problems, an effectively crafted and disseminated prevention message is the key control measure. Applying communication theory to disease prevention messages can increase the effectiveness of the messages and improve public health.

Is There a Hard-To-Reach Audience?
1990 U.S. Department of Health and Human Services: Public Health Reports, May/June 1990;  Vol. 105
The “hard-to-reach” label has been applied to many different audiences. Persons who have a low socioeconomic status (SES), members of ethnic minorities, and persons who have a low level of literacy often tagged as “hard-to-reach.” The authors identify reasons why these groups have been labeled “hard-to-reach,” discuss preconceptions associated with the “hard-to-reach” label, propose alternative conceptualizations of these audience, and present implications of such conceptualizations for health communication campaigns. Pejorative labels and preconceptions about various groups may lead to depicting these audiences as powerless, apathetic, and isolated. The authors discuss alternative conceptualizations, which highlight the strengths of different audience segments and encourage innovative approaches to the communication process. These alternative conceptualizations emphasize interactive communication, a view of society in which individuals are seen as members of equivalent—albeit different—cultures, and a shift of responsibility for health problems from individuals to social systems. Recommendations for incorporating these alternative concepts into health campaigns include formative research techniques that create a dialogue among participants, more sophisticated segmentation techniques to capture audience diversity, and new roles for mass media that are more interactive and responsive to individual needs.

Lisa M. Goodin, MBA:
Psychological Reports, June 2003; Part 1, Vol.92 No.2
This study assessed psychometrics of an HIV/AIDS knowledge scale and the relation of scores to HIV risk behaviors among African-American women 17 to 44 years of age (N=405). Data were collected from five communities located in Atlanta, Georgia. The HIV/AIDS risk-behavior knowledge scale and the HIV risk-behavior factors were collected. Analysis indicated reliability coefficients of the HIV/ AIDS knowledge scale were virtually identical for high- and low-risk groups. The high-risk group scored statistically significantly better (76% correct answers) than the low-risk group (67% correct answers). The KR-20 coefficients were identical for both risk groups (.73), suggesting that the AIDS knowledge scale has suitable reliability.

Dean M. Krugman, PhD:
Cigarette Advertising in Popular Youth and Adult Magazines: A Ten-Year Perspective
Journal of Public Policy & Marketing, Fall 2006 Vol. 25 No.2
Cigarette advertising for youth brands delivered sufficient impressions to reach youths at high reach and frequency levels during the 1993–2002 period. However, a precipitous drop in such advertising is also found at the end of the period. The authors reconcile the findings with those of previous studies and examine the efficacy of guidelines that have been used to evaluate cigarette advertising in publications with high youth readership. Click for full article

Understanding the Role of Cigarette Promotion and Youth Smoking in a Changing Marketing Environment.
Journal of Health Communication, April/May 2005 Vol.10 No.3
In 2001, $11.21 billion was spent on domestic cigarette advertising and promotion, an increase of 16.9% over 2000. This article explains how cigarette industry efforts stimulate demand and encourage smoking within the context of recent changes, including the 1998 Master Settlement Agreement (MSA) and resulting litigation, and variations in tobacco marketing policies. Communication concepts are combined with adolescent development concepts to explain how youth are impacted. Industry documents and current syndicated research data are used to reveal and explain key concepts.

Teenage Exposure to Cigarette Advertising in Popular Consumer Magazines.
Journal of Public Policy & Marketing, Fall 2000 Vol.19 No.2
The tobacco industry indicates that it does not advertise in magazines that reach a high percentage of young people. To avoid reaching teens, current tobacco industry practice is to use circulation data to assess the number of young people who receive a magazine. Results from the reported study demonstrate that using circulation data is not an accurate method for estimating the size of the teenage audience. The authors analyze readership data from 1998 and construct specific media schedules to examine the extent to which teenagers are reached by popular consumer magazines that contain cigarette advertising. Results reveal that tobacco marketers routinely reach a high percentage of teenagers 12-17 years of age when placing advertisements in popular consumer magazines. Click for full article

Do cigarette warnings warn? Understanding what it will take to develop more effective warnings.
Journal of Health Communications, June 1999 Vol.4 No.2
Warnings in cigarette advertisements have been the principal method mandated by the federal government to educate consumers about the risks of smoking. Warnings have been required in all cigarette ads for 30 years and have remained largely unchanged during this time. The current warning program was neither developed nor implemented with specific communication goals in mind. Instead, it was negotiated by the government and tobacco industry representatives. The warning program has served the tobacco industry well by providing it with a key argument in tobacco litigation: "We warned you." It has, however, failed as a public health strategy, since much research has shown that the current warnings are ineffective communication devices. If Congress is to be effective in its efforts to educate consumers about the risks of smoking, it needs to rethink the warning strategy while making use of knowledge regarding how warnings work. The paper draws from current studies in order to develop realistic cigarette warning objectives and points out the considerations necessary to create such warnings. To be effective, warnings must be developed, targeted, tested, and revised over time.

Journal of Advertising Research, November/December 1994
Currently mandated and new health warnings in the context of magazine ads for two cigarettes were studied among adolescents. Focus groups were used to garner a basic understanding of how adolescents react to cigarette advertising and currently mandated Surgeon General Warnings, and to develop new warnings. Two currently mandated warnings and two new warnings were then imbedded in magazine ads for two cigarette brands and presented to 326 adolescents. Subjects viewed each ad as long as desired while state-of-the-art eye-tracking equipment recorded point of gaze, fixation, and saccades. Following presentation of the ads and eye-tracking measurement, subjects completed a masked recall task. Analyses addressed the number of subjects who noticed the warning, their time to first fixation within the warning, and the time spent fixating on the warning. The masked recall measure permitted examination of the possible link of eye-tracking measures with cognitive processing of a warning. Results indicated that within the competitive reading environment of a cigarette ad, new warnings attract greater readership, with quicker attention to warnings than mandated warnings. New warnings were noticed in 1 to 2½ seconds less time. Total attention devoted to all warnings ranged from 2 to 3 seconds. Eye-tracking measures were significantly related to masked recall of warning content. Click for full article

Jennifer L. Monahan, PhD:
Priming Welfare Queens and Other Stereotypes: The Transference of Media Images into Interpersonal Contexts.
Communication Research Reports, August 2005 Vol.22 No.3
Specific stereotype portrayals of African American women were hypothesized to produce stereotype-consistent judgments made of a different African American woman. Participants (N = 76) observed a mammy, jezebel or welfare queen video-segment. Then they observed an African American woman in a mock job interview and rated the interviewee. Participants who observed a specific stereotype associated the interviewee more quickly with stereotype-consistent adjectives than with stereotype-inconsistent adjectives for all three stereotypes. For measures of how suitable the woman was for jobs that were related to the stereotypes, only the welfare queen prime produced significant effects. Click for full article

Priming Mammies, Jezebels, and Other Controlling Images: An Examination of the Influence of Mediated Stereotypes on Perceptions of an African American Woman.
Media Psychology, 2005 Vol.7 No.1
This study examines how mediated portrayals of African American women influence judgments of African American women in social situations. Participants (N = 182) observed a mammy, jezebel, or nonstereotypic image on video. Participants then observed a mock employment interview involving either an African American or White woman. Participants completed measures of implicit and explicit racial prejudice. As hypothesized, participants associated the African American interviewee more quickly with negative terms (e.g., aggressive) than with positive terms (e.g., sincere). Also as hypothesized, when evaluating the job interviewee, participants who observed the jezebel stereotype video and the African American female interviewee responded more quickly to jezebel-related terms (e.g., sexual) than positive, negative, and mammy (e.g., maternal) terms. These results call for an expansion of the boundaries used in stereotype research and closer investigation of how mediated imagery might influence person perception.

Alcohol as Social Lubricant.
Human Communication Research, April 2000 Vol.26 No.2
This study examines how consuming alcohol differentially affects the communicative behavior and perceptions of high and low social self-esteem (SSE) women as they engage in a brief interaction with a flirtatious male. Alcohol myopia theory proposes that alcohol affects behavior when it blocks a person's normal inhibitions about enacting a behavior. It was predicted that low SSE women would be more inhibited when talking to a flirtatious male than would high SSE women and, therefore, that alcohol would have a stronger effect on the low SSE women's behavior. Following administration of a social self-esteem measure and random assignment to an alcoholic or nonalcoholic beverage condition, participants (N = 50) talked with an attractive, flirtatious male confederate. Low SSE women were less anxious and self-disclosed more when drinking than when sober, whereas high SSE women were not significantly affected by alcohol consumption. The discussion highlights the complex and often contradictory effects of alcohol consumption on social interaction. Click for full article

Click for full article The Stem of Misunderstanding

Donald L. Rubin, PhD:
Elaboration in Processing Adolescent Health Messages: The Impact of Egocentrism and Sensation Seeking on Message Processing.
Journal of Communication, December 2002 Vol.52 No.4
The present studies explored how adolescents process information in making decisions about risk behavior. We studied two developmental aspects of adolescent egocentrism: personal fable (a sense of invulnerability) and imaginary audience (focus on others), along with individual difference variables (sensation seeking, self-esteem, and peer pressure). The studies investigated the effects of a message variable, elaboration demand, which is driven by a developmental view of adolescents' cognitive processing. Results of 3 studies indicated the deep elaboration message was partially effective in changing message perceptions and adolescents' intentions to behave in ways to reduce risks. The message type interacted with developmental indicators (age and cognitive development), gender, and topic to explain behavioral intentions, message perceptions and retention.

Jeffrey K. Springston, PhD:
Effects of Mass and Interpersonal Communication on Breast Cancer Screening: Advancing Agenda-Setting Theory in Health Contexts.
Journal of Applied Communication Research, February 2006 Vol.34 No.1
Drawing on components of agenda-setting theory and the two-step flow of information from mass media to news audiences, this study examines the effects of mass and interpersonal communication on breast cancer screening practices among college- and middle-aged women (n = 284). We theorized that screening behaviors among younger women would be influenced more by interpersonal sources of information while screening among middle-aged women would be more influenced by exposure to mass-mediated information. Findings supported anticipated patterns, revealing important and varying roles for both mass and interpersonal communication in the health behaviors of women. Implications for health practitioners and campaign planners, as well as recommendations for future research, are discussed.

Public relations effectiveness in public health institutions.
Journal of Health and Human Services Administration, Fall 2005 Vol.28 No.2
This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

Public relations and cultural aesthetics: designing health brochures.
Public Relations Review, November 2004 Vol.30 No.4
Brochures continue to be one of the most common tools available to health public relations practitioners. However, few studies have focused on the best ways to design health brochures for minority publics. Yet statistics show that African Americans and members of other minority publics suffer higher incidences of mortality from many diseases than do Caucasians. This two-part study examines ways to better design brochures to appeal to African American women. The study reveals that African American women prefer designs that reflect the cultural aesthetics. Part one of this study identifies a number of preferred design characteristics. Part two of this study tests the effectiveness of a culturally tailored brochure that advocates mammography screening. Results indicate that the brochures promoted significant gains in knowledge about breast cancer and mammography screening, a positive shift in perceived benefits of mammography, and a reduction in perceived barriers to getting mammograms. The brochure was preferred over standard "off the shelf" brochures that are not culturally tailored.

Mammography adherence and beliefs in a sample of low-income African American women.
International Journal of Behavioral Medicine, 1999 Vol.6 No.3
The purpose of this article is to describe the relation of perceptions of perceived breast cancer risks and perceived benefits and barriers to mammography and stage of mammography adherence in a convenience sample of low-income African American women. The theoretical framework of the Health Belief Model and the Transtheoretical Model were used to identify concepts and stage of mammography adherence. Data were obtained in waiting rooms of multipurpose centers. Scores for susceptibility and benefits were lowest for those who were in (a) precontemplation (had not thought about having a mammogram); as compared to (b) contemplation (had thought about having a mammogram, but not yet acted); (c) action (had a mammogram as recommended by the American Cancer Society); and (d) relapse (had a mammogram in the past, but overdue). Barriers scores were highest for those who had not had a mammogram (precontemplators and contemplators). In addition, individual barriers were significantly lower for women in action. Results have implications for interventions to increase screening in low-income African American women.