Progress 10/01/09 to 12/31/11
Outputs
OUTPUTS: During this period, I worked on (1) assessing what kinds of antismoking intervention strategies are available on new media environments targeting youths; and (2) investigating the process through which antismoking messages are effective among youths. In addition, to better understand smoking as a health issue among adolescents, I studied what are the major health concerns among adolescents and what are the interpersonal and mediated communications' role in their ability to cope with health issues (health literacy). For the first line of research, I examined the extent to which anti-smoking websites use intervention strategies that have been informed by four prominent theories of health-related behavior change: the health belief model, the theory of reasoned action/theory of planned behavior, the transtheoretical model, and social cognitive theory. For this study, content analysis was applied to 67 unique and independent anti-smoking websites to determine their use of 20 intervention strategies based on the four theories. For the second line of research, I examined how peer perceptions mediate adolescents' self-reported exposure to antismoking messages and their smoking attitudes and behavior. The study uses the influence of presumed influence (IPI) model, which incorporates the perceptions of others in the context of media influence. Explicating the mediating mechanisms through which antismoking campaigns work should prove useful to antismoking campaign practitioners. Traditionally, campaigners have developed messages that aim to influence adolescent behavior directly. In contrast, as a potentially more effective alternative, the following analysis recommends a less direct strategy that does not put smoking behavior at center stage. Instead, it suggests that messages may be more effective when they encourage adolescent target audiences to conform to the already existing antismoking behaviors of their peers. To undertake this research, the two-wave longitudinal survey was conducted among adolescents in two middle schools. For the third line of research, I, in collaboration with two professors at University of Georgia, conducted both focus group and survey studies among middle school students in rural and urban middle schools. In the Focus group research, girls and boys were asked of their major health concerns and their rationale for why some are of greater concern than others. In the survey study, they were asked of (a) health socialization agents (frequency of hearing health information from interpersonal channels and traditional and non-traditional media channels); (b) amount of time spent on traditional and online media; and (c) demographic and environmental factors (sex, race, rural/urban residence, adolescents' own health status, ease of access to various health information sources and friends' and parents' risky health behaviors). They were also asked of their level of health literacy defined as the degree to which individuals have the capacity to obtain, process, and understand basic health information. PARTICIPANTS: Dr. Thomas Hove: Assistant Professor in the Department of Advertising, Public Relations, & Retailing at Michigan State University Dr. Albert Gunther: Professor in the School of Journalism and Mass Communication at University of Wisconsin-Madison Dr. Douglas McLeod: Professor in the School of Journalism and Mass Communication at University of Wisconsin-Madison Dr. Hyun Jae Yu: Assistant Professor in the School of Communication, Sogang University, South Korea. Dr. Ruthann Lariscy: Professor in the Grady College of Journalism and Mass Communication at University of Georgia Dr. Bryan Reber: Associate Professor in the Grady College of Journalism and Mass Communication at University of Georgia; Bae, Beom Jun, PhD candidate, Florida State University TARGET AUDIENCES: For smoking media environments studies, adolescents are major target audiences because of their importance in tobacco control and smoking prevention PROJECT MODIFICATIONS: Nothing significant to report during this reporting period.
Impacts
The first line of research found that anti-smoking websites used the health belief model the most and social cognitive theory the least. In addition, websites devoted to smoking cessation used these theories more extensively than websites devoted to smoking prevention. The findings provide implications that anti-smoking website designers should take more advantage of the Internet as a health promotion medium and use more intervention strategies that have been informed by scientifically tested theories of behavior change, particularly with respect to affective and behavioral strategies. The second line of research found that the exposure to antismoking campaigns seems to achieve the desired outcome indirectly through perceived media influence on peers. The findings imply that, first, antismoking campaigns that target adolescents may be more effective if their messages employ norm appeals; second, intervention programs should attempt to cultivate the perception that antismoking campaigns do in fact influence peer attitudes and behaviors to oppose smoking. If such programs acknowledge the importance of actual and perceived social influence, they could also counter adolescents' typical misperception that many of their peers regard prosmoking media messages favorably; third, campaign planners need not assume that their messages must have a direct effect on attitudes and behaviors. Instead, they should understand and cultivate the mediating mechanisms that enable such messages to reach audiences in the desired way. The third line of research provides a bigger picture of health concerns among adolescents and processes through which they can cope with the concerns. The focus group research found that health concerns are remarkably similar among rural and urban participants, and include illegal drug use, smoking marijuana, smoking cigarettes, HIV/AIDS, drinking liquor, becoming a young parent, being hurt in a fight, cancer, diabetes, and having a bad heart. Five overarching themes emerged accounting for why certain health issues command their concern, which include: (1) desire to avoid dying at a young age, (2) social stigma, (3) choices that have negative legal and health ramifications, (4) choices that eliminate youth activities, and (5) avoiding the "heredity is destiny" syndrome. Findings on used and trusted information sources suggest that online social media (MySpace, Facebook) provide a parasocial experience and should be examined as potential socialization agent. If online social media can overcome some wariness regarding credibility they may become important sources for adolescents seeking health information. In addition, the survey research finds that both interpersonal and media socialization agents are significantly and positively related to adolescent health literacy. Media socialization agents seem to play a strong role in health literacy orientation, not much weaker than those of inter- personal socialization agents. The proposed health socialization model could contribute to the literature on how adolescents acquire health-related information and channels through which they are most receptive.
Publications
- Paek, H.-J., Bae, B. , Hove, T., & Yu, H. (2011). Theories into practice: A content analysis of anti-smoking websites. Internet Research. 21(1), 5-25.
- Paek, H.-J., Gunther, A. C., McLeod, D. M., & Hove, T. (2011). How adolescents' perceived media influence on peers affects smoking decisions. Journal of Consumer Affairs, 45 (1), 123-146.
- Lariscy, R., Reber, B., & Paek, H.-J. (2011). Exploration of health concerns and the role of social media information among rural and urban adolescents: A preliminary study. International Electronic Journal of Health Education, 14, 16-37.
- Paek, H.-J., Reber, B. H., & Lariscy, R. W. (2011). Roles of interpersonal and media socialization agents in adolescent self-reported health literacy: A health socialization perspective. Health Education Research, 26, 131-149.
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Progress 01/01/10 to 12/31/10
Outputs
OUTPUTS: During this period, I focused on the three broad project objectives: (1) to assess prevalence and employment of school tobacco policies across Michigan; (2) to assess what kinds of pro- and anti-smoking messages are available on new and traditional media environments targeting youths; and (3) to investigate what kinds of antismoking messages are effective among youths and under what conditions the messages are effective. For the first objective, I joined the State Tobacco-Free School Team, where the Centers for Disease Control (CDC) and the National Association of School Boards (NASB) provided technical assistance. This team did the following activities: (1) established and sustained a state team to address school-based youth tobacco prevention in Michigan as collaborative efforts among Michigan Department of Community Health, Michigan Department of Education, Michigan Association of School Administrators, Michigan Public Health Institute; (2) identified public school districts that do and do not have 24/7 tobacco-free school policies, and identified challenges that schools face in enforcing 24/7 policies; (3) continued to provide technical assistance and resources to assist public schools in the adoption, implementation, and enforcement of 24/7 tobacco-free school policies; and (4) continued to apply for external funding to increase 24/7 tobacco-free policies among public school districts and to increase school-based tobacco prevention and cessation programming. In particular, the team conducted a survey among public schools in Michigan to get a sense of which schools have or do not have a 24/7 school policy and who may be interested in participating in the intervention project. For the second objective, I analyzed antismoking popular magazines (traditional media) to examine strategies and tactics that cigarette advertisements have used to promote implicitly healthful images and messages. Also in the areas of new media and technology, I investigated the prevalence of pro- and anti-smoking messages on the Internet, specifically YouTube. Understanding smoking environments via new media is important according to the social ecological model, which emphasizes the importance of understanding multi-level factors and environments. Such factors range from intrapersonal factors to interpersonal, neighborhood and community where the youths belong, and larger media environments. For the third objective, I conducted a series of antismoking message evaluation studies among youths. In particular, the studies tested the impact of norm appeals on audience response to antismoking messages. Many scholars have long recognized the powerful influence of social norms on behavior. It has been known that youths are vulnerable to social influences and norms. But empirical evidence needs to support further whether social norms can be reflected in antismoking messages and whether such norm appeals can be effective. If normative appeals are found to be effective in promoting antismoking norms and in preventing youths from smoking, antismoking norms should be established along with enforcing tobacco control school policies. PARTICIPANTS: For State Tobacco-Free School Team activities, the following individuals (titles and institutions) worked together with Paek. Tom Langdon, School Superintendent and President, Michigan Association of School Administrators Mary Teachout, Physical Activity, Nutrition and Tobacco Coordinator, Michigan Department of Education Shawn Cannarile, Asthma Schools Coordinator, Michigan Public Health Institute, Asthma Section Erin Kinch, Executive Assistant and Director of Marketing, Michigan Association of School Boards Karen Yoder, Coordinated School Health Consultant, Michigan Department of Community Health, Adolescent and School Health Unit Teri Wilson, Consultant, Michigan Department of Community Health, Tobacco Section For the studies of pro- and anti-smoking media environments, collaborators were the following. Dr. Leonard Reid: Professor in the Department of Advertising & Public Relations at University of Georgia Dr. Thomas Hove: Assistant Professor in the Department of Advertising, Public Relations, & Retailing at University of Georgia Graduate students: Kyoungseok Kim, Jordan Lynn, and Hojoon Choi at University of Georgia Hyun Ju Jeong at Michigan State University TARGET AUDIENCES: Public school administrators in order to clearly inform and educate them about 24/7 school tobacco policies For smoking media environments studies, adolescents are major target audiences because of their importance in tobacco control and smoking prevention PROJECT MODIFICATIONS: Not relevant to this project.
Impacts
Regarding the state mail survey among public schools, a total of 144 public schools returned their completed surveys. The results show that 20.8% of the school districts that responded have comprehensive 24/7 policies, and 66% have 24/7 on-campus policies only. More worrisome, the schools that responded to having 24/7 tobacco-free policies did not actually have comprehensive tobacco-free policies. Some of the schools did not have off campus tobacco control policy, while others had 24/7 tobacco-free comprehensive policy but with exemption for certain community events. The results imply the needs of clearly educating the schools about what 24/7 tobacco school policies are, and to improve their understanding and more accurate implementation of the policies. In addition, the results provide information on which school districts do not employ tobacco school policies and should therefore be targeted first as part of a tobacco school policy intervention. My three studies examined smoking-related media environments surrounding youths. First, the analysis of 1,135 cigarette advertisements samples in popular consumer magazines (with high youth readership) between 1954 and 2003 indicated that the level of implicit health information (i.e., light cigarette, cigarette pack color, verbal and visual health cues, cigarette portrayals, and human model-cigarette interaction) in post-Master Settlement Agreement [MSA] era ads is similar to the level in ads from earlier smoking eras. Light cigarettes were frequently promoted, and impressionistic verbal health cues (e.g., soft, mild, and refreshing) appeared more frequently in post-MSA era ads than in pre-MSA era ads. Most notably, a majority of the cigarette ads portrayed models smoking, lighting up, or offering a cigarette to others. Second, I examined the prevalence, accessibility, and characteristics of eroticized smoking portrayal, also referred to as smoking fetish, on YouTube. The analysis of 200 smoking fetish videos revealed that the smoking fetish videos featured explicit smoking behavior by sexy, young, and healthy females, with the content corresponding to PG-13 and R movie ratings. The results provide implications for a potential impact of the prosmoking new media environments on youths and for a need of controlling and monitoring closely the environments. I interviewed with WKAR and disseminated the findings to the general public. Lastly, another study linked characteristics of antismoking videos on YouTube with the number of viewers and viewer preferences. The results show that, the more the antismoking videos have the audio-visual features of a televised message that elicits sensory, affective, and arousal responses (i.e., message sensation value), the more they invite viewers and their responses. The videos with a higher level of message sensation value tend to receive higher viewer rating. The results provide implications about which types of antismoking messages are likely to receive more favorable audience responses.
Publications
- Paek, H.-J., Kim, K. S., & Hove, T. (2010). Content Analysis of Antismoking Video Clips on YouTube: Message Sensation Value (MSV), Message Appeals, and Their Relationships with Viewer Responses. Health Education Research. DOI: 10.1093/her/cyq063
- Paek, H.-J., Reid, L., Choi, H., & Jeong, H. (2010). Promoting Health (Implicitly) A Longitudinal Content Analysis of Implicit Health Information in Cigarette Advertising, 1954-2003. Journal of Health Communication.
- Kim, K. S., Paek, H.-J., & Lynn, J. A. (2010). A content analysis of smoking fetish videos on YouTube: Regulatory Implications for Tobacco Control. Health Communication, 25, 97-106.
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