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BACKGROUND: Communication inequalities are important mechanisms linking socioeconomic backgrounds to health outcomes. Guided by the structural influence model of communication, this study examined the intermediate role of health communication in the relationship between education, income, and preventive behavioral intentions during the COVID-19 pandemic in the United States and South Korea. METHODS: The data were collected through two online surveys conducted by two professional research firms in the US (April 1-3, 2020) and South Korea (April 9-16, 2020). To test the mediating role of health communication, as well as the hypothesized relationships in the proposed model, we performed a path analysis using Mplus 6.1. RESULTS: In analyzing survey data from 1050 American and 1175 Korean adults, we found that one's socioeconomic positions were associated with their intentions to engage in COVID-19 preventive behaviors through affecting their health communication experiences and then efficacious beliefs. Differences in education and income were associated with willingness to engage in preventive behaviors by constraining health communication among people with low levels of education and income. The findings showed notable differences and some similarities between the US and South Korea. For example, while income was positively associated with health communication in both US and South Korea, education was only significantly related to health communication in US but not in South Korea. CONCLUSIONS: This study suggests health communication strategies such as choice of communication channels and messages to promote intention for COVID-19 prevention behaviors in particular consideration of individual differences in socioeconomic positions in countries with different cultural features. Pubic policies and health campaigns can utilize the suggestions to promote efficacy and preventive behavioral intention during early pandemics.

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The influence of presumed influence hypothesis (IPI hypothesis) explains that people have biased perceptions of media influence and they change their behavior based on such perceptions. This study explicated the mechanisms of influence of presumed influence in health communication by integrating the theoretical explanations of the IPI hypothesis with theories of normative influence. The causal chains of the IPI hypothesis were examined using an experimental methodology with a HIV prevention, PrEP (pre-exposure prophylaxis). The results supported the expectations. Presumed exposure to health messages about PrEP shaped presumed influence of the messages on others, which in turn affected one's own intentions for information seeking and prosocial behaviors about PrEP. The findings also show that descriptive norms and injunctive norms interact with presumed influence differently. This study discusses the potential benefits of the IPI hypothesis in health communication.

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The purpose of this study is to seek an effective strategy to promote COVID-19 vaccination among young adults. Given that COVID-19 is less deadly for young adults, this study explores whether highlighting potential benefits or disadvantages that others may experience as a result of one's vaccination increases young adults' intention to get vaccinated, particularly for those who have low perceived risk of COVID-19. To test this idea, we conducted an experiment and analyzed the effect of interaction between message frame (gain vs. loss) and reference point (self vs. others) on intention for vaccination by one's perceived risk (low vs. high). The results show that for those with low perceived risk of COVID-19, messages about potential negative consequences to others (e.g., family, friends, community members) from one's failure to get vaccinated led to message elaboration and favorable attitude toward vaccination, which in turn promoted one's intention to get vaccinated. We discuss practical implications of the findings for message strategies that target populations experiencing COVID-19 disparities.

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According to the influence of presumed influence (IPI) hypothesis, people's presumption of media effects tend to impact their willingness to engage in unhealthy behaviors (e.g., smoking) by shaping the normative perception of such behaviors. By applying the IPI hypothesis to media content for health promotion, this study explores how presumed media influence promotes health prevention behaviors in college students. Moreover, this study adopts three health behaviors to test the IPI processing mechanisms across different types of prevention behaviors (i.e., ambiguity and privacy). The results show that one's perceived influence of health promotion media content on others promotes one's own intentions to engage in healthy behaviors of safe sex, diet and nutrition, and skin cancer prevention. The findings also indicate that descriptive norms play various roles depending on the types of behavior. We discuss the IPI hypothesis as a persuasive strategy for health campaigns using mass media.

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This study used an experiment (N = 504) to test whether the fit between sensation-seeking disposition and frame enhances the persuasiveness of gain- and loss-framed HIV test promotion messages. Gain- and loss-framed messages may be consistent with low and high sensation seekers' disposition with respect to risk behavior. We hypothesized that a loss-framed message would be more persuasive for high sensation seekers and that a gain-framed message should be more effective for low sensation seekers. We also expected elaboration to mediate the interaction. Results demonstrated the hypothesized interaction. When the message frame fit with the viewer's way of thinking, the persuasive power of the message was enhanced. The mediation hypothesis was not supported. Practical implications for targeting and message design are discussed.

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BACKGROUND: With the increasing penetration of digital mobile devices among adolescents, mobile texting messaging is emerging as a new channel for patient-clinician communication for this population. In particular, it can promote active communication between healthcare clinicians and adolescents with asthma. However, little is known about the content of the messages exchanged in medical encounters via mobile text messaging. Therefore, this study explored the content of text messaging between clinicians and adolescents with asthma. MATERIALS AND METHODS: We collected a total of 2,953 text messages exchanged between 5 nurse case managers and 131 adolescents with asthma through a personal digital assistant. The text messages were coded using a scheme developed by adapting categories from the Roter Interaction Analysis System. RESULTS: Nurse case managers sent more text messages (n=2,639) than adolescents with asthma. Most messages sent by nurse case managers were targeted messages (n=2,475) directed at all adolescents with asthma, whereas there were relatively few tailored messages (n=164) that were created personally for an individual adolescent. In addition, both targeted and tailored messages emphasized task-focused behaviors over socioemotional behaviors. Likewise, text messages (n=314) sent by adolescents also emphasized task-focused over socioemotional behaviors. CONCLUSIONS: Mobile texting messaging has the potential to play an important role in patient-clinician communication. It promotes not only active interaction, but also patient-centered communication with clinicians. In order to achieve this potential, healthcare clinicians may need to focus on socioemotional communication as well as task-oriented communication.

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This study examines the moderating role of emotional communication competence in the relationship between computer-mediated social support (CMSS) group participation, specifically giving and receiving emotional support, and psychological health outcomes. Data were collected as part of randomized clinical trials for women diagnosed with breast cancer within the last 2 months. Expression and reception of emotional support was assessed by tracking and coding the 18,064 messages that 236 patients posted and read in CMSS groups. The final data used in the analysis was created by merging (a) computer-aided content analysis of discussion posts, (b) action log data analysis of system usage, and (c) baseline and six-month surveys collected to assess change. Results of this study demonstrate that emotional communication competence moderates the effects of expression and reception of emotional support on psychological quality of life and breast cancer-related concerns in both desired and undesired ways. Giving and receiving emotional support in CMSS groups has positive effects on emotional well-being for breast cancer patients with higher emotional communication, while the same exchanges have detrimental impacts on emotional well-being for those with lower emotional communication competence. The theoretical and practical implications for future research are discussed.