OBJECTIVE:Assess employers' use of information from government sources during the coronavirus disease 2019 pandemic. METHODS:Virtual interviews with employers from 28 US companies in 9 National Occupational Research Agenda sectors. Transcribed interviews were thematically coded and analyzed using MaxQDA24. RESULTS:All but 3 companies relied on the Centers for Disease Control and Prevention as their primary source for policy decisions and workforce communications, supplementing this with information from state and local health agencies, OSHA, trade and professional associations. Half of the respondents asked additional experts to interpret guidance for their industry, and all but a few modified available materials to share with their workforce. National Occupational Research Agenda sectors were not effective for audience segmentation. Perception of worksite transmission was loosely aligned with preference for and confidence in information sources. CONCLUSION:Employers want industry-tailored information during a public health emergency; providing that remains a challenge.

Background Cultural tailoring of health information has been associated with better health outcomes in minority populations. While contractors and partner organizations are asked to produce culturally appropriate materials, there are no government-endorsed metrics to assess the “cultural content” of health communication materials.Aims To fill this implementation gap we created a cultural tailoring score that can be used to guide creation or pretesting of health communication materials. It is based on research demonstrating the importance of: (1) Levels of engagement of the intended audience in the production, (2) use of understandable and culturally meaningful language, incorporation of (3) surface cultural cues and (4) deeper cultural constructs, (5) presence of a narrative to bind the information and cultural elements into a relatable story, and (6) factors associated with concrete psychological construal level (“now,” “here,” “you”).Methods We document a trial of the cultural tailoring score conducted by graduate students identifying as Filipino, Haitian, or Hispanic/Latinx reviewing 17 ads promoting COVID-19 vaccine that had been pretested during the pandemic for perceived effectiveness with convenience samples of these same ethnic groups.Results We achieved a combined Spearman’s Rank Correlation rho of 0.45 between the cultural tailoring score and perceived effectiveness ranking of all 17 ads (individual cultural groupings range from Spearman’s rho 0.45 to 0.90), suggesting that cultural components were moderately to strongly associated with perceived effectiveness. Open-ended comments from pretesting respondents support this finding and suggest that cultural components facilitated what the Elaboration Likelihood Model describes as central processing of the main health messages, thereby enhancing health literacy.Discussion The paper discusses recommendations for further development and testing of the CTS to produce a simple tool to guide future multicultural health communication materials production or pretesting.

BACKGROUND:US businesses were considerably impacted by the COVID-19 pandemic. Return to work after exposure or illness was challenging. OBJECTIVE:This study aimed to assess employers' experiences and perspectives during the pandemic with SARS-CoV-2 testing in their workforce. METHODS:An anonymous survey was delivered to employers across nine NORA sectors. Data were analyzed using SAS Version 9.4. RESULTS:Thirty percent of the respondents worked in a small-sized company (<100 employees), 28% were 100-500 employees, and 42% were more than 500. Small, medium, and large companies were differentially affected, with larger companies affected the most. Sixty-eight percent reported utilizing testing in their return-to-work strategy. Delay in getting results was the most common reported barrier to testing during the early phase of the pandemic (60%). CONCLUSION:This study will help prepare employers in return-to-work testing decisions in future pandemics.

Purpose The purpose of this innovative case study research was to integrate community-based social marketing and system dynamics modeling to address colorectal cancer screening disparities. The resulting framework, Community-Based Prevention Marketing (CBPM) for Systems Change, was designed to build academic-community partners’ social marketing and systems thinking capacities, for designing, implementing and evaluating multilevel prevention strategies. Design/methodology/approach This case study used a CBPM framework, integrating participatory system dynamics modeling to design, implement and evaluate a multilevel intervention. Implementation of group modeling techniques during the workshops with a cancer community coalition guided development of causal loop diagrams, leverage points identification and intervention scenarios to enhance colorectal cancer screening rates in a specific US community. Refinement of qualitative and quantitative models emerged and were refined through integration of community wisdom, secondary data and rich discussions when applying systems thinking visualization tools. Findings The participatory system dynamics modeling process was valued by the partners. However, there was a mismatch between the community partners’ expectations for quick results and the longer timelines suggested by the simulation modeling. The difference between what the partners hoped to achieve and what the simulations revealed led them to question the utility of the simulation modeling. As a result, they decided to continue developing and implementing the social marketing strategy without further using the simulation tools. Anticipation of such an outcome should be incorporated when designing systems thinking approaches with community organizations. Originality/value To the best of the authors’ knowledge, this is the first social marketing application integrating participatory system dynamics simulation modeling and community-based social marketing. Findings suggest that the two orientations, a marketing orientation and systems thinking orientation can inform shared decision-making. Yet, more real-world applications are needed to facilitate shared learning among social marketing researchers, practitioners and clients.

US businesses were considerably impacted by the COVID-19 pandemic. Return to work after exposure or illness was challenging. This study aimed to assess employers' experiences and perspectives during the pandemic with SARS-CoV-2 testing in their workforce. An anonymous survey was delivered to employers across nine NORA sectors. Data were analyzed using SAS Version 9.4. Thirty percent of the respondents worked in a small-sized company (<100 employees), 28% were 100–500 employees, and 42% were more than 500. Small, medium, and large companies were differentially affected, with larger companies affected the most. Sixty-eight percent reported utilizing testing in their return-to-work strategy. Delay in getting results was the most common reported barrier to testing during the early phase of the pandemic (60%). This study will help prepare employers in return-to-work testing decisions in future pandemics.

Introduction. Immigrant nail salon owners and employees face multiple barriers to accessing occupational health training and services. We formed an academic-community-based organization-business owner partnership-unique in that all partners were culturally congruent-to develop a pilot intervention program for the nail salon community. Methods. Eighteen individuals (nine salon owners and nine employees) from the Greater Philadelphia region received the training in their native language and provided feedback through in-depth qualitative interviews. Interview guide was developed using the Consolidated Framework for Implementation Research (CFIR). Themes of perceived benefits and barriers were identified and aligned with relevant CFIR constructs to gain better understanding of the implementation challenges. Results. Reported benefits of program were improved knowledge of the workplace hazards and safety practices, and the potential to attract more customers and retain employees. Perceived barriers to implementing recommended practices were limited availability of safer products and high cost, challenges communicating with customers, lack of engagement from some owners, organizational management practices affecting employees' motivation, and limited partnership with local government to assist small immigrant-owned businesses. Conclusions. Our study revealed multiple factors that pit long-term health protection of nail salon workers against the economic viability of the businesses that employ them. Our research highlights the need to (1) advocate for federal policies making safer products to be more accessible to the masses, (2) establish local policy and culturally appropriate technical support programs that engage community-based organizations, and (3) develop economic opportunities and mentorship for immigrant entrepreneurs to operate profitable healthy salons.

The cancer incidence among adolescents and young adults (AYAs) has significantly increased in recent years, but there is limited information about the factors that influence the perceived cancer risk among AYAs. A cross-sectional, web-based survey of 281 physically active Black and White AYA women was administered to assess the influences of demographic characteristics, family history of cancer, cancer risk factor knowledge, and lifestyle-related risk and protective behaviors on perceived cancer risk. Linear regression analyses were performed in SAS version 9.4. Self-reported Black race (β = −0.62, 95% CI: −1.07, −0.17) and routine doctor visits (β = −0.62, 95% CI: −1.18, −0.07) were related to a lower perceived cancer risk. Family history of cancer (β = 0.56, 95% CI: 0.13, 0.99), cancer risk factor knowledge (β = 0.11, 95% CI: 0.03, 0.19), and current smoking status (β = 0.80, 95% CI: 0.20, 1.40) were related to a higher perceived cancer risk. Perceptions of cancer risk varied among this sample of physically active, AYA women. Lower perceptions of cancer risk among Black AYA women demonstrate a need for culturally tailored cancer educational information that presents objective data on lifetime cancer risk. Reportedly higher perceptions of cancer risk among AYA smokers presents an ideal opportunity to promote smoking cessation interventions. Future interventions to address cancer risk perception profiles among physically active, AYA women should tailor approaches that are inclusive of these unique characteristics.

It is an assumption that physically active adults lead an overall healthy lifestyle. To examine this assumption, we administered a cross-sectional, web-based survey to a sample of young-to-middle-aged US adults between 18 and 49 who self-reported participation in at least one recreational sporting event in the past month. Logistic regressions were conducted to examine demographic characteristics associated with cancer risk and protective behaviors. Gender was represented equally (N = 938), and the average age was 32 years (SD: 8.4). Most participants reported >three days of moderate- to high-intensity physical activity (79%), but not meeting fruit and vegetable consumption guidelines (78%). Many reported current tobacco use (32%), binge drinking at least once in the past 30 days (62%), and suboptimal sun protection use (67%). Participation in lifestyle-related cancer risk and protective behaviors varied based on age, sex, education, routine doctor visits, perceived overall health, health-information-seeking behavior (how participants obtained health information), or team-based sport participation in regression models. Future interventions should be tailored to address varied cancer risk profiles among even physically active adults to encourage multiple healthy behavior changes.

Background More than 50% of colorectal cancer (CRC)–related deaths could be prevented with early detection and treatment. Federally Qualified Healthcare Centers (FQHCs)—safety-net facilities that provide primary care services to uninsured, underinsured and minority patients—report some of the lowest CRC screening rates. Effective CRC screening interventions within FQHCs may help to promote CRC screening utilization among patients from diverse backgrounds. Focus of Article This study was designed to explore average-risk, patient perceptions of facilitators and impediments of using the Fecal Immunochemical Test (FIT) kit for CRC screening within the social marketing framework of the 4 “P’s”—product, price, place, and promotion. Research Aim To conduct formative research with priority populations (i.e., diverse, FQHC patients), assess acceptability of the FIT kit, and identify ways to better meet preferences and needs. Program Design/Approach Qualitative, Focus Groups. Importance to the Social Marketing Field Findings from this study would aid in the future development of a community-based prevention marketing intervention to promote CRC screening within FQHCs that serve diverse patient populations. Methods Focus groups were conducted in English and Spanish with CRC screening age-eligible patients from a South Florida FQHC System. Interview guides were designed to better understand FQHC patient perceptions of CRC Screening via the FIT kit (product) by up-to-date and not up-to-date participants. Additional topics included likes/dislikes (price), preferred location for completing CRC screening and receiving CRC prevention education (place), and strategies for persuasive communication to increase CRC screening among patients who visit FQHCs (promotion). Data were analyzed to identify FIT screening facilitators and impediments using thematic coding in MaxQDA. Results Five focus groups, involving 36 participants aged 50 and older, were conducted. Over half of participants self-identified as Hispanic (36%) or non-Hispanic Black (28%). Key facilitators were the convenience and simplicity of at-home testing (product), presumed affordability of it compared to colonoscopy (price), and ability to return by mail (place). Participants also shared numerous strategies for promotion, including direct referral from Primary Care Providers, mass media campaigns, mailed or electronic reminders from the clinic, and peer advocacy events in churches. Recommendations for Research or Practice Social marketing provides an adequate approach for developing a patient-centered campaign to promote CRC screening uptake at FQHCs. Future CRC screening promotional campaigns at FQHCs should build on the motivation that patients must prioritize their health by emphasizing the convenience of completing CRC screening at home with the capability of mailing it back. Clinics should also work to reduce patient responsibility by developing automated clinic system reminders to openly communicate with patients about CRC screening.

To achieve the lowest risk level for various cancers, individuals would engage in several healthy lifestyle behaviors and age-eligible cancer screenings as recommended. Nonetheless, research has largely omitted exploration of concurrent primary and secondary prevention behaviors. This study was designed to explore influences of cervical cancer screening among physically active women who reported participation in recreational sports. U.S. based women between the ages of 21-49, who had never been diagnosed with cancer, were eligible to complete a web-based survey. Logistic regression analyses were conducted using SAS 9.4. On average, women were 31 years of age (N = 394) and self-identified as Black (51.3 %). Although low overall (30.7 %), higher odds of cervical cancer screening were associated with age (OR = 1.06, 95 % CI = 1.03-1.10), employment (OR = 2.43, 95 % CI = 1.14-5.18), knowledge of cancer-related risk behaviors (OR = 4.04, 95 % CI = 1.33-12.28), routine doctor's visit (OR = 4.25, 95 % CI = 1.56-11.54), and team-based vs individual-based sport participation (OR = 1.95, 95 % CI = 1.13-3.34). Our study provides insight into the health profile of physically active women, ages 21-49, as it relates to risks for cervical cancer. Screening uptake among this diverse sample was much lower than the general population and national goals set by Healthy People 2030. Interventions should be tailored to increase knowledge of cancer-related risk behaviors, access to healthcare, and recommended cervical cancer screenings among even assumed-to-be healthy populations.

Perceived effectiveness (PE) is a validated tool for predicting the potential impact of anti-tobacco public service announcements (PSAs). We set out to evaluate the added predictive value of facial expression analysis when combined with PE in a remote (online) survey. Each of 302 tobacco users watched 3 PSAs and allowed transmission of webcam videos from which metrics for “attention” (head position) and “facial action units” (FAU) were computed. The participants completed scales for their subjective emotions, willingness to share on social media, and intention to quit smoking using the Tobacco Free Florida website. Based on PE, both ready to quit (RTQ) and not ready (NR) respondents favored the same PSAs but RTQs assigned higher PE scores. Negative PSAs (“sad” or “frightening”) were more compelling overall but RTQs also favored surprising ads and were more willing to share them on social media. Logistic regression showed that the combination of Attention + FAU+ PE (AUC = .816, p < .0001) outperformed single factors or factor combinations in distinguishing RTQ from NR. This study demonstrates that on-line assessment of facial expressions enhances the predictive value of PE and can be deployed on large remote samples.

Background: This study examined employer experience with SARS-CoV-2 (COVID-19) asymptomatic testing through a social marketing lens. Social marketing uses commercial marketing principles to achieve socially beneficial ends including improved health and safety behavior. Method: Twenty employers across 11 occupational sectors were interviewed about implementation of COVID-19 testing from January through April 2021. Recorded transcripts were coded and analyzed using marketing's "Four P's": "product," "price," "place," "promotion." Results: COVID-19 tests (product) were uncomfortable, were easily confused, and didn't solve problems articulated by employers. Testing was not widely available or didn't line up with shifts or locations (place). The perceived price, which included direct and associated costs (e.g., laboratory fees, productivity loss, logistical challenges) was high. Most crucially, the time to receive (PCR) results negated the major benefit of less time spent in quarantine and challenged employer trust. A potential audience segmentation strategy based on perceptions of exposure risk also emerged. Conclusions: This social marketing analysis suggests ways to improve the value proposition for asymptomatic testing through changes in product, price, and placement features in line with employers' expressed needs. Study findings can also inform creation of employee communication materials that balance perceived rewards of testing against perceived risks of exposure.

During the first year of the COVID-19 pandemic, U.S. companies were seeking ways to support their employees to return to the workplace. Nonetheless, the development of strategies to support the access, use, and interpretation of SARS-CoV-2 testing was challenging. In the present study, we explore, from the perspective of owners and company leadership, the barriers to SARS-CoV-2 testing among U.S. companies. Key informant interviews with company representatives were conducted during January–April 2021 about SARS-CoV-2 testing. A pre-interview survey assessed respondent socio-demographic and organizational characteristics. Interview sessions were transcribed, coded, and analyzed using MaxQDA. A total of twenty interviews were completed with at least two interviews conducted in each major U.S. industry sector. Ninety percent of participants represented companies in business >10 years, comprising both small and large workforces. Using a grounded theory approach, six themes emerged: (1) access to and knowledge of SARS-CoV-2 tests; (2) strategies for symptomatic and asymptomatic testing of workers; (3) type/availability of personal protective equipment to mitigate coronavirus exposures; (4) return-to-work policies; (5) guidance and communication of SARS-CoV-2 Testing; and (6) use of contact tracing and SARS-CoV-2 vaccination. Various modifiable and non-modifiable challenges for SARS-CoV-2 testing among U.S. companies were identified and can inform work-related SARS-CoV-2 testing strategies.

Ideal efforts for cancer prevention would include lifestyle modifications along with routine, age-eligible cancer screening. Employing an asset-based approach within vulnerable populations already engaging in at least one healthy behavior (i.e., physical activity) may be an ideal way to further reduce cancer risk across peer groups with low cancer screening rates. Guided by the theory of planned behavior (TPB), the aim of this study was to identify constructs associated with cancer screening intentions among young to middle aged adults for influencing educational and behavioral interventions designed to promote cancer prevention. A cross-sectional, web-based survey was utilized to assess attitudes, subjective norms, perceived behavioral control, and intention to screen for cancer among physically active adults aged 18–49 years. Descriptive and bivariate analyses were conducted to characterize the sample, and hierarchical linear regression analyses were conducted to assess the influence of sociodemographic variables and TPB constructs on cancer screening intentions. Age, female sex, reporting a routine doctor’s visit, reported knowledge of physical activity as a lifestyle behavior to reduce cancer risk, and an increased number of motivating factors for engaging in physical activity were significantly associated with higher cancer screening intention (P < 0.001). With the addition of TPB constructs (i.e., subjective norms and perceived behavioral control), the final analytic model accounted for 31

Background Much social marketing research is done on-line recruiting participants through Amazon Mechanical Turk, vetted panel vendors, social media, or community sources. When compensation is offered, care must be taken to distinguish genuine respondents from those with ulterior motives. Focus of the Article We present a case study based on unanticipated empirical observations made while evaluating perceived effectiveness (PE) ratings of anti-tobacco public service announcements (PSAs) using facial expression (FE) analysis (pretesting). Importance to the Social Marketing Field This study alerts social marketers to the risk and impact of disinterest or fraud in compensated on-line surveys. We introduce FE analysis to detect and remove bad data, improving the rigor and validity of on-line data collection. We also compare community (free) and vetted panel (fee added) recruitment in terms of usable samples. Methods We recruited respondents through (Community) sources and through a well-known (Panel) vendor. Respondents completed a one-time, random block design Qualtrics® survey that collected PE ratings and recorded FE in response to PSAs. We used the AFFDEX® feature of iMotions® to calculate respondent attention and expressions; we also visually inspected respondent video records. Based on this quan/qual analysis, we divided 501 respondents (1503 observations) into three groups: (1) Those demonstrably watching PSAs before rating them (Valid), (2) those who were inattentive but completed the rating tasks (Disinterested), and (3) those employing various techniques to game the system (Deceitful). We used one-way analysis of variance (ANOVA) of attention (head positioning), engagement (all facial expressions), and specific facial expressions (FE) to test the likelihood a respondent fell into one of the three behavior groups. Results PE ratings: The Community pool (N = 92) was infiltrated by Deceitful actors (58%), but the remaining 42% was “attentive” (i.e., no disinterest). The Panel pool (N = 409) included 11% deceitful and 2% disinterested respondents. Over half of the PSAs change rank order when deceitful responses are included in the Community sample. The smaller proportion of Deceitful and Disinterested (D&D) respondents in the Panel affected 2 (out of 12) videos. In both samples, the effect was to lower the PE ranking of more diverse and “locally made” PSAs. D&D responses clustered tightly to the mean values, believed to be an artefact of “professional” test taking behavior. FE analysis: The combined Valid sample was more attentive (87.2% of the time) compared to Disinterested (51%) or Deceitful (41%) (ANOVA F = 195.6, p < .001). Models using “engagement” and specific Fes (“cheek raise and smirk”) distinguished Valid from D&D responses. Recommendations False PE pretesting scores waste social marketing budgets and could have disastrous results. Risk can be reduced by using vetted panels with a trade-off that community sources may produce more authentically interested respondents. Ways to make surveys more tamper-evident, with and without webcam recording, are provided as well as procedures to clean data. Check data before compensating respondents! Limitations This was an accidental finding in a parent study. The study required computers which potentially biased the pool of survey respondents. The community pool is smaller than the panel group, limiting statistical power.

For more than two decades, health communication educators and practitioners have been working toward establishing a competency model to guide health communication education. This article reports the results of a survey to identify competencies for health communication specialists with master's degrees. To prepare the survey, a working group drafted a competency list through reviewing the literature and soliciting feedback from attendees at a professional society meeting, resulting in lists of items reflecting 18 knowledge domains, 11 skill sets, and 14 application bundles labeled "abilities." The survey asked participants to rate the 43 items in terms of their importance and provide their opinions about the preparation of health communication specialists. The survey was disseminated online through professional associations and completed by 142 participants (74 educators and 68 practitioners). Nearly all of the 43 items were rated "somewhat important" or higher. The lists were reduced to 10 knowledge domains, three skill sets, and five abilities through factor analyses. Replication of the findings and triangulation with studies employing different research methods will help advance this line of inquiry.