BACKGROUND:Communicable and infectious diseases, many of which are preventable, disproportionately burden low-income communities, deepening global health disparities. Limited access to prevention and care services amplifies vulnerability, making health communication a critical tool for motivating risk reduction and behavior change. The current emphasis is on communicating health within the cultural context and the use of multiple communication strategies for efficiency and effectiveness. METHODS:Grounded in the Social Amplification of Risk Framework (SARF) and the Health Belief Model (HBM), this study examined how interpersonal communication and religiosity - as a culturally embedded factor - influence risk-reduction behavior. Survey data were collected from a sample of adults in Kenya (N = 715). RESULTS:Religiosity was positively associated with key motivators of self-protective behavior, including risk perceptions and response efficacy. Additionally, religiosity moderated the relationship between interpersonal information sources, their frequency of use, and self-protective behavior. CONCLUSIONS:Integrating religiosity as a cultural dimension into health communication frameworks enhances explanatory power and offers actionable insights for intervention design. These findings underscore the value of culturally responsive, interpersonal communication strategies for promoting self-protective behavior against communicable diseases in sub-Saharan Africa.

Introduction: Building on risk communication scholarship, this study examines the effectiveness of communication efforts of the National Bio and Agro-Defense Facility through a survey of community residents living near the facility.Methods: An online survey (n = 478) was conducted in summer of 2024 with residents living within 20 miles of the National Bio and Agro-Defense Facility.Results: Results indicate that sufficient and consistent communication efforts by the facility, though directly relating to knowledge levels and information seeking behaviors, were also directly associated with the community's risk and preparedness perceptions, circumventing knowledge and information seeking behaviors. Misinformation frequency led to increased knowledge and information seeking behaviors. While knowledge was not associated with risk or preparedness perceptions, it increased information seeking behaviors, which in turn led to higher risk perceptions.Conclusion: Findings imply the importance of leveraging local partners, like the local university, to increase knowledge about the science conducted at the National Bio and Agro-Defense Facility, while at the same time pointing to the fact that information consistency and sufficiency are more important in increasing community preparedness than knowledge itself.

Media system dependency theory posits that during times of crisis, individuals are more dependent on mass media for information, leading to attitudinal and behavioral change. The outset of the COVID-19 pandemic in the spring of 2020 provided a unique opportunity to study the impact of a global crisis within a new media context dominated by social and digital media. Using a cross-sectional survey administered in the United States at the outset of the COVID-19 pandemic, the present study found support for media dependency's impact on knowledge and engagement in protective behaviors. Television news was the strongest positive predictor, while radio dependency was found to have a negative impact, and social media dependency had none.

The prevalence of HIV infections in the province of Papua is rising. The study aimed to examine the effect of a sexual reproductive health-based HIV prevention program on knowledge, subjective norms, and attitudes, as well as the behavior control of reproductive health and HIV prevention. A quasi-experimental study was applied in this study with an equivalent control group. The total of 289 students is divided into the experimental group (n = 134) and the control group (n = 155). The experimental group received the sexual reproductive health-based HIV prevention program. The control group received the routine program from the school. The results found a significant difference in knowledge, subjective norms and attitudes, and behavior control of reproductive health and HIV prevention among intervention groups before and after receiving the Sexual Reproductive Health School-Based HIV Prevention program (p-value

African immigrants in the United States have contributed to a culturally and linguistically diverse US population. This also implies an increase in health disparities as minority populations experience a higher prevalence of communicable diseases that are closely linked with social, economic, and environmental disadvantages. Although African immigrants are more likely to be educated, they are also more likely to be challenged by factors associated with cultural differences, language skills, lower health literacy, and access to health information and care services. The purpose of this study was to examine if media use, including social media usage and other communication-related factors (health literacy, eHealth literacy, and health information seeking) influenced their motivations for the prevention of communicable diseases. Based on the Protective Motivation Theory, the study also examined the influence of communication-related factors on threat appraisal (risk perception, vulnerability, and perceived seriousness), coping appraisal (self-efficacy and response efficacy), and risk-reduction behaviors.

Applying the Protection Motivation Theory, this study examines factors affecting community preparedness in the context of biotechnological hazards. In particular, residents living nearby the National Bio and Agro-Defence Facility (NBAF), a biosafety level-4 facility currently under construction, were surveyed. The survey assessed residents' perceptions of key risk communication elements, transparency, consistency, and source, as well as risk perception, knowledge, collective efficacy, involvement, civic engagement behaviours, and preparedness perceptions. Results indicate that sources such as local organisations and mass media, as opposed to social media and word-of-mouth, are more reliable and lead to increased knowledge. The structural model suggests that transparent and consistent risk communication leads to community preparedness through knowledge, involvement, risk perception, and collective efficacy. Theoretical implications for the Protection Motivation Theory and practical implications for risk communication regarding biotechnological hazards are discussed.

Background:Despite the increasing prevalence of obesity in the United States, negative attitudes toward obese individuals are widespread. Health-care providers, including dietetics and nutritionists, are not exempt from showing bias toward obese individuals, which may lead to subsequent psychological and health problems. Objectives:The purpose of this study was to measure the extent of weight bias among dietetics and nutrition students and investigate its determinants. Materials and Methods:A cross-sectional survey (316) was conducted among undergraduate dietetics and nutrition students at a large Midwestern University to assess weight bias using the Fat Phobia Scale. Eating competence was measured using the ecSI 2.0 and body dissatisfaction using the Stunkard Figure Rating Scale. Other variables included experience with obesity, media exposure to health and nutrition information, and demographic characteristics. Results:About 36% of the participants had weight bias, 64% were unsatisfied with their body image and none of the participants had eating competence. Media exposure to health information, body dissatisfaction, and eating competence was related to fat phobia (P < 0.05). Conclusion:These findings highlight that weight bias is an apparent issue among students enrolling in health-related programs. Considering their future role in clinical and community settings, this issue should be addressed properly.

Abstract This entry focuses on factors that contribute to health disparities in the African context. Whereas the region is disproportionately impacted by several communicable and noncommunicable diseases, some of which are exacerbated by the tropical conditions that support pathogenic microbes, their impact on populations is varied based on socioeconomic, cultural, environmental, behavioral, and communication‐related factors that lead to inequities in health outcomes and access to healthcare. As the culture‐centered approach to health communication is emphasized, cultural elements including religious beliefs, values, and practices need to be taken into consideration in addition to other socioeconomic, behavioral, and environmental factors that contribute to health inequities in Africa. Health literacy and indigenous knowledge of alternative and traditional medicine are also crucial in communication interventions that seek to address health and healthcare disparities from a cultural perspective.

This study examined the influence of health information sources on the efficacy of the COVID-19 vaccine and other motivations for self-protective behavior. Based on the protection motivation theory, the study focused on threat appraisal factors (risk perception and perceived severity), response efficacy, and health information sources (media and interpersonal channels) as predictors for vaccine efficacy and self-protective behavior. Data were gathered in Kenya through a self-administered survey (n = 715) that was conducted at the pick of the COVID-19 pandemic. Results show that media sources (newspapers, radio, television, internet, and telephone) were viewed as more useful compared to interpersonal sources (health professionals, family, friends, and other personal influencers) for COVID-19-related information. Additionally, media sources influenced risk perception, perceived severity, response efficacy, vaccine efficacy, and self-protective behavior. Interpersonal sources were also correlated with perceived severity and response efficacy, and self-protective behavior but did not influence vaccine efficacy. The study suggests exploring the use of media and other digital sources including mobile phones to enhance threat appraisal and promote vaccine efficacy among other motivations for self-protection behavior in future pandemics or disease outbreaks, especially in resource-poor settings.

Cardiovascular disease (CVD, i.e., disease of the heart and blood vessels) is a major cause of death globally. Current assessment tools use either clinical or non-clinical factors alone or in combination to assess CVD risk. The aim of this review was to critically appraise, compare, and summarize existing non-clinically based tools for assessing CVD risk factors in underserved young adult (18–34-year-old) populations. Two online electronic databases—PubMed and Scopus—were searched to identify existing risk assessment tools, using a combination of CVD-related keywords. The search was limited to articles available in English only and published between January 2008 and January 2019. Of the 10,383 studies initially identified, 67 were eligible. In total, 5 out of the 67 articles assessed CVD risk in underserved young adult populations. A total of 21 distinct CVD risk assessment tools were identified; six of these did not require clinical or laboratory data in their estimation (i.e., non-clinical). The main non-clinically based tools identified were the Heart Disease Fact Questionnaire, the Health Beliefs Related to CVD-Perception measure, the Healthy Eating Opinion Survey, the Perception of Risk of Heart Disease Scale, and the WHO STEPwise approach to chronic disease factor surveillance (i.e., the STEPS instrument).

Through an online survey of community residents living nearby the National Bio and Agro-Defense Facility (NBAF), this study examined how high-risk organizations can communicate organizational legitimacy, and how legitimacy perception may affect public trust and risk perceptions. Results illustrated the importance of transparent and consistent communication in organizational legitimacy-building, as well as the role of legitimacy, especially for high-risk organizations, to garner public trust, to ease public uncertainty, and to increase public preparedness.

A nationally representative online survey was conducted in the United States in July 2020 to examine the role of social media use in knowledge about COVID-19, compliance with public health guidelines, and protective behaviors. Building on the Protection Motivation Theory, the analysis revealed that threat severity perceptions and self-efficacy, but not vulnerability perceptions, mediated the negative impact of social media use during the pandemic. Given the current debates surrounding the effect of social media use on both political and health knowledge, the study's findings suggest that rather than inundating social media with messages about the severity of the disease, risk communication that meets audiences where they are and enhance both self-efficacy and severity perceptions could lead to wider adoption of protective responses.

Abstract Background Studies have demonstrated that health care students and practitioners are not immune to stigma towards people living with HIV (PLHIV). This attitude could lead to poor quality of care if it remains uncorrected. However, little is known about dietetic students’ acceptance of PLHIV despite their substantial role in treatment. This study aimed to measure the extent of knowledge and stigma towards PLHIV among dietetic students and to determine the associated factors using the attribution theory. Methods Students from three dietetics schools in Indonesia (n = 516) were recruited to participate in this cross-sectional study. Survey questions covered demographic information, interaction with PLHIV, access to information sources, cultural values, and beliefs as predictor variables. The outcome variables were comprehensive knowledge of HIV, HIV and nutrition-specific knowledge, and attitudes. Analyses with linear regression and the stepwise selection were performed to determine factors related to the outcome. Results The levels of HIV comprehensive knowledge and HIV-nutrition specific knowledge among dietetic students were low, as indicated by the average score of 19.9 ± 0.19 (maximum score = 35) and 8.0 ± 0.11 (maximum score = 15), respectively. The level of negative attitudes towards PLHIV was high, with 99.6% of participants reported having a high stigma score. Types of university affiliation (public or private), beliefs and values, exposure to HIV discourse, access to printed media, and years of study were significantly related to HIV comprehensive knowledge (p < 0.05). Nutrition-specific knowledge was also correlated with university affiliation, beliefs and values, participation in HIV discussion, and years of study (p < 0.05). HIV comprehensive knowledge, university affiliation, discussion participation, and ethnicities were associated with attitudes (p < 0.05). Conclusions Awareness and acceptance of PLHIV must be further improved throughout dietetic training to ensure patients’ quality of care since students represent future dietary care providers. Considering the consistent findings that affiliation to education institution correlates with HIV knowledge and attitude, some examinations concerning the curriculum and teaching conduct might be necessary.

Background: This study examined factors associated with perceived risks for the harmful use of alcohol among young adults in the context of HIV and AIDS. This is the alcohol use that affects physical and mental health and has social consequences. Informed by the protection motivation theory and the social cognitive theory, the study focused on the motivational and cognitive factors that influence risk perception, which includes knowledge, self-efficacy, and outcome expectancies.Methods: Data were gathered through a self-administered survey among young adults (n = 402) who were recruited using the intercept method (Median = 22 years, Mean = 22.5 years).Results: Key findings show a low level of risk perception for the harmful use of alcohol and a high level of alcohol-related self-efficacy. Participants had moderately high knowledge about HIV and AIDS, low HIV-related risk perception but high HIV-related self-efficacy. There was a correlation between alcohol risk perception and perceived risk of HIV and AIDS. Significant determinants of alcohol risk perception included sex-related alcohol expectancies, HIV risk perception, and HIV self-efficacy. Sex-related alcohol expectancies were correlated with risk perception for HIV infection and the harmful use of alcohol.Conclusion: The study provides insights on factors that public health and communication specialists must consider when communicating about the harmful use of alcohol. Enhancing risk perception and self-efficacy for the harmful alcohol use and communicating in the context of HIV and AIDS in high-risk environments is crucial. Furthermore, addressing sex-related alcohol expectancies may lower the risk of HIV and other sexually transmitted infections among alcohol consumers.

Responding to the increasing reports of health students and professionals demonstrating stigmatized attitudes toward people living with HIV (PLHIV), this article examined the learning process that takes place during their academic training. Using symbolic interactionism as a theoretical framework, we studied the way lecturers in dietetic schools in Indonesia make meaning of their understanding and experience of HIV in relation to their teaching conduct. We found that the current curriculum does not provide adequate opportunities for students to learn and interact with PLHIV. Participants described HIV discussion is mainly limited to the clinical aspects and essential treatment as they were uncomfortable discussing HIV with the students. The ostensible symbolic meaning of HIV among dietetic lecturers in Indonesia was compounded with limitations and restrictions affecting their teaching practices and attitudes to PLHIV. Future intervention is required to help lecturers recognize their degree of awareness and personal values about HIV.

The human papillomavirus (HPV) is one of the most common but preventable sexually transmitted infections that affect males and females but knowledge about it and vaccine uptake remain low. As organizations adopt eHealth communication strategies to communicate about HPV, this study examines the association between eHealth literacy (and related elements) and the motivators for HPV prevention that are based on the protection motivation theory. A survey was conducted among 472 young adults in Kenya and results show moderate eHealth literacy (M = 3.21, SD = 1.03) and online information seeking (M = 3.57, SD = 1.08) but low HPV knowledge and risk perception. eHealth literacy was correlated with HPV knowledge, perceived risk, self-efficacy, and response efficacy whereas online health information seeking were correlated with perceived seriousness of HPV infection. This study suggests examining the discrepancy between online information seeking and knowledge and the disparities in eHealth literacy among young adults in HPV communication.

ABSTRACTIntroductionYouth empowerment programs have increasingly gained attention in public health as emphasis shifts on children and adolescents as decision makers in their health and well‐being. Adolescence obesity is among the public health concerns that require more active engagement at individual and community level while empowering adolescents to take charge of their own health. This study examines the influence of youth empowerment on nutritional and physical activity factors associated with adolescence obesity.MethodsData were gathered through a self‐administered survey among adolescents (N = 410) ages 11–15 years in three U.S. States ‐ Kansas, Ohio and South Dakota.ResultsFindings show that youth empowerment significantly influences adolescents' self‐efficacy, perceptions for healthy food choice, healthy eating, attitudes towards physical activity and the overall motivation for health. Gender differences exist in adolescents' self‐efficacy for physical activity whereas ethnicity played a role in perceived youth empowerment and perceived barriers to healthy eating. Age was also a significant contributor in efficacy for healthy food choice and perception of healthy food availability.ConclusionsThis study suggests more focus on youth empowerment in interventions that seek to reduce obesity and improve adolescents' overall health by creating environments where they can play a more active decision‐making role. With empowerment, adolescents are more likely to be motivated to adopt healthier dietary habits and engage more in physical activity. Further research would establish the impact of youth empowerment on obesity reduction and other public health problems that impact children across ages.

As part of a USDA multi-year grant, this project has used community-based participatory strategies to help overcome barriers to eating more fruits and vegetables and increasing physical activity, and ultimately sparking youth to create healthy communities for a lifetime. The project supports teams of community and school partners in limited income neighborhoods. Obesity is a multifaceted, complex problem, but a sedentary lifestyle is a major contributor to this national health issue. Approximately one-third of children nationwide are overweight or obese; and minority children and those with a low socioeconomic status have the highest prevalence rates. Urban youth have been shown to be less physically active than rural youth. Supportive physical activity environments (understood as the geography, observations, and perceptions of features such as recreational facilities, sidewalks, bike lanes, traffic patterns, etc.) have been positively associated with adolescent physical activity behaviors within urban settings. As part of a socio-ecological intervention to improve physical activity behavior, the Physical Activity Resource Assessment (PARA), the Active Neighborhood Checklist (ANC), and focus groups to assess the physical activity influences within an urban middle school and surrounding community were completed. The assessments suggested that lack of parks, lack of walkability in the streets, perceptions of crime, lack of school programs, and parental and peer influences were all barriers to physical activity opportunities. The ANC, PARA and focus groups each added valuable information for program planning to improve adolescent physical activity behavior. From our initial experiences, environmental audits and focus groups are relatively easy to conduct by Extension professionals, working in partnership with a school and community team, and support a socio-ecological approach to improving physical activity with an urban setting.

Objective: To test the effectiveness of a 15-month intervention for reducing sugar-sweetened beverage (SSB) intake among college students and assess fruit and vegetable (F/V) intake and physical activity (PA) habits and their relationship to SSB intake. Design: Randomized, controlled study. Participants: A total of 156 college students (aged 18-24 years) from a Kansas university, mostly female (72%), white (89%), and freshmen (51%). Intervention: Two-staged intervention included participants receiving: (1) 3 weekly stage-tailored messages on healthful behaviors for 10 weeks; and (2) 3 monthly stage-tailored messages and 1 monthly e-mail encouraging a visit to the portal page, after the 3-month physical assessment. Main Outcome Measure(s): Stages of change for PA and F/V intake, self-reported PA scores, self-reported F/V intake, and SSB intake habits. Analysis: Generalized linear mixed models and linear regression models were used to test changes and associations among outcome measures. Results: No significant decrease occurred in SSB consumption (P > .05) among intervention participants. Both control and intervention groups recorded low F/V intake and moderate PA scores. Conclusions and Implications: Low F/V intake and high SSB intake evident among study participants may pose risk for unwanted weight gain and obesity-related conditions. Furthermore, college campuses can continue to support an environment conducive for being physically active, while promoting healthy eating behaviors.