Meredith K. Reffner Collins

University of North Carolina at Chapel Hill

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Allison J. Lazard

University of North Carolina at Chapel Hill

Catherine Benedict

Stanford University

Brad Love

The University of Texas at Austin

Carmina G. Valle

University of North Carolina at Chapel Hill

Tushar Varma

University of North Carolina at Chapel Hill

Francesca R. Dillman Carpentier

University of North Carolina at Chapel Hill

Ashley Hedrick

University of North Carolina at Chapel Hill

Rhyan N. Vereen

University of North Carolina at Chapel Hill

Erin E. Kent

University of North Carolina at Chapel Hill

Maria Leonora G. Comello

University of North Carolina at Chapel Hill

Cooperative Institutions

University of North Carolina at Chapel Hill

UNC Lineberger Comprehensive Cancer Center

Imperial College Healthcare NHS Trust

Imperial College London

St Mary's Hospital

Virginia Commonwealth University

Pfeiffer University

St Mary's Hospital

St. Mary's Hospital

London Cancer

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Reel Resilience: Unveiling the Potential Role of Entertainment Media Narratives in Improving Psychological Well-Being Among Adolescent and Young Adult Cancer Survivors

Journal of Adolescent and Young Adult Oncology (2023)

Meredith K. Reffner Collins

10.1089/jayao.2023.0114

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Citations (1)

How Do Behavioral Framing, Linguistic Certainty, and Target Specification Impact Responses to Vaping Prevention Messages?

Journal of Health Communication (2024)

Haijing Ma Meredith K. Reffner Collins Caroline Ritchie E Galper Paschal Sheeran

While research on youth vaping prevention has begun to grow, little work has examined language choice in vaping prevention messages. This study examined adolescents' responses to vaping prevention statements that varied on three features: behavioral framing, linguistic certainty, and target specification. We conducted a 2 (behavioral framing) by 2 (linguistic certainty) by 2 (target specification) by 3 (risk type) plus control condition between-subjects experiment using a national probability sample. Adolescents (N = 1,603) were randomly assigned to one of 25 conditions in which they viewed a vaping prevention statement (or a control statement about vape litter) followed by measures of perceived message effectiveness (PME), perceived severity and susceptibility of vaping risks, message trustworthiness, message relevance, and intentions to seek more information about vaping risks. Results showed main effects of behavioral framing, such that a declarative frame ("Vaping can … ") led to higher PME, higher perceived severity, and greater information seeking intentions than a contingent frame ("If you vape, it can…"), while an interaction revealed that most declarative frame effects were driven by adolescents who were susceptible to vaping. There were also main effects of linguistic certainty, such that the word "can" ("Vaping can … ") led to higher PME, higher perceived susceptibility and severity, and greater information seeking intentions than the word "could" ("Vaping could … "). No main effect of target specification ("you" vs. "teens") was observed. Overall, findings suggest that vaping prevention messages that communicate greater certainty have greater behavior change potential.

Certainty

Framing (construction)

Framing effect

10.1080/10810730.2024.2355299

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Exploring the Acceptability of Text Messages to Inform and Support Shared Decision-making for Colorectal Cancer Screening: Online Panel Survey (Preprint)

Soohyun Hwang Allison J. Lazard Meredith K. Reffner Collins Alison T. Brenner Hillary M. Heiling

BACKGROUND While online portals may be helpful to engage patients in shared decision-making at the time of cancer screening, because of known disparities in patient portal use, sole reliance on portals to support cancer screening decision-making could exacerbate well-known disparities in this health care area. Innovative approaches are needed to engage patients in health care decision-making and to support equitable shared decision-making. OBJECTIVE We assessed the acceptability of text messages to engage sociodemographically diverse individuals in colorectal cancer (CRC) screening decisions and support shared decision-making in practice. METHODS We developed a brief text message program offering educational information consisting of components of shared decision-making regarding CRC screening (eg, for whom screening is recommended, screening test options, and pros/cons of options). The program and postprogram survey were offered to members of an online panel. The outcome of interest was program acceptability measured by observed program engagement, participant-reported acceptability, and willingness to use similar programs (behavioral intent). We evaluated acceptability among historically marginalized categories of people defined by income, literacy, and race. RESULTS Of the 289 participants, 115 reported having a low income, 146 were Black/African American, and 102 had less than extreme confidence in their health literacy. With one exception, we found equal or greater acceptability, regardless of measure, within each of the marginalized categories of people compared to their counterparts. The exception was that participants reporting an income below US $50,000 were less likely to engage with sufficient content of the program to learn that there was a choice among different CRC screening tests (difference –10.4%, 95% CI –20.1 to –0.8). Of note, Black/African American participants reported being more likely to sign up to receive text messages from their doctor’s office compared to white participants (difference 18.7%, 95% CI 7.0-30.3). CONCLUSIONS Study findings demonstrate general acceptance of text messages to inform and support CRC screening shared decision-making.

Health Literacy

10.2196/preprints.40917

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Initiation and changes in use of social media for peer support among young adult cancer patients and survivors

Psycho-Oncology (2021)

Allison J. Lazard Meredith K. Reffner Collins Ashley Hedrick Lindsey N. Horrell Tushar Varma

Social isolation is a prominent challenge for many young adults with cancer. Despite desires for peer-to-peer connections through technology, little is known about how young adults initiate or use social media for support over time.We interviewed young adults with cancer (n = 45; age 18-39, in or post cancer treatment) to explore their initiation of social media for support, changes in use over time, and types of connections sought.Young adults with cancer learn about online support through individual personal recommendations, advocacy organizations, or searching on Google or social media. Most were reluctant to use social media support initially because of feeling overwhelmed-from diagnoses, abundance of online information, or demands of participation-and joined when informational and emotional needs arose. Many wished they had joined earlier. Some participants use social media to make close connections while others simply want to "see" others' shared experiences or crowdsource information.Young adults with cancer often haphazardly find online support from personal recommendations or Internet searches. Desires for social media connections are not one-size-fits-all; there are important audience segmentations for the degree and type of peer support.Better promotion of online social support options and benefits-early in one's cancer timeline and systematically through healthcare providers, cancer organizations, or family and friends-could improve access to helpful peer-to-peer support.

Peer Support

Media Use

10.1002/pon.5758

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Citations (31)

‘It’s Nothing Like Cancer’: Young Adults with Cancer Reflect on Memorable Entertainment Narratives

Health Communication (2023)

Meredith K. Reffner Collins Allison J. Lazard Ashley Hedrick McKenzie Tushar Varma

A cancer diagnosis in young adulthood disrupts the achievement of developmental milestones, and young adults struggle to make sense of their cancer experience due to a lack of opportunities to both openly talk about cancer and engage in reflective activities. However, entertainment narratives – or stories – may be an alternative to prompt these activities, as narratives can elicit self-expansion that may help fulfill intrinsic needs. One way to think about these narratives is as memorable messages. These messages stick with a person for a long period of time, have an anticipatory socialization effect, and may prompt the sense-making process through narrative communication. Little is known, though, about the use of entertainment narratives among young adults with cancer. We interviewed 25 young adults with cancer about entertainment narratives that were memorable during their cancer experience and how those narratives affected them. From these in-depth, semi-structured interviews, we found that entertainment narratives were generally helpful if they provided distraction from cancer, were relatable, and/or prompted participants to explore their emotions. We found that entertainment narratives were generally harmful if they worsened participants' emotional state, either by exacerbating fears of death and/or depicting cancer unrealistically. Our findings suggest that entertainment narratives are memorable messages, and that helpful messages increased feelings of competence and validation, which could promote psychological adaptation to the disease. Harmful messages increased fear and invalidated participants' difficult experiences, which could lead to greater illness centrality and internalized stigma. Implications for future research are discussed.

Nothing

10.1080/10410236.2023.2174403

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Citations (5)

Achieving good-quality consent: review of literature, case law and guidance

BJS Open (2020)

Pasha Normahani Viknesh Sounderajah W. Harrop‐Griffiths Aneke Emmanuel Chukwuemeka Nicholas S. Peters

Abstract Background Informed consent is an integral part of clinical practice. There is widespread agreement amongst health professionals that obtaining procedural consent needs to move away from a unidirectional transfer of information to a process of supporting patients in making informed, self-determined decisions. This review aimed to identify processes and measures that warrant consideration when engaging in consent-based discussions with competent patients undergoing elective procedures. Methods Formal written guidance from the General Medical Council and Royal College of Surgeons of England, in addition to peer-reviewed literature and case law, was considered in the formulation of this review. Results A framework for obtaining consent is presented that is informed by the key tenets of shared decision-making (SDM), a model that advocates the contribution of both the clinician and patient to the decision-making process through emphasis on patient participation, analysis of empirical evidence, and effective information exchange. Moreover, areas of contention are highlighted in which further guidance and research are necessary for improved enhancement of the consent process. Conclusion This SDM-centric framework provides structure, detail and suggestions for achieving meaningful consent.

10.1002/bjs5.50306

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Citations (6)

How Narrative Engagement with Young Adult Literature Influences Perceptions of Anorexia Nervosa

Health Communication (2020)

Meredith K. Reffner Collins Allison J. Lazard

Narratives have been shown to alter health beliefs through a process called narrative engagement; however, this process has yet to be empirically investigated for how the increasingly popular young adult (YA) novel format can impact health beliefs about anorexia nervosa among emerging adults. Using an experimental design, we found that the YA format fosters narrative engagement through mechanisms of transportation, which is associated with greater endorsement of accurate social and emotional beliefs about anorexia nervosa. Compared to an informational brochure, the narrative format where the main character was a "supportive peer" (but not experiencing the illness herself) increased self-referencing and was perceived as more relevant among emerging adult participants. Results suggest narratives may be viable tools to communicate about little understood social and emotional aspects of chronic diseases with emerging adults, who are more likely to provide support for sick peers than experience chronic illnesses. Encouraging narrative engagement could facilitate a better understanding of the social and emotional complexity of anorexia nervosa and improve the quality of peer interactions.

Anorexia nervosa

10.1080/10410236.2020.1785375

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Citations (4)

Reel reflections: the role of entertainment media narratives in coping among young adult cancer survivors

Journal of Psychosocial Oncology (2024)

Meredith K. Reffner Collins Allison J. Lazard Francesca R. Dillman Carpentier Maria Leonora G. Comello Catherine Benedict

Young adult cancer survivors (YACS; ages 18-39) report a significant psychological burden. Entertainment media narratives (e.g., books, movies, shows that are produced for mass consumption) might be an effective tool for reducing this distress, although little is known about present use among YACS.

Reel

10.1080/07347332.2024.2337043

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Controlled trial using computerized feedback to improve physiciansʼ diagnostic judgments

Academic Medicine (1992)

Roy M. Poses Randall D. Cebul Robert S. Wigton Robert M. Centor Meredith K. Reffner Collins

The goal of this study was to test an innovative method to improve physicians' diagnostic judgments by integrating the use of a computer program (employing cognitive feedback to teach a clinical rule that predicts the probability of streptococcal pharyngitis), a traditional lecture, and periodic disease-prevalence reports. In a controlled trial using pre- and postintervention measures involving 885 patients, the authors compared the effects of the integrated method on the diagnostic judgments of seven experienced physicians at a university health service (from 1982 to 1985) with the effects of the lecture alone on the judgments of seven experienced physicians at a different university health service (1986 to 1987). The integrated method significantly improved the quality of the physicians' judgments as measured by calibration curves and Brier scores, and increased the level of agreement between the physicians' judgments and those made by the clinical prediction rule. The lecture alone produced less improvement in the quality of the physicians' judgments, and decreased the level of agreement with the rule. The authors conclude that this method, based on cognitive psychology, is a promising educational tool.

Brier score

10.1097/00001888-199205000-00017

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Citations (34)

User experiences, usability, and social presence of a peer-to-peer support app: survey of young adults affected by cancer

Journal of Applied Communication Research (2021)

Catherine Benedict Allison J. Lazard Susan M. Smith Amit Kumar Agrawal Meredith K. Reffner Collins

Young adult (YA) cancer survivors often experience social isolation. Mobile apps facilitate peer-to-peer connections, yet little is known about their use. YA survivors (N = 181) were surveyed about a peer-to-peer cancer support app. Among those with it downloaded, 36% reported daily/weekly use. One-to-one messaging and group chat features were easy-to-use and useful, but facilitation of social presence was variable. Within group chats, 55% participated in discussions; 45% observed conversations without contributing. The app was helpful for convenient access to peer support (84%), particularly when offline social networks were inadequate (83%); some (16–25%) reported nervousness initiating connections. Qualitative feedback identified facilitators and barriers to adoption and sustained engagement. Recommendations centered on improving design and logistical factors and facilitating in-app connections. App-based peer support is promising for addressing social isolation among YA survivors. Future research should examine theory-based communication and design features to encourage meaningful engagement and longitudinal effects on psychosocial outcomes.

Peer Support

Social Isolation

Facilitation

Mobile apps

Social facilitation

10.1080/00909882.2021.1971737

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Citations (2)