Media, Health Communication, and the Cancer Risk Factors of Smoking and Obesity

Introduction: Smoking is the leading cause of preventable death in the United States, and obesity is the second cause. Both are risk factors for various types of cancer. Specifically, smoking is linked to lung, esophageal, bladder, kidney, and stomach cancers; and obesity is linked to postmenopausal breast, colorectal, endometrial, pancreatic, and gallbladder cancers. Multiple factors affect health behavior, and this dissertation investigated the role of media and health communication as modifiable influences related to smoking and obesity. Methods: Paper 1 examined the association between average hours of television viewing per day and smoking status among all Hispanic adults (n=675) and within the subgroups of Puerto Rican (n=182) and Dominican (n=396) adults using multivariable logistic regression models. Paper 2 explored how health information sources inform decision-making related to childhood obesity among Hispanic mothers during their children’s first 1000 days of life (conception-age 24 months) using seven focus groups. Paper 3 documented the development and uptake of a media competition (with 595 student participants) implemented in the context of a multi-sector community intervention targeting childhood obesity prevention through process evaluation. Paper 3 also examined community, organizational and provider characteristics that explain variation in implementation effectiveness and described diffusion of the media competition across community sectors using 54 key informant interviews. Results: In Paper 1, Hispanic adults who watched 5+ hours (5-15 hours) of TV per day were more likely to be a smoker than those who watched ≤2 hours, with the same association among Puerto Ricans. In Paper 2, trusted health information sources for Hispanic mothers included health care providers, female and male family members, BabyCenter.com and other Internet sources, selected social media, and television. In Paper 3, salient themes that emerged as implementation facilitators were having a cascade of champions and adaptability through providing opportunity to participate in the media competition outside traditional class time. Discussion: Papers 1 and 2 support the importance of understanding the nuances and differences in Hispanic adults in order to design appropriate media and health communication interventions. Paper 3 provides insight about how to replicate media competitions for children in other communities.