IU Indianapolis ScholarWorks :: Browsing by Author "Cox, Dena S."

Browsing by Author "Cox, Dena S."

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Can Self-Prediction Overcome Barriers to Hepatitis B Vaccination? A Randomized Controlled Trial
(2012-01) Cox, Anthony D.; Cox, Dena S.; Cyrier, Rosalie; Graham-Dotson, Yolanda; Zimet, Gregory D.
Objective: Hepatitis B virus (HBV) infection remains a serious public health problem, due in part to low vaccination rates among high-risk adults, many of whom decline vaccination because of barriers such as perceived inconvenience or discomfort. This study evaluates the efficacy of a self-prediction intervention to increase HBV vaccination rates among high-risk adults. Method: Randomized controlled trial of 1,175 adults recruited from three sexually transmitted disease clinics in the United States over 28 months. Participants completed an audio-computer-assisted self-interview, which presented information about HBV infection and vaccination, and measured relevant beliefs, behaviors, and demographics. Half of participants were assigned randomly to a “self-prediction” intervention, asking them to predict their future acceptance of HBV vaccination. The main outcome measure was subsequent vaccination behavior. Other measures included perceived barriers to HBV vaccination, measured prior to the intervention. Results: There was a significant interaction between the intervention and vaccination barriers, indicating the effect of the intervention differed depending on perceived vaccination barriers. Among high-barriers patients, the intervention significantly increased vaccination acceptance. Among low-barriers patients, the intervention did not influence vaccination acceptance. Conclusions: The self-prediction intervention significantly increased vaccination acceptance among “high-barriers” patients, who typically have very low vaccination rates. This brief intervention could be a useful tool in increasing vaccine uptake among high-barriers patients.
The CDC Revised Recommendations for HIV Testing: Reactions of Women Attending Community Health Clinics
(2008-01) Burrage, Joe W.; Zimet, Gregory D.; Cox, Dena S.; Cox, Anthony D.; Mays, Rose M.; Fife, Rose S.; Fife, Kenneth H.
The purpose of this study was to examine reactions to the Centers for Disease Control and Prevention revised recommendations for HIV testing by women attending community health clinics. A total of 30 women attending three community clinics completed semistructured individual interviews containing three questions about the recommendations. Thematic content analysis of responses was conducted. Results were that all agreed with the recommendation for universal testing. Most viewed opt-out screening as an acceptable approach to HIV testing. Many emphasized the importance of provision of explicit verbal informed consent. The majority strongly opposed the elimination of the requirement for pretest prevention counseling and spontaneously talked about the ongoing importance of posttest counseling. The conclusion was that there was strong support for universal testing of all persons 13 to 64 years old but scant support for the elimination of pretest prevention counseling. In general, respondents believed that verbal informed consent for testing as well as provision of HIV-related information before and after testing were crucial.
Communicating the Consequences of Early Detection:The Role of Evidence and Framing
(2001-07) Cox, Dena S.; Cox, Anthony D.
Despite the enormous benefits of early-detection products, consumers are reluctant to use them. The authors explore this reluctance, testing alternative approaches to communicating the consequences of detection behaviors. The results suggest that anecdotal messages are more involving than statistical messages and that positive anecdotes (about gains from screening) are less persuasive than negative anecdotes (about the losses from failing to get screened); positive anecdotes appear to cause a “boomerang” effect. The authors discuss implications for promoting consumer risk-reduction behaviors.
Consumer Response to Drug Risk Information:The Role of Positive Affect
(2010-07) Cox, Anthony D.; Cox, Dena S.; Mantel, Susan Powell
Risk disclosure is an essential element of the marketing of prescription drugs and other medical products. This study examines how consumers respond to verbal information about the frequency and severity of medical-product risks and how media-induced affect can moderate such responses. The study finds that consumers tend to overestimate the actual likelihood of adverse events described with words such as “common” or “rare” (compared with the probabilities such terms are typically intended to convey) and that consumers tend to give little weight to such probability language when forming product use intentions. However, consumers in positive media-induced moods seem to engage in more nuanced evaluation of product risk information, weighing both frequency and severity information and using such information to make inferences about other product attributes (e.g., product efficacy). These findings suggest that medical marketers and regulators need to devise more effective means of communicating risk probability to consumers and that positive mood induction (e.g., by placing advertisements in upbeat media environments) can enhance consumers' ability to process product risk information.
The Effect of Background Music on Ad Processing: A Contingency Explanation
(1993-10) Kellaris, James J.; Cox, Anthony D.; Cox, Dena S.
Music is an increasingly prominent and expensive feature of broadcast ads, yet its effects on message reception are controversial. The authors propose and test a contingency that may help resolve this controversy. Experimental results suggest that message reception is influenced by the interplay of two musical properties: attention-gaining value and music-message congruency. Increasing audience attention to music enhances message reception when the music evokes message-congruent (versus incongruent) thoughts.
The effects of HIV testing advocacy messages on test acceptance: a randomized clinical trial
(2014-11) Kasting, Monica L.; Cox, Anthony D.; Cox, Dena S.; Fife, Kenneth H.; Katz, Barry P.; Zimet, Gregory D.
Background Nearly 1 in 5 people living with HIV in the United States are unaware they are infected. Therefore, it is important to develop and evaluate health communication messages that clinicians can use to encourage HIV testing. Methods The objective was to evaluate health communication messages designed to increase HIV testing rates among women and evaluate possible moderators of message effect. We used a randomized four-arm clinical trial conducted at urban community outpatient health clinics involving 1,919 female patients, 18 to 64 years old. The four health message intervention groups were: i) information-only control; ii) one-sided message describing the advantages of HIV testing; iii) two-sided message acknowledging a superficial objection to testing (i.e., a 20 minute wait for results) followed by a description of the advantages of testing; and iv) two-sided message acknowledging a serious objection (i.e., fear of testing positive for HIV) followed by a description of the advantages of testing. The main outcome was acceptance of an oral rapid HIV test. Results Participants were randomized to receive the control message (n = 483), one-sided message (n = 480), two-sided message with a superficial objection (n = 481), or two-sided message with a serious objection (n = 475). The overall rate of HIV test acceptance was 83%. The two-sided message groups were not significantly different from the controls. The one-sided message group, however, had a lower rate of testing (80%) than the controls (86%) (OR, 0.66; 95% CI, 0.47–0.93; P = 0.018). “Perceived obstacles to HIV testing” moderated this effect, indicating that the decrease in HIV test acceptance for the one-sided message group was only statistically significant for those who had reported high levels of obstacles to HIV testing (OR, 0.36; 95% CI, 0.19–0.67; P = 0.001). Conclusions None of the messages increased test acceptance. The one-sided message decreased acceptance and this effect was particularly true for women with greater perceived obstacles to testing, the very group one would most want to persuade. This finding suggests that efforts to persuade those who are reluctant to get tested, in some circumstances, may have unanticipated negative effects. Other approaches to messaging around HIV testing should be investigated, particularly with diverse, behaviorally high-risk populations.
Understanding Consumer Responses to Product Risk Information
(2006-01) Cox, Anthony D.; Cox, Dena S.; Zimet, Gregory D.
Two experiments examine how message framing moderates consumer responses to product risk information. The findings suggest that contrary to an influential theory, consumers exposed to loss-framed messages exhibit a general aversion to product risk involving both short-term adverse effects and more permanent harm. In contrast, consumers exposed to gain-framed messages differentiate among different types of product risk. They essentially ignore temporary product risks but give considerable decisional weight to risks of permanent harm. This article discusses the implications of these findings for those who design and regulate promotional messages that contain product risk disclosures.
Use of Drawings to Explore US Women's Perspectives on Why People Might Decline HIV Testing
(2011-04) Mays, Rose M.; Sturm, Lynne A.; Rasche, Julie C.; Cox, Dena S.; Cox, Anthony D.; Zimet, Gregory D.
The purpose of this research is to explore through drawings and verbal descriptions women's perspectives about reasons why persons might decline human immunodeficiency virus (HIV) testing. We asked 30 participants to draw a person that would NOT get tested for HIV and then explain drawings. Using qualitative content analysis, we extracted seven themes. We found apprehension about knowing the result of an HIV test to be the most commonly identified theme in women's explanations of those who would not get tested. This technique was well received and its use is extended to HIV issues.
Vaginal Microbicide Preferences Among Midwestern Urban Adolescent Women
(2008-10) Tanner, Amanda E.; Katzenstein, Jennifer M.; Zimet, Gregory D.; Cox, Dena S.; Cox, Anthony D.; Fortenberry, J. Dennis
Purpose The purpose of this study was to assess adolescent women's preferences for specific microbicide characteristics including pregnancy prevention, timing of application, potential for side effects, and whether it targeted human immunodeficiency virus (HIV) or other sexually transmitted infections (STI). Potential differences in microbicide preferences by adolescent age group and behavioral patterns including engaging in sexual intercourse and use of hormonal contraception were examined, as it was hypothesized that as adolescents progress into adulthood and gain sexual experience their preferences in microbicide characteristics may shift. Method Adolescent and young women (N = 405, 56.0% African American; 24.0% Euro-American) between the ages of 14 and 20 (mean = 17.0, SD = 1.8) were recruited from urban community-based clinics. Video-Audio Computer-Assisted Self-Interviews were conducted with the young women, during which they were asked about their preferences regarding the characteristics of hypothetical vaginal microbicides. Conjoint analysis was utilized to determine adolescent women's relative preferences for each microbicide characteristic and intent-to-purchase microbicides based upon a combination of the selected properties. Results Overall, the results suggest adolescent and young women had an ordered preference for a microbicide with (1) no side effects, (2) pregnancy prevention, (3) postcoital application, and (4) protection against HIV. Age and behavioral group conjoint analyses resulted in the same pattern of preferences as those reported for the entire group. However, women having sex and not using hormonal contraception had a stronger preference for postcoital application. Conclusion The findings suggest that young women's ratings of microbicides were sensitive to characteristics such as side effects, pregnancy prevention, and timing of application and should be considered in microbicide development. The conjoint analysis approach is useful in understanding microbicide preferences, and should be utilized with other populations to assess preferences for specific microbicide characteristics.
What Does Familiarity Breed? Complexity as a Moderator of Repetition Effects in Advertisement Evaluation
(1988-06) Cox, Dena S.; Cox, Anthony D.
This article examines how consumers' attitudes toward advertisements are affected by their previous exposure to them. The results of our experiment suggest that the effects of exposure on ad attitudes may be moderated by the complexity of the advertisement: evaluations of complex ads become more positive with exposure, while those of simple ads do not. This finding may help explain why previous studies of ad exposure effects have yielded mixed results.

Browsing by Author "Cox, Dena S."

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