title: Determinants of First-Time Cancer Examinations in a Rural Community: A Mechanism for Behavior Change.
abstract: OBJECTIVE
  After conducting a media campaign focusing on the importance of oral and pharyngeal cancer (OPC) examinations, we assessed mechanisms of behavior change among individuals receiving an OPC examination for the first time.
  
  
  METHODS
  We used data from 2 waves of telephone surveys of individuals residing in 36 rural census tracts in northern Florida (n = 806). The second survey occurred after our media intervention. We developed media messages and modes of message delivery with community members via focus groups and intercept interviews. We performed a mediation analysis to examine behavior change mechanisms.
  
  
  RESULTS
  Greater exposure to media messages corresponded with heightened concern about OPC. Heightened concern, in turn, predicted receipt of a first-time OPC examination, but only among men.
  
  
  CONCLUSIONS
  We extended earlier studies by measuring an outcome behavior (receipt of an OPC examination) and demonstrating that the putative mechanism of action (concern about the disease) explained the link between a media intervention and engaging in the target behavior. Improving the quality of media campaigns by engaging community stakeholders in selecting messages and delivery methods is an effective strategy in building public health interventions aimed at changing behaviors.
authors.affiliation: At the time of the study, Henrietta L. Logan, Amber S. Emanuel, Virginia J. Dodd, John G. Marks, and Joseph L. Riley III were with the Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, Gainesville. Yi Guo and Keith E. Muller were with the Department of Health Outcomes and Policy, College of Medicine, University of Florida. James A. Shepperd was with the Department of Psychology, College of Liberal Arts and Science, University of Florida.
authors.forename: Henrietta L
authors.initials: HL
authors.lastname: Logan
authors.forename: Yi
authors.initials: Y
authors.lastname: Guo
authors.forename: Amber S
authors.initials: AS
authors.lastname: Emanuel
authors.forename: James A
authors.initials: JA
authors.lastname: Shepperd
authors.forename: Virginia J
authors.initials: VJ
authors.lastname: Dodd
authors.forename: John G
authors.initials: JG
authors.lastname: Marks
authors.forename: Keith E
authors.initials: KE
authors.lastname: Muller
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Riley
mesh_terms: D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida / Q000453:epidemiology; D017144:Focus Groups; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods; D006306:Health Surveys; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008402:Mass Media; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D010610:Pharyngeal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D012424:Rural Population / Q000706:statistics & numerical data*