Background
Using fear appeals theories to inform message development
Methods
Background
Phase 1 data collection
Communication Concept 1: CMV is severe. 1. Congenital CMV is a very serious condition. 2. Some babies born with congenital CMV develop disabilities such as hearing loss, vision loss, or mental disability. 3. Congenital CMV is one of the most common causes of birth defects. 4. Emma is not a typical three-year-old. She rarely rolls over and cannot sit up on her own. She makes lots of noise, but has yet to speak a word. She does not drink from a sippy cup or feed herself - most of her food is provided through a feeding tube. She has multiple seizures each day. Developmentally, she is five months old. These issues, along with many others, are the result of Emma’s congenital CMV. | Communication Concept 2: CMV is common. 5. CMV is the most common congenital infection. 6. Each year, 30,000 babies are born with CMV. 7. 1 in 150 babies are born with congenital CMV infection. 8. 1 in 750 babies has a disability due to congenital CMV. 9. Each year, 5500 babies develop a disability due to congenital CMV. 10. Congenital CMV causes as much disability in children as Down syndrome, fetal alcohol syndrome, or spina bifida. | Communication Concept 3: CMV is preventable. 11. Congenital CMV is preventable. 12. You can protect your baby from congenital CMV. 13. A pregnant woman can prevent transmission of CMV by washing hands often and trying to avoid getting a young child’s urine or saliva in her eyes, nose, or mouth. 14. Studies show that pregnant women can prevent CMV infection by following a few basic prevention guidelines. 15. Avoiding contact with urine or saliva—especially from preschool children—can lower your chance of getting CMV and passing it to your unborn baby. Here are a few simple steps to avoid getting urine and saliva in your eyes, nose, or mouth: • Wash your hands often with soap and water, especially after - changing diapers, - feeding a child, - wiping a child’s nose or mouth, - handling children’s toys. If water is not available, use an alcohol-based hand sanitizer. • Do not share food, drink, or utensils with young children. • Do not put a child’s pacifier in your mouth. • Clean toys, countertops, and other surfaces that come into contact with children’s urine or saliva with soap and water or a disinfectant. • Avoid contact with saliva when kissing a young child. |
Phase 1 data analysis
Phases 2 and 3 data collection
Communication Concept 1: CMV is severe. 1. Some babies born with congenital CMV develop disabilities such as hearing loss, vision loss, or mental disability. 2. Congenital CMV is one of the most common causes of birth defects. 3. Mark was born with congenital CMV. By nine months old he still could not crawl and did not respond to his name. We had his hearing checked and found out that he had some hearing loss in both ears. As he grew older, Mark also had some trouble walking. Despite these problems, he is now a happy eight year old boy who loves to play video games and laugh. | Communication Concept 2: CMV is common. 4. 1 in 750 babies has a disability due to congenital CMV. 5. Each year 5500 babies develop disabilities due to CMV. 6. Congenital CMV causes as much disability in children as Down syndrome, fetal alcohol syndrome, or spina bifida. | Communication Concept 3: CMV is preventable. 7. Congenital CMV is preventable. 8. A pregnant woman can prevent transmission of CMV by washing hands often and trying to avoid getting a young child’s urine or saliva in her eyes, nose, or mouth. 9. Prevent CMV infection when you are pregnant by: • Not putting things in your mouth that have just been in a child’s mouth. For example: food, cups or silverware, toothbrush, pacifier. • Trying to avoid getting saliva in your mouth when kissing a child. You can do this by kissing on the cheek or forehead instead of the lips. • Washing your hands after touching a child’s urine or saliva. |
Communication Concept 1: CMV preventive strategies are similar to other behavior changes women make during pregnancy. 1. Women make lots of changes while they are pregnant, like not eating certain types of fish, not drinking alcohol and caffeine and not smoking. Adding a few more changes into your routine can help keep your unborn baby safe from CMV. These changes might include washing your hands often and trying to avoid getting a young child’s urine and saliva in your eyes, nose, or mouth. Keep in mind, these are changes you only need to make during pregnancy. | Communication Concept 2: Preventive strategies can be incorporated in moderation to reduce exposure. 2. Congenital CMV is one of the most common causes of birth defects, but there are ways you can reduce the risk to your unborn baby. Although it may be hard to avoid all possible exposures to CMV, by making a few recommended changes while you are pregnant, you can help protect your unborn baby from infection. These include: • Avoid putting things in your mouth that have just been in a child’s mouth. When possible, try not to share food, cups, or silverware with your child or put their pacifier in your mouth. • Avoid getting saliva in your mouth when kissing a child. You can do this by trying to give more kisses on the cheek or forehead instead of the lips. • Clean your hands after touching a child’s urine or saliva. For example, try to make a habit of cleaning your hands after changing a diaper, feeding a child, or wiping a child’s nose or mouth. | Communication Concept 3: CMV is severe but preventable. 3. My son Mark was born with congenital CMV. By nine months old he still could not crawl and did not respond to his name. I had his hearing checked and found out that he was deaf in both ears. As he grew older, Mark also had some trouble walking. I learned from his doctors that these issues were caused because I was exposed to CMV while I was pregnant with him. I wish I had known about the simple things I could have done to keep Mark from getting this virus. All moms should know that there are things they can do to protect their unborn babies from being exposed to congenital CMV. You can prevent CMV infection when you are pregnant by: • Not putting things in your mouth that have just been in a child’s mouth. For example: • Food • Cups or silverware • Toothbrush • Pacifier • Avoid getting saliva in your mouth when kissing a child. You can do this by kissing on the cheek or forehead instead of the lips. • Washing your hands after touching a child’s urine or saliva. For example, after: • Changing diapers • Feeding a child • Wiping a child’s nose or mouth. |
Phases 2 and 3 data analysis
Results
Phase 1 results
Phase 1(N = 32) | Phase 2(N = 38) | Phase 3(N = 32) | |
---|---|---|---|
Characteristic | |||
Age | |||
18–25 | 1 (3%) | 10 (26%) | 2 (6%) |
26–30 | 4 (13%) | 14 (37%) | 8 (25%) |
31–35 | 15 (47%) | 7 (18%) | 10 (31%) |
36–40 | 10 (31%) | 7 (18%) | 12 (38%) |
41–45 | 2 (6%) | --a
| --a
|
Race/Ethnicity | |||
Asian-American | 9 (28%) | --a
| --a
|
Black or African-American | 2 (6%) | 20 (53%) | 16 (50%) |
White or Caucasian | 18 (56%) | 18 (47%) | 16 (50%) |
Hispanic-Latina | 3 (9%) | --a
| --a
|
Education Level | |||
High school diploma, GED, or <high school | 3 (9%) | 3 (8%) | 3 (9%) |
Technical college, Associate degree, or some college | 2 (6%) | 19 (50%) | 7 (22%) |
College degree or more | 27 (84%) | 16 (42%) | 22 (69%) |
Pregnancy Status | |||
Planning | --a
| 21 (55%) | 26 (81%) |
Pregnant | 1 (3%) | 17 (45%) | 6 (19%) |
Phase 1 message testing
CMV is severe
CMV is common
CMV is preventable
Phase 1 message decisions
Phases 2 and 3 overall results
How is CMV spread? | 42 |
How does CMV work/ cause disabilities? | 25 |
Can my toddler, spouse, or I get tested for CMV infection? | 22 |
Do doctors check newborns for CMV-related effects/ symptoms? | 13 |
Is there a vaccine (or other form of prevention)? | 9 |
How do I know my child is infected? | 9 |
What are the statistics (e.g., prevalence)? | 9 |
Is there a treatment or cure? | 7 |
Is CMV something new? | 7 |
How old are the young children who typically spread CMV? | 7 |
Other | 15 |
TOTAL | 165 |
Phase 2 message testing
CMV is common
CMV is preventable
Phase 2 message decisions
Phase 3 message testing
Preventive behaviors can be incorporated in moderation to reduce exposures
Congenital CMV is severe but preventable
Guideline | Very likely to follow No.(%) | Somewhat likely to follow No.(%) | Not at all likely to follow No.(%) |
---|---|---|---|
Do not put things in your mouth that have just been in a child’s mouth. | 15 (47%) | 16 (50%) | 1 (3%) |
Avoid getting saliva in your mouth when kissing a child. | 18 (56%) | 11 (34%) | 3 (9%) |
Wash your hands after touching a child’s urine or saliva.a
| 29 (94%) | 2 (6%) | 0 |