Kaskutas L A, Greenfield T K
Alcohol Research Group, Western Consortium for Public Health, Berkeley, CA 94705-2176, USA.
Am J Health Promot. 1997 Jan-Feb;11(3):186-93. doi: 10.4278/0890-1171-11.3.186.
Guided by information processing theory and the health belief model, this paper considers the relationship between health consciousness among the general population and attention to environmental health warnings about alcohol consumption. Mechanisms of exposure to three dominant types of impersonal alcohol-related health messages in the environment are explored.
Cross-sectional survey using telephone interview data.
A representative nationwide sample of adults was interviewed in 1993 (n = 1026), with a response rate of 63%.
Key variables include exposure to warning labels on alcoholic beverages, to point-of-sale posters, and to advertisements in the media, as well as respondents' alcohol consumption, health problems (indicative of salience of health warnings), and level of health consciousness assessed by items tapping concern with nutrition and seeking information on health topics.
In the total sample, over a third had seen a warning label or poster and almost all had seen an advertisement about the risks associated with alcohol consumption in 1993. Survey respondents scored very high on five individual items that make up the health consciousness scale introduced here, with 69% endorsing all items. The scale demonstrated good internal reliability (alpha = .70) and was significantly correlated (p < .01) with not enjoying getting drunk and with usually reading product warning labels, suggesting construct validity. Yet the hypothesized strong relationships between health consciousness and attention to health warnings about drinking were not observed; nor was salience of messages a predictor of recall. Importantly, high proportions of underage drinkers and young adults at elevated risk for drinking problems are reached by container warning label messages. Mechanisms of exposure recall vary based on message source, with "container label recall" associated with heavier drinking, younger age, and purchasing patterns; "poster recall" associated with purchasing and health consciousness; and "advertisement recall" associated with heavy consumption and younger age.
These results are contrary to predictions from skeptics of broad-based informational interventions, who argue that only the already-health conscious are attentive to health warnings about the risks of alcohol consumption. These data suggest that the label is reaching intended target audiences, especially younger people, males, and heavier alcohol consumers. Future research in predicting attention to impersonal health warnings in the environment should continue to improve the assessment of constructs such as salience and health consciousness, and should further test the applicability of available theoretical models. Subsequent research should also consider additional measures to tap mechanisms of exposure to impersonal health messages to enable a better understanding of the population that is not being reached by such public health interventions.
以信息加工理论和健康信念模型为指导，本文探讨了普通人群的健康意识与对酒精消费的环境卫生警告的关注之间的关系。研究了接触环境中三种主要类型的非个人化酒精相关健康信息的机制。
采用电话访谈数据进行横断面调查。
1993年对全国具有代表性的成年人样本进行了访谈（n = 1026），回复率为63%。
关键变量包括接触酒精饮料上的警告标签、销售点海报和媒体广告，以及受访者的酒精消费、健康问题（表明健康警告的显著性），以及通过涉及对营养的关注和寻求健康主题信息的项目评估的健康意识水平。
在总样本中，超过三分之一的人看过警告标签或海报，几乎所有人在1993年都看过关于酒精消费风险的广告。调查受访者在构成本文引入的健康意识量表的五个单项上得分非常高，69%的人认可所有项目。该量表显示出良好的内部信度（α = 0.70），并且与不喜欢喝醉和通常阅读产品警告标签显著相关（p < 0.01），表明具有结构效度。然而，未观察到健康意识与对饮酒健康警告的关注之间假设的强关系；信息的显著性也不是回忆的预测指标。重要的是，容器警告标签信息覆盖了很大比例的未成年饮酒者和有饮酒问题高风险的年轻人。接触回忆机制因信息来源而异，“容器标签回忆”与饮酒量较大、年龄较小和购买模式相关；“海报回忆”与购买和健康意识相关；“广告回忆”与大量消费和年龄较小相关。
这些结果与对广泛信息干预持怀疑态度者的预测相反，他们认为只有已经有健康意识的人才会关注关于酒精消费风险的健康警告。这些数据表明标签正覆盖目标受众，尤其是年轻人、男性和大量饮酒者。未来预测对环境中非个人化健康警告的关注的研究应继续改进对显著性和健康意识等构念的评估，并应进一步测试现有理论模型的适用性。后续研究还应考虑采取额外措施来挖掘接触非个人化健康信息的机制，以便更好地了解此类公共卫生干预未覆盖的人群。
