Health message quality is best understood in terms of a message’s ability to effectively produce change in the variables that it was designed to change. The importance of determining a message’s effectiveness in producing change prior to implementation is clear: The better a message’s potential effectiveness is understood, the better able interventionists are to distinguish effective from ineffective messages before allocating scarce resources to message implementation. For this purpose, research has relied on perceived message effectiveness measures as a proxy of a message’s potential effectiveness. Remarkably, however, very little conceptual work has been done on perceived message effectiveness, which renders its measures under-informed and inconsistent across studies. To encourage greater conceptual work on this important construct, we review several threats to the validity of existing measures and consider strategies for improving our understanding of perceived message effectiveness.

Vaccination rates for the human papillomavirus (HPV) vaccine fall below targets and only 2 states and the District of Columbia require the vaccine for middle school-age children. Messages conveyed through news media-to parents, providers, policymakers, and the general public-may contribute to sluggish vaccination rates and policy action. In this commentary, we review the findings from 13 published studies of news media coverage of the HPV vaccine in the United States since FDA licensure in 2006. We find 2 important themes in news coverage: a rising focus on political controversy and a consistent emphasis on the vaccine as for girls, even beyond the point when the vaccine was recommended for boys. These political and gendered messages have consequences for public understanding of the vaccine. Future research should continue to monitor news media depictions of the HPV vaccine to assess whether political controversy will remain a pronounced theme of coverage or whether the media ultimately depict the vaccine as a routine public health service.

Clinicians, medical and public health researchers, and communication scholars alike have long been concerned about the effects of conflicting health messages in the broader public information environment. Not only have these messages been referred to in many ways (e.g., “competing,” “contradictory,” “inconsistent,” “mixed,” “divergent”), but they have been conceptualized in distinct ways as well—perhaps because they have been the subject of study across health, science, and political communication domains. Regardless of specific terminology and definitions, the concerns have been consistent throughout: conflicting health messages exist in the broader environment, they are noticed by the public, and they impact public understanding and health behavior. Yet until recently, the scientific evidence base to substantiate these concerns has been remarkably thin. In the past few years, there has been a growing body of rigorous empirical research documenting the prevalence of conflicting health messages in the media environment. There is also increasing evidence that people perceive conflict and controversy about several health topics, including nutrition and cancer screening. Although historically most studies have stopped short of systematically capturing exposure to conflicting health messages—which is the all-important first step in demonstrating effects—there have been some recent efforts here. Taken together, a set of qualitative (focus group) and quantitative (observational survey and experimental) studies, guided by diverse theoretical frameworks, now provides compelling evidence that there are adverse outcomes of exposure to conflicting health information. The origins of such information vary, but understanding epidemiology and the nature of scientific discovery—as well as how science and health news is produced and understood by the public—helps to shed light on how conflicting health messages arise. As evidence of the effects of conflicting messages accumulates, it is important to consider not just the implications of such messages for health and risk communication, but also whether and how we can intervene to address the effects of exposure to message conflict.

The encouragement of human papillomavirus (HPV) vaccination is an important goal for interventions among American Indians (AIs), given the significant disparities AIs face with respect to HPV cancers. Tailoring intervention messages to the culture of message recipients has been proposed as a potentially useful intervention approach, yet cultural tailoring of HPV messages has never been tested among AIs. The objective of this research was to test the effectiveness of cultural tailoring in positively affecting two variables that have been proposed as mechanisms of tailoring effects, namely identification with the message and perceptions of message effectiveness. We conducted a between subjects randomized experiment among 300 parents of AI children. Participants saw one of three messages that differed in the extent to which the message contained cues to AI culture. Analysis of variance (anova) showed that participants identified more strongly (partial eta = 0.10) with messages that included stronger AI cultural features and thought these messages were more convincing (partial eta = 0.14) and pleasant (partial eta = 0.11) compared to messages that included weaker cultural cues. Effects on message identification and convincingness were moderated by AI identity, such that the more participants identified themselves with AI culture, the stronger the effects of the culturally-tailored messages were (R = 0.043 and 0.020 in hierarchical regression analyses). These findings suggest good potential for cultural tailoring to encourage HPV vaccination among AIs.