The Interplay Between Media Use and Interpersonal Communication in the Context of Healthy Lifestyle Behaviors: Reinforcing or Substituting?

Abstract

This study aims to explore how media use for health information and interpersonal health communication interact in the context of healthy lifestyle behaviors. This study hypothesizes that media use for health information and interpersonal health communication will serve as substitutes for one another. To test this hypothesis, this study uses a nationally representative survey of 2,107 civilian, noninstitutionalized adults in the United States. The results show that the associations between television use and Internet use and healthy lifestyle behaviors are enhanced among those who talk about health issues with their family and friends less frequently, which supports the substitution model. The implications that these findings have for future research are discussed.

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Notes

¹The current research focuses only on health-inducing interpersonal interaction, as is clearly delineated in the wording of the interpersonal health communication construct (see the Measurement section). Admittedly, some interpersonal communication networks provide health-threatening information that contradicts media information; this type of information can diminish the beneficial effects of media exposure on healthy lifestyle behaviors (Bearman, Moody, & Stovel, 2004; Christakis & Fowler, 2007; Maxwell, 2002). Therefore, even when media and interpersonal sources provide contradictory information, the substitution effects rather than the reinforcement effects will be supported. However, it is beyond the scope of the present research to discuss this issue in greater detail.

²Additional detailed information for the data collection procedure is described elsewhere (i.e., Lee, 2008).

³This study does not report Cronbach's alpha for the index of healthy lifestyle behaviors. Cronbach's alpha assumes that all items comprising a scale commonly capture one latent variable, whereas an index consists of mutually exclusive items of healthy lifestyle behaviors (for an overview, see Bollen & Lennox, 1991; Streiner, 2003). Content validity and face validity are crucial in constructing indexes, whereas statistics tapping internal consistency are not relevant. As Streiner argued, validity for indexes heavily depends on prior research. One evidence for the validity of the index of healthy lifestyle behaviors comes from the fact that this same index has been used in the fields of public health (e.g., Gottlieb & Green, 1984), health communication (e.g., Rimal et al., 1999), and epidemiology (e.g., Berkman & Syme, 1979) during the past couple of decades.

⁴Weights for the U.S. population are available and are used to verify some results. However use of weights produces inflated standard errors and thus reduces statistical power. This article is meant to test theory; we were willing to sacrifice surer claims of national representativeness to increase the power for, and thus maximize sensitivity to, tests of theory.

Notes: N = 2,107. *p < .05. **p < .01. ***p < .001. Cell entries are final standardized regression coefficients for Blocks 1 and 2 and before-entry standardized regression coefficients for Block 3.

⁵I am indebted to an anonymous reviewer for this point.

Additional information

Notes on contributors

Chul-joo Lee

Chul-joo Lee (Ph.D., University of Pennsylvania, 2009) is Assistant Professor in the School of Communication at The Ohio State University. His research interests include the effects of public health campaigns and eHealth.