Mi Zhou

Background: Sugar-sweetened beverage (SSB) consumption contributes to adverse health outcomes and disproportionately affects young adult Latinas in the United States. Aim: This study examined the relationship between current SSB consumption and intention to reduce intake, with attitudes, subjective norms, and perceived behavioral control as mediators, and cultural values as a potential moderator. Methods: A cross-sectional online survey was conducted among young adult Latinas ( N = 829; ages 18–29) in the United States. SSB consumption was assessed using the validated BEVQ-15 (15-item Beverage Intake Questionnaire). Path analysis was conducted to examine direct, indirect, and moderated associations. Summary: Higher SSB consumption was associated with more negative attitudes (β = −0.006, p < 0.001) and lower perceived behavioral control (β = −0.008, p < 0.001), but was not directly associated with intention ( p = 0.76). Attitudes (β = 0.348, p < 0.001), subjective norms (β = 0.166, p < 0.001), and perceived behavioral control (β = 0.161, p < 0.001) were positively associated with intention to reduce SSB intake. Cultural values did not significantly moderate the relationship between consumption and intention ( p = 0.29), although they were negatively associated with intention (β = −0.143, p = 0.03). Findings highlight the importance of psychosocial determinants in shaping intentions to reduce SSB intake and suggest that interventions should address both behavioral patterns and contextual factors, particularly among high SSB consumers. These results inform culturally relevant strategies to reduce SSB consumption among Latina populations.

In the United States (U.S.), racial and ethnic groups face health inequities in many perspectives, from higher rates of chronic disease and barriers to preventive care to unequal experiences when i...

This study examined the association between fatalism and sugar-sweetened beverage (SSB) consumption among young adult Latinas, with food insecurity as a moderating factor. A cross-sectional online survey was conducted with 829 Latina women aged 18–29. Measures included fatalism, food insecurity, daily SSB intake, education, and income. Moderation analyses showed that fatalism was positively associated with SSB consumption (β = 5.22, p = 0.002), as was food insecurity (β = 20.40, p = 0.010). A significant interaction between fatalism and food insecurity (β = −4.85, p = 0.024) showed that fatalism predicted higher SSB intake among food-secure participants but not among food-insecure individuals. Neither education nor income were significantly associated with SSB consumption. Findings suggest that the behavioral influence of fatalistic beliefs is contingent on material context rather than uniformly expressed, underscoring the importance of integrating psychological and structural factors in research on health-related behaviors. The cross-sectional design limits causal interpretation.

Objective: To investigate the relationship between self-perceived overall dietary healthfulness and self-reported sugar-sweetened beverage (SSB) consumption among young adult Latinas, accounting for socio-economic and acculturation-related factors. Design: Cross-sectional analysis using survey data. SSB intake was assessed using the BEVQ-15, and dietary self-perception was measured via a two-item scale. Multiple linear regression models examined associations between self-perception and total daily SSB intake, adjusting for income, education and two validated acculturation indicators. Setting: Participants were recruited from a national online panel across the USA. Participants: A total of 881 Latina women aged 18–29 years participated. After removing cases with invalid outcome responses and outliers, 840 and 829 were included in descriptive and regression analyses. Results: Better dietary self-perception was significantly associated with greater total SSB intake in both unadjusted (B = 1·74, P = 0·048) and fully adjusted models (B = 2·10, P = 0·017). Lower income (B = –0·64, P = 0·031) and lower education (B = –0·77, P = 0·026) were also associated with higher intake. Acculturation variables were NS. Subcategory models showed positive associations between self-perception and sweet tea (B = 0·99, P < 0·001) and black coffee/tea with sugar (B = 0·51, P < 0·01) and a marginal inverse association with soft drinks (B = –0·47, P = 0·060). Conclusions: Young Latinas who perceive their diets as healthy may consume more added sugar from beverages than recommended. Public health efforts should address this perception gap and emphasise culturally relevant messaging about hidden sugars in commonly consumed drinks.

Purpose: To test the relative effectiveness of culturally tailored vs non-tailored messages in narrative and non-narrative formats on empowering Mexican American young adults. Design: Two parallel randomized controlled trials comparing: (1) cultural tailoring (holding message format constant) and (2) message format (narrative vs infographic; both are culturally tailored). Setting: Online experiment with participants recruited through a commercial national pool; Mexican American women aged 18-29 years (N = 767). Intervention: Single exposure to 1 of 3 messages: standard infographic, culturally tailored infographic (non-narrative), or culturally tailored comic book (narrative). Messages addressed sugary beverage consumption, industrial racialized marketing practices, and community action. Measures: Pre-post measures of empowerment including community control, perceived effectiveness of collective action, and perceived ability to influence community decisions. Analyses: ANCOVA was used to evaluate intervention effects while controlling baseline scores. Results: Culturally tailored infographics significantly increased empowerment-related perceptions ( P = 0.022, d = 0.19) while non-tailored infographics did not (Experiment 1; P = 0.262). When comparing formats with cultural tailoring held constant (Experiment 2), infographics increased empowerment-related perceptions ( P = 0.003, d = 0.20), while comic books did not ( P = 0.380). Both culturally tailored formats significantly improved perceived effectiveness of collective action ( P < 0.001). Community control increased only with the culturally tailored infographics ( P = 0.003). Conclusion: Results demonstrate that culturally tailored messages, particularly in non-narrative format, can empower members of minoritized communities to resist racialized marketing practices.

This study explores how social media, family, and peer influences are perceived in relation to body image among Middle Eastern women living in the United States. Guided by the Tripartite Influence Model and Social Comparison Theory, the study uses a mixed-method Q-methodology design to identify distinct subjective viewpoints. Participants ( N = 40) sorted 48 statements related to body image influence and completed follow-up questionnaires. Factor analysis revealed four shared and distinct perspectives: negative influence from all sources, mixed perceptions, family as a protective buffer, and positive influence from supportive relationships. The findings highlight how media, cultural and relational contexts are interpreted by participants, suggesting implications for health education strategies that promote media literacy, supportive communication, and culturally inclusive messaging. This study expands current health psychology literature by centering an underrepresented population and offering insight into the complex interplay of cultural identity, social relationships, and digital engagement in shaping body image.

Excessive sugar-sweetened beverage (SSB) consumption poses a significant public health concern, particularly among historically marginalized populations targeted by industry marketing. This study compares the effectiveness of empowerment-based versus fear-based messaging on individual sugary beverage consumption intention and critical health literacy among Latinas aged 18 to 29 years ( N = 231). Participants were randomized online to view either an empowerment-based video highlighting the risks of sugary beverage consumption and the beverage industry’s manipulative practices or a usual care fear-based video centering on individual behaviors and risks. Between- and within-subject analyses were conducted using analysis of variance (ANOVA) and repeated ANOVA. Results revealed that empowerment-based messages were perceived as more effective ( p < .001, η ² = 0.12) and generated less reactance ( p < .05, η ² = 0.02). The empowerment-based messages also yielded significantly greater improvements in media literacy scores ( d = 0.40 vs. 0.05, p < .01) and community control ( d = 0.49 vs. 0.15, p < .01) and effectiveness of actions ( d = 0.47 vs. 0.28, p < .05). Results suggest empowerment messaging strategies could effectively counter industry marketing while fostering critical awareness and collective action.

Health literacy has evolved from a construct focused on individual capabilities to navigate the healthcare system to a broader, more encompassing understanding that includes the ability to engage w...

Background: Latinos suffer from health disparities associated with excessive consumption of sugar-sweetened beverages. This study aimed to test the effectiveness of messaging using critical health communication approaches and delivered by two narrative modalities (video and comic book) with similar content that aims to empower Latinos to advocate for social change and to make individual behavior change related to sugary beverage consumption. Methods: Participants (N = 129 Mexican American women between 18 and 29 years) completed an online survey before and after exposure to an embedded stimulus. Participants were randomly assigned to a stimulus, a narrative message in video or comic book format, both developed using critical health communication approaches that focused on individual harms and social causes of sugary beverage consumption. Results: Paired sample t-test results showed that both narrative messages increased intentions to reduce sugary beverage consumption (Video: P < 0.01; d = 0.43; Comic: P = 0.03; d = 0.28). Both groups also demonstrated significant improvements in sugary beverage-related media literacy (Video: P = 0.01, d = 0.34; Comic: P = 0.05, d = 0.25), public health literacy (Video: P = 0.05, d = 0.24; Comic: P = 0.01, d = 0.32), and empowerment to engage in sugary beverage-related community movements (Video: P = 0.003, d = 0.38; Comic: P = 0.034, d = 0.27). Conclusions: This study provides initial evidence indicating the effectiveness of narrative messages in two modalities using critical health communication for promoting individual behavioral intention and social activation in reducing sugary beverage consumption.

Targeted marketing contributes to the overconsumption of sugary beverages, which contributes to obesity and diabetes disparities among African American and Latino populations in the U.S. Health communicators can similarly use culturally tailored messages to decrease sugary beverage consumption among these groups, yet the specific strategies to operationalize cultural tailoring—the message components essential for such tailoring—are ill-described. We sought to identify and validate authentically created, culturally tailored messages using a multiple step mixed-methods approach. First, we used a snowball approach to identify nutrition education messages targeting ethnic minorities about reducing sugary beverage consumption (N = 85). Via content analysis, we assessed message features (character gender and race/ethnicity), level of change of the appeal (individual or social), and level of cultural tailoring (surface level tailoring in the form of matching character gender and race/ethnicity with target audience versus deep structural tailoring in the form of appealing to values is an effective message strategy). The highest-rated videos were then validated by a sample of the target audience using a quantitative survey and qualitative comments (N = 76). The results inform theorizing on message tailoring and provide a validated pool of culturally relevant messages intended both to reduce intentions to consume sugary beverages and to engage in social change actions.