JHC Link Newsletter SummariesVolume 12, Issue 1 (January/February 2007)Article Summaries:Age Analysis of Newspaper Coverage of Mental Illness --Natalie B. Slopen, Amy C. Watson, Gabriela Gracia, Patrick W. Corrigan Communications researchers
have established that newspapers function as a powerful force in the shaping
of public attitudes across important social issues, including attitudes
about mental illness. It is important for mental health advocates to be
precisely aware of the nature and content information that the public
is receiving about mental illness in order to effectively lobby news organizations
to improve coverage of mental health issues. This article presents an
age analysis of a nationally representative sample of news articles about
mental illness in order to explore variations in the coverage of children
and adults with mental illness. A sample of 1252 articles were coded for
(1) type of article, (2) types of disorders named or described, (3) themes
related to crime, attributions of the disorder, treatments, and critiques
of the mental health system, and (4) "elements of responsible journalism",
including inclusion of perspectives from mental health experts, statistics
related to mental illness, referrals to additional sources of information,
and avoidance of slang terminology. Age group comparisons revealed that
the child article subset contained a significantly higher proportion of
feature articles, were significantly more likely to discuss behavior and
conduct disorders, alcohol and drug abuse, ADHD, anxiety disorders, and
eating disorders, and to contain themes of causation, treatment, critiques
of the mental health system. The adult article subset contained a significantly
higher proportion of episodic news stories, and was significantly more
likely to present themes of dangerousness and crime. Our analysis found
that child articles were significantly more likely to incorporate elements
of responsible journalism, while adult articles were significantly more
likely to use stigmatizing terminology. Our findings lead us to encourage
journalists to develop contextually comprehensive and informative presentations
of mental illness and issues surrounding the mental health system for
all population groups, and recommend further collaboration between journalists
and mental health advocates. Exploration
of the Construct of Reliance Among Patients Who Talk with Their Providers
About Internet Information Research into clinician-patient
communication has reported the importance of understanding the patient's
perspectives and preferences. The construct of reliance was developed
by Greg Makoul to measure the extent to which a patient prefers to rely
on a physician rather than himself or herself in health and medical issues.
The effect of the internet on patients' ability to seek health information
and on the clinical relationship is significant and seems to have implications
for the construct of reliance. This study was designed to examine those
implications. 350 participants, recruited from internet health message
boards, completed online surveys about their experiences talking with
health care providers about internet health information. Two distinct
dimensions of reliance emerged from the data, one regarding the patient's
reliance on the health care provider for decision making and the other
regarding the patient's reliance on the health care provider to stay healthy.
Self-reliant patients tended to be female, have lower incomes, and report
less frequent visits to the health care provider than did health care
provider-reliant patients. Age, comfort level, and frequency of talking
about internet health information were not related to reliance level.
These results suggest that patient preference for involvement in decision-making
are associated with the extent to which patients search for and discuss
internet health information. Pharmaceutical
Websites and the Communication of Risk Information Consumers are increasingly
turning to pharmaceutical web sites to learn about a prescription drug's
benefits, risks and side effects. While it is clear that these sites communicate
the drug's benefits, no research has systematically evaluated the extent
to which these sites communicate drug risks and side effects. This article
presents the results of a content analysis of pharmaceutical web sites
that quantifies the extent to which drug side effects are completely communicated.
Three operational definitions of "completeness" are used to
evaluate side effect communication in two separate locations on pharmaceutical
web sites: the homepage and the internal site page dedicated to the communication
of risk and side effects. Results suggest that few pharmaceutical web
sites completely communicate drug-related side effects. This is especially
true when completeness is operationally defined as the communication of
the single highest incidence and the top three highest incidence side
effects. The findings highlight two key problems with the communication
of drug risk and side effect information on pharmaceutical web sites.
First, the pharmaceutical companies do not take advantage of the near
limitless space on their drugs' web sites to completely communicate drug-related
side effects. Second, many of the inconsistencies observed across web
sites and the resulting incompleteness of side effect communication is
the result of ambiguity in FDA regulations governing direct-to-consumer
pharmaceutical advertising. Public
(Mis)understanding of the UV Index Australia has the
highest rate of skin cancer of any country in the world with over 270,000
new cases being reported each year. Efforts to motivate Australians to
increase their sun protection behaviours have been ongoing since the early
1980s. Contributing to this effort, the UV Index has been routinely broadcast
for a decade now on television, in newspapers and on radio. However the
most recent usage statistics suggest only one-third of the population
use the UV Index once or more per month over summer. Research about why
usage of the UV Index remains so low is in its infancy, but there is some
suggestion that understanding of the measure is suboptimal, contradicted
by other research that suggests understanding is 'good'. Part of the problem
appears to be that there is no consensus within the scientific community
as to what constitutes satisfactory understanding. Health behaviour models
suggest that knowledge alone is insufficient to motivate behavioural change.
However in terms of the UV Index, understanding of the measure is an obvious
prerequisite for its effective utilisation. This article explores public
understanding of the UV Index and concludes that although awareness and
basic understanding of the UV Index is high amongst Australians, understanding
of appropriate behaviour associated with varying levels of the UV Index
is poor. The results of a series of focus groups followed by a survey
of 400 sunburn prone adults suggested that most appreciate that higher
UV Index values indicate more intense UV conditions. However most other
aspects of the UV Index are misunderstood. For example, a majority of
survey respondents did not understand: the normal ranges of the UV Index;
the independent nature of the UV Index from temperature; that the UV Index
only indicates the peak UV conditions of the day at solar noon; and how
cloud cover affects UV conditions. Efforts are currently underway in a
number of countries to increase the salience (and by extension use of)
the UV Index via novel and visually appealing display methods. The major
implication of this research is that such efforts will be wasted unless
they attempt to combat misconceptions about the measure, either before
launching their new display methods, or by incorporating devises into
the displays that clarify these misconceptions. What this research does
not answer is whether better understanding of the UV Index actually influences
appropriate sun protection behaviours, which is an avenue for future research.
A
Computer-based Approach to Preventing Pregnancy, STD, and HIV in Rural
Adolescents A computer- and Internet-based
intervention was designed to influence several variables related to the
prevention of pregnancy, STDs, and HIV in rural adolescents. The intervention
was guided by the Extended Parallel Process Model, and evaluated using
a pretest-posttest control group design with random assignment at the
school level. Three-hundred and twenty-six tenth-grade males and females
enrolled in two rural Appalachian public high schools completed the survey
at both points in time. Results indicate the vast majority (88.5%) of
students in the experimental school completed at least one activity (M
= 3.46 for those doing at least one activity). Further, both the overall
program and all but one of the activities were rated positively by participants.
Regarding the effects of the intervention, results indicate that students
in the experimental school were less likely to initiate sexual activity,
had greater general knowledge, greater condom negotiation self-efficacy,
more favorable attitudes toward waiting to have sex, and greater situational
self-efficacy than in the control school. In tandem, the results suggest
that the computer-based programs may be a cost-effective and easily replicable
means of providing teens with basic information and skills necessary to
prevent pregnancy, STDs, and HIV. Acceptability
of a Bilingual Interactive Computerized Educational Module in a Poor,
Medically Underserved Patient Population Health care providers
are increasingly turning to consumer health informatics (CHI) (e.g. interactive
computer modules) as a way to exchange health information and maximize
provider time spent with patients. Computer technology has the potential
to empower individuals to seek appropriate health treatments and access
useful health information. While CHI is very effective and well studied
in mainstream populations, few data report experiences with CHI among
non-English speaking, underserved patient populations. Expanding CHI applications
to patient populations with language and literacy barriers is a growing
need. In our study (N=296), we determined the factors that affect participants'
learning experience and trust of the information provided by the computer.
The computer module was designed to be appropriate for low literacy participants
who spoke either Spanish or English, and "friendly" for persons
with little or no computer experience. Our data suggest that culturally
appropriate CHI applications tailored for a non-English speaking, socioeconomically
disadvantaged group may be useful to improve patient knowledge and influence
attitudes and beliefs. We found that the interactive computer-assisted
health information program appears to have the greatest benefit among
populations that have the least exposure to and experience with this medium.
Perceived ease of use was the strongest predictor of learning something
new and trusting the computer in our patient population. These findings
suggest that the potential barriers with interactive computer modules
can be overcome by creating a module that has language concordance and
low complexity. CHI applications appear to be a complement to patient
data collection and education approaches and can be implemented successfully
in a busy, inner city health clinic waiting room. This research informs
communication and patient education strategies in health care that target
underserved, diverse populations with limited computer literacy. Volume 12, Issue 2 (March 2007)Media
Usage as Health Segmentation Variables The purpose of this
research is to contrast a traditional audience segmentation model that
uses demographics and health evaluations against a model that uses these
same variables plus media usage variables. The goal was to determine whether
media usage variables-typically not used in health segmentation studies-add
predictive power in determining health behaviors and attitudes. The results
of the analysis showed an increase in the ability to predict health behaviors
such as aspirin use, vitamin use, diet and exercise, and suggest that
there is predictive value for including media variables as part of the
segmentation process. Implications for public health education and campaign
planning are discussed. Fighting
AIDS Among Adolescent Women: Effects of a Public Communication Campaign
in Brazil In 2003, Brazil's
Ministry of Health launched a national campaign aimed at promoting the
use of condoms by adolescent women. The Carnival Campaign was broadcast
on television and radio between February 16 and March 3 and targeted young
women, between 13 and 19 years of age, a social group which had previously
registered a growth in the number of cases of AIDS and other sexually
transmitted diseases. The Ministry hired Kelly Key, a Brazilian pop singer,
to deliver the campaign messages. One of the objectives was to empower
the girls and encourage them to not be ashamed to buy condoms and to demand
that their partners use them. The article presents the results of a national
survey conducted with 1,006 adolescent women, which was sponsored by the
Ministry of Health. The results show that campaign materials reached the
main target public and that they were very positively received. Moreover,
the survey data show that the Carnival Campaign had important effects,
generating discussions in the adolescents' social environments and reinforcing
a social norm that favors the participation of women in the purchase and
use of condoms. The
"Choose With Care System" - Development of Education Materials
to Support Informed Medicare Health Plan Choices Roughly two million
Americans turn 65 each year and become eligible for Medicare, the U.S.
federal health insurance program for people aged 65 and older. People
aging into Medicare need to choose a health plan. This article describes
the genesis, testing and lessons learned from the Choose with Care System
of print and web-based products. The Choose with Care system has two key
objectives. First, to help consumers aging into Medicare better understand
the basics of the Medicare program and why getting supplemental insurance
is important. Second, to increase the likelihood that those consumers
making Medicare plan choices for the first time will factor plan performance
(i.e., quality information) into their decision making. Choose with Care
is an innovative decision support tool for employers to use to assist
people approaching age 65 to learn about their Medicare health plan options
and how to incorporate information on the quality of care and services
offered by health plans into their choices. Employers, particularly those
who offer employer-based retiree coverage, are the focus for distributing
the Choose with Care materials because they are one of the most recognized
and accessible formal intermediaries for information about health insurance.
The design of the Choose with Care materials was informed by adult learning
principles and health communication theories, lessons learned in designing
effective health plan choice materials, and a sensitivity to plain language
and health literacy. A multi-method approach--including interviews, focus
groups, experiments and expert review-was used to develop and test the
Choose with Care products. Randomized experiments showed that the Choose
with Care materials increase older consumers' knowledge of Medicare and
how it relates to retiree health insurance and improves their comprehension
and use of comparative quality information when choosing a health plan.
Employers reacted positively to the products and generally would consider
implementing the Choose with Care products to supplement their current
strategies for educating their employees/retirees about Medicare. The
Effectiveness in Utilizing Chinese Media to Promote Breast Health Among
Chinese Women To increase the awareness
and practice of breast health guidelines, a media-based education campaign
on breast health was launched among immigrant Chinese community in San
Francisco. The media campaign included airing two public service announcements
(PSA's) on Chinese television and radio stations and publishing the same
message in Chinese newspapers during 2000. Seven hundred and ten face-to-face
interviews were conducted with women who were recruited from various settings
in the city of San Francisco to evaluate the impact of the campaign. Survey
participants were asked to describe the content of the PSA's. Having viewed
the PSA was significantly associated with the ability of identifying all
four guidelines (OR = 1.96; 95% CI: 1.35 - 2.85), knowing how to perform
breast self exam (BSE) (OR = 2.25; 95% CI: 1.53 - 3.29), having performed
BSE within the past month (OR = 3.12; 95% CI: 2.05 - 4.74), and having
a clinical breast exam (OR = 2.98; 95% CI: 1.82- 4.90) and mammogram (OR
= 1.97; 95% CI: 1.16 - 3.36) in the past year. The study findings support
that a media campaign utilizing PSA's is effective in improving knowledge
of breast health guidelines, teaching Chinese women how to perform breast
self-exams, and increasing breast health practices. Healthy
or Unhealthy Slogans: That's the Question In response to a growing
health consciousness in adult consumers, companies started to position
their products as being healthy. Recently, the food industry has expanded
this health strategy to younger segments (e.g., Sultana cookies, Kellogg's
cereal bars, etc.). But how effective is this strategy? To examine this
issue, an experiment was conducted to examine the effect on adolescents
of different health appeals (healthy versus unhealthy) in ads for healthy
and unhealthy perceived foods. The results did not reveal a main effect
of product or slogan, but indicated a significant interaction effect between
slogan and product. The healthy slogan only led to significantly more
positive attitudes and purchase intentions when it promoted a healthy
food product. An unhealthy food product received better results in combination
with an unhealthy slogan than with a healthy one. This indicates that
adolescents react better to ads in which the health appeal is congruent
with the health perception of the product. Moreover, we took into account
gender and health concern as potential moderators in the relationship
between slogan and ad responses. Gender did not lead to different responses
to healthy or unhealthy food ads, whereas health concern did interact
significantly with the slogan type. Highly concerned adolescents responded
more favorably to a healthy slogan in terms of attitudes. A necessary
first step seems to be making adolescents more health conscious. A following
step is to reinforce their positive attitudes towards healthy foods and
turn them into real behavior. Social
Support and Social Undermining as Correlates for Alcohol, Drug, and Mental
Disorders in American Indian Women Presenting for Primary Care at an Indian
Health Service Hospital The purpose of this
study was to determine the relationship of two types of social support
(emotional and instrumental support) and two types of social undermining
(critical appraisal and isolation) with five categories of alcohol, drug,
or mental disorders (ADM; any mood, any anxiety, any substance abuse,
any disorder, and two or more disorders) in 169 American Indian women
presenting for primary care at an Indian Health Service facility. Social
support and social undermining are often treated as opposite poles, but
in fact are distinct factors with independent effects. The findings illustrate
that social support and undermining variables have a significant relationship
with ADM outcomes even when controlling for confounding demographic variables.
Any substance abuse was associated with all four social variables, while
two or more disorders was associated with instrumental support and isolation.
Any anxiety (isolation), any mood (critical appraisal), and any disorder
(isolation) were each associated with one social variable. Overall, social
undermining appears to have a stronger relationship with mental health
than social support. Copyright © 2005 Taylor & Francis Group. Taylor & Francis, 325 Chestnut Street, Philadelphia, PA 19106. |