ABSTRACTS

Volume 11, Number 7
October-November 2006

Vol. 11, Number 7: Contents | Editorial | Abstracts

Pictures Worth a Thousand Words: Noncommercial Tobacco Content in the Lesbian, Gay, and Bisexual Press
    Elizabeth A. Smith A1, Naphtali Offen A1, Ruth E. Malone A1

A1 University of California, San Francisco, California, USA

Smoking prevalence in the lesbian, gay, and bisexual (LGB) community is higher than in the mainstream population. The reason is undetermined; however, normalization of tobacco use in the media has been shown to affect smoking rates. To explore whether this might be a factor in the LGB community, we examined noncommercial imagery and text relating to tobacco and smoking in LGB magazines and newspapers. Tobacco-related images were frequent and overwhelmingly positive or neutral about tobacco use. Images frequently associated smoking with celebrities. Text items unrelated to tobacco were often illustrated with smoking imagery. Text items about tobacco were likely to be critical of tobacco use; however, there were three times as many images as text items. The number of image items was not accounted for by the number of text items: nearly three quarters of all tobacco-related images (73.8%) were unassociated with relevant text. Tobacco imagery is pervasive in LGB publications. The predominant message about tobacco use in the LGB press is positive or neutral; tobacco is often glamorized. Noncommercial print images of smoking may normalize it, as movie product placement does. Media advocacy approaches could counter normalization of smoking in LGB-specific media.

Language, Literacy, and Communication Regarding Medication in an Anticoagulation Clinic: A Comparison of Verbal vs. Visual Assessment
    Dean Schillinger A1, Frances Wang A1, Jorge Palacios A1, Maytrella Rodriguez A1, Edward L. Machtinger A2, Andrew Bindman A2

A1 University of California-San Francisco, Center for Vulnerable Populations, Division of General Internal Medicine, San Francisco General Hospital, San Francisco, California, USA
A2 University of California-San Francisco, Division of General Internal Medicine, San Francisco General Hospital, San Francisco, California, USA

Despite the importance of clinician-patient communication, little is known about rates and predictors of medication miscommunication. Measuring rates of miscommunication, as well as differences between verbal and visual modes of assessment, can inform efforts to more effectively communicate about medications.

We studied 220 diverse patients in an anticoagulation clinic to assess concordance between patient and clinician reports of warfarin regimens. Bilingual research assistants asked patients to (1) verbalize their prescribed weekly warfarin regimen and (2) identify this regimen from a digitized color menu of warfarin pills. We obtained clinician reports of patient regimens from chart review. Patients were categorized as having regimen concordance if there were no patient-clinician discrepancies in total weekly dosage. We then examined whether verbal and visual concordance rates varied with patient's language and health literacy.

Fifty percent of patients achieved verbal concordance and 66% achieved visual concordance with clinicians regarding the weekly warfarin regimen (P < .001). Being a Cantonese speaker and having inadequate health literacy were associated with a lower odds of verbal concordance compared with English speakers and subjects with adequate health literacy (AOR 0.44, 0.21-0.93, AOR 0.50, 0.26-0.99, respectively). Neither language nor health literacy was associated with visual discordance. Shifting from verbal to visual modes was associated with greater patient–provider concordance across all patient subgroups, but especially for those with communication barriers.

Clinician-patient discordance regarding patients' warfarin regimen was common but occurred less frequently when patients used a visual aid. Visual aids may improve the accuracy of medication assessment, especially for patients with communication barriers.

Does MTV Reach an Appropriate Audience for HIV Prevention Messages? Evidence from MTV Viewership Data in Nepal and Brazil
     Cynthia Waszak Geary A1, Holly McClain Burke A1, Shailes Neupane A2, Laure Castelnau A3, Jane D. Brown A4

A1 Family Health International, Research Triangle Park, North Carolina, USA
A2 Valley Research Group, Kathmandu, Nepal
A3 IBOPE, São Paulo, Brasil
A4 School of Journalism and Mass Communication, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

In response to the growing numbers of young people affected by HIV around the world, MTV (Music TV), the world's largest television network, has aired a global HIV prevention campaign since 1999, expanding it into a multicomponent campaign in 2002. Questions have been raised, however, about whether MTV is an appropriate channel for these messages, given its provocative content and its reach to those at the upper end of the socioeconomic scale. To address questions about who MTV reaches, viewership data were analyzed from baseline surveys conducted as part of an evaluation of the 2002 HIV prevention campaign. The two sites included in this analysis were Kathmandu, Nepal, and São Paulo, Brazil—each with very different cultures and media environments. We found that, in general, heavier viewers of MTV are younger, better educated, and more dependent on their parents, and they have more access to satellite television and the Internet. MTV viewing was associated with positive attitudes toward HIV prevention behaviors (except for abstinence until marriage) but not with premarital sexual activity.

Promoting Organ Donation to Hispanics: The Role of the Media and Medicine
    Janice Frates A1, Gloria Garcia Bohrer A2, David Thomas A3

A1 Health Care Administration Program, California State University Long Beach, California, USA
A2 OneLegacy, Los Angeles, California, USA
A3 Synovate, Los Angeles, California, USA

This study assesses the impact of a paid media advertising campaign employing Spanish language, culturally sensitive television and radio spots airing on major Hispanic stations in southern California. An advertising tracking study with a baseline and three postintervention telephone surveys was conducted from 2001 through 2003 among 500 randomly selected self-identified, primarily Spanish language dominant adult Hispanics.

Measures of organ donation attitudes and behaviors (decision and declared intent to donate organs) improved significantly (P < .05) in 2001 and 2002, then leveled off or declined in 2003. Among the reasons given for not making a decision to donate was fear that medical personnel might withhold care from identified organ donors, suggesting lack of knowledge and distrust of the health care system. Few respondents talked to health care professionals or contacted the organ procurement agency for information either before or after the campaign. Findings from this study indicate a need for ongoing public education in the Hispanic community about organ transplantation and donation. Health professionals need to become more engaged in encouraging Hispanic patients to learn about organ transplantation and donation, and to inform their families that they have made the personal decision to donate.

Operation Storefront Hawaii: Tobacco Advertising and Promotion in Hawaii Stores
    Karen Glanz A1, Nicole M. Sutton A2, Kimberly R. Jacob Arriola A3

A1 Department of Behavioral Sciences and Health Education, Emory Prevention Research Center, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA
A2 REAL: Hawaii Youth Movement Against Tobacco Use, Cancer Research Center of Hawaii, Honolulu, Hawaii, USA
A3 Department of Behavioral Sciences and Health Education, Rollins School of Public Health of Emory University, Atlanta, Georgia, USA

Our objective was to explore the nature and location of tobacco product advertising and promotion in retail stores in Hawaii. We performed a cross-sectional study of tobacco product store-based advertisements, including the number, location (indoor/outdoor; proximity to candy, toys, school), size, and brand of the ads. Trained youth (ages 12–19 years) collected data on 3,151 advertisements and promotions among 184 stores. We found that most ads appeared indoors, and the most heavily advertised brand was Kool. Kool is also the most heavily smoked brand among youth in Hawaii. This study underscores the high visibility of retail store advertising and promotions (both indoor and outdoor) in places that attract the attention of youth.

Book Review

A Review of: “D'Cruz, P. (2004). Family Care in HIV/AIDS: Exploring Lived Experience.”: Thousand Oaks, CA: Sage Publications. ISBN: 076193233X
Ashley Duggan