Journal of Health Communication: International Perspectives
UP FRONTVolume 2, Number 3 Vol. 2, Num 3: Contents | Editorial | Up Front | Abstracts From this Issue | From Other Sources | World Wide Web Sources | Upcoming Conferences and Events | Publications | Prescriptions | Special Recognition | Call for Information In keeping with our international as well as national focus, we begin this issue of the Journal of Health Communication with an article from Israel’s bicycle helmet campaign. Ressler and Toledo examine the functional approach to attitudes for its potential contribution to improving models of attitude-behavior consistency and to demonstrate its potential application to social marketing. To this end, a study of children’s attitudes toward bicycle helmets is reported on and its results examined. The study was under-taken to plan Israel’s first-ever media campaign to encourage the use of bicycle helmets by children. Responses of the 783 Israeli children (ages 7 to 14 years) who participated in the study are to test the hypothesis generated by this application of functional theory. According to the theory, children’s attitudes toward wearing bicycle helmets serve primarily an expressive function. The results suggest cautious support for the functional hypothesis. In conclusion, possible extension of this approach to other areas of social marketing are discussed. Ressler, W. H., Toledo, E., A Functional Perspective on Social Marketing: Insights from Israel’s Bicycle Helmet Campaign. The following article returns to the United States in its study of emotionally disturbed children’s reactions to violent media segments. This study examines the reaction of children with a diagnosed disruptive behavior disorder (DBD) to violent movie scenes. Children without one of these disorders were tested as well. DBD children ranged in age from 8 to 12 years and were outpatients at The University of Kansas Medical Center’s Department of Child Psychiatry. These children were diagnosed by a child psychiatrist as meeting diagnostic criteria for having at least one of three emotional disorders: attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and conduct disorder (CD). Results showed that the disordered children differed from the nondisordered children on several dimensions. This suggests that DBD children process the anti-social messages in violent movies differently from children without a psychiatric disorder. An unabated diet of antisocial media could have harmful effects on children with a psychiatric illness. Grimes, T., Vernberg, E., Cathers, T., Emotionally Disturbed Children’s Reactions to Violent Media Segments. In the third article, we turn from mass media to interpersonal communication in a study of doctor’s and patient’s communication. This article argues that previous coding schemes used to assess doctor-patient interaction have been inadequate with respect to the scope of categories used to identify information exchange and relational communication as well as thematic topics of talk. Thirty-two doctor-patient interviews were analyzed with a new coding scheme that includes multiple categories of information exchange and relational communication, and allows for identification of thematic topics of talk. The results revealed both effective and less effective patterns of information exchange and relational communication between doctors and patients. These patterns were further elaborated by examining the topics of talk with which they occurred. Particular attention was given to implications the results have for communication skills training for doctors and patients. Cegala, D. J., A Study of Doctors’ and Patients’ Communication During a Primary Care Consultation: Implications for Communication Training. This issue’s forum article focuses on violence against women. According to Botta and Pingree, previous research has shown that one in four women experience rape or attempted rape by the time she is in college. Only half of these women name those experiences as sexual assault, an action which is an important part of recovery. This article examines whether a convenience sample of 123 undergraduate women, living in dormitories and sororities at a large Midwestern university, who experienced unwanted anal, oral, or vaginal intercourse through threat of force, force, drugs, or intoxication name those experiences as rape and whether those women who acknowledge their rapes have better psychosocial adjustment. It further examines whether interpersonal communication variables predict rape acknowledgement. Results indicate women who acknowledge their experiences as rape score better on examined psychosocial adjustment variables. Hierarchical regression including demographics, situational variables specific to their own rapes, and interpersonal communication variables about acquaintance rape reveal that interpersonal communication about rape significantly predict acknowledging rape above and beyond situational and demographic variables. Therefore, sharing common stories is an important way in which these young women name or redefine their experiences as rape. Botta, R. A., Pingree, S., Interpersonal Communication and Rape: Women Acknowledge Their Assaults. In keeping with the idea behind a peer reviewed academic
journal, Elayne Clift expresses different opinions in a response following
the article to conclude the forum section. Researchers have developed a Health Care Providers’ Teaching and Communication Behavior (TCB) scale to assess the teaching and communication behavior of clinicians treating patients with asthma. The flow of information between the patient and the health care provider must provide for accurate diagnosis and appropriate treatment recommendations, on one hand, and an understanding of the disease and confidence in one’s ability to manage it at home, with guidance. The authors believe that the TCB scale may help measure the health professional’s effort to engage patients in communication and education and help sustain a solid partnership for chronic disease management. Clark NM et al, 1997. A Scale for Assessing Health Care Providers’ Teaching and Communication Behavior Regarding Asthma. Health Education and Behavior 24 (2): 245-256. Low-intensity dietary interventions, such as self-help materials, may be an important public health strategy for changing nutritional habits. Researchers found that although the resulting change in dietary behavior may be small at the individual level, its impact at the population level could be dramatic. Moreover, the simple intervention in the study only required between 1-3 minutes of a clinician’s time, followed by discretionary time by the participants using self-help materials at their own pace. In contrast, an intensive intervention may require 18 scheduled one-hour group sessions. Given the public health benefits of moderate but widespread improvements in dietary habits, such low-intensity interventions are very cost-effective. Beresford SAA et al., 1997. A Dietary Intervention in Primary Care Practice: The Eating Patterns Study. American Journal of Public Health 87 (4): 610-616. Mountain bike riders suffered 23,409 injuries in 1994, 7 percent of which warranted admission to a hospital. During the American Academy of Orthopaedic Surgeons meeting in San Francisco, California, Mary Bos, MD, of the Institute for Bone and Joint Disorders in Phoenix, Arizona reported that half the injuries were to riders’ upper extremities, particularly the shoulder and rib areas. About 22 percent of the injuries were to the face and head. Knee injuries were less common, occurring in about 7 percent of those injured. About one fourth of the injured bikers sustained a fracture, and another one fourth had lacerations. The US Consumer Product Safety Commission has reported that in 1995 mountain biking injuries more than doubled to 48, 604. Voelder, R Mountain Bike Injuries Mount. JAMA. 277 (12), 951. A survey of members of the National Association of Managed Care Physicians and executive directors and constituent employers of the National Business Coalition on Health found that respondents agreed about most aspects of managed care, including its essential characteristics, but differed over its disadvantages. Both physicians and employers were evenly divided on managed care’s most important goal. About one third of respondents of each group chose one of the following top goals: containment of costs, improvement of quality, or optimization of trade-offs among goals. To achieve its most important goal, respondents agreed that managed care should achieve better use and control of resources, encourage consumers’ responsibility in health care purchasing, collect health outcomes data, and include more preventive care. Managed care’s cost effectiveness is its most important advantage. Physicians and employers agreed that reduced patient freedom of choice was its primary disadvantage, but they differed on its other disadvantages. Managed care is in the process of transforming the medical care landscape. To fulfil its potential, physicians and employers agreed that it is important to work together on a variety of issues to measure and improve quality, to use resources efficiently, and to define employee responsibility for health. Survey results were published in Managed Care Medicine: Goldschmidt PH, 1p A. How doctors and employers view managed care: results of a NAMCP/NBCH survey. Managed Care Medicine 1996; 3 (5): 19-28. The World Health Organization’s annual report, "Conquering
Suffering, Enriching Humanity," says the number of cancer cases is expected
to at least double in most countries during the next 25 years. Heart disease
and stroke will become more common in poorer countries, the report states,
and diabetes will more than double world-wide by the year 2025. "Emerging
infectious diseases was chosen as the theme for World Health Day 1997
to send a clear and urgent message: infectious diseases are still with
us" WHO Director-General Hiroshi Nakajima stated. For information on "The
World Health Report 1997: Conquering Suffering, Enriching Humanity," contact
Thomson Prentice, Health Communications and Public Relations, WHO, Geneva,
Switzerland. Phone (41 22) 791-4224; Fax (41 22) 791-4870; E-mail: prenticet@who.ch.
On April 15, the U.S. Department of Health and Human Services launched HealthfinderTM, a consumer health information internet service that links over 600 selected Federal agencies, academic and professional organizations, and other non-commercial organizations. HealthfinderTM features easy key word searching for on-line publications, organizations, and other web resources. It has links to state and local health departments, links to medical, university and public libraries, links to hotlines and discussion groups, and many other innovations. While consumers and patients use HealthfinderTM to locate information to help them gain health information, navigate the health care system, or learn about medical options, public health and medical professionals are also using it to understand the range of health information that is available on-line. The URL is www.healthfinder.gov. Comments and suggestions for improvement are welcome through the on-line feedback buttons or by emailing mdeering@osophs.dhhs.gov. Access Publishing Company, is a provider of medical information for doctors and medical professionals. They have just launched their new Web Site. It is a free, comprehensive website including products, services, suppliers, continuing medical education, professional organizations, professional titles, and patient education materials. The site features a Continuing Medical Education section that covers all specialties and is searchable by month, year, and subject for the next three years. Also featured is a Bookshelf Section (Professional Titles and Patient Education Materials) for all medical specialties, organized by subject and including titles from 1993 through new titles. All of the sections are hotlinked throughout so users can jump directly to a Suppliers Web Site, e-mail for more information, or go to an information page about the organization within accesspub.com’s web site. The site can be found at: http://www.accesspub.com. The third national conference, Partnerships for Networked
Consumer Health Information, was held in Washington, D.C. in April of
1997. The conference has its own website at http://odphp.osophs.dhhs.gov/confrnce/partnr97.
The transcripts of the sessions can be found on the web site. Keynote
sessions focused on the implications of interactive health communication
for medical care delivery, public health, the telecommunications and technology
sectors, and on research about the effectiveness of technology-based health
communication. Featured speakers included Molly Joel Coye, M.D., M.P.H,
Vice President for Strategic Development at HealthDesk, Inc., formerly
director of the state health departments for California and New Jersey
and the head of the Division of Public Health at the Johns Hopkins School
of Hygiene and Public Health. Other speakers included Reed Hundt, Chairman
of the Federal Communications Commission, and Tom Ferguson, M.D., of the
Center for Clinical Computing at Harvard Medical School. Upcoming Conferences and Events The World Federation of Public Health Associations 8th International Congress "Health in Transition: Opportunities and Challenges" will be held in Arusha, Tanzania from October 12-16, 1997. The meeting is hosted by the Tanzanian Public Health Association. Participants include health practitioners, policymakers, administrators, development workers, researchers and others from government, academia, international organizations and the NGO community. For further information contact: WFPHA Secetariat, c/o APHA, 1015 15th Street N.W., Suite 300, Washington, D.C. 20005 USA, or fax (202) 789-5661. The European Health Futures Symposium "New ways of developing strategy in health and social care" will be held in London, England on November 10-11, 1997. The key aim of the symposium is to generate new thinking in future health planning. The workshops will: examine past and current experiences using health futures techniques, explore the use of futures techniques, and consider key issues such as communication technologies and biotechnology. This program is relevant for policymakers, strategists and planners, NHS managers, General Practitioners, purchasers and social services directors. For more information, please contact Vivien Bucke at the King’s Fund on 0171 307 2595 or write to her attention at King’s Fund, 11-13 Cavendish Square, London W1M 0AN, England. The Centers for Disease Control and Prevention (CDC), the Hepatitis Foundation International (HFI), and the Public Health Training Network (PHTN) will cosponsor a live, interactive satellite teleconference course for primary care physicians, physician specialists, staffs of blood banks, nurses, physician assistants, health educators, social workers, and other health care providers. Hepatitis C: Diagnosis, Clinical Management, Prevention will be held on Saturday, November 22, 1997, from 8:30 to 11:00 a.m. Eastern Standard Time, with a repeat broadcast from 12:00 noon to 2:30 p.m. that same afternoon. At the conclusion of the teleconference, participants should be able to describe the natural history and the risk factors for Hepatitis C Virus (HCV) infection, describe appropriate serologic and laboratory tests used to diagnose and evaluate patients infected with HCV, and discuss treatment options and the most effective methods for counseling patients. For registration and presenter information, call 1-800-CDC-FAXX and ask that document number 130010 be faxed to you. Additional information can be obtained from Louise Barden at (404) 639-2709. There is a $25 cost for the course which includes a reference text. The 12th National Conference on Chronic Disease Prevention and Control, "Prevention Opportunities for the 21st Century," will be held in Washington D.C. on December 3-5, 1997 at the Washington Hilton and Towers, 1919 Connecticut Ave., N.W. The conference is sponsored by the National Center for Chronic Disease Prevention and Health Promotion at Centers for Disease Control and Prevention, and the Association of State and Territorial Chronic Disease Program Directors. It will include numerous sessions on communicating health messages to the diverse constituents of public health. These will include the topics of physical activity promotion, teen pregnancy prevention, tobacco and women’s health initiatives, as well as skills building sessions on media advocacy and social marketing. Registration information can be obtained by calling 1-800-722-8232 The National Heart, Lung and Blood Institute, the Cardiovascular Disease Outreach, Resources and Epidemiology Program, the University of California, San Francisco, and the California Cardiovascular Disease Prevention Coalition are cosponsoring "Cardiovascular Health: Coming Together for the 21st Century, A National Conference" from February 19-21, 1998 at the Hyatt Regency Embarcadero Hotel-On the Waterfront in San Francisco, California. This national conference is designed to bring new momentum to the fight against cardiovascular disease. The conference theme is Challenges, Solutions and Skills for the Next Millennium. The conference begins and ends with plenary sessions related to the overall focus of the conference. Eight major topics identified as important areas in cardiovascular health will be the focus of a single Major Session each. Smaller sessions and workshops will be organized around the eight major topics. For more information, write Cardiovascular Health Conference Secretariat, Office of Continuing Medical Education, Registration Office, Box 0742, University of California, San Francisco, California 94143-0742 or fax to (415) 476-0318. You may also obtain information from the web site at http://cme.ucsf.edu or call with questions at (415) 476-5808. The Administration on Children, Youth and Families, Department
of Health and Human Services, in collaboration with Columbia University
and the Society for Research in Child Development, announces Head Start’s
Fourth National Research Conference, "A Research Agenda on Children and
Families in an Era of Rapid Change," to be held July 9-12, 1998, in Washington,
DC. Inquiries about papers or conference details should be directed to
Dr. Faith Lamb Parker, Project Director, Colombia School of Public Health,
CPFH, 60 Haven Ave., B3, New York, NY 10032 or call (212) 304-5252. The National Health Service (NHS), the British health care service, celebrates its 50th anniversary next year. To mark this occasion, the King’s Fund is publishing a review of the British health care system since the introduction of the NHS in 1948. From Cradle to Grave, the first 50 years of the health service is written by Geoffrey Rivett and traces the major achievements and events in medicine, nursing, hospital development, primary health care and NHS management. The book is meant to be a unique reference guide to the NHS. The book will be published in January of 1998 and will be sold for £25 (approximately $40-45). The King’s Fund is offing a 20 percent discount to all customers ordering before publication. You may place an order with the King’s Fund Bookshop at 0171 307 2591. Please quote reference LU/etgl to qualify for your discount. The newsletter of the Judicious Antibiotic Use Campaign, "Abx CAUSE (Careful Antibiotic USE)" is available for people who are interested in halting the spread and decreasing the incidence of antibiotic resistance. It will be distributed on a quarterly basis and will highlight the progress and activities of Centers for Disease Control and Prevention (CDC) and its partners in changing the practices of parents and providers as related to antibiotic use. Issues will also include educational resources, relevant meetings and conferences, and funding opportunities. Interested people can obtain copies by contacting Lela F. Folkers, Centers for Disease Control and Prevention, 1600 Clifton Road, MS C-09, Atlanta, GA 30333. A newly revised publication aimed at informing the medical community about chronic fatigue syndrome (CFS) is available from the National Institute of Allergy and Infectious Diseases (NIAID). The booklet, which is designed to help physicians and other health professionals develop a supportive program of patient management while dispelling myths about the disorder and its treatment, reviews the history, epidemiology, and etiologic theories of CFS and includes guidelines for its clinical evaluation and management. Requests for the free booklet, Chronic Fatigue Syndrome: Information for Physicians, should be directed to CFS Booklet, NIAID Office of Communications (31/7A50), 31 Center Drive, MSC 2520, Bethesda, MD 20892-2520. The booklet and other information about CFS are also available on NIAID’s home page at http://www.niaid.nih.gov. Brennan, P.F., Schneider, S.J., and Tornquist, E. eds., 1997 have written a volume entitled Information Networks for Community Health, published by Springer-Verlag in New York. The chapters in this volume cover linkages at the community and state level, the patient-computer dialogue, on-line consumer and patient self-care and self-help networks, stand alone computer-based support programs, patient services through telephones, and many other aspects of electronic health communication. A National Institute for Occupational Safety and Health
(NIOSH) sponsored symposium has developed a draft health education plan
aimed at preventing contact dermatitis in the construction industry. Prepared
cooperatively by representatives from government, academia, health care,
manufacturers, employers and labor, the plan includes a multi-level educational
campaign. For proceedings, contact: Jamie Blume, Occupational Health Foundation,
1126 Sixteenth Street, N.W., Washington, D.C. 20036 or call (202) 887-1980.
You may also fax to (202) 887-0191. Ressler and Toledo’s international article, which examines the functional approach to attitudes for its potential contribution to improving models of attitude-behavior consistency and to demonstrate its potential application to social marketing, offers us three suggestions for more effective Social Marketing campaigns in the future.
Grimes, Vernberg, and Cathers joined to test the reaction of children with diagnosed Disruptive Behavior Disorders (DBD) to violent movie segments. The studies findings have implications for mass media health messages as well as network television.
Cegala reports a study of doctor-patient discourse patterns with emphasis on implications for communication skills training. He has set forth eight guidelines for communication skills training for doctors and patients.
Botta and Pingree studied the relationship between interpersonal communication and sexual assault survivor’s perceptions of their assault experiences. They have developed five recommendations for universities addressing sexual assault on campus.
Porter Novelli awarded two William Novelli Awards for Innovation
in Social Marketing at the 3rd Annual Innovations in Social Marketing
Conference in Boston May 19. The winning paper for innovation in social
marketing research was titled "The Individual and the Organization Understanding
Roles of Identification and Disidentification in Social Marketing" by
C.B. Bhattacharya and Kimberly Elsbach of the Goizueta Business School
at Emory University. The winning paper for innovation in social marketing
practice was title 'Changing Traditions: Preventing Illness Associated
with Chitterlings" by Anne Peterson and Jane Koehler of the Georgia State
Health Department. You are enthusiastically invited to suggest items for inclusion in Up Front! Please adhere to our guidelines by providing the following information:
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