Vol. 3, Num. 3: Contents | Editorial | Up Front | Abstracts

Enhancing the Effectiveness of HIV/AIDS Prevention Programs Targeted to Unique Population Groups in Thailand: Lessons Learned from Applying Concepts of Diffusion of Innovation and Social Marketing
      Svenkerud, P.J. & Singhal, A.

Diffusion of innovations theory and social marketing theory have been criticized for their limited applicability in influencing unique population groups (e.g. female commercial sex workers working in low-class brothels).  The present study investigated the applicability of these two theoretical frameworks in outreach efforts directed to unique populations at high-risk for HIV/AIDS in Bangkok, Thailand.  Further, the present study examined Thai cultural characteristics that influence communication about hIV/AIDS prevention.  These results suggest that certain concepts and strategies drawn from the two frameworks were used more or less by effective outreach programs, providing several policy-relevant lessons.  Cultural constraints, such as the lack of visibility of the diseases, and traditional sexual practices, influenced communication about HIV/AIDS prevention.

Demystifying AIDS in Thailand: A Dialectical Analysis of the Thai Sex Industry
     Chay-Nemeth, C.

The AIDS pandemic throughout the world, particularly in Thailand, is not just a physical disease that has evaded much of our control.  It is symptomatic of a chronic, more pervasive and sinister plague that governs modern societies.  This plague is social and political in nature.  In the case of Thailand's AIDS pandemic, this paper argues that the underlying socio-political plague that further aggravates the AIDS crisis may be found in the internal contradictions that govern the Thai sex industry and its commodification of women/sex.  It further suggests that current Thai management of the AIDS pandemic, though effective in terms of increasing the public's awareness about AIDS, its transmission modes and preventive measure, is less effective in the long run, because it fails to adequately address structural formation, contradictions and practices that constitute and reproduce the Thai sex industry.  Two objectives are attempted in this paper: first, a dialectical analysis of the internal contradictions in Thai society, as it related to the sex industry, the family, and Buddhist institutions in Thailand; and second, a line of response to the AIDS pandemic in Thailand.

Perpetuating Passivity: Reliance and Reciprocal Determinism in Physican-Patient Interaction
     Makoul, G

This study introduces, profiles and tests the explanatory value of reliance, a construct that emerged from, and is expected to illuminate, consideration of perceived control in medical encounters.  The investigation also links communication sciences with the truly interactive perspective of reciprocal determinism, highlighting the impact of personal relations and the significance of perceived control.  Data from 271 encounters between general practitioners and patients in Oxford (England) were collected via videotapes, patient questionnaires, medical record reviews, and physician questionnaires.  The analysis indicated that physician-reliant patients (i.e., those who rely upon physicians to make decisions for them) tended to be older and from a more "working class" background than were self-reliant patients (i.e., those more interested in participating in choices about their health care).  The physician-reliant patients also had more externally-oriented outcome expectations and tended to see physicians more often than did their self-reliant counterparts.  In addition to defining reliance at the conceptual and operational levels, this study provide preliminary evidence that reciprocal determinism is operating in medical encounter:  Despite their preference for patients who feel in control of their health, physicians tended to adapt to patients' reliance orientation, sharing decisions with self-reliant patients and making decisions for physician-reliant patients.  Accommodating the passive orientation of physician-reliant patients is likely to diminish their changes for maintaining control in the medical encounter, which has implications for health outcomes, cost and compliance.

FORUM

Health Education Goes to Hollywood: Working with Prime-time and Daytime Entertainment Television for Immunization Promotion
     Glik, D., Berkanovic, E,. Stone, K., Ibarra, L., Jones, M.C., Rosen, B., Schreibman, M., Gordon, L., Minassian, L., & Richardes, D.

This article presents an entertainment education strategy used to influence Hollywood primetime and daytime television programs to add story-lines on the importance of immunizations to their shows.  Rather than giving information about immunizations to show producers, directors, actors, and writers, we furnished "log lines" and true stories about immunizations that could be used to inspire scripts that included immunization themes.  By working through personal contacts within the entertainment television industry's closed system of networks, we were able to gain entree and some air-time for our campaign agenda.  Embedded messages have aired on eight popular shows in the 1996-97 broadcast season, with five scheduled to air in the 1997-98 season.  these efforts were evaluated qualitatively, focusing on issues of personal networks, content of aired messages, and comparative costs for paid air time.  The strategy developed can be adapted for a range of entertainment education interventions.

Book Reviews

Health Communication: Strategies for Health Professionals.  Northouse, L. L. & Northouse, P.G.
reviewed by: Parrott, R.L.

The Cigarette Papers.  Glantz, S.A., Slade, J., Bero, L.A., Hanauer, P. & Barnes, D.E.
reviewed by: Basil, M.D.