ABSTRACTS

Volume 6, Number 2
April-June 2001

Vol. 6, Num 2: Contents | Editorial | Up Front | Abstracts

A Comparison of Views of Individuals with Type 2 Diabetes Mellitus and Diabetes Educators About Barriers to Diet and Exercise
 Shultz, J.A, Sprague, M.A., Branen, L.J., and Lambeth, S.

Diet and exercise are the cornerstones of treatment for persons with type 2 diabetes mellitus; yet, patients find these areas of self-management to be the most difficult.  Considerable research has indicated that barriers to diet and exercise are critical influences determining adherence to diet and exercise plans.  Standards of practice require educators to assess patient barriers to self-management.  However, little research has investigated whether or not patients and educators perceive these barriers similarly.  This project’s objectives were to compare and contrast patients’ and educators’ perspectives of patient barriers to following a meal or exercise plan, and to identify differences in patients’ perceived barriers as related to patient characteristics.  Patients with type 2 diabetes mellitus (n = 97) from three eastern Washington area hospitals and diabetes educators (n = 143) from the Washington Association of Diabetes Educators were recruited for a mail survey.  From the patient survey, the proportion of patients on a meal plan (52%) or exercise plan (26%) was low.  Certain barriers were prominent for both patients and educators relative to diet (difficulty maintaining a diet away from home; liking foods not in the meal plan) and exercise (not a high priority; weather).  However, multivariate analyses indicated that patients and educators view barriers differently. Similarities and differences between educators and patients in response to barriers are discussed relative to enhancing diabetes counseling and education, and overall communication between educators and patients.

On Being Responsible: Ethical Issues in Appeals to Personal Responsibility in Health Campaigns
     Guttman, N. and Ressler, W.H.

     Appeals to personal responsibility are highly prevalent in health communication campaigns, but their use entails both moral and strategic considerations.  This article provides an overview of the notion of personal responsibility as a persuasive appeal in public health communication campaigns and an analysis of concomitant ethical implications.  Whereas the issue of responsibility often is acknowledged by practicioners and scholars as a perennial challenge in health interventions, conceptual tools for the indentification of its subtle manifestations are not readily available.  This article outlines a framework that contextualizes potentially paradoxical consequences of campaign appeals to personal responsibility that can be explained by the medieval allegory of the "Tragedy of the Commons,"  psychological attribution theory, and public health concerns regarding "blaming the victim."  Practice-oriented questions are introduced to help identify ethical issues in personal responsibility appeals that can be utilized in the design and implementation of health campaigns.

Personal Communication Networks and the Effects of an Entertainment-Education Soap Opera in Tanzania
Mohammed, S.

 The personal networks of listeners and non-listeners to an entertainment-education radio soap opera in Tanzania are examined to determine the effects of interpersonal discussion of the soap opera’s educational themes of family planning and HIV prevention. Listeners are more likely to discuss these two educational issues in their personal communication networks, and are also more likely to have other listeners to the radio program in their personal communication networks. Respondents demonstrate a relatively high degree of homophily with their network partners, and are more likely to discuss matters arising from the radio program with their network partners who are of similar tribal membership, religious affiliation, and gender, and those who are equally or more highly educated than themselves.

Understanding Barriers to Preventive Health Actions for Occupational Noise-Induced Hearing Loss
Patel, D.S., Witte, K., Zuckerman, C., Murray-Johnson, L., Orrego, V., Maxfield, A.M., Meadows-Hogan, S., Tisdale, J., and Thimons, E.

 A theoretically based formative evaliation was conducted with coal miners in the Appalachian Mountains who were at high risk for noise-induced hearing loss (NIHL).  The results of four focus groups indicate that despite high levels of knowledge, strong perceived severity of negative consequences, and strong perceived susceptibility to hearing loss, two main categories of barriers (environmental and individual) keep coal miners from using their hearing protection devices (HPD).  Further analysis suggests that environmental factors, rather than individual variables, more strongly influence decisions against protective actions.  Recommendations and practical implications are offered.

FORUM
The Reporting of Crime and Violence in the Los Angeles Times: Is There a Public Health Perspective?
Rodgers, S. and Thorson, E.

The authors examine how crime and violence is reported and framed by the Los Angeles Times. Using a public health perspective, we examine whether health-oriented variables, such as causal factors and societal effects of crimes, are present in crime news stories. The classic stereotyping of crime and violence framing is strongly present in the Times. We discuss what changes would be useful to provide news consumers with a more accurate picture of crime in their community

BOOK REVIEW
Balancing the Secrets of Private Disclosures
Shaner, J.L.

COMMENTARY
Reporting of Crime and Violence in the Los Angeles Times: Is There a Public Health Perspective?
Reviewed by J.Gregory Payne