UPFRONT

Volume 8, Number 5
September-October 2003

Vol. 8, Num. 5: Contents | Editorial | Up Front | Abstracts

From This Issue | Prescriptions

Vital Data

From This Issue

In April 2002 the Swedish National Food Administration along with researchers at Stockholm University’s Department for Environmental Chemistry raised an alarm regarding the potential health risks associated with eating fried and baked food such as potatoes and bread. The alarm led to world-wide concern on the topic, with WHO taking the lead and with regulatory authorities in a number of European and North American countries verifying the results of the original Swedish study. In addition, a number of research efforts funded by both governments and industry on how acrylamide formed in
fried carbohydrates has been established in a wide array of countries including the European Union as a whole (via its 6th Framework Programme), Norway, Sweden, UK, and the United States. However, to date there has not been a systematic evaluation of the communication aspects associated with the Swedish acrylamide alarm. Based on lessons
derived from the risk communication literature, were the Swedish authorities right to hold a press conference and put forward statements such as those by Leif Busk who said, ‘‘I have been in this field for 30 years and I have never seen anything like this before ...It may now be possible to explain some of the cases of cancer caused by food’’? Was the
media right in amplifying the acrylamide scare to the degree it did, with both live television coverage and front page headlines? This study is accompanied by commentaries by Professor Ortwin Renn, Professor at the Centre for Technology Assessment in the State of Baden Wurttemberg, Stuttgart, Germany and widely regarded as Europe’s
foremost expert on risk communication as well as David Sharp, former editor of the Lancet. In conclusion, the author offers a short postscript where he brings the readers up to date on what has happened with regard to communication issues around the acrylamide topic over the past six months. Lofstedt, R.E. Science Communication and the Swedish
Acrylamide Alarm (p. 407).

Tanning bed use is on the rise, especially among young women in the United States. Media images of tanned celebrities and the availability of tanning salons may contribute to this phenomenon. Tanning bed use is especially problematic as a risky behavior because the negative outcomes may be far removed (e.g., skin cancer in 10 years or even
longer). This delayed time frame is different from more immediate consequences to a risky behavior such as pregnancy or getting a DUI. Various message forms have been explored to reduce risk behavior, but it is not known if narrative or statistical messages might be more effective in changing tanning behavior. The second study of this issue of the Journal of Health Communication explores different message types and also includes a self-assessment manipulation to increase perceived susceptibility. The 3 (statistical, narrative, or no message) 2 (self assessment or none) design was utilized in a pre-post test design with 141 college women. Results indicated both the statistical and narrative messages were somewhat effective but in different ways, and the self-assessment resulted in higher perceived susceptibility. One particular finding is that any tanning message was better than no message, and many studies do not include such a control condition. This finding points to a need for more tanning messages to combat increased tanning salon
publicity and media images displaying tanned actors. Greene, K. Brinn, L. Messages Influencing the Use of Tanning Beds by College Women: Statistical Versus Narrative Evidence Format and a Self-Assessment to Increase Perceived Susceptibility (p. 445).

Questions still remain about who most influences youth’s AIDS-protective behaviors: peers, adults, or a combination of both? The third paper in this issue explores interpersonal communication about reproductive health information among Ghanaian youth, and the association of this communication with different types of reported AIDS-preventive
behaviors. Findings point to the importance of social context and peer influence. Contacts of peer educators in Ghana were surveyed at three sites during April 1998. Respondents age 11 to 26 years were included in the analysis (N = 490). Youth in the study who spoke with peers were significantly more likely to report AIDS-protective behaviors than those who spoke with no one, and youth who spoke with both peers and adults were more likely to engage in AIDS-protective behaviors than those who had only one source of reproductive health information. Youth who spoke with adults only were
not more likely to report AIDS-protective behaviors than youth who spoke with no one. Sexually-active youth were twice as likely to speak with peers as adults. Reported types of AIDS-protective behaviors differed substantially depending upon whether the youth communicated with adults, peers, or both. Those who spoke with peers were more likely
to report condom use and mutual monogamy compared with youth who spoke with adults, who were likely to report avoiding ‘‘bad’’ people as an AIDS-protective strategy, or avoiding sharing razors and blades. This implies that peers and adults are offering, and are perhaps comfortable with, different types of HIV prevention messages. Understanding
these social networks better and the interrelationship between peer and adult influence will allow program managers to design and implement increasingly effective HIV/AIDS prevention programs. Wolf, R.C., Pulerwitz, J. The Influence of Peer Versus Adult Communication on AIDS-Protective Behaviors among Ghanaian Youth (p. 465).

Newspapers have long been an important source of health-related information and attitudes in the mass societies of the 20th century. Audience segmentation, often along social-structure lines, allows more effective targeting of health messages. However, despite the overwhelming volume of health information available, minorities, individuals
living in rural communities, and the poor are less knowledgeable about disease issues than the general population. To reduce health information disparities, identification of needs (social diagnosis) in relation to problems prevalent (epidemiological diagnosis) is an important step in this process. The fourth article in this issue examines the coverage of
leading chronic diseases in Canada as presented in print media designed to serve the aboriginal (First Nations, Me´tis, Inuit) communities. It provides an initial descriptive ‘‘epidemiological’’ diagnosis as presented in media. To do this, 14 English-language newspapers, from the period 1996–2000, which explicitly targeted First Nations, Me´tis, and Inuit communities in Canada were surveyed for coverage of chronic diseases (cardiovascular disease, cancer, diabetes mellitus); these diseases were selected because they contribute significant mortality for Canadians; also included in the survey was coverage of HIV/AIDS since this disease has a higher incidence in aboriginal youth. Results of the
study showed that coverage of cardiovascular diseases and cancer were significantly under-reported in the aboriginal media. Cancer coverage tended to be biased toward breast cancer coverage, possibly reflecting a spill-over from mainstream media. The limited media coverage of cardiovascular diseases and a virtual absence of lung cancer
coverage were in contrast to the documented prevalence in aboriginal communities of tobacco use (a known risk factor for cardiovascular disease and lung cancer). If policy planners and health educators want to address health concerns of Aboriginal Canadians in a sustained way, documenting disparities in type and degree of exposure to health information, and understanding culture-specific preferences for how health information is delivered, will be needed. Hoffman-Goetz, L., Shannon, C., Clarke, J.N. Chronic Disease Coverage in Canadian Aboriginal Newspapers (p. 477).

Research has shown that parents play an important role in preventing substance use among adolescents. Effective parenting involves establishing and enforcing rules that minimize children’s exposure to risky situations, staying involved in and actively monitoring children’s activities, and clearly expressing disapproval of illegal alcohol and other drug use. The final article of this issue examines the effectiveness of a paid radio commercial designed to promote parent-child communication about alcohol use, which was sponsored by the Bureau of Substance Abuse Services, Massachusetts Department of Public Health. The advertisement ran as a paid spot during a four-week period in 1997. Overall, the spot was played over 1,400 times on stations reaching both Boston and Worcester and several hundred times in other parts of the state. The investigators assessed the radio advertising campaign’s impact through a random-digit-dial telephone survey of Massachusetts parents of children ages 10–17 years. One series of questions asked to what extent the respondents agreed or disagreed with several statements related to family discussion of alcohol use. The respondents also reported on how many occasions in the past 30 days they had talked with each of their children ages 10–17 about the con-sequences of drinking alcohol and the average length of those discussions. Reach of the present campaign was limited, with only 12.4 of the survey respondents being able to recall the radio spot unassisted. Survey respondents who had unassisted recall of the spot were more likely to disagree completely with the idea that a discussion about the con-sequences of alcohol use is useful only if children have begun to experiment with alcohol. In addition, a higher percentage of these respondents reported having three or more discussions with their children compared to those who did not recall the spot. These findings suggest the potential benefit of paid media campaigns to encourage parents to talk with their children about alcohol. Surkan, P., DeJong, W., Herr-Zaya, K., Rodriguez-Howard, M., and Fay, K. A Radio Advertising Campaign to Promote Parent-Child Communication about Alcohol (p. 491).

Prescriptions

Lofstedt studied the communication aspects associated with the Swedish acrylamide alarm. From his research he put forward a series of recommendations including:

. If one can avoid doing so, do not amplify risk/events that are by their very nature attenuated. Do not involve too many scientific bodies in crafting communication messages. Avoid all forms of company ‘‘brand’’ communication when one is unsure of the findings. Avoid making enemies of the media. Understand the importance of trust when communicating to stakeholders and the public. —R. E. Lofstedt

Greene and Brinn studied messages influencing college women’s use of tanning beds. From their research they offer these findings:

There is a need for specific persuasive messages encouraging college women to decrease tanning bed use, and media images encouraging tanning may contribute to this problem. Narrative messages can be used to increase realism but statistical messages can be used to increase information; some combination of narrative and statistical messages should be explored. Self-assessments should be included in messages to personalize threat, and these also involve viewers/readers. Women with low self esteem, body image, and eating disorders are more likely to use tanning beds and are especially at risk. —K. Greene and L. Brinn

Wolf and Pulerwitz explored interpersonal communication about reproductive health information among Ghanaian youth, and the association of this communication with different types of reported AIDS-preventive behaviors. Their findings suggest the following:

Reproductive health communication with peer educators appears to have more of an effect on AIDS-protective behaviors of Ghanaian youth than communication with adults, but combining the two sources of reproductive health information has the greatest effect. Combining multiple sources of reproductive health information is preferable to a single source, but well-trained peers should be one of the sources of information. Sexually active youth (i.e., youth potentially at risk of HIV) are more than twice as likely to talk to peers about reproductive health and diseases prevention as compared to adults. This further points to the importance of supporting peer education programs for HIV/AIDS prevention. Youth who conferred with peers and youth who conferred with adults often reported different types of AIDS-protective behaviors. Youth who spoke with peers were more likely to report condom use, for instance, compared with youth who spoke with adults, who were likely to report avoiding ‘‘bad’’ people as an AIDS-protective strategy. This implies that peers and adults are offering, and are perhaps comfortable with, different types of HIV prevention messages, but additional research is needed to investigate the different educational messages offered, as well as their impact. —R. C. Wolf and J. Pulerwitz

Hoffman-Goetz, Shannon, and Clarke studied the volume and type of newspaper coverage about HIV/AIDS, cancer, diabetes mellitus, and cardiovascular disease aimed at First Nations populations in Canada. Results of their research suggest the following:

Applied health researchers and program planners need to focus on developing effective strategies to reduce health information disparities among First Nations peoples and other minority cultures. Availability of disease incidence and mortality statistics, stratified by ethnicity, will be necessary in order to provide ethnic and culture-specific health promotion information in the media. Health communication researchers should work with stakeholders in the First Nations media community to ensure that relevant mobilizing information is included in mass media channels. —L. Hoffman-Goetz, C. Shannon, and J. N. Clarke

Surkan, DeJong, Herr-Zaya, Rodriguez-Howard, and Fay conducted a study of a paid radio commercial designed to promote parent-child communication about alcohol use. Based on their research they developed the following recommendations for public health campaign planners and researchers:

Because of the important role of parents in preventing substance use among adolescents, mass media campaigns designed to encourage parent-child communication are a potentially valuable tool in substance use prevention. Future radio campaigns directed to parents could benefit from additional broad-cast time to increase audience exposure and being time-coordinated with supporting messages in other media channels. Comparing respondents who recall the content of an advertising campaign and those who do not is a common evaluation strategy but one that has obvious shortcomings. Hence, future media campaigns directed to parents should be evaluated through experimental or quasi-experimental research designs that compare intervention and control communities. —P. J. Surkan, W. DeJong, K. M. Herr-Zaya, M. Rodriguez-Howard, K. Fay

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The Up Front section is edited by Wendy Meltzer, Managing Editor, Journal of Health Communication: International Perspectives.