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Editor’s Note:

The challenges of the overall economy and health costs will undoubtedly strain our current systems.  Yet, with aging populations, rising chronic and non-communicable disease globally, antecedent risks such as obesity on the rise, projections of climate change and environmental degradation challenging public health systems, the time is now for communication to strengthen a global focus on health.  Health as we know it today can be protected with proven health and hygiene techniques, 21st century evidence for primary, secondary and tertiary prevention, health literacy goals for people to act upon information and make health decisions appropriately, and a robust opportunity to advance medical science with new discoveries, developments and treatments.  In the global marketplace often led by economics and security concerns, of utmost importance is the health of the people.  We need to communicate these at all levels and begin to act with policies and strategies to advance health globally.

Read more in my recent editorial.

Scott C. Ratzan, MD, MPA
Editor-in-Chief, Journal of Health Communication
Vice President, Government Affairs, Europe
Johnson & Johnson

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Table of Contents 

• Recent Articles in JHC
  • Volume 13, Issue 4
  • Volume 13, Issue 5
• Featured Book Review
• Cases Online Journal
  

Recent Article in JHC:

Volume 13 Issue 4 (June 2008)
Click on the title to purchase the article!

• Using Culture-Centered Qualitative Formative Research to Design Broadcast Messages for HIV Prevention for African American Adolescents
  Jennifer R. Horner;  Daniel Romer;  Peter A. Vanable;  Laura F. Salazar;  Michael P. Carey;  Ivan Juzang;  Thierry Fortune;  Ralph DiClemente;  Naomi Farber;  Bonita Stanton; Robert F. Valois
  The authors describe formative research for developing radio and television messages to augment the iMPPACS youth HIV-prevention project. In semi-structured interviews, adolescents discussed their experiences with personal relationships and sexual health. Narratives of condom use and delay of sexual initiation were analyzed with respect to the arguments used by adolescents to justify the views and behaviors of themselves and their peers. These arguments provided the basis for brief vignettes dramatizing conflicts over sexual health behaviors and modeling arguments in support of protective practices.  

• Global and Local Networking for HIV/AIDS Prevention: The Case of the Saathii E-Forum
  - Rebecca DeSouza; Mohan Jyoti Dutta
  The global spread of HIV/AIDS has sparked the proliferation of civil society groups working on various aspects of the disease such as prevention, treatment, support, and policy. In this article, we explore the role of the Internet in networking civil society organizations working on HIV/AIDS-related issues across local and global spaces. Specifically, we conducted a thematic analysis of an e-forum established by the non-governmental organization (NGO) Saathii, working on HIV /AIDS issues in India to (a) identify the specific functions served by the e-forum and (b) explore how global and local actors use the e-forum to network with each other. The thematic analysis documented four key functions of the online forum, (a) to provide HIV/AIDS related news, (b) to serve as an informational resource, (c) to promote political activism, and (d) to express emotions. The discussion elaborates on the how global and local actors network with each other and build solidarity.

• An Outcome Assessment of an ABC-Based HIV Peer Education Intervention Among Kenyan University Students
  - Ann Neville Miller;  Mike Mutungi;  Elena Facchini;  Benard Barasa; Wycliffe Ondieki; Charles Warria
  Peer education appears to be the most popular approach to HIV prevention on sub-Saharan African university campuses, but its effectiveness has rarely been evaluated. Miller and colleagues evaluated the outcome of a large “ABC” (Abstain, Be faithful, use Condoms) -based peer education intervention at the main campus of Kenyatta University in Nairobi, Kenya. After two years of on-campus intervention, no campus-wide changes in behavior were evident with respect to either abstinence or number of sexual partners. A small increase was found in condom use, and a large increase in HIV testing was evident. These findings raise concerns about the effectiveness of peer education programs for conveying all three safe-sex behavioral messages. The authors caution, though, that specific research is needed on exactly how peer educators function as models in multi-message programs.

• Reporting AIDS and the Invisible Victims in China: Official Knowledge as News in the People's Daily, 1986-2002
  - Dong Dong;  Tsan-Kuo Chang; Dan Chen
  This study represents the first systemic, longitudinal analysis of news coverage of AIDS in China at the national level.  The purpose is to determine how the disease has been constructed as a health issue in public communication as China continues to move forward towards economic modernization and political openness. Two major research questions were asked: What is the pattern of AIDS reporting in the People’s Daily—the national news medium that sets the tone for the rest of other media—over time?  How is its AIDS coverage tied to the large social structure in China?  Given the domination of the state in the spirit and practices of the Chinese media, this study contends that the AIDS news represents a form of official knowledge and sets up the parameters for public awareness and deliberation, if any, in Chinese society.

• Using Diffusion of Innovation Theory to Encourage the Development of a Children's Health Collaborative: A Formative Evaluation
  - A. Celeste Farr; Natalie Ames
  When children lack access to medical treatment and preventive care, it affects their immediate well-being, has potential consequences for their physical and mental health as adults, and burdens on an already taxed health care system.   The development of interactive social networks can place community organizations in a position to share limited resources, develop creative solutions to problems, and improve children’s access without increases in the current in-network funding structure. The study reported in this paper was designed as the first step in planning and implementing a community-wide collaborative to work on improving medically underserved children’s access to health care. The purpose of the study was to examine the existing children’s health social system in one community, identify any opinion leaders, and determine, relevant community organizations’ interest in creating a social system focused on increasing children’s access to health care.

• Antecedent Characteristics of Online Cancer Information Seeking Among Rural Breast Cancer Patients: An Application of the Cognitive-Social Health Information Processing (C-SHIP) Model
  - Bret R. Shaw;  Lori L. DuBenske;  Jeong Yeob Han;  Ludmila Cofta-Woerpel;  Nigel Bush;  David H. Gustafson; Fiona McTavish
  Little research has examined the antecedent characteristics of patients most likely to seek online cancer information. This study employs the Cognitive-Social Health Information Processing (C-SHIP) model as a framework to understand what psychosocial characteristics precede online cancer-related information seeking among rural breast cancer patients who often have fewer healthcare providers and limited local support services.  This study supports the applicability of the model to discern why people afflicted with cancer may seek online information to cope with their disease.

• A Computer-based Approach to Preventing Pregnancy, STD, and HIV in Rural Adolescents- Anthony J. Roberto;  Rick S. Zimmerman;  Kellie E. Carlyle; Erin L. Abner. Volume 12, Issue 1, 2007, Pages 53 - 76. FULL TEXT
  

• HIV/AIDS Risk Factors as Portrayed in Mass Media Targeting First Nations, Mtis, and Inuit Peoples of Canada - Laurie Hoffman-Goetz;  Daniela B. Friedman; Juanne N. Clarke. Volume 10, Issue 2, 2005, Pages 145 - 162.

• Reinforcement and Punishment of Substance Abuse During Ongoing Interactions: A Conversational Test of Inconsistent Nurturing as Control Theory
  -Ashley P. Duggan; Ren M. Dailey; Beth A. Le Poire
  The authors examined Inconsistent Nurturing as Control (INC) theory during ongoing interpersonal influence episodes between substance-abusive individuals and their romantic partners. This study sought to determine how nonverbal (i.e., kinesic and vocalic) and verbal reinforcement and punishment of substance abusive behavior during actual interactions influenced substance abusive individuals’ recidivism and perceptions of non-using partners’ persuasive effectiveness. The findings reveal consistent verbal punishment of substance abuse (e.g., threats, nagging) predicted lower relapse, while verbal reinforcement (e.g., telling the partner they are more fun when they use) predicted higher relapse.  With regard to nonverbal communication, vocalic punishment and vocalic reinforcement predicted relapse and persuasive effectiveness.  Results suggest the combination of behaviors resemble intermittent reinforcement and punishment and should actually strengthen the substance-abusive behavior the partner is trying to curtail. FULL TEXT

• Mental Disorders Stigma in the Media: Review of Studies on Production, Content, and Influences
  - Anat Klin; Dafna Lemish
  This article analyzes two decades of research regarding the mass media's role in shaping, perpetuating, and reducing the stigma of mental illness. It concentrates on three broad areas common in media inquiry: production, representation, and audiences. The analysis reveals that descriptions of mental illness and the mentally ill are distorted due to inaccuracies, exaggerations, or misinformation. The ill are presented not only as peculiar and different, but also as dangerous. Thus, the media perpetuate misconceptions and stigma. Especially prominent is the absence of agreed upon definitions of “mental illness,” as well as, the lack of research on the inter-relationships in audience studies between portrayals in the media and social perceptions. The analysis concludes with suggestions for further research on mass media’s inter-relationships with mental illness.
  
  
• Does the Internet Displace Health Professionals?
  - Chul-Joo Lee
  Scholars have paid close attention to the effects of the rapidly changing health information environment. However, the issue of how Internet use for health information affects the frequency of contact with health professionals has not been examined. Directly addressing this issue, this study uses a two-wave panel dataset with a U.S. national representative sample gathered in 2005 and 2006. In total, 4,957 first-wave cases were collected from January 2005 through May 2006. However, the one year follow-up study was limited to the 1,486 respondents who were first interviewed between March 2005 and July 2005. Overall, the results show that Internet use at wave one positively predicts health professional contact at wave two, controlling for wave-one health professional contact and other potential confounders. The implications that these findings can have for future research in this area are discussed. 
  
  
• Comparison of Latina and Non-Latina White Women's Beliefs About Communicating Genetic Cancer Risk to Relatives
  - Deborah J. MacDonald;  Linda Sarna;  Joyce Newman Giger;  Gwen Van Servellen;  Roshan Bastani; Jeffrey N. Weitzel
  Breast cancer accounts for 30% of cancer among Latinas and ovarian cancer is more common in Latinas than in non-Latina Whites. Latinas with a personal and/or family history of these cancers are increasingly referred for genetic cancer risk assessment (GCRA), but little is known about their perspectives regarding informing relatives of genetic cancer risk. We described and compared the pre-GCRA beliefs about informing relatives of genetic cancer risk, using survey data previously collected within a larger study. Findings revealed that most women believed their relatives should be informed of genetic cancer risk, that informing was strictly a personal duty, and that informing should be done in only person.
   
  
• Adolescents' Responses to Anti-tobacco Advertising: Exploring the Role of Adolescents' Smoking Status and Advertisement Theme
  - Erin L. Sutfin;  Lisa R. Szykman; Marian Chapman Moore
  Sutfin, Szykman, and Moore assessed how viewing different types of anti-tobacco advertisements was related to adolescents' emotional and cognitive responses to the ads and their intentions to smoke in the
  future. Additionally, we investigated how smoking status was related to responses to the ads. Findings suggest a media campaign focusing on how smoking negatively impacts teens' lives can be an effective component of a tobacco control program aimed at adolescents. Results also revealed that smokers respond differently to anti-tobacco ads and their responses need to be considered when developing effective anti-tobacco advertising campaigns.
   
  
• A Framework for Health Numeracy: How Patients Use Quantitative Skills in Health Care
  - Marilyn M. Schapira;  Kathlyn E. Fletcher;  Mary Ann Gilligan;  Toni K. King;  Purushottam W. Laud;  B. Alexendra Matthews;  Joan M. Neuner; Elisabeth Hayes
  The authors developed a conceptual framework for the construct of health numeracy based on patient perceptions. Participants were assigned to focus groups stratified by gender and educational level. Group discussions focused on how numbers are used in the health care setting.  Data were presented from clinical trials to further explore how quantitative information is used in health communication and decision-making.  A framework of health numeracy was developed to reflect the themes that emerged.  Three broad conceptual domains for health numeracy were identified: primary numeric skills, applied health numeracy, and interpretive health numeracy.  Across domains, results suggested that numeracy contains an emotional component; with both positive and negative affect reflected in patient numeracy statements.
  Health numeracy is a multifaceted construct that includes applied and interpretive components and is influenced by patient affect.

• Exploration of the Construct of Reliance Among Patients Who Talk with Their Providers About Internet Information - Carma L. Bylund; Christina M. Sabee; Rebecca S. Imes; Amy Aldridge Sanford. Volume 12, Issue 1, 2007, Pages 17 - 28.

• Increasing Mental Health Literacy via Narrative Advertising - Chingching Chang. Volume 13, Issue 1, 2008, Pages 37 - 55.

• Assessing Health Numeracy Among Community-Dwelling Older Adults - Lorie Donelle; Laurie Hoffman-Goetz; Jose F. Arocha. Volume 12, Issue 7, 2007, Pages 651 - 665.
  

Foster, E. (2007). Communicating at the End of Life: Finding Magic in the Mundane. Reviewed by Sharlene R. Thompson Click here to read the entire review
Click here to read the entire review

The George Washington University is proud to present the second annual volume of Cases in Public Health Communication & Marketing.

This year's theme is the application of new media in public health campaigns. Cases on this topic include MTV/KFF's think HIV Campaign, CDC's VERB Campaign, and North Carolina's RE3.org Campaign.

Cases in Public Health Communication & Marketing is an open-access journal which is published yearly on the Internet. The journal's mission is to foster learning based on the practical applications of topics within the fields of public health communication and social marketing. Each volume features peer-reviewed student cases, invited cases and editorials. The current volume can be found at http://www.casesjournal.org.