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2008 Impact Factor: 2.057
Ranking: 2/45 (Communication), 9/61 (Information Science & Library Science)
© 2008 Thomson Reuters, Journal Citation Reports®

Editor's Note:

Health care reform is in the news as President Obama pledges to be the last President to tackle health care reform. He states that economic challenges are also manifest in health: ‘‘The greatest threat to America’s fiscal health is not Social Security. . . . By a wide margin, the biggest threat to our nation’s balance sheet is the skyrocketing cost of health care.’’

The complexity of health reform––from a political to policymaking process––will continue to be the focus of academic writings and political and public discourse. If we are to follow suggestions by President Obama in his January 2009 address to Congress, to ‘‘make the largest investment ever in preventive care, because that is one of the best ways to keep our people healthy and our costs under control,’’ we must come up with a way that does not drive such ‘‘care’’ into an expensive system. A requisite of prevention could be to develop a simple score or index of 5–10 key indicators/areas that every American citizen needs to know about his or her own body. A ‘‘personal’’ health score could give people a general idea of what these mean, dialogue points to discuss with their physician, and ample interest to get their ‘‘score’’ both on the individual measures and the composite into a range that would translate into better health (and possibly lower premiums). Of course, as this is science and evidence based, they would feel better, be sick less, be more productive at work and home, and contribute to a new ‘‘personalized population health.’’

Any real health reform structure must move toward prevention as a goal while still prepared for appropriate intensive and specialty care. The leadership of the federal government to galvanize change, set standards, and embark upon a path for all Americans to have access to quality care is no small effort. The ideal of health is too important to do major surgery on some parts of the system while ignoring others. In any case, we also must take bold steps and innovative approaches to advance a culture and change so that we can practice what the evidence shows—that prevention of disease and early intervention is much more humane and effective in the overall health and well-being of America.

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 14, Issue 5
  • Volume 14, Issue 6
• Featured Book Review
  

Recent Article in JHC:

Volume 14 Issue 5 (July/August 2009)
Click on the title to purchase the article!

• Obama's Wired Campaign: Lessons for Public Health Communication
  -- Lorien C. Abroms and R. Craig Lefebvre
  The Obama campaign has relevance for how we conduct and build communities around our public health campaigns. As such, an understanding of how new media was used in energizing the public in the Obama campaign is worthy of reflection. The Obama campaign’s use of new media can be grouped into those applications related to: 1) the campaign website, 2) the campaign TV channel, 3) social networking sites, and 4) mobile phones. The authors also briefly describe 5) the campaign materials created by supporters which made use of new media, as these also contributed the campaign. The authors briefly describe each of these and, where available, provide indicators of use by the public. Then, through the lens of public health communication principles, the authors discuss what seems to have been effective about their efforts, and how public health campaigns can make use of similar strategies in the future.
  FULL TEXT

• Mass Media and HIV/AIDS in China
  -- Li Li;  Mary Jane Rotheram-Borus;  Yao Lu;  Zunyou Wu;  Chunqing Lin; and Jihui Guan
   Li and colleagues identified the source(s) of HIV information for the general Chinese population and examined their association with HIV transmission knowledge and stigmatizing attitude towards people living with HIV/AIDS (PLWHA). A total of 3,716 market workers in Fuzhou, China participated in a cross-sectional survey.  Multiple regression models were used to describe correlations among respondents’ HIV/STD information sources, HIV transmission knowledge, and stigmatizing attitude towards PLWHA.  Mass media sources, such as TV programs, newspapers and magazines, were more frequently identified as the channels for HIV information than interpersonal sources, such as friends and service providers. Exposure to multiple sources of HIV information (where at least one source is mass media) was significantly related to HIV knowledge and less stigmatizing attitude towards PLWHA. The result suggested that mass media in China has been a major source of HIV information to the public. Enhancing the content and penetration of HIV/AIDS campaigns within various channels of the media can be an important strategy in disseminating HIV knowledge and reducing HIV related discrimination.

• Presentation Format Affects Comprehension and Risk Assessment: The Case of Prenatal Screening
  -- Talya Miron-Shatz;  Yaniv Hanoch;  Dana Graef; and Michal Sagi 
  The authors studied the effects of presentation formats (frequency, 1-in-N, and visual) and numeracy level on students’ understanding of prenatal screening results, as well as their risk assessment for having a fetus with Down syndrome. Frequency format (vs. 1-in-N and visual formats) improved participants’ ability to accurately assess the chances of having a fetus with Down syndrome, and was associated with lower risk estimates. High numeracy levels were associated with a better ability to judge risk likelihood. For individuals of low numeracy levels, however, the frequency format significantly facilitated accurate understanding of probability information. This suggests that presenting information if frequency format is particularly beneficial for certain populations.
  

• Influence on Consumer Behavior: The Impact of Direct-to-Consumer Advertising on Medication Requests for Gastroesophageal Reflux Disease and Social Anxiety Disorder
  -- Nile M. Khanfar;  Hyla H. Polen; and Kevin A. Clauson
  Direct-to-consumer advertising (DTCA) is a controversial topic among healthcare providers, professional organizations, and pharmaceutical manufacturers.  Advocates state that DTCA empowers patients whereas critics suggest that it increases healthcare costs and leads to conflict between the provider and the patient.  A 68-question Internet survey was used to determine the impact of televised direct-to-consumer advertising (DTCA) on consumer-initiated medication changes for the treatment of gastroesophageal reflux disease (GERD) and social anxiety disorder (SAD).  Of the 427 respondents, 10% that viewed DTCA for GERD and 6% that viewed DTCA for SAD reported that they subsequently initiated a conversation with their physician.   Nearly half of respondents, 47.4% for GERD and 40% for SAD, reported a change in therapy occurred as a direct result of these discussions.  Televised DTCA for these two drug classes can have a significant impact on patient-initiated prescription requests.
  

• Interactive Graphics for Expressing Health Risks: Development and Qualitative Evaluation
  -- Jessica S. Ancker;  Connie Chan; and Rita Kukafka
  MRecent findings suggest that interactive game-like graphics might be useful in communicating probabilities. We developed a prototype for a risk communication module, focusing on eliciting users’ preferences for different interactive graphics and assessing usability and user interpretations.
  Feedback from five focus groups was used to design the graphics. The final version displayed a matrix of square buttons; clicking on any button allowed the user to see whether the stick figure underneath was affected by the health outcome. When participants used this interaction to learn about a risk, they expressed more emotional responses, both positive and negative, than when viewing any static graphic or numerical description of a risk. Their responses included relief about small risks and concern about large risks. The groups also commented on static graphics: arranging the figures affected by disease randomly throughout a group of figures made it more difficult to judge the proportion affected but was often described as more realistic. Interactive graphics appear to have potential for expressing risk magnitude as well as the feeling of risk. This affective impact could be useful in increasing perceived threat of high risks, calming fears about low risks, or comparing risks.
  

• Cancer Prevention Information-Seeking Among Hispanic and Non-Hispanic Users of the National Cancer Institute's Cancer Information Service: Trends in Telephone and LiveHelp Use
  -- Erika A. Waters;  Helen W. Sullivan; and Lila J. Finney Rutten
  We examined cancer prevention information requests to the Cancer Information Service (CIS) via telephone (1-800-4-CANCER toll-free telephone information service) and LiveHelp (an instant messaging service provided in English only) from 2003 to 2006.  We summarized differences in the communication channel utilized by ethnicity (Hispanic vs. non-Hispanic) and, among Hispanic information seekers, the language used during the contact (English vs. Spanish).  Utilization of LiveHelp was higher among non-Hispanic than Hispanic seekers of cancer prevention information.  LiveHelp use for seeking cancer prevention information increased between 2003 and 2006 for both groups, but the increase was greater among non-Hispanics than Hispanics.  Nearly half of Hispanics who sought cancer prevention information did so in Spanish.  Because LiveHelp is not available in Spanish, the number of Spanish-only speakers who preferred to contact CIS via LiveHelp instead of telephone is unknown.  When communicating cancer prevention information via multiple channels, it is important to consider differences in access to communication technologies and preferred communication channels among ethnic minority groups.
  

• Information-Seeking Styles Among Cancer Patients Before and After Treatment by Demographics and Use of Information Sources
  -- Christie R. Eheman;  Zahava Berkowitz;  Judith Lee;  Supriya Mohile;  Jason Purnell;  Elisa Marie Rodriguez;  Joseph Roscoe;  David Johnson;  Jeffrey Kirshner; and Gary Morrow
  We analyzed data from a longitudinal study of adult cancer patients from outpatient clinics for whom information needs and behaviors were assessed by survey before and after treatment. We evaluated the relationships between information-seeking style (active, moderately active and passive styles) and demographics, cancer type, and health status for the pretreatment and posttreatment periods and overall. Analyses included 731 case participants, including female breast cancer patients (51%), male genitourinary cancer patients (18%), and lung cancer patients of both sexes (10%). At pretreatment, 17% reported an active information-seeking style, 69% were moderately active, and 14% were passive. During this period, 19% of those with at least some college education reported being very active compared to 14% of those with less education. With adjustment for all other covariates, male genitourinary and lung cancer patients had a higher odds of having a more active information-seeking style in the pretreatment than in the posttreatment period, with an odds of 4.5 (95% confidence interval [CI]: 2.4-8.4 ) and 5.4 (95% CI: 2.7-10.6), respectively. Controlling for all covariates, breast cancer patients had 1.5 (95% CI: 1.0–2.1) times higher odds of being more active in seeking information than other patients.
  FULL TEXT

Volume 14 Issue 6 (September 2009)
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• Older Adults' Health Information Wants in the Internet Age: Implications for Patient–Provider Relationships
  -- Bo Xie
  A qualitative, exploratory study was conducted to investigate the health information behavior of older adults, especially those who have sought health information online. Grounded theory was used to conduct the data analysis and construct the theory that best explains the data. The concept of health information wants (HIW), or health information that one would like to have but may or may not necessarily use to make healthcare decisions, emerged from the data analysis and led to the development of the HIW framework. While Internet use has not changed these older adults’ conventional reliance on medical professionals for critical information and decisions, it has opened up new venues for gathering information that they want but do not use to make decisions and information that they want and do use to make decisions. Both the Internet and the perpetuating influence of a provider-centered model are at play in the patient-provider relationship of these older adults. The HIW framework can be used to develop new survey instruments which can be used both to more broadly evaluate and validate this framework and to learn more about its broader implications.
  

• Enhancing Web-Based Kidney Disease Prevention Messages for Hispanics Using Targeting and Tailoring
  -- Anthony J. Roberto;  Janice L. Krieger; and Michael A. Beam
  Roberto, Krieger, and Beam conducted an online experiment to test the effects of targeting and tailoring the perceived susceptibility in messages about kidney disease with a national sample of older Hispanic adults. Guided by the extended parallel process model, results indicate higher levels of perceived-susceptibility for people exposed to tailored messages, followed by targeted and generic messages, and then the control message. This research also suggests tailoring can be an effective way to increase perceive susceptibility by including only personally relevant information.
  

• Associations Between Smoking and Media Literacy in College Students
  -- Brian A. Primack;  Jaime Sidani;  Mary V. Carroll; and Michael J. Fine
  Organizations recommend media literacy to reduce tobacco use, and higher media literacy has been associated with lower smoking among high school students. However, the relationship between smoking media literacy and tobacco use has not been systematically studied among college students. We conducted the National College Health Assessment at a large, urban university, adding 6 items measuring smoking media literacy. A total of 657 students responded to this random sample email survey. We used multiple logistic regression to determine independent associations between smoking media literacy items and current smoking. High smoking media literacy is independently associated with lower odds of smoking. Smoking media literacy may be a valuable construct to address in college populations.
  

• Aversion to Ambiguity Regarding Medical Tests and Treatments: Measurement, Prevalence, and Relationship to Sociodemographic Factors
  -- Paul K. J. Han;  Bryce B. Reeve;  Richard P. Moser; and William M. P. Klein
  Aversion to “ambiguity”—uncertainty about the reliability, credibility, or adequacy of risk-related information—is an important problem that may influence judgments and decisions about medical interventions. However, ambiguity aversion (AA) varies among individuals and has been under-studied in the health domain. To explore this phenomenon further, we developed a new theory-based measure of aversion to ambiguity regarding medical tests and treatments, and examined the prevalence and association of AA with sociodemographic factors. The “AA-Med” scale was developed using a large survey sample of the US public (n=4398), and scale psychometric properties and the population distribution of AA were evaluated. The scale demonstrated acceptable reliability (α = .73) and validity as ascertained by association with respondents’ interest in a hypothetical ambiguous cancer screening test. AA was associated with older age, non-white race, lower education and income, and female sex. The AA-Med scale is a promising new measure, and ambiguity aversion is associated with several sociodemographic factors. We discuss implications of these findings and potential applications of the scale for future research. 
  

• How Can We Reach Them? Information Seeking and Preferences for a Cancer Family History Campaign in Underserved Communities
  -- Kimberly M. Kelly;  Amy C. Sturm;  Kathleen Kemp;  Jacquelin Holland; and Amy K. Ferketich
  Individuals with a family history of cancer are at elevated risk for the disease, and web-based tools are available to assist in assessing risk. Preferences for a potential campaign to promote awareness of the role of family history in cancer risk were sought, guided by McGuire’s Input-Output Persuasion Model. A randomized telephone survey administered to 5 underserved communities assessed potential campaign messages, channels, sources, receivers, and destinations and use of the Internet (n=101). Information sources sought about hereditary cancer and their predictors were assessed. Nearly half of the sample was African American and had annual income below $25,000. Our survey provided a wealth of information for understanding how to best launch our family history cancer risk communication campaign. Education level affected information-seeking, and efforts are under way to lessen this potential barrier.
  

• Development of a Spiritually Based Educational Intervention to Increase Informed Decision Making for Prostate Cancer Screening Among Church-Attending African American Men
  -- Cheryl L. Holt; Theresa A. Wynn; Penny Southward; Mark S. Litaker; Sanford Jeames; and
  Emily Schulz
  This paper describes the development of a Community Health Advisor-led intervention aimed at increasing informed decision making for prostate cancer screening among church-attending African American men.  Full-color print educational booklets were developed and pilot tested with extensive community participation of church-attending African American men age-eligible for screening.  The intervention development phase consisted of ideas solicited from an Advisory Panel of African American men, who identified core content and developed the spiritual themes.  The importance of working closely with the community when developing interventions is discussed, as well as the importance of pilot testing of educational materials.

Featured Book Review

A Review of: “Harcourt, J. (Ed). (2006). Current Issues in Lesbian, Gay, Bisexual and Transgender (LGBT) Health.” Reviewed by Karen L. Daas. New York: Harrington Park Press.
Click here to read the entire review

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