ABSTRACTS

Volume 1, Number 3
July-September 1996

Vol. 1, Num 3: Contents | Up Front | Abstracts

Theory and Method in Health Audience Segmentation
    M.D. Slater

Audience segmentation is widely regarded as essential to effective health communication campaign efforts. Nonetheless, its practice is typically ad hoc. The conceptual history and theoretical bases for audience segmentation are reviewed, and typical audience segmentation strategies for health communication efforts are described and critiqued. An anology is drawn between the methodological problems associated with audience segmentation and those of multivariate classification and taxonomy in botany and zoology. Cluster analytic techniques responsive to these issues are described, as are applications of these techniques for analysis of health communication campaign audiences. Approaches that would permit widespread use of such segmentation strategies are discussed, and recommendations for such efforts are made.

Mass-Media-Generated Interpersonal Communication as Sources of Information About Family Planning
    T.W. Valente, P.R. Poppe, & A.P. Merritt

This study suggests that mass-media-generated interpersonal communication networks vary according to an individual's change-of-behavior stage. As people in Peru adopted modern family planning methods, they increasingly formed and perhaps relied on information from more technical interpersonal communication networks, which shifted from peers to doctors and other service providers. Moreover, information seeking and giving varied with adoption stages in unexpected ways. In collaboration with Apoyo de Programmas de Población Advocacy for Population Programs of Peru, we present a model of how interpersonal communication networks generated by mass media messages vary with stage of behavior change.

Evaluating Health Knowledge: An Alternative Approach
    J.G. Power

Health campaigns concerned with HIV and AIDS confront two important barriers: the stigmatized nature of the disease and cultural values that exacerbate the taboo nature of the information disseminated. The use of surveys in HIV and AIDS research requires respondents to provide descriptions of sexual acts and body parts as measures of their knowledge. Focus groups and interviews require respondents to speak publicly about these topics. Although many young people know about HIV and AIDS, they may not have the vocabulary to express their complete knowledge either textually or verbally. This article describes an alternative approach designed to evaluate HIV and AIDS knowledge among 587 adolescents in Mexico, where the number of official cases of AIDS has increased steadily since 1981. Participants stratified on sex and social class were required to draw modes of HIV transmission. The drawings were categorized into drawings of objects and persons, focusing on behaviors or cognitions, with a relational or contextual emphasis. The utility of this method for measuring knowledge about HIV infection and AIDS in education campaigns and evaluation research is discussed.

FORUM

Economic, Ethical, and Outcome-Based Decisions Regarding Aggressive Surgical Management in Patients With Penetrating Craniocerebral Injury
     M.L. Levy, S. Davis, J.G. McComb, & M.L.J. Apuzzo

Each year fatalities in the United States increase as a result of gunshot wounds to the head. This increase, coupled with the progressive limitation of medical and economic resources available at major trauma centers, has brought into question the concept that everything possible should be done to save the lives of victims who have only a minimal and nonpredictable chance of having a good outcome. When a good outcome can be predicted, treatment should be aggressive. However, when a good outcome cannot be predicted, surgical intervention will have no effect and the potential costs of aggressive treatment must also be considered.

Clearly, there are ethical dilemmas involved in withholding operative treatment from any individual, even if there is only a minimal chance of a reasonable neurologic recovery. A negotiation-based approach should be used in determining the medical and ethical benefits of aggressive management strategies. Unfortunately, the care of critically ill patients is inconsistent with this approach. In order to insure that the best decision is made, guidelines dictating when to surgically intervene must be made an essential part of the patient/health care provider negotiation -- even in worst case scenarios.

The combination of an extremely poor prognosis for these injuries, and economic constraints faced by government-run facilities today could suggest that some patients should be allowed to die. Thus, the physician must be a source of information for the families, providing support and becoming a decision-making partner regarding potential intervention. In each situation, a strict set of guidelines must be formulated to establish a moral foundation for the ultimate mutual decision.

BOOK REVIEW

Linda M. Harris (ed.). Health and The New Media: Technologies Transforming Personal and Public Health. Mahwah, New Jersey: Lawrence Erlbaum, 1995, 262 pp., $24.50.
Reviewed by Peter Cukor, Ph.D.