Journal of Health Communication: International Perspectives
UP FRONTVolume 4, Number 1 Vol. 4, Num. 1: Contents | Editorial | Up Front | Abstracts From this Issue | From Other Sources | Upcoming Events and Conferences | Internet Sources | Publications | Prescriptions | Call for Information
From This Issue The first article in this issue of the Journal addresses difficulties faced by Spanish- and French-speaking health communicators in assessing the readability level of health education materials. The SMOG readability formula provides a measure of the difficulty experienced by people reading a given text in relation to certain linguistic characteristics of the text. Contreras et al. conducted a study to assess whether the SMOG formula, originally developed and tested in English, was also valid for texts written in Spanish and French. Study results showed that the SMOG formula seemed to be consistent in measuring readability in the three languages. However, the scores varied from language to language. The authors offer two hypotheses to explain these results. First, the SMOG equation is systematically biased for texts in Spanish or French. Second, English is more readable than French, and French is more readable than Spanish. Under the assumption of a systematic bias in the SMOG formula, the authors developed SOL formulas to convert SMOG scores between Spanish, English, and French. In addition, a new scale for grading reading difficulty is proposed based on SMOG scores obtained from classical literature. These formulas will aid Spanish- and French-speaking health communicators in preparing written materials appropriate to the level of comprehension of specific target audiences. Contreras, A., García-Alonso, R., Echenique, M, Daye-Contreras, F. The SOL Formulas for Converting SMOG Readability Scores Between Health Education Materials Written in Spanish, English, and French. To promote health in the entire U.S. population, more effective health communication methods are needed to influence behavior in minority communities. Ramirez et al. show how a cancer prevention program combining media and interpersonal communication can do just that. The program was conducted in Brownsville, Texas with a comparison population in Laredo, Texas. Both these populations had low income levels, minimal education, and were predominantly Spanish-speaking. To evaluate the program, a quasi-experimental panel design study followed 107 women in the program site and 105 women in the comparison site from 1994 to 1996. Women in the program site reported an increase in levels of Pap screening adherence, suggesting an association between the demonstrated participatory communication approach and the promotion of cancer screening. Ramirez, A. G., Villarreal, R., McAlister, A., Gallion, K. J., Suarea, L., Gomez, P. Advancing the Role of Participatory Communication in the Diffusion of Cancer Screening among Hispanics. The third article also addresses the issue of more effective health communication methods to influence behavior in minority communities. The Sisters Together, Move More Eat Better pilot communication program focuses on young Black women in three inner-city communities to encourage improved nutrition and increased physical activity. The design for Sisters Together is based on an expansion of a public health campaign that combines social marketing with community building efforts. The program model has five stages: design, promotion, demonstration, transfer, and sustained activity. The model has potential to increase the life span of a campaign and contribute to community building. This descriptive article illustrates the elements of the hybrid communication design model with examples from Sisters Together, Move More Eat Better. Rudd, R. E., Goldberg, J., Dietz, W. A Five-Stage Model for Sustaining a Community Campaign. The fourth article provides a formative evaluation of south Georgian migrant farm workers’ access to information and products that promote pesticide protection and understanding of cancer risks associated with pesticide exposure. The study was informed by field observation, in-depth interviews of Georgia’s migrant Health Program’s outreach workers, and structured face-to-face surveys of migrant farm workers. Fewer than one-third of the pesticide products reviewed contained messages about proper pesticide use and human exposure risks. When risk information was provided, it appeared only in English. Few protective devices were available for purchase by migrant farm workers. The workers were aware in a very general sense of health risks posed by pesticides, but they were specifically unaware of the reach of pesticides sprayed, as illustrated by their field behaviors. Findings also demonstrated the need to educate outreach workers about migrant farm workers’ cancer risk, so they may act as health advocates to reduce the adverse effects associated with pesticide exposure. Parrott, R., Wilson, K., Buttram, Cl, Jones, K., Steiner, C. Migrant Farm Workers’ Access to Pesticide Protection and Information: Cultivando Buenos Habitos Campaign Development. The forum article discusses whether general practitioners (GPs) should give unsolicited antismoking advice to patients who smoke. Patient preference and GP advice-giving are discussed with particular reference to professional roles. It is suggested that giving unsolicited advice against smoking at nearly every encounter is a competitive rather than collaborative behavior. The author suggests that general practitioners should ascertain patients’ readiness for change before offering to help produce individualized agreements of joint benefit on change. Three strategies for negotiation — bridging, trading, and logrolling — are discussed. Buetow, S.A., Unsolicited GP Advice Against Smoking: To Give or Not to Give? Diabetes disproportionately affects the Hispanic population in the United States. Most diabetes studies that focused on Hispanics have been conducted among Mexican Americans and have found that approximately one out of every 10 persons aged greater than or equal to 20 years has diabetes. However, the U.S. Hispanic population comprises many ethnically distinct groups that tend to be regionally concentrated. The CDC analyzed data from the Behavioral Risk Factor Surveillance System (BRFSS) to assess the prevalence of diabetes among Hispanic adults in the United States and Puerto Rico. The findings of this analysis indicate that the prevalence of diabetes among U.S. Hispanics is approximately twice the prevalence among non-Hispanic whites and varies by geographic location and education. Self-Reported Prevalence of Diabetes Among Hispanics -- United States, 1994-1997. MMWR 48(1): 8-12. The report may also be found on the Internet at: www.cdc.gov/epo/mmwr/preview/mmwrhtml/00056251.htm In the Journal of Public Health Policy, Alaniz and Wilkes examine pro-drinking messages and message environments for young adults. The paper discusses targeted alcohol advertising in three ethnic U.S. communities: African Americans, Latinos, and Native Americans. The authors focus on the appropriation of cultural systems and the reinvention of them as commodities to consumers. They outline the specific strategies used in each ethnic community. For African Americans, there is an emphasis on selling malt liquor to young adults through the use of “power” and gang-related images. For Latinos, there is an appropriation of historical and cultural symbols such as the national flags and maps of Mexico and Central America. The authors report that Native Americans have coalesced to keep the image of a chief and warrior, Crazy Horse, from being used to market malt liquor. Each of the ethnic groups is engaged in action to prevent alcohol-related problems in their communities. Alaniz, M. L., Wilkes, C. Pro-Drinking Messages and Message Environments for Young Adults: The case of Alcohol Industry Advertising in African American, Latino, and Native American Communities. Journal of Public Health Policy 19(4): 447-472. Do movie stars encourage adolescents to start smoking? This is the question posed by Distefan et al. in their recent article in Preventive Medicine. The purpose of the study was to examine the relationship between adolescents’ favorite movie stars and their smoking status, controlling for variables associated with smoking initiation. The 1996 California Tobacco Survey questioned 6,252 adolescents about their favorite stars, smoking history, exposure to smokers, rebelliousness, knowledge, and attitudes regarding smoking and cigarette advertising and promotion. The top 10 favorite stars were tested for differential preference between ever and never smokers. Favorite stars differed significantly among adolescent ever and never smokers. A majority of favorite stars of ever smokers smoked on and off screen compared to favorite stars of never smokers. In multivariate analyses, adolescent never smokers who preferred favorite stars of adolescent ever smokers were significantly more likely to be susceptible to smoking even after adjustment for known predictors of adolescent smoking and demographic variables. This effect was only slightly weaker than that of exposure to friends and family who smoke. This study provides preliminary evidence that stars who smoke on and off screen may encourage youth to smoke. Distefan, J. M., Gilpin, E. A., Sargent, J. D., Pierce, J. P. Do Movie Stars Encourage Adolescents to Start Smoking? Evidence from California. Preventive Medicine 28(1): 1-11. Granich et al. studied patterns of health seeking behavior (HSB) during episodes of childhood diarrhea in the highlands of Chiapas, Mexico. A rapid ethnographic survey was conducted in Navenchauc, Chiapas, to determine hypothetical HSB patterns for each of four major types of childhood diarrhea. Additionally, the actual HSB for the last episode of childhood diarrheal illness within the household was examined. One hundred households participated in the survey. Households reported using a mean of 1.3 types of in-home remedies. Oral rehydration therapy (ORT) was used in less than two percent of the 368 HSB patterns elicited for the four types of diarrhea. HSB patterns utilized an eclectic combination of traditional, allopathic, local, and distant health care options. A mean of 2.5 outside-the-home health care options were reported for each diarrheal type; the local grocery store was reported in 67% of the hypothetical HSB patterns and as a first option in 54%. Maternal and/or paternal education had little impact on hypothetical HSB. Households with lower SES were more likely to report using local grocery stores as a first option and were less likely to use options outside the village. The study suggests that interventions targeting local stores may lead to increase use of ORT, thereby potentially reducing early morbidity and mortality due to childhood diarrhea. Granich, R., Cantwell, M. F., Long, K., Maldonado, Y., Parsonet, J. Patterns of Health Seeking Behavior During Episodes of Childhood Diarrhea: A study of Tzotzil-Speaking Mayans in the Highlands of Chiapas, Mexico. Social Science & Medicine 48(4): 489-495. Upcoming Conferences and Events The Drug Information Association will present the Tenth Annual Symposium on Medical Communications March 28-31, 1999 at the Hyatt Regency Hotel in Hilton Head, South Carolina. The symposium will include a core curriculum for medical communication professionals practicing in the pharmaceutical industry. The curriculum will focus on the basic behaviors and requirements for developing a successful drug information (DI) practice in the industry and include roundtable discussions. The symposium sessions include looks into the past and future of DI practice, technology geared toward expanding business opportunities for medical information departments, and liaison techniques. For more information, please contact the Drug Information Association in Fort Washington, Pennsylvania, phone: 215-628-2288, fax: 215-641-1229, e-mail: dia@diahome.org or visit their website at www.diahome.org. The World Health Organization is looking for people to help launch the Global Movement for Active Ageing on Saturday, October 2, 1999 with the Global Embrace, a series of walk events worldwide. The Global Movement will be a network for all those who are interested in moving policies and practice toward Active Ageing. It will provide models and ideas for programs and projects that promote Active Ageing. The movement is dedicated to maintaining health and quality of life across the lifespan as well as building a harmonious intergenerational community and a dynamic economy. For additional information please contact the Ageing and Health Programme, WHO, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Phone: +41-22-791-3486. Fax: +41-22-791-4839. E-mail: activeageing@who.ch. The Fourth International Congress on Medical-Legal Aspects of Work Injuries will be held June 6-9, 1999 at the Grand Bay Hotel in Toronto, Canada. The international congress brings together experts from law, medicine, social policy, occupational safety, health protection, and other related areas. As a major theme, the Congress will compare European and North American approaches in prevention, rehabilitation and compensation. The event is co-hosted by the Institute for Work & Health and the Workplace Safety & Insurance Board of Ontario. The Institute for Work & Health’s mission is to research and promote new ways to prevent workplace disability, improved treatment, optimal recovery and safe return-to-work. For registration information contact Greer Palloo, Institute for Work & Health, phone: 416-927-2027 ext. 2131, e-mail: gpalloo@iwh.on.ca, or visit the Institute’s website at www.iwh.on.ca. The National Human Genome Research Institute has launched an online multimedia glossary to help people better understandterms and concepts associated with many of the recent advances in genetics. The glossary combines text, audio, and visuals simultaneously in an accessible and user-friendly format. The glossary features nearly 200 terms and offers pronunciation guides, brief text definitions, and dozens of diagrams of selected terms. The glossary also includes in-depth audio clips provided by more than two-dozen researchers in the fields of genetics, molecular biology, and medicine. The glossary is available on the Internet at www.nhgri.nih.gov/DIR/VIP/Glossary. Recent reorganization at the National Cancer Institute (NCI) has led to the new Division of Cancer Control and Population Sciences (DCCPS). The DCCPS plans and directs an extramural program of cancer control and population science research for NCI and serves as the Institute focal point for extramural research in epidemiology, cancer genetics, behavioral sciences, cancer surveillance and cancer survivorship. Additionally, DCCPS develops and maintains liaison activities to facilitate communication, information exchange, and cooperation. It develops and supports multidisciplinary research training and career development in cancer control and disseminates relevant research information to the lay and professional communities. The Division also provides leadership in setting national priorities for research in the areas central to cancer control and in conducting regular program reviews to assess the impact of funded initiatives. For more information on the Division, please visit their Internet site at dccps.nci.nih.gov/DCCPS. British Airways Travel Clinics in South Africa has launched an Internet-based malaria study, claimed to be a world first. The new website gives malaria victims, or those familiar with them, the opportunity to report the circumstances of how they contracted their illness. This site was developed in an effort to provide the traveling public with an accurate picture of the number and types of malaria cases afflicting travelers. British Airways Travel Clinics hope this site will provide the information that will be useful in educating the public about malaria andhelp medical and pharmacy colleagues by providing relevant up-to-date information on the prophylaxis of malaria. The site may be visited at www.malaria.co.za. A report on “Traumatic Occupational Injury Research Needs and Priorities” was recently published by the National Institute for Occupational Safety and Health (NIOSH). The report covers one of the 21 priority areas identified as part of the National Occupational Research Agenda (NORA), an effort by NIOSH to develop a framework to guide occupational health and safety research for the next decade. The report covers research objectives in surveillance, analytic injury research, implementation, evaluation, prevention and control. The report was prepared by a team of experts from government, industry, labor, and academia. Copies of the report, DHHS (NIOSH) Publication No. 98-134, may be obtained from NIOSH Publications Dissemination, 4676 Columbia Parkway, Cincinnati, OH 45226-1998 or by phone: 800-356-3674, fax: 513-533-8573, or e-mail: pubstaft@cdc.gov. The purpose of the CDC-supported National Hispanic/Latino Diabetes Initiative for Action is to promote and evaluate interdisciplinary and culturally appropriate procedures to prevent diabetes and its complications in the U.S. Hispanic community. Under this initiative, the CDC published the patient-care guide, Take Charge of Your Diabetes, in Spanish after testing the publication among Hispanic persons. A copy of this guide is available from CDC in Spanish and English by calling toll-free: 877-232-3422. Through their research into converting the SMOG index into readability levels for Spanish and French health education material, Contreras, García-Alonso, Echenique, and Daye-Contreras developed recommendations for health communicators who seek to use readability formulae for designing and translating written materials. Their suggestions are:
Ramirez, Villarreal, McAlister, Gallion, Suarez, and Gomez studied the effects of a campaign combining mass media and interpersonal participatory communication on cervical cancer screening adherence. From this research they developed the following recommendations for public health campaign planners:
Rudd, Goldberg, and Dietz
designed a hybrid model for a pilot campaign that combines social marketing
strategies with a community development focus. Their pilot program
Sisters Together Move More Eat Better is currently in the last phase of
implementation and is undergoing evaluation. The pilot program experience
resulted in the following guidelines for communicators using the model
for a community campaign.
In the Forum article, Buetow examines physician and patient perceptions of and reactions to unsolicited advice about smoking. From his research, the author developed recommendations for helping patients in general practice to quit smoking.
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