UPFRONT

Volume 7, Number 1
January-February 2002

Vol. 7, Num. 1: Contents | Editorial | Up Front | Abstracts

From This Issue | Upcoming Conferences and Events | Internet Sources | Publications | Prescriptions

Vital Data

From This Issue

In order for consumers to make well-informed decisions about the use of dietary supplements, they need to have accurate and complete informat ion about the safety of these products. Many people rely on magazines and other news media for dietary supplement information, but the quality of the information provided by these sources is uncertain. In the first article in this issue of the Journal of Health Communication, Kava and coworkers describe their analyses of the quality of information on supplement safety provided by 254 articles published during 1994-98 in ten major magazines popular among older readers. The focus was on older readers because older people are the heaviest users of both dietary supplements and medications (some of which may interact in detrimental ways with dietary supplements). The analysis showed that more than two-thirds of the articles did not include comprehensive information about the safety aspects of the dietary supplements that they discussed. Even articles that did an excellent job of presenting information on other aspects of dietary supplement use often fell short when it came to safety. For example, an otherwise responsible article on vitamin D might fail to mention that excessive doses of this vitamin could be toxic. An article on the herb ginkgo biloba might fail to state that this herb could interact with anticoagulant drugs. Kava and coworkers also examined the frequency of advertising of dietary supplements in the magazines that they analyzed. They identified 2,983 advertisements for more than 130 different dietary supplements in the 10 magazines, with an increase in the number of advertisements per year between 1995 and 1998. The increase in advertising likely reflects the passage of the Dietary Supplement Health and Education Act in 1994; this act created a new framework for the regulation of supplements that has made their marketing easier. Supplements of particular interest to older adults (such as antioxidants, calcium, garlic, ginkgo biloba, joint health products, liquid oral supplements, and multivitamins) were among the most frequently advertised products. Although magazines popular among older readers contain extensive information about dietary supplements, these publications cannot be relied upon to provide readers with all of the information that they need in order to use supplements safely. Health professionals, educators, and supplement users need to work together to make sure that the gaps in the supplement safety information provided by the media are filled with reliable advice from other sources. Kava, R., Meister, K. A., Whelan, E. M., Lukachko, A. M., and Mirabile, C. Dietary Supplement Safety Informat ion in Magazines Popular Among Older Readers. (p. 13)

Secondhand tobacco smoke is well recognized in the U.S. as a cause of substantial morbidity and mortality. Asian immigrants who come from countries with high smoking rates for men and low smoking rates for women may be less acquainted with the hazards posed by secondhand smoke. Further, because it is the men who smoke, wives and children may be exposed to secondhand smoke. In the second article in this issue of the Journal of Health Communication, Brugge and coworkers describe an exercise designed to develop culturally appropriate public health messages for Chinese and Vietnamese immigrant communities in Boston, Massachusetts. A series of focus groups were conducted in Chinese and Vietnamese. Translation and transcription of the focus group audiotapes was used to explore culturall y specific themes. One of the interesting issues that arose was that women did not feel that they could ask men to stop smoking around themselves or their children, and that respondents generally were hesitant to be seen as disrespectful to elders or employers. Accordingly, both mutual respect and stricter laws were suggested as ways to control secondhand smoke, both of
which obviate the need to confront others directly. From these observations, a set of broad themes emerged that were used to craft six Chinese and six Vietnamese language ``message concepts.’’ Each concept was then matched with a black and white photographic image to produce novel public health materials. Subsequent focus groups and surveys suggested that the messages were well received by the target communities. Based on their experiences, the authors conclude that they did find that there were culturall y specific factors that should be taken into consideration rather than just using verbatim translation of mainstream messages, although they also point out that there was overlap between what was viewed positively by mainstream and immigrant communities. Limitations of the study included the use of two specific communities that might not be generalizable and the absence of an evaluation of a full-scale in-tervention comparing the culturally specific materials to simple translati on of main-stream messages. Brugge, D., DeJong, W., Shih, C., Le, Q., Wong, A., Tran, A., and Hyde, J. Development of Targeted Message Concepts for Recent Asian Immigrants About Secondhand Smoke. (p. 25)

Entertainment education strategies to educate youth and change social norms to prevent disease and promote health have been well-documented in developing world contexts, less so in the developed world. One trend that has occurred in the U.S. and other developed countries is the use of live theater with youth participants to communicate important health messages to other youth. In the third article in this issue of the Journal of Health Communication, Glik and co-authors present a descriptive analysis of the use of this approach in the U.S. Twenty-five programs from different cities were selected based on their attendance at a national conference in 1997. Programs reviewed were well established and were mainly run and funded by HIV/AIDS prevention efforts. Quantitative and qualitative surveys of participants were analyzed to define program characteristic s as well as nine domains of action and organization for these programs. Specifically all programs were local and voluntary and participants were both interested in social action and working in theater. Youth participants were mainly from high schools and helped to create, stage, and act in productions that dealt with a range of health and social issues using storytelli ng, skits, and plays. Message development was based on topic areas, and performances were ideally carried out for middle and high school students in schools. Organizational, leadership, and fundraisi ng activitie s to sustain programs were all-consuming and, as in many nonprofit community based efforts, there was not a great deal of evaluation
or research of impact, even though youth participants and adult leaders felt strongly that what they are doing was well-liked and made a difference. The latter part of the article uses findings from the descriptive analysis to suggest how these programs can be comprehensively evaluated with formative, process, and summative components, so that a more developed literature and practice can evolve. Also, characteristics of successful programs are addressed. The authors make a good case for continued support and research of this form of entertainment - education that both educates and empowers youth. Glik, D., Nowak, G., Valente, T., Sapsis, K., and Martin, C. Youth Performing Arts Entertainment - Education for HIV/AIDS Prevention and Health Promotion: Practice and Research. (p. 39)

In the first quantitative study to test a model of the relationship between organizational factors, campaign design elements, and campaign quality of communication across many organizations, Kiwanuka-Tondo and Snyder studied 91 AIDS prevention campaigns in Uganda in the fourth article of this issue of the Journal of Health Commmunication. The context for the study was AIDS education and outreach campaigns in Uganda during a time of successful decrease in the spread of HIV infection. Since only 14% of the organizations collected exposure or outcome data, the study focused on the factors affecting campaign quality. Quality was examined by measuring goal specificity, execution quality, and message quality. The results show that these dependent variables are predicted by both organizational and communication campaign design elements. First, goal specificity directly depended on financial resources and organizational structure. This indicates that small, poor organizations are trying to do too much at once. So they need to focus on a single goal at a time. All organizations should be more flexible and willing to try new ideas in their approach in order to improve their campaign goals. Second, execution quality depended directly on financial resources, number of target groups, number of channels, and goal specificity. This means that small, poor organizations are less likely to use multiple channels for their campaign, and they have poorer execution quality. Therefore, they need to know the value of using a variety of channels and should use cheap retention in getting elements to raise their execution quality. All organizations need specific campaign goals if they are to have good execution quality. Finally, message quality depended directly on supervision and participation of outreach workers. This implies that all organizations need to allow ideas from the field workers since they are closer to the audience. Furthermore, organizations with clearly defined purposes are more likely to allow participation of the audience and outreach workers and hence have better message quality. All organizations should insist on supervisi on of outreach workers since this helps the organizations to know the problems that may be in the messages and hence improve them. It is also vital to note that training enables the campaign designers to know the value of using multiple channels, doing research, and allowing participation of the audience. Therefore, all organizations should strive to train their professional staff in running communication campaigns. The results further show that pretesting of messages is a vital communication campaign design element. The results have import for campaign planners, managers of organizations conducting campaigns, and funding organizations. In addition, it is vital that organizations collect exposure and outcome data in the future to provide feedback on each campaign. Kiwanuka-Tondo, J. and Snyder, L. B. In¯uence of Organizational Characteristics and Campaign Design Elements on Communication Campaign Quality. (p. 59)

Beginning with the 2002 volume year, the Journal of Health Communication has been expanded to five issues per year instead of four.

Upcoming Conferences and Events

The 2002 National STD Prevention Conference, co-sponsored by the Centers for Disease Control and Prevention (CDC) and the American Social Health Association (ASHA) will be held in San Diego on March 4±7, 2002. 2002 marks the sixth year since the Institute of Medicine, in its landmark report, ``The Hidden Epidemic: Confronting Sexually Transmitted Diseases,’ ’ challenged the STD prevention community and its multiple partners to take new steps to address STDs in the United States. In the ever-changing societal and political context within which STDs exist, we must constantly explore these trends in order to build healthy communities that are not burdened by STDs. This conference will provide an opportunity to discuss these challenges through exploration of the latest science, the best practices, and how science and practice interface. http://www.stdcon-!/\!www:stdconference:org

2002 marks the 40th anniversary of the Diffusion of Innovations Theory and its application in the fields of health and population. As part of Public Health Week, a critical review and discussi on of the theory will be held at the George Washington University in Washington, DC, during the first week of April 2002. The one-day conference is a collaboration between the National Cancer Institute, the Academy of Educational Development, Widmeyer Communications, and the George Washington School of Public Health and Health Services. For registrati on and date information please contact either Muhuiddin Haider at iphmxh@gwumc.edu or Gary Kreps at gary.kreps@nih.gov.

Internet Sources

``Bioterror’’ is a companion web site to the Nova show ``Bioterror’’ broadcast in November. Highlights include The Making of Vaccines section, which goes through the process of creating vaccines with a step-by-step Flash exercise; A Global Guide section with a clickable map explaining the status of different countries’ bioweapons programs and interviews with bioweapons experts; the full text of the Biological & Toxin Weapons Convention; a list of links; and a teacher’s section. http://www.pbs.org/wgbh/nova/bioterror

The Providers Guide to Quality & Culture is available online to assist healthcare organizations throughout the US to provide high quality, culturally competent services to multi-ethnic populations. Throughout the site you will find links to other web sites containing useful information related to cultural competence and healthcare.
http://erc.msh.org/mainpage.cfm?file = 1.0.htm&module = provider&language = English
A new cancer web site from HBO has its roots in research for an HBO show called ``Cancer: Evolution to Revolution.’’ The consumer-friendly site goes through the American Cancer Society’s recommended cancer screenings, genetic testing, and offers risk reduction informat ion. http://www.hbo.com/cancer/cmp/screening.html

Publications

Achieving Cultural Competence: A Guidebook for Providers of Services to Older Americans & Their Families is available online. This guidebook is designed for use by providers of services to racially and ethnically diverse older populations. For readers who have taken more formal courses to acquire cultural competence, this guidebook might serve as a review - a tool to enable evaluation of current programs with a critical eye toward achieving cultural competence. http://www.aoa.gov/minorityaccess/guidbook2001/default.htm#contents

Manpower Demonstration Research Corporation (MRDC) is a nonprofit, nonpartisan social policy research organization dedicated to learning through survey data and ethnographic interviews that works to improve the well-being of low-income people (www.mdrc.org). A new report, entitled ``The Health of Poor Urban Women: Findings from the Project on Devolution and Urban Change,’ ’ is available for download on the web site. The authors are Denise F. Polit, Andrew S. London, and John M. Martinez. http://www.mdrc.org/WelfareReform/UrbanChangepage.htm

Prescriptions

Kiwanuka-Tondo and Snyder conducted a quantitative study of 91 AIDS prevention campaigns in Uganda to assess which factors contributed to campaign design quality. They developed the following recommendations based on their research:

If you would like to suggest material s for this section, please send your suggestions with your name, e-mail address, and fax and phone numbers to:

Journal of Health Communication
The GW Center for International Health
Department of Internati onal Public Health
School of Public Health and Health Services
The George Washington Universit y
2175 K Street, NW, Suite 820
Washington, DC 20037
Telephone: (202) 416-0426

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The Up Front section is edited by Wendy Meltzer, Assistant Editor, Journal of Health Communication. Journal of Health Communication, Volume 7, pp. 5-11, 2002