ABSTRACTS

Volume 9, Number 4
July-August 2004

Vol. 9, Number 4: Contents | Editorial | Abstracts

Nationwide Newspaper Coverage of Physician-Assisted Suicide: A Community Structure Approach
    John C. Pollock A1 and Spiro G. Yulis A2

A1 Communication Studies Department, The College of New Jersey Ewing, New Jersey, USA
A2 University of Medicine & Dentistry of New Jersey, New Brunswick, New Jersey, USA

Using a community structure approach linking city characteristics and variations in media coverage, the authors examined newspaper coverage of physician-assisted suicide. A nationwide sample of 15 city newspapers yielded 288 articles in a four year period. Content analysis of article “prominence” (placement, headline size, story length, presence of photos) and overall article direction (favorable, unfavorable, or balanced/neutral) yielded a combined and widely varied single score “Media Vector” or measure of issue “projection” for each newspaper. Correlation and factor analysis yielded two significant city characteristic factors: a “stakeholder” factor, age (percent over 75) associated with unfavorable coverage of physician-assisted suicide (r = - .491; p = 000); and an “access” factor—combining media access (newspaper circulation, cable stations, FM or AM stations) and health care access (health care facilities, physicians)—linked to favorable coverage
(r = .472; p = .000), combining to account for 46.3 percent of the variance. Western US newspapers and public opinion are most favorable to physician-assisted suicide.

Coverage of Breast Cancer in the Australian Print Media – Does Advertising and Editorial Coverage Reflect Correct Social Marketing Messages?
     Sandra C. Jones A1

A1 Health and Productivity Research Centre, University of Wollongong, Wollongong, Australia

Early detection of breast cancer by mammographic screening has the potential to dramatically reduce mortality rates, but many women do not comply with screening recommendations. The media are an important source of health information for many women – through both direct social marketing advertisements and indirect dissemination of information via editorial content. This study investigated the accuracy of breast cancer detection messages in the top-selling Australian women's magazines and three weekend newspapers in the six-month period from December 2000 to May 2001 that included any reference to breast cancer and found that current coverage of breast cancer in the Australian print media conveys messages that are unlikely to encourage appropriate screening.

Improving Doctor-Patient Understanding of Probability in Communicating Cancer-Screening Test Findings
     Yaniv Hanoch A1

A1 Center for Adaptive Behavior and Cognition, Max Planck Institute for Human Development, Germany, Berlin

Several researchers have questioned the merits of early mammography and prostate-specific-antigen (PSA) screening policies, arguing that these programs have not been proven useful in lowering mortality rates. This controversy highlights the necessity and importance of effectively communicating probability information to patients. Probability information, however, has been plaguing the health care profession—as numerous investigators have shown that it is often difficulty to understand and transmit. These difficulties can be overcome by changing the presentation format from a probabilistic format to a frequency format, thereby enhancing doctors' and patients' ability to solve and understand statistical information. Although I highlight this problematic issue with a discussion of mammography and prostate-specific-antigen screening, the suggested solution is not confined to a single medical procedure, but can be extended to any other medical domains where doctors are faced with the difficult task of providing complex probability data to patients.

Advice-Giving Styles by Finnish Nurses in Dietary Counseling Concerning Type 2 Diabetes Care
    Päivi Kiuru A1, Marita Poskiparta A2, Tarja Kettunen A3, Juha Saltevo A4, Leena Liimatainen A5

A1 , Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
A2 , Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland
A3 , Department of Health Sciences, University of Jyväskylä, Jyväskylä,, Finland
A4 , Central Hospital of Middle Finland, Jyväskylä, Finland
A5 , Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland

Dietary advice-giving is an important part of dietary counseling in diabetes care and prevention. The strategies of advice-giving, however, have not been explicated and the qualitative characteristics of conversations in diabetes counseling have remained mainly unstudied. This article describes the styles in which nurses responsible for diabetes counseling in Finnish primary care practices offer dietary advice for patients with recently diagnosed type 2 diabetes or impaired glucose tolerance. The data consisted of 55 videotaped naturally occurring counseling sessions between 18 patients and five nurses and were analyzed using typology as an analyzing method. Four different styles of dietary advice-giving were recognized from the speech episodes concerning dietary behavior: recommending, persuasive, supportive, and permitting styles. Recommending style of advice-giving is recognized to be the dominant style that has arisen from the data and, actually, it seems to be the starting point in advice-giving practices. The other styles were used rarely, which suggest that the nurses rely upon quite a narrow selection of communication strategies that helps them to control the topics and the situation, although patient-centered counseling is strongly demanded nowadays. On the basis of our results we suggest that health professionals may need to become more aware of their advice-giving practices in routine situations through conscious effort of self-evaluation. A more detailed analysis of interpersonal conversations during counseling sessions is also needed as it may offer valuable information to promote patients' self-management skills by facilitating observation of conversational elements recognized to be successful in diabetes counseling.

Newspaper Articles as a Tool for Cardiovascular Prevention Programs in a Developing Country
     Sania Nishtar A1, Yasir Abbas Mirza A2, Saulat Jehan A3, Yasmin Hadi A4, Asma Badar A4, Shazia Yusuf A5, Saqib Shahab A6

A1 Heartfile, Pakistan, Islamabad, Pakistan
A2 Heartfile, Pakistan, Islamabad, Pakistan
A3 Heartfile, Pakistan, Islamabad, Pakistan
A4 Heartfile, Pakistan, Islamabad, Pakistan
A5 Heartfile, Pakistan, Islamabad, Pakistan
A6 Health Services Academy, Islamabad, Pakistan

The purpose of this study was to evaluate changes in knowledge and attitudes as intermediate measures of community impact of a health education campaign using newspaper articles. The intervention involved prominently placed, illustrated newspaper articles by Heartfile (heartfile.org) with nationwide urban outreach, posted regularly in the largest English newspaper in Pakistan using newspaper donated space for a period of 130 consecutive weeks. The post intervention evaluation involved a cross sectional telephone survey in a major city. In the total sample, 26.5% were readers of the newspaper and majority of them (72%) stated that they were regular readers. These 500 persons were eligible for the interview; of these, 93% remembered having seen the Heartfile articles. In this group, 87% of the respondents stated that the articles significantly supplemented their knowledge about diet, and in 5% they were the sole source of information. With respect to exercise, these articles supplemented the knowledge of 77% of the respondents and were the sole source of information for 9% whereas in the case of smoking, knowledge was supplemented in 85% and the articles were the sole source of information in 4% of the cases. Of those interviewed, 40% reported that they had made some dietary changes, 39% made some changes in their exercise habits and 8% reduced the amount of tobacco consumption as a result of reading these articles. In relation to newspaper articles, the per article production cost was US$ 169 and the articles were read regularly by an estimated 0.66 million and occasionally by 0.79 million individuals all over the country. Newspaper articles are a useful supplement to other health education activitiesas part of cardiovascular disease prevention programs. Lessons from the Heartfile experience in Pakistan could be useful for other similar initiatives in low resource settings.

The National Immunization Information Hotline
     D. A. Gust A1, P. Gangarosa A2, B. Hibbs A3, C. Wilkins A4, K. Ford A5, M. Stuart A6, R. Brown-Bryant A7, G. Wallach A8, R. T. Chen A9

A1 Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
A2 Data Management Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
A3 Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
A4 Information Services Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
A5 National Immunization Information Hotline, Research Triangle Park, North Carolina
A6 National Immunization Information Hotline, Research Triangle Park, North Carolina
A7 Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
A8 National Immunization Information Hotline, Research Triangle Park, North Carolina
A9 Epidemiology and Surveillance Division, National Immunization Program, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

The National Immunization Information Hotline (NIIH) has been providing information regarding immunizations to the public and to health care professionals since March 1997. We describe the operations of the NIIH, its experience over the first two and a half years of operation and lessons learned for other immunization hotlines. From 1998–2000, the hotline answered 246,859 calls. Calls concerning immunization information requests totaled 175,367; data about the calls were collected from 35,102. Approximately a third of the 35,102 calls were from health care providers. Of the remaining calls from the public, the greatest number of calls concerned childhood immunizations. Immunization schedule queries from the public increased 323.0% from 1998 to 2000. While the major goal of the NIIH is to provide accurate and reliable information to the public and to health care providers, data from the hotline can be used to monitor changes over time in calls concerning inquires about the immunization schedule in addition to other variables of interest.

Book Review

Partners in Health, Partners in Crime: Exploring the Boundaries of Criminology and Sociology of Health and Illness.
Timmermans, S., and Gabe, J., Eds. (2003)
Reviewed by Carey Noland, Northeastern University