Tag: Health Communication

Next Level Data Presentation

By Arshya Gurbani

It’s probably safe to guess that lot of people studying Health Communication feel strongly about data, how it’s presented, and the “story” it has to tell. I thought it was about time to re-watch this, one of my favorite TED talks, about using statistics effectively. Hans Rosling presents data on child mortality, but in doing so he layers it with context and bias and paints a picture that is remarkably clear and moving.  It’s good stuff–seriously, get some popcorn and a handkerchief before you watch/re-watch it!

What’s culture got to do with it?

By: Courtney Luecking MPH, MS, RD Doctoral candidate: Nutrition

What happens when a cultural and political sociologist teams up with health researchers? Answer: some really fascinating work and advancement of how we think about the influence of culture on health.

Meet Andrew Perrin, Ph.D. He is a professor in the Department of Sociology at the University of North Carolina in Chapel Hill.

perrin

While his work focuses mostly on “what people need to know, be and do to make democracy work”, his family has opened up the opportunity to share his expertise with the public health arena. Does culture influence health? If so, how, and to what extent?

Dr. Perrin suggests that although the public health and health communication world may be able to measure certain aspects of culture well, there is a lack of breadth and depth of conceptualizing culture. This could mean we, public health and communication groups, are missing or misinterpreting a big piece of the health puzzle. He offered context of the contemporary synthesis of culture as presented by Johnson-Hanks and colleagues. A cyclical interaction between culture in the world and culture in our mind influences our individual and collective decisions and actions, but how can we robustly measure this?

culture

Fortunately, Dr. Perrin and an interdisciplinary crew are working to develop tools to measure culture in the world and culture in the mind within the context of obesity. Once measured, they will work to interpret the effects of culture on health. One project looks to explain variations and health outcomes in a county in North Carolina using a combination of geocoded photographs (culture in the world) and focus groups (culture in the mind). Results for this are forthcoming. Another project looked at obesogenic behaviors and stigma in children’s movies. You may or may not be surprised to learn that unhealthy behaviors are represented more than healthy behaviors, and movies contain messages that encourage weight-related teasing or bullying. For more information and results about this, review the paper on Pass the Popcorn.

Thanks to Dr. Perrin for sharing his time and expertise with our class! He highlighted the value interdisciplinary teams bring to thinking about problems in a more holistic manner that could ultimately benefit the public’s health.

 You can learn more about Dr. Perrin’s work at his website.

It’s Not Me, It’s You: Signs that its time to Break Up With Your Doctor

By: Aria Gray MPH: Maternal and Child Health candidate 2017

I recently broke up with one of my doctors, and while it was a difficult decision, I felt much better once I decided not to see that provider anymore. The doctor was recommended to me as a great expert in the field, but I never felt that they were truly listening to me, which is why I ultimately left.

However, finding a new doctor can be difficult. Learn more below to see if it is time to make a change in your health care.

Poor Communication: It is important to understand your condition and diagnosis as well as the recommended course of treatment. Make sure to ask follow-up questions and to communicate to your doctor that you do not understand. However, if communication issues are still not resolved, it may be time to make a change.

Poor Listening Skills: Patient care should be adjusted based on the needs and experiences of each individual patient. If there is a medication or treatment plan you have tried without success or are not willing to pursue, your doctor should listen to your thoughts and feelings and make a treatment plan accordingly. If you feel your doctor isn’t listening to you, find one that will.

Long Wait Times & Limited Access to Care: If it commonly takes you weeks or months to get an appointment with your doctor or if you consistently face long wait times in the office, it may be time to find a new doctor. It is important to receive prompt treatment and also to have your valuable time respected.

As I mentioned, making the decision to change doctors is not easy, and the process of finding a new doctor is often not easy (not to mention all of the paperwork!). Follow these tips for an easy transition to a new provider.

Fearful of Food?

By: Courtney Luecking MPH, MS, RD Doctoral candidate: Nutrition

I started following the Conscienhealth blog years ago. The organization aims to “advance sound approaches to health and obesity…(and) advocate evidence-based prevention and treatment”. Part of their approach is to provide a daily reflection about how a hot topic might influence our view of obesity or health policy.

A recent post got me thinking about whether fear-based messages are an effective or appropriate way to speak to consumers about food and nutrition. A meta-analysis published last year pooled 127 articles to look at the effect of fear appeals on attitudes, intentions, and behaviors. [Notes: Meta-analysis is a technique that aims to provide a conclusion based on statistical evidence about a large number of studies. Fear appeals are messages designed to persuade people to take action by sparking fear.]

Interestingly enough, fear appeals were found to have generally positive effects but less so for repeated behaviors. We eat multiple times each day, definitely a repetitive behavior, so perhaps fear-based messages are not the best way to communicate food-related lifestyle messages.

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So how should talk about food? Headlines often pose negative or sensational statements to entice us to read. An example of this: Why Sitting is Killing You. But evidence suggests it might be more useful to share gain-framed messages. That is, focus on action people can take and what the positive outcome would be.An example of this: Review suggests eating oats can lower cholesterol as measured by a variety of markers.

Two decades ago, a study reported that Americans perceived food to be mostly associated with health and least associated with ple
asure. Americans reported more action to change diet to support health, yet they were also less likely to consider themselves healthy eaters. What would it look like if we talked in a more positive, less fearful or restrictive manner about food?

 

Resources:

Rozin P, Fischler C, Imada S, Sarubin A, Wrzesniewski A. Attitudes to food and the role of food in life in the U.S.A., Japan, Flemish Belgium and France: possible implications for the diet-health debate. Appetite, 1999 Oct; 33(2): 163-180.

Tannenbaum MB, Hepler J, Zimmerman RS, Saul L, Jacobs S, Wilson K, Albarracin D. Appealing to fear: a meta-analysis of fear appeal effectiveness and theories. Psychol Bull, 2015 Nov; 141(6): 1178-204.

Wansink B, Pope L. When do gain-framed health messages work better than fear appeals? Nutr Rev, 2015 Jan; 73(1): 4-11.

October is Domestic Violence Awareness Month

By: Aria Gray MPH: Maternal and Child Health candidate 2017

What is Domestic Violence? Domestic violence is the willful intimidation, physical assault, battery, sexual assault, or other abusive behavior as part of a systematic pattern of power and control perpetrated by one intimate partner against another. It can include physical violence, sexual violence, psychological violence, and emotional abuse. Domestic violence affects individuals in every community regardless of age, economic status, sexual orientation, gender, or other demographic factors. However, domestic violence is most commonly experienced by  women between the ages of 18-24.

Domestic violence is preventable. Part of domestic violence prevention includes talking about this issue and reducing the stigma associated with it as a community. While all of October is Domestic Violence Awareness Month, the National Network to End Domestic Violence is hosting a week of action from October 16-October 22.

Here are some ways that you can get involved during the week of action and throughout all of October. You can also search for events that may be happening in your community with local organizations.

  • Wear purple for #PurpleThursday on Thursday October 20
  • Speak Out: Talk with a friend, family member, or colleague about domestic violence to help eliminate stigma and show survivors that they are supported.
  • Follow the National Network to End Domestic Violence on social media (Facebook, Twitter, and Instagram and change

For anonymous, confidential help available 24/7, call the National Domestic Violence Hotline at 1-800-799-7233 (SAFE) or 1-800-787-3224 (TTY) now.

Putting the Pieces Together

By: Courtney Luecking MPH, MS, RD Doctoral candidate: Nutrition

Making decisions for our health can feel like putting together a 1,000-piece puzzle – time-consuming or perhaps frustrating – and that’s if you have all the pieces.

When it comes to health decisions, we first have to find trustworthy resources, then we need to be able to interpret and apply that information to make what is hopefully the best decision. This process is called Health Literacy, and it is of national concern. How big of a concern? 9 out of 10 people, to no fault of our own, do not have the skills needed to find or interpret health information.9-out-of-10-health-literacy

What is being done about this?

The National Action Plan to Improve Health Literacy recognizes it will take a mass effort of organizations, professionals, policymakers, communities, and individuals to change how our nation communicates health information. The plan highlights 7 goals and accompanying strategies.

Additionally, since 2010, federal law requires federal agencies to provide training for staff and use plain language when communicating with the public. Plain language means the audience is able to understand something the first time they read or hear it.

Click here for a before-and-after comparison. Which version do you think is easier to understand?

What can you do?

  • Find training in health literacy, plain language, and culture and communication
  • Work with people who specialize in communicating with plain language
  • Make use of existing tools to evaluate and/or plan materials

The Centers for Disease Control and Prevention offers a Clear Communication Index that is a short, evidence-based form to use when developing or evaluating a communication product. I look forward to giving this a try

 

Let’s help our fellow citizens put all the pieces of their health puzzle together.

 

References and Resources:

Boston University. Health Literacy Tool Shed. http://healthliteracy.bu.edu/

Centers for Disease Control and Prevention. The CDC Clear Communication Index. http://www.cdc.gov/ccindex/index.html

Center for Plain Language. http://centerforplainlanguage.org/

National Network of Libraries of Medicine. Health Literacy. https://nnlm.gov/outreach/consumer/hlthlit.html

Office of Disease Prevention and Health Promotion. National Action Plan to Improve Health Literacy. https://health.gov/communication/initiatives/health-literacy-action-plan.asp

Brain Drain

By: Courtney Luecking MPH, MS, RD Doctoral candidate: Nutrition

We are bombarded with nutrition and other ‘healthy’ lifestyle information from friends, family, news stories, social media, and online content on a daily basis. In an attempt to stay up-to-date with topics of conversation, I receive a daily email of a wide range of nutrition-related headlines. I often just scroll without clicking – it can be a real brain drain to filter through everything.

But The Hunger in Our Heads (how physical activity might quell the eating binges that follow intense mental activity) piqued my interest enough for a click. I’ve always wanted to believe the reading, writing, and critical thinking associated with being a grad student was the cause of my brain drain come day’s end. But was there really evidence to support this, or was I just being dramatic? I immediately went to the source of inspiration of the story to do some fact checking. [Side note: there IS evidence that mentally demanding tasks can lead to fatigue and even overeating.]

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Headlines are headlines for a reason, and they can lead to confusion about what to do to lead a healthy lifestyle. A few reasons nutrition headlines are confusing include:

  • Research is a process and it is usually designed to answer a very specific question. But what is reported often extends beyond what the study actually showed.
  • Research studies have different results. This is an important part of the research process, and there may be good reasons why.
  • Not all studies are created equal. The quality with which a study was done plays a major part on how the results should be interpreted.

Fortunately the Harvard T.H. Chan School of Public Health’s Nutrition Source offers 7 questions to help put health news in context and the International Food Information Council Foundation offers a quick guide to evaluating evidence.

The bottom line is, take a moment to see if the evidence really supports all the hype. Your brain just might thank you.

 

Resources:

Harvard T.H. Chan School of Public Health. Deciphering Media Stories on Diet. https://www.hsph.harvard.edu/nutritionsource/media/

International Food Information Council. Hot Off the Presses: 5 Key Takeaways for Evaluating Nutrition in the Media. http://www.foodinsight.org/evaluating-nutrition-science-media-headlines

Reynolds, Gretchen. The Hunger in Our Heads. http://www.nytimes.com/2016/09/11/well/eat/how-to-stop-your-food-cravings.html?_r=1

 

Breaking Rural Health Barriers

For those of us that are fortunate to live near hospitals and primary care clinics, that question of rural vs. urban care is unlikely to even cross our minds. But for those living in remote locations, lack of access is a common issue. Unfortunately, what many of us take for granted is another person’s struggle, especially if they are plagued with chronic conditions, such as asthma or diabetes. And in many cases, most folks in this situation often go without treatment.

The National Rural Health Association reports that while a quarter of the U.S. population lives in rural areas, only one-tenth of our nation’s physicians choose to practice in these areas. And while only a third of automobile crashes occur in rural locations, two-thirds of deaths attributed to those accidents occur on rural roads, indicating a shortage in acute trauma care.

These figures certainly give rise to the need for increased access to care within rural communities. Another factor that contributes to this issue is that Medicare reimburses rural hospitals at a lower rate than urban hospitals, resulting in fewer physicians choosing to practice in such locations. Over the last 25 years, nearly 500 hospitals have closed, many of which were located in rural communities.

Fortunately, this is the age of digital know-how. Technology is king, and health care is one of the leading industries taking advantage of such innovation and wisdom. General Electric (GE) is doing its part to improve women’s health in remote areas like Wyoming, where the average woman has to commute 70 miles just to receive a mammogram.

In 2014, the company started the GE healthymagination program, to expedite cancer innovation and improve cancer care to 10 million patients, over the next six years (until 2020). One of the program’s most influential aspects is the GE Mammovan, equipped with mammography technology to provide free mammograms to all women living in remote areas.

GE chose to pilot the program in Wyoming, which has the lowest number of citizens and lowest population density (after Alaska). Many of the women using the van cited it was their first time having ever received a mammogram, stating that travel time or insurance requirements had precluded them from being screened for breast cancer. GE’s website reports that because of Wyoming’s uneven population distribution, a third of women living in that state over age 40 never receive a mammogram.

Since nearly two years ago, the mobile unit has traveled throughout the state, setting up in locations where women can receive a mammogram within an hour, allowing them to avoid the hassles of taking off from work and/or driving long distances. In many ways, the van serves a dual purpose—by eliminating the barriers rural residents previously faced and improving access to preventative care. By detecting breast cancer as early as possible saves the health care industry billions and ultimately, saves lives.

While North Carolina isn’t as rural as Wyoming, you might be surprised to learn that 85 percent of our state’s counties are, in fact, considered to be rural. And with nearly 2 million people receiving Medicaid, access to care is certainly an issue of interest among health care workers and lawmakers. And while mobile units are pricey to create and maintain, the progress the GE Mammovan has made in Wyoming is a good example of how health information technology can work to address some of our most pressing issues that impede quality health for everyone.

RESEARCH SPOTLIGHT: MIKE NEWTON-WARD

Mike Newton-Ward, MSW, MPH, of the Gillings School of Global Public Health, at the University of North Carolina at Chapel Hill (UNC), spoke with the Upstream writing team recently to share his lifelong experiences working with social marketing and how this form of communication is effective in public health.

Newton-Ward, an adjunct professor, received both a Masters in Social Work and a Masters in Public Health from UNC, and spent many years working with the N.C. Division of Public Health and the N.C. Department of Health and Human Services helping to create and implement various social marketing campaigns aimed at populations across the state. He retired in 2015 and is now an independent consultant with RTI International.

He spoke to the class to highlight the importance of social marketing campaigns in public health and discussed what steps are needed to ensure optimal effectiveness with selected target audiences.

One of the most valuable aspects of social marketing is that it takes feedback generated from the target audience (the group the campaign is intended for) and uses that data to help determine the layout of the campaign itself. Using this approach is key for garnering participant interest and ensuring improved outcomes.

Newton-Ward also discussed other aspects of social marketing, such as its interdisciplinary approach, and how the input of several fields is effective at campaign development, as well social marketing’s unique ability to influence behaviors in all directions. Since public health is primarily geared toward prevention at the population level, social marketing can be used to influence behaviors upstream through social or policy change. Likewise, it can also be used to produce changes downstream (hence, the name of our blog!), by treating or educating populations to change negative behaviors. Finally, social marketing can work sidestream, by allowing partner organizations to collaborate for promoting the best environment possible to ensure a continuum of positive outcomes.

Newton-Ward concluded his talk by answering questions from the audience and discussing the “simplified elicitation methodology,” a strategy used in many public health campaigns, which seeks to identify determinants of behavior by asking three pairs of questions, including:

  • “What makes a behavior harder or easier to do?”
  • “What are the good things and bad things that happen when one does the behavior?”
  • “Who would approve or disapprove of the behavior?”

 The answers generated from these questions are strong indicators for discovering and learning about target audience reactions, and are key drivers for developing successful campaigns.

Is Health Advertising Worth the Cost? You Be the Judge.

From a small printed flyer to a 30-second T.V. spot during the Super Bowl, there’s no question that advertising is expensive. And while there are many different forms of getting the word out, there are different reasons we advertise as well. It’s safe to say most advertising or marketing, particularly on a large scale, is done for competitive reasons—to boost sales and detract potential customers from going someplace else. But what about when the product being advertised isn’t actually for sale? What’s the goal of marketing something if you aren’t going to profit financially?

In the health communication field, organizations choose to advertise as a means of communicating something to the general public. This could be a health message to get tested for HIV or a celebrity testimonial to stop domestic violence. Either way, in health communication, the the “seller” or advertiser doesn’t stand to gain a profit on their effort in the financial sense, but rather, to promote healthy behaviors that in the long term, save lives. But these ads aren’t cheap. As health communicators, how do we know when the message we’re promoting is effective at producing change for the better?

That’s just what research economist Paul Shafer is trying to determine. A doctoral student in health policy and management, Shafer is working to determine the effectiveness of tobacco cessation advertisements from the Tips From Former Smokers campaign. The ads aired from March 4 to June 21, 2013. To determine effectiveness, Shafer and his colleagues looked at web traffic and determined the number of unique visitors the site had during the time the ads were aired.

The federally funded national tobacco education campaign resulted in the Centers for Disease Control’s (CDC) campaign website having over 900,000 total visits and nearly 1.4 million page views. There were an additional 660,000 unique visitors, meaning users returned to the site after their initial visit.

In his paper, published online Feb. 17, in the Journal of Medical Internet Research, Shafer seeks to demonstrate the relationship between the amount of advertising and the resulting numbers in web traffic. He attempts to show that by increased advertising leads to increased traffic, for both new and returning visitors, thus, implying the advertisements are effective at least getting people’s attention.

Shafer explains the uniqueness of his study is that he and his researchers were able to record the variation of media dose over time and across markets, as opposed to comparing aggregated traffic before, during, and after the campaign.

In addition, he and his team were able to determine fluctuation between the two types of ads, both aimed at providing resources to smokers desiring to quit. The ads used different tagging methods, such as a URL or a telephone hotline number, with results showing that the URL ads were more effective at driving users to the website, but that the hotline ads were also effective at increasing web views.

While Shafer’s study makes it difficult to determine the number of individuals who quit smoking as a direct result of the ads, the study does imply that such campaigns not only serve as a call to action, but also are effective at linking people to resources they would otherwise likely not know about. Finally, the results of the study imply the potential researchers have at more accurately forecasting the impact such ads will have at increasing web usage and interest in online resources that promote healthy behaviors.

So, aside from the fact that health campaigns can be quite expensive to implement, and there are no guarantees of success, with careful formative research and a targeted approach, such campaigns are valuable for the potential they have at impacting populations on a large scale at changing behaviors for good.