Author: R Dooley

“Horrors of Methamphetamine” Misses the Mark

A new anti-meth campaign sponsored by Rehabs.com features longitudinal photographs of people arrested for meth-related offenses. The pictures show how the drug impacts the aging process, depicting subjects with increasingly sunken eyes, clumpy hair, blemished and pocked skin, and receding gums. The gallery looks more like the zombie apocalypse than a public health campaign.

In fact, it’s neither. It’s advertising. Rehabs.com project manager Dan Tynski openly admits that the campaign, modeled off the Multnomah County Sheriff Office’s “Face of Meth Program,” is designed to help his website gain a share in the $4.5 billion dollar drug rehabilitation industry. Tynski says the “Horrors of Methamphetamine” was intended to go viral, spreading over social media sources and driving traffic to Rehabs.com.

The commercial nature of “Horrors of Methamphetamine” isn’t inherently problematic. A larger issue is that the campaign’s analogue, “Faces of Meth,” was found to be ineffective at discouraging drug use. Many new meth users are young, and anti-drug campaigns that use scare tactics don’t appeal to people in this demographic. They generally don’t view the ads as salient to them or view themselves as susceptible to extreme negative effects of drugs.

While public health dollars are limited, relationships between commercial entities and public health organizations can be leveraged for social good. Organizations like Health in Hollywood work to ensure that health messages in television and movies are accurate and compelling. How might those in health communication do a better job of networking with businesses to accomplish similar ends in advertising campaigns?

Article source: http://www.huffingtonpost.com/2012/12/06/horrors-of-methamphetamin-rehabscom-photos_n_2240401.html

Big Pharma’s Trojan Horse

According to the CDC, 23 million Americans currently have diabetes, and projections estimate that one third of adults could have diabetes by 2050. Every year Americans spend more than $100 billion on diabetes care. The disease can be complicated, and until the Internet made sharing information and tricks with fellow diabetic easier, a diabetes diagnosis could also be isolating.

Kerri Sparling remembers that when she was diagnosed with diabetes at the age of 7, she didn’t have a community of support until she attended a diabetes camp where all other campers also had the disease. Now, the DOC – the diabetes online community – is active, vibrant, and an extensive source of information. There are videos, blogs, and testimonials that contain tips on disease management and product reviews. Big pharma has taken notice.

Diabetes drug giant SanofiUs runs a blog, Twitter account, Facebook page, and a diabetes dictionary. It’s currently looking into imbedding itself on Pinterest and Instagram. And in addition to tweeting about new products, the companies also sponsor patients like Sparling who blog about diabetes. While some argue that it is mutually beneficial for drug companies and patients for the companies to understand how consumers perceive medical devices. Jeff Chester,  executive director of the Center for Digital Democracy, disputes the benefits of big pharma’s social media presence, contending that pharmaceutical companies are using social media to promote their gadgets and drugs in a deceptive way. Testimonials, which have been through rigorous message design to enhance their persuasive effects, appear to be from regular patients but are often from people on drug companies’ pay rolls.

Sparling says this isn’t an issue. People in the diabetes community want attention from pharmaceutical manufacturers. Now, the trick is ensuring that digital relationships benefit business and patients alike.

What’s your take? Should the FDA compel drug companies to disclose their online presence?

Story source: http://www.npr.org/blogs/health/2012/12/03/166241115/social-media-helps-diabetes-patients-and-drugmakers-connect

A Picture’s Worth a Thousand Words

Over the course of the semester, I’ve spent more time reading news and blog posts about obesity. They stand in stark contract to academic articles. While the typical journal article has a formulaic structure, including tables with statistics, charts, and graphs, newspaper articles get to have much more eye-catching content. They tell the story of obesity’s prevalence and effects in America using images of the people most impacted. In increase in attention to the obesity epidemic is good, right?

The more I read, the less sure I become. Content aside, there’s a disturbing pattern in the images news stories and blogs use in stories about obesity.  In a content analysis of news stories about obesity, Heuer, McClure, and Puhl (2011) found that 72% of images that depicted an overweight person did so in a negative, stigmatizing manner.

Compared to their non-obese counterparts, obese individuals were more likely to have their heads cut out of the photos, be portrayed only showing their stomachs or lower bodies, and to be shown eating or drinking. They were also less likely to be show fully clothed, wearing professional clothing, or exercising.

Here’s a link to a story in the Huffington Post, widely considered to be liberal and progressive in its treatment of social issues, that exemplifies the pattern in image use: http://www.huffingtonpost.com/2012/11/28/belly-fat-osteoporosis-bone-strength_n_2200380.html?utm_hp_ref=healthy-living

Stigma matters. It influences the policies we’re willing to support to address obesity as well as the way non-obese people treat their overweight counterparts on a day to day level. Though overweight and obese people now constitute the majority of the American population, they remain one of the last acceptable targets of open disregard and denigration. Pervasive stigmatization in the images accompanying articles about obesity. may serve to reinforce that prejudice and discrimination.

Misinformation Nation – Why Facts Fail Us Part 3

While misinformation may seem pervasive and its effects intractable, don’t despair! There are strategies health communicators can take to reduce the impact of misinformation.

  • During debunking, provide people with information and alternative explanations that will fill the newly created gaps in their mental models.
  • Offer repeated retractions but try to include as little of the original misinformation as possible to avoid rendering it more familiar.
  • Similarly, emphasize the facts you want to communicate rather than myths. Myth and fact strategies have serious potential to backfire.
  • If you do need to mention a myth, provide an explicit warning about the nature of the misinformation in advance.
  • Provide information in a simple and brief manner.
  • Consider how to frame the content of a retraction to avoid threatening audience members’ worldviews.
  • If you need to present content in a way that may threaten audience members’ worldviews, focus on opportunities and benefits rather than risks and threats and encourage self-affirmation.

Our information and communication technology environment makes it easy for misinformation to be spread and repeatedly rapidly but also offers great potential for setting the record straight. When exercising the retraction strategies above, consider the reach and credibility associated with potential media. For more information and greater in-depth discussion, check out the original article.

Information source: Lewandowsky, S., Ecker, U., Seifert, C., Schwartz, N., & Cook, J. (2012). Information and   its correction: Continued influence and successful debiasing. Psychological Science in the Public Interest, 13(3), 106-131.

Image source: http://obrag.org/

 

Misinformation Nation – Why Facts Fail Us Part 2

Last week, I wrote about sources of misinformation in public health, and this week, I’m shifting my attention to the cognitive mechanisms that support or perpetuate misinformation.

Social norms around everyday conversational conduct imply that content is true unless otherwise stated, so it’s difficult for people to identify misinformation without a correction or retraction. As Lewandowsky and colleagues so articulately write, “Belief is an inevitable consequence of—or, indeed, precursor to—comprehension.” Suspension of belief, prompted by substantial attention, significant implausibility of the message, or high levels of distrust toward the source, necessitates additional motivation and cognition.  When people do cognitively engage with information to determine whether it is true, they focus on whether the information is consistent with their other preconceived beliefs, forms a plausible gestalt, and originates with a trustworthy source. They also consider whether others seem to believe the information.

In neutral scenarios in which people have no reason to believe one set of statements is more or less accurate than another, retractions and corrections are rarely effective in reducing reliance on misinformation in decision-making. When media sources attempt to correct information by providing a retraction accompanied by an explanation, people become even more likely to rely on the misinformation.

There are a number of proposed explanations for how and why the brain rejects retractions. One hypothesis is that people build mental models of unfolding events, and if a retraction impacts a piece of information essential to their model of events, the event representation will only make sense if the false assumption is maintained. Next, retrieval failures such as misattribution of a piece of information’s source, and people may attribute information to an authoritative report rather than to a report that was subsequently retracted. Additionally, if statements directly or indirectly repeat false information in order to correct it, the misinformation becomes more familiar and coherent. Finally, because people do not generally like to be told what to think or do, social reactance may render retractions ineffective.

For a discussion of proactive and reactive strategies for reducing the impact of misinformation, check out my post next.

Information source: Lewandowsky, S., Ecker, U., Seifert, C., Schwartz, N., & Cook, J. (2012). Information and   its correction: Continued influence and successful debiasing. Psychological Science in the Public Interest, 13(3), 106-131.

Image source: http://obrag.org/

 

Misinformation Nation – Why Facts Fail Us

Because information is the basis for the political and societal decisions that determine the fabric of society, misinformation can result in serious consequences in a range of domains, including health. Demonstrating this point, unsubstantiated claims of a link between vaccination and autism resulted in decreased vaccination and subsequent increases in vaccine-preventable disease.

What accounts for the spread of misinformation? Studies have indicated that people are most likely to pass on information if it elicits an emotional  response in the recipient regardless of the information’s truth. When parents who believe their children have developed autism as a result of vaccines present their beliefs as facts, for example, their claims are more likely to be repeated in popular TV, radio talk shows, TV dramas, and documentaries. People also tend to extract knowledge from sources that are overtly fictional. Marsh, Meade, and Roediger (2003) demonstrated that even when information from clearly fictitious stories contradicts common knowledge, people still use relied on it to respond to quiz questions.

There are also instances in which misinformation is intentionally manufactured. Though the public is generally aware that politicians are not always credible, they are often unable to distinguish between politicians’ inaccurate and accurate statements (Ramsay et al., 2010). Within 5 weeks of Sarah Palin posting a comment about “death panels” on Facebook, 86% of Americans had heard the death-panel claim. Among these, half either believed it or were not sure of its accuracy. Vested interest groups also disseminate misinformation, particularly in the realm of public health. In 2006, a U.S. federal court found that major cigarette companies had intentionally denied, distorted, and minimized the hazards of cigarette smoking (Smith et al., 2011).

Our information environment is ripe with potential for misinformation. Media can inadvertently oversimplify, misrepresent, or overdramatize scientific reporting, leading to misunderstanding. Additionally, unreliability proliferates many websites. A content analysis of the first 50 Web sites matching the search term “weight loss diets” revealed that only 3 delivered accurate dietary advice. Even so, the majority of Americans look for health information online (Fox & Jones, 2009).

For information on why and how our brains resist correction of misinformation, check out next week’s post.

Information source: Lewandowsky, S., Ecker, U., Seifert, C., Schwartz, N., & Cook, J. (2012). Information and   its correction: Continued influence and successful debiasing. Psychological Science in the Public Interest, 13(3), 106-131.

Image source: http://obrag.org/

Twitter Shines Through Hurricane Sandy

With no power or Internet, backed up phone lines, and flooded streets, mobile social media platforms were an invaluable communication tool to emergency services, government officials, and individuals living in the path of Hurricane Sandy alike.  In what The Inquisitor called “a new frontier for first responders,” the NYFD used their Twitter account to send up to the minute information and respond to non-emergency issues, keeping phone lines clear for true emergencies:

@FDNY Pls advise where there are shelters that are deaf friendly- use sign language- have interpreters?? THANK YOU

@LouiseASL You can find information about shelters on nyc.govgoogle.org/crisismap/2012…

ABC News also reported that New York Gov. Andrew Cuomo and New Jersey Governor Chris Christie, among others, used Twitter to get emergency messages to the public. For example, they sent evacuation alerts before press conference announcements in case people lost power and were unable to get this information through radio or television.

To help connect the public to the right sources and to facilitate communication between the public and emergency response groups, Twitter quickly created a page on their blog called “Hurricane Sandy Resources,” which identified key Twitter accounts and hashtags to follow.  The page also identified two methods for receiving tweets via SMS, one of which also allows even non-account holders to receive Tweets from any Twitter feed on their phones. Others used this capability to check on the whereabouts of friends and family.

As reported by Justia.com, however, the ability for anyone to post whatever information they want can be dangerous. Shashank Tripathi, then manager for Republican Christopher Wight’s campaign for the House of Representatives, posted several false stories such as “BREAKING: Governor Cuomo is trapped in Manhattan. Has been taken to a secure shelter.”  These were then retweeted, feeding into existing panic and confusion.

Mobile channels proved to be an excellent resource during Hurricane Sandy. Do you think the benefits outweigh the risks?

Think cigarette companies have shifted their advertising focus away from the American market? Think again!

Recently, researchers from the University of Sydney’s medical school published a study investigating the availability of pro-smoking apps in the Apple App Store and the Android Market. The low down: the stores offer a combined total of 107 pro-smoking apps, with purposes ranging from helping consumers locate cigarette vending locations to actually allowing them to simulate smoking. With only apps distributed by Marlboro asking users to enter their birthdays for distribution, the other apps remain available to children and adolescents. Folks, that’s one low-down that’s simply down-low.

To provide more context, one app called MyAshtray allows users to click on the image of an ashtray to drop simulated cigar and cigarette ash and butts. After a few clicks, messages such as, “Would be even better with a beer in your hand” pop up.  Another app, Puff Pass Puff, is a cartoon game that allows players to click on cartoon characters to get them to smoke and pass cigarettes to other characters. Those who pass the cigarettes in the same order at increasing paces accrue points.  Other applications feature high-quality image of digital cigarettes that users can “smoke” by making inhaling and exhaling noises near their phone’s microphone. The cigarette burns faster with inhalation, and smoke is displayed with exhalation. Some of these games claim to help users quit smoking.

Mobile phone applications in general have global reach, a huge consumer base of various age groups, and are subject to less strict regulation policies than other communication media, presenting cigarette companies with a vast opportunity to promote their products. What measures do you believe should be taken to address cigarette promotion through mobile applications?

Combatting Eating Disorders Online: The Dark Side of the Thinternet Part II

Proliferation of the Internet has had an inarguable positive outcome on consumers’ access to health knowledge, but increased information availability has also had negative health consequences. As Emery blogged yesterday, some web users, predominantly young females,  frequent sites that promote anorexia and bulimia and provide users with tips on how to stay thin. These “pro-ana” websites contain blogs, forums, calorie counters, videos, tips, poetry and pictures, as well as networking opportunities that allow those with active eating disorders to provide one another social support in favor of maintaining their eating disorders.

Because the United States Supreme Court has deemed web-based speech a form of expression with the utmost Constitutional protection, local, state, and federal agencies have limited capacity to pass legislation regulating websites that promote eating disorders. Private entities, however, have taken steps on their own to address pro-anorexia and bulimia content. For example, in 2001, Yahoo! and other Web portals banned “pro-ana” sites, and this year, Pinterest, Tumblr and Instagram banned “thinspo,” a term associated with finding inspiration for thinness. To complement the web industry’s voluntary self-regulation, non-profits, researchers, medical doctors, and healthy weight activists have worked to develop websites like Proud2Bme.org that promote eating disorder recovery by providing information with formats and frames that appeal to potential pro-ana site users.

While Proud2Bme.org receives 7,000 daily visitors, its exposure is low compared to its “pro-ana” counterparts. What steps do you think need to be taken to drive traffic away from websites that promote eating disorders to those that encourage recovery? Do you think the government should be able to regulate “pro-ana” sites to protect potentially vulnerable web surfers who have eating disorders?

Image source: http://www.ruthgwily.com/illustrations.html

Read This Post Twice Daily

Is there a difference between “Take twice daily” and “Take every 12 hours?” Almost half of Americans don’t know. Each year, confusing instruction labels are responsible for more than one million medication mix-ups, and a recent study demonstrated that 46% of patients misread prescription medication instructions.

There are multiple causes for misunderstanding prescription label instructions, including labeling variations from drugstore to drugstore and labels written in physicians’ shorthand. Varying literacy levels are also a huge issue. While everyone is susceptible, those with lower education levels are 34 times more likely to misread medication labels.

To address the issue of confusing prescription drug labels, the U.S. Pharmacopeial Convention (USP), s non-profit that often sets drug safety standards, has recommended changing labels so that they are easier for patients to read. Recommended changes include:

  • Display the drug name, patient instructions, and dose prominently in clear, large type at the top of the label. Less important information (pharmacy name, drug quantity) should be placed away from dosing instructions.
  • Make dosing instructions clear: For example, write, “Take two tablets in the morning and two tablets in the evening” instead of “Take two tablets twice daily.”
  • Avoid unclear directions like “take as directed.”
  • Use terms that do not require high health literacy to understand – i.e. write “for high blood pressure” instead of “for hypertension.”
  • Print the label in the patient’s first language.

The decision about whether or not to adopt the USP recommendations is up to each state’s board of pharmacy, but experts believe the proposed changes will ultimately be implemented.

Image source: http://www.clinuvel.com/en/blog/ceos-blog/talking-off-the-label-part-one/