Category: Interpersonal Communication


Surgeon General: Hair is no good excuse to not exercise

In a unique example of insight into health disparities, particularly the lack of physical activity among many African-American women,  General Dr. Regina Benjamin’s decided to address the Bronner Bros. International Hair Show in Atlanta. As reported by the New York Times, she said,

“Oftentimes you get women saying, ‘I can’t exercise today because I don’t want to sweat my hair back or get my hair wet,’ ” she said in an interview. “When you’re starting to exercise, you look for reasons not to, and sometimes the hair is one of those reasons.”

The problem, Dr. Benjamin said, is that many women — particularly black women, like herself — invest considerable amounts of time and money in chemical relaxers and other treatments that transform naturally tight curls into silky, straight locks. Moisture and motion can quickly undo those efforts, with the result that many women end up avoiding physical activity altogether.

Surgeon General Benjamin has already faced criticism over her remarks. Some say she needs to stick to the big issues, while other think that talking about hair trivializes the issue and ignores the many other causes of lack of physical activity (lack of time, work and family demands, dangerous living conditions, etc.).

However, as noted in the NYT article, there is scientific evidence to back up the Surgeon General’s comments,

When researchers at Wake Forest Baptist Medical Center in North Carolina sampled 103 black women from the area, they found that about a third exercised less because they were concerned it would jeopardize their hair.


[S]tudies have shown that black men and women are more likely to see a doctor and pay attention to their health when prodded by their barbers and hairdressers and that they see hairstylists as health ambassadors of sorts.

Health communicators have tried to convince people for decades to get more exercise and eat right, yet obesity rates continue to creep upward. Is it time to look for the underlying reasons — the socio-cultural context — instead of solely focusing on the bigger picture items? Let us know what you think!

The importance of “talk” in mass media campaigns

Why should mundane, everyday conversations between people matter when considering mass media campaign design and evaluation?  Colleagues and I have spent the last few years considering exactly that question and what we’ve found suggests we probably should spend more time monitoring social networks than we currently do.  My colleague, Marco Yzer, and I outlined at least three theoretical roles for talk — media campaign outcome, moderator, and mediator — in a 2007 review piece we wrote for Communication Yearbook.

Recently, several of us had the opportunity to empirically test the possibility of indirect mediation using data from 1,079 tobacco smokers in the Netherlands who were targeted by a smoking cessation media campaign (van den Putte et al., 2011).  While one might suspect the main role of media campaign exposure would be a direct cessation prompt, data suggested that campaign exposure also led to conversations about cessation and those conversations about cessation were subsequently linked to actual cessation attempts.  In other words, some of those people not directly exposed to the campaign nonetheless appear to have been affected indirectly through conversations that were generated in part by the campaign.

All of that suggests that actively leveraging social networks to indirectly spread campaign messages might be a useful strategy.  At the same time, such an approach is not without pitfalls, though.  In a 2010 Social Science & Medicine piece with some other colleagues (Southwell et al., 2010), for example, we reported that peer referral of health information depended in part on the availability of social networks in one’s zip code.  In that light, we might worry about disparities between people — whether in the neighborhood or in Facebook — in the extent to which some people diffuse campaign messages and others do not.

At this moment when social media are ubiquitous in popular culture, it appears that campaign evaluators and health communication scholars have plenty of work to do in assessing exactly how the myriad and sometimes complicated connections between people amplify, shape, facilitate and mitigate our carefully planned campaigns.


Southwell, B. G., Slater, J. S., Rothman, A. J., Friedenberg, L. M., Allison, T. R., & Nelson, C. L. (2010). The availability of community ties predicts likelihood of peer referral for mammography: Geographic constraints on viral marketing. Social Science & Medicine, 71(9), 1627-1635.

Southwell, B. G., & Yzer, M. C. (2007). The roles of interpersonal communication in mass media campaigns. In C. Beck (Ed.), Communication Yearbook 31 (pp. 420-462). New York: Lawrence Erlbaum Associates.

van den Putte, B., Yzer, M., Southwell, B., de Bruijn, G.-J., & Willemsen, M. (2011). Interpersonal communication as an indirect pathway for the impact of antismoking media content on smoking cessation. Journal of Health Communication, 16(5), 470-485.

This post is a guest blog written by Brian Southwell, Ph.D.
Research Professor, School of Journalism and Mass Communication, UNC-Chapel Hill
Senior Research Scientist, RTI International
He has studied a variety of topics relevant to health communication, including campaign measurement and evaluation, with special emphases on the intersection of interpersonal communication, social networks, and mass communication and on the role of aging.


Doctor examining a patient

Doctors and social media: To tweet or not to tweet?

A recent Wall Street Journal Health Blog post described the pros and cons of doctors using social media to discuss medical issues. The post features a video produced by the Mayo Clinic Center for Social Media that encourages doctors to use social media to disseminate general but medically accurate information for patients.

But, as Katherine Hobson reports in the blog post, there are some dangers for docs who use social media,

Privacy violations are one big pitfall. While it’s desirable for physicians to discuss patient cases, when they do so on Twitter or Facebook they have to “recognize that they are having a conversation in a hallway, not in a conference room with the door closed,” says Victor Montori, a Mayo endocrinologist and medical director of the clinic’s social media center. … Broadcasting purely personal activities can also affect a doctor’s professional image. Would you be totally confident in the ICU physician who just talked to you about your ailing mother if the first page of a Google search features a photo of him doing a keg stand?

What do you think of doctors and other health care professionals using social media? Does it enhance the conversation or muddy the waters even more? Would you go to a doctor who tweets, even anonymously, about his or her patients? Would you like to be able to communicate interactively with your doctor via social media?

Click here to watch the Mayo Clinic’s video on YouTube – “The Doctor is Online: Physician Use, Responsibility, and Opportunity in the Time of Social Media”


Direct-to-doctor marketing: What are students learning in med school?

Public health officials and journalists aren’t the only ones communicating about health issues. Drug companies spend billions of dollars on direct-to-consumer (DtC) advertisements each year. However, they are also communicating about these drugs with medical students — your soon-to-be doctors.

A HealthDay News article recently reported on a study done at Harvard and published in the journal PLoS Medicine that found 90 percent of clinical medical students receive marketing materials from drug companies, and most find no ethical problems with taking gifts from those same companies. The article states,

Their justifications included financial hardship or pointing out that most other medical students accepted such gifts. Nearly two-thirds of the medical students claimed that drug company promotions, gifts or interactions with sales representatives did not affect their impartiality regarding drug makers and their products.

The authors of the study suggest reforms are needed to shield medical students from marketing pressures due to the often misunderstood effects of advertising.

Why do these companies spend so much money on marketing and advertising if it isn’t effective? Can doctors be truly unbiased when considering treatment options for patients? What else besides rules about contact between medical students and drug companies could help reduce the pressure to use certain pharmaceutical treatments? How much do patients contribute when they ask doctors for drugs they’ve seen on television?

You’ve got…Gonorrhea: An evaluation of STD e-card notifications

Maybe you’ve heard of an e-health tool that’s been around since 2004 where you can send identified or anonymous e-cards to your past sexual partners to notify them that you’ve recently been diagnosed with an STD and encourage them to get tested? If you knew about the STD e-card tool, would you use it if you were diagnosed with an STD? That’s the question a study published in May in Sexually Transmitted Diseases set out to answer.

The CDC estimates that in the U.S. there are about 19 million new STD infections each year. One way to disrupt the spread of STDs is to encourage people who have been diagnosed to notify their recent partners who may also have been exposed to the STD. Laws about partner notification requirements vary by state and considering more than 80% of Americans use the Internet to search for health information, it makes sense to develop ways for people to use the Internet to provide sexual health information to their partners. Since 2004, more than 30,000 people have sent STD e-cards through a website called inSPOT to notify their past sexual partners that they may have been exposed to an STD. The e-cards also include region-specific information about STD testing and treatment resources.

The study published in Sexually Transmitted Diseases set out to evaluate how to make people in a Colorado clinic aware of the STD e-card tool and encourage its use. The STD e-card website was briefly promoted in Denver through website banners, newspaper ads, and radio ads. The results of a survey in a Denver-based clinic indicated that desire to use an e-card to notify partners about STD risk was low (less than 5%) compared to a strong preference to tell partners in-person (nearly 90%). What do these results mean for how we might be able to better use e-health tools? If the idea of anonymously and quickly being able to notify sexual partners of potentially embarrassing news seems appealing, why do you think people reported such reluctance to use the e-card service?

Italian Scientists on Trial for Words at Press Conference

Last week an Italian judge ruled that seven scientists will stand trial for charges of manslaughter stemming from what one of the seven scientists said during a press conference just days before an earthquake and what the other six scientists didn’t say. The 5.8 magnitude earthquake hit L’Aquila, Italy and tragically killed more than 300 people on April 6, 2009.

Fears about an impending earthquake near L’Aquila had been heightened in the weeks leading up to the actual quake because of seismic activity and the predictions of another scientist. In response to these fears, six days before the terrible earthquake the seven scientists, members of a national risk committee, participated in a press conference about the potential for an impending earthquake. During the press conference, one member of the risk committee allegedly said, “The scientific community tells me there is no danger, because there is an ongoing discharge of energy. The situation looks favorable.” This statement was not corrected or countered by the other six members of the risk committee. Townspeople have said they would have left their homes if not for the reassurances of the risk committee and so prosecutors have moved forward with charges against all seven scientists. At issue is how these scientists communicated a scientifically uncertain risk (predicting if an earthquake will occur) and the question is whether their reassurances that minimized that risk are tantamount to manslaughter.

From a health communication perspective, this tragic case brings to light issues about how scientists (or doctors and researchers for that matter) communicate about risk with the public. How should scientists communicate scientific uncertainty? Where is the line between providing the public with the best available information and creating a panic? I have often wondered how to best summarize potential risks of health recommendations in digestible sound bites that are accurate, but don’t cause a panic. In the case of the Italian scientists, should they be charged with manslaughter?


Tablet computer

College health centers go high tech

A recent MSNBC story highlights a growing trend at campus counseling centers: the use of technology to help handle an overload of patients. AP reporter Marth Irvine spoke with health professionals at multiple U.S. campuses and found that,

To help deal with the demand, more campus counseling centers are using computerized questionnaires, some that generate color-coded charts, to help them flag a serious problem more quickly than traditional paper-and-pencil evaluations… Many counselors say high-tech methods like these appeal to students, who are often more comfortable communicating with smart phones, iPads and laptops.

Psychologists interviewed in the article noted that the computerized feedback is often more forthcoming than what patients are willing to say in person, especially if they are not entirely comfortable with their therapists. Fifteen schools are using an electronic program called the Behavioral Health Measure, or BHM. Developed by a psychology professor, it has both short and long versions, depending on the waiting room time. Additionally, reports Irvine,

A psychiatrist at Johns Hopkins has developed a free service called Mood 24/7 that sends a daily text message to its users, asking them to rate their mood on a scale of 1 to 10. The data can then be accessed by the user, their mental health counselor and even family and friends.

What do you think of this use of technology to treat college students for mental health problems? What are the possible drawbacks? How could it be expanded outside of the counseling and psychological health realm to serve other health problems prevalent in the higher education setting?

Help make Mother’s Day healthy

Mother’s Day kicks off “Women’s Health Week” (May 8 – 14). The CDC and other public health agencies want everyone to remember that the health of America’s 83 Million moms is a crucial component of the nation’s health, and has a list of activities that will help;

Regular physical activity, healthful eating, healthy weight maintenance, quitting tobacco use, managing stress, protecting themselves from injury, and periodic check-ups are a few of the many actions that can lead to safer and healthier lives.

Still need to get mom a present? Here are the CDC’s suggestions for healthy Mother’s Day gifts:

  • Offer to change the batteries in the smoke detector if they haven’t been changed recently.
  • Help her get prepared for spring and summer storms.
  • Get her a fabulous spring hat for sun protection against skin cancer.
  • If she’s a senior, help reduce her risk for falls by making her home safer. Falls can lead to injuries, such as hip fractures and head traumas.  Falls are also the leading cause of non-fatal injuries for all children ages 0 to 19.
  • Learn together the common symptoms of a heart attack and what to do in case of one. Make the Call. Don’t Miss a Beat.
  • If she is pregnant or a new mom, sign her up for free text messages from text4baby.

You can even send Mom a healthy e-card from the CDC’s website. What healthy activities will you be doing with your moms this week? Also, don’t forget, the Monday after Mother’s Day is always National Women’s Check-up Day, so consider calling your doc and making an appointment.

Questionnaire may provide earlier autism diagnoses

The New York Times recently ran a story on how a questionnaire administered at a child’s 1-year check up can detect autism and other developmental delays. However, the test has a high rate of false positives.

Photo at left: Although the brain of a person with autism sometimes uses different areas, looking at the brain isn’t the only way to see if a child might be autistic.

Researchers examining the effectiveness of the questionnaire had pediatricians in San Diego use the tool and then followed the babies that had been identified as potentially having autism or other developmental issues. Out of the nearly 190 children they followed, 25 percent did not end up having autism or another developmental issue, according to the article.

Previous research has shown that early intervention can be more effective,  so it seems that getting a diagnosis early could be useful and helpful to the child and the parents.

However, with a quarter of diagnoses being wrong, it seems like communication could play a very big role. What do you see as the role of communication? How does one communicate that a test may provide false positives and make this understandable?


friends at the beach

NPR asks: “Do our friends make us fatter?”

Are your friends sabatoging your summer beach bod? Many research results say it’s possible, if not plausible. NPR’s Robert Krulwich asks in his blog “Krulwich Wonders…” if our friends make us fatter.

Re-reporting, from a blog by Jonah Lehrer, Krulwich discusses the stunning results of some correlational research by Nicholas Christakis and James Fowler, who analyzed 32 years of data for trends related to obesity:

Christakis and Fowler reported that when two people are friends for a long while, if one of them becomes obese, the chances that the friend will do the same increased by 57 percent. That’s a big number, far more predictive than if those two people shared genes associated with obesity, says Jonah.

Many health behavior theories note that at least somewhere in the process, peers and social factors can have some sort of influence on attitudes and actions (e.g. Social Cognitive Theory, the Transtheoretical Model, the Health Belief Model, just to name a few).

What sort of communication campaigns could we produce to target social aspects of obesity? What public policies would help attack obesity from this important angle? Do the news media give enough coverage to this component of the causes of obesity, or do they focus too much on just individual or larger societal/policy levels?