Tag: Health Communication

Appointments From Home? Embracing the Digital Doctor

For many Americans on the go, getting sick means more than dealing with aches and pains and feeling under the weather. For most, it can also mean having to take time off from work or school to visit the doctor — an event that most of us would consider less-than pleasant in our busy schedules.

But technology has given us an option to make the pain of getting sick a bit easier. Now, smartphone users can login to a mobile app to not only schedule their next primary care appointment, but they can also been seen and treated by a doctor — all from the convenience of the patient’s own home.

This form of medical treatment, known as cybermedicine, appeals to patients not only for its simplicity, but also for its value. Many users have found embracing a “digital doctor” ends up costing less than their usual co-pay associated with a traditional appointment. The form of treatment has proven so successful, several major hospitals and mainstream health insurers are now covering digital consultations to offset the shortage of primary care physicians. Users also cite far shorter wait times, as well as the convenience of being treated 24 hours a day, seven days a week.

In 2015, there were close to 7.2 million doctor-patient video consultations, but predictions estimate this form of treatment to reach 124 million in just three years.

However, many in the medical world remain skeptical. Some organizations say cybermedicine can prevent patients from forming lasting relationships with providers — an element they feel is key to correcting the overarching issue of improved care coordination between patients and providers. Some critics also feel misdiagnoses are more common with this particular form of treatment.

A final reason the healthcare industry is opening an eye to cybermedicine is money. Predictions indicate that it could save employers around $6 billion per year. And while recent data indicates only about 385 of insurance plans cover it, 81% of carriers plan to include it in their coverage plans by 2018.

So if you’re feeling ill and are just too tired to make it off the couch, consider making your next appointment using your phone or tablet. You don’t even have to change clothes or freshen up.

My Final Post & Reflections

For my final blog as a contributing writer on Upstream, I’d like to reflect back on the last two semesters and what I’ve learned completing my Interdisciplinary Certificate in Health Communications. First and foremost: communication really is key.

In my Masters of Public Health program, we learn the ins and outs of nutrition basics –what the recommendations are throughout the the life cycle, how to treat difficult medical conditions with food, how to plan impactful public health programs, how to analyze the latest research, and more. In the first part of my internship to become a Registered Dietitian, I also learned firsthand how communication can make or break health promotion efforts, the success of a grant proposal, or a one-on-one counseling session. A recurring theme in all of this is that the communication has to be exceptional in order to see a favorable outcome.

Health communication is a rigorous social science. There are theories (more than I’m able to wrap my head around) trying to predict how communication strategies will affect behavior change. Research looks at how images may affect attitudes and self-efficacy, how visual appeal dictates our trust, how tailoring communications helps make them more effective, how the media promotes but can also combat stigma, and how interpersonal communication can enhance large-scale campaigns. The list goes on.

What I’ve come to find in my short time in the health comm world is that human beings are very complicated creatures, and how (or when or who or why) you communicate health messages to them is extremely important to the success of that message getting through.  Applying this to my future profession in nutrition, you can’t just tell someone to eat healthy and expect results! The same goes for public health efforts attempting to reach people at the population level. This is especially important to remember as a health professional, because the way we think about these topics may diverge from how the general public thinks of them. We should always trust the audience and know that however a message resonates with them is important to the way we design our campaigns and messages.

So thank you, health communication world, for letting me get a glimpse into your complex and necessary world. I hope the things I’ve learned can help me become a better nutrition professional where I can make lasting changes for people who need it.



Photo source: Virginia Sea Grant via Flickr.com


Dr. Maria Leonora “Nori” Comello is an assistant professor here at UNC in the School of Media and Journalism as well as a teacher so much loved by students.

Having expertise in public relations and health communication, Dr. Comello’s research has focused on intersection of strategic communication, health, and identity.

Especially, Dr. Comello is an insightful researcher fascinated by “identity.” She was first inspired for the concept by a quote of William James, a psychologist in the late 1800s: “Neither threats nor pleadings can move a man unless they touch some one of his potential or actual selves.”

She has worked on a variety of health communication research exploring effects of valued and activated identities on behavioral decision-making, including tobacco-prevention research among Mexican-American youth audiences and substance-prevention research incorporating ideas of self-concepts and behavioral willingness to use substances.

Her recent research interest includes the potential for games to support identities in a health communication context (e.g, how cancer survivors or patients with chronic diseases use games to achieve meaning in life). In one of the relevant studies, she looked at if game playing had beneficial effects on cancer survivors who often experience physical symptoms as well as emotional symptoms, such as anxiety, fatigue, and fear of recurrence. She found that intrinsic motivation cancer survivors has while playing games was positively associated with cancer self-efficacy, resilient coping, and flourishing; sense of community was also positively associated with resilient coping and flourishing.

Cosmic Mihaiu “Physical therapy is boring — play a game instead

What’s the main problem of current physical therapy? The therapy is boring and painful so that patients are not able to follow the prescription to do repetitive movements for recovery. As a result, patients need more time to recover. Most of the patients feel boring, frustrating, and confusing for the exercise.

Screen Shot 2015-12-03 at 9.08.19 PMHowever, Mihaiu declared that video game can fix this problem by making the exercise more interesting and engaging.

When he was a child, he climbed a tree but fell from the tree and broke his arm. At first, his physical therapist worked with him, but then it’s up to him to do the exercises at home. At that time, he thought doing repetitive movements was boring, so he barely did it. As a result, he had to have another six weeks to regain the range of movement lost due to the injury.

In order to fix this problem, Mihaiu created a software — MIRA to make physical therapy interesting and engaging. This software is a platform where physicians are able to change prescription for physical exercises to digital video game. On this platform therapists can easily program video games in accordance with different needs from various patients. By making the physical extension and flexion more interesting, patients feel more engaged and more confident so that they are more likely to do the exercise.

In addition to the customization, this software also has three different categories targeting at different patients: children, adult, and senior. Most importantly, this platform provides data collected during patient’s exercise. The gathered data not only gives patients a sense of achievement, but provides valuable information for the physical therapist to adapt patient’s treatment.

Photo credit: http://www.takingonthegiant.com/2013/05/17/can-physical-therapy-be-fun-and-fast-romanian-entrepreneur-cosmin-mihaiu-proves-it-can/


who contributes to the poor care coordination in the U.S. health system?

The organization of the private health sector contributes to the poor care coordination in the United States health system.

Firstly, with different purposes to provide health care service, it’s difficult for public and private health sector to cooperate. Unlike public health care providers, the purpose of private providers is to make a profit. The payment of private providers is not transparent and the health care costs rise rapidly, leaving patients with little choice but to go into debt to pay for the care. As a result, private health care is too expensive for Americans. Some patients may decide not to seek help because of the financial problem. However, with the goal of promoting health status of entire population, the payment for public health sector is relatively law with the comparison to private health sector. Due to the existing inconsistency of the payment, the care coordination is a serious challenge.

Secondly, due to the disparate competitors, the cooperation between public and private health sector is difficult. Private health care provider needs to compete with other providers. Thus, in order to attract more consumers, several health services with low price but poor health care quality will be created. However, the competitor for public health care sector is health problem. With the purpose of addressing health problem successfully, the public provider will provide high health care quality with relatively high price. Therefore, a potential competition of price between private and public health care may harm the care cooperation.

In general, the private health sector makes care coordination a serious challenge by largely fragmenting the health care delivery system. This fragmenting leaves patients with poor-quality health care outcomes. Medical errors can occur as a patient moves from one care setting to another, or is prescribed different medications that interact.

James R. Knickman and Anthony R. Kovner (2011). Jonas and Kovner’s health care delivery in the United States. Springer Publishing Company.

Photo credit: http://svlg.org/policy-areas/health-policy/health-policy-committee

5 Gaps in Clinical Preventive Services for Women

The U.S. Preventive Services Task Force (USPSTF) recently released its fifth annual report to Congress on high-priority evidence gaps for clinical preventive services. This report is a requirement of The Patient Protection and Affordable Care Act, Sec. 4003 (F):

“The submission of yearly reports to Congress and related agencies identifying gaps in research such as preventive services that receive an insufficient evidence statement, and recommending priority areas that deserve further examination, including areas related to populations and age groups not adequately addressed by current recommendations.”

The USPSTF does not conduct it’s own research, but reviews existing peer-reviewed evidence to make these recommendations. These recommendations are not based on costs or insurance coverage decisions. For more information on the Task Force process for making recommendations, please see the full report here.

The five gaps the Task Force identified the following as areas in need of improvement:

  1. Screening for Intimate Partner Violence, Illicit Drug Use, and Mental Health Conditions
  2. Screening for Thyroid Dysfunction
  3. Screening for Vitamin D Deficiency, Vitamin D and Calcium Supplementation to Prevent Fractures, and Screening for Osteoporosis
  4. Screening for Cancer
  5. Implementing Clinical Preventive Services


Drunk driving: completely preventable crime (2)!

The high rate of death related to drunk and drugged driving can be dramatically reduced by the installation of ignition interlock device (IID) for all convicted drunk drivers, including first-time offenders with a blood alcohol concentration (BAC) of .08 or greater. States with this restrictive law have witnessed a significant decline in drunk driving deaths compared to states with laws requiring only repeat offenders or first-time offenders with a  BAC of .15 or greater to install IID. With the implementation of this more restrictive law, drunk driving fatalities of Arizona and Oregon decreased 43.2% and 42.7% respectively. To the contrary, states with law requiring the installation of IID among only repeat offenders or first-time offenders with a BAC of .15 or higher had slow declines. The fatality reductions concerning DUI in Florida and Nevada were 21.7% and 26.8%.

A report published by the Insurance Institute for Highway Safety also confirmed the effectiveness of IID for all convicted drunk drivers, including first-time offenders with a BAC of 0.08 or higher. It also found that focusing on convicted drunk drivers with .15 BAC or greater is a bad policy because the target population of this bad policy is too narrow to make sense. Moreover, the research from Centers for Disease Control and Prevention (CDC) indicated that first-time offenders have driven drunk for at least 80 times before being arrested. Therefore, asking all convicted drunk drivers including first-time offenders with a BAC of .08 or greater to install IID is an effective way to reduce the fatality rate related to drunk driving.

Photo credit: http://news.onlineautoinsurance.com/consumer/labor-day-car-insurance-98023

Drunk driving: completely preventable crime (1)!

An 18-year-old man was charged with driving while intoxicated in a fatal crash. On October 12th, a man was killed by an underage drink and drugged driving crash in High Point. It was a head-on crash happened around 2 a.m.. Although both Turner and Yeomans were transported to Mose Cone Hospital immediately after the collision, Yeomans died while receiving treatment and Turner had serious, but not life-threatening injuries. As a result, 18-year-old Turner was charged with not only driving while intoxicated (DWI) but also driving after consuming under the age of 21. Why this vehicle crash deserves our attention? Because this accident did not simply destroy two people, instead, it destroyed two families.

Almost 30 people every day died of motor vehicle crashes involving an alcohol-impaired driver in the United States in accordance with the article published by CDC. “Over 10,000 people every year are killed and another 290,000 are injured as a result of drunk driving,” said MADD National President Colleen Sheehpey-Church, who lost her 18-year-old son in an underage drink and drugged driving crash. Do you really think these terrifying numbers are non of your business? Do you really believe that you or your family members will never meet any irresponsible drivers who drink while driving?

Hopefully, your answers for these two questions above are no.

Drunk driving is completely preventable crime!

Photo credit: http://brandongaille.com/35-best-anti-drinking-and-driving-slogans/

Dewey Mooring on Three Simple Rules for Marketing Success

Earlier this week, the writers of Upstream had the pleasure of hearing Dewey Mooring, the Vice President of Jennings: Healthcare Marketing talk about three simple rules for marketing success.

Mooring, a UNC alumni, graduated with a B.A. in Radio, TV and Motion pictures in 1993. He started his career in communications at WCHL, a local radio station in Chapel Hill, by helping with the broadcast of Tar Heel basketball and football games.

Fifteen years ago, he decided to join the advertising world, and now as the Vice President of Jennings, he leads the account team, authors strategic plans, creative briefs, and oversees research for various clients including Vidant Health, Cooper University Health Care, Southwestern Vermont Medical Center, and Darmouth-Hitchcock Medical Center, among others.

As aspiring health communicators, we all benefited from Mooring’s valuable advice about successful marketing. He offered these three simple rules to follow:

1.) Know

Get to know your audience. If you don’t understand who you’re talking to, you won’t be successful in talking to them. Mooring suggests creating a persona for your audience in order to best market to them. Give that person a name, an age, a salary, and find out their media interests, like what they watch on TV, what magazines they read, and what brands they like.

2.) Engage

Once you get to know your audience, it becomes important to use this information to engage them. In the world of healthcare, peer-to-peer communication has become a huge trend, especially among online health information seekers. Because of this, finding ways to use social and digital media to connect brands with their target audiences can be a successful strategy. Mooring exemplifies this by talking about the company’s use of a blog for Lowell General Hospital & Floating Hospital for Children titled, Our Circle of Moms, that engages moms in the hospital’s brand by allowing them to connect and share with other moms in the community.

3.) Measure

When working with clients, it is important to not only show them what you spent their money on, but also to justify the money spent with measured results. This can be done by keeping track of visits to websites, how many people signed up for a program after information sessions, and radio and digital reach. Mooring points out that while measuring results is easier than it was before, it can still be difficult in the area of healthcare, as the majority of hospital services and treatments do not lend themselves to immediate action by consumers.

World AIDS Day: who is at-risk?

As the World AIDS Day is approaching on December 1, AIDS is more discussed openly and with compassion instead of in secrecy and shame.
Do you still believe population with high-susceptibility are sexual workers, drug users, and men who have sex with men? Yes or No!
Yes. They do have high risk of being infected by HIV.
No. There is a large number of teenagers being infected by HIV. According to CDC, youth aged from 13 to 24 accounted for a substantial number (estimated 26%) of all new HIV infections in the United States in 2010.
However, although previous research studied the knowledge, attitudes, practice, and influencing factors concerning AIDS among teenagers in the United States,  a group of teenagers is missing.
Chinese international students, a vulnerable group, need to be taken care!

With high-susceptibility of being infected by HIV, Chinese international students did not be studied before. Based on the report published by National Center for AIDS/STD Control and Prevention (China), there was an increasing number of students who were infected by HIV. Those students accounted for 1.64% of the total HIV carriers and people living with HIV/AIDS in 2011, increased from 0.96% in 2006. Of those students, almost half of them (49%) were aging from 20 to 24. Therefore, teenagers, especially college students, are the most vulnerable group concerning the chance of getting AIDS (He et al., 2008; Liu, 2006; Wang, 2002). Unfortunately, most of the previous research in China studied the knowledge, attitudes, and practice (KAP) concerning AIDS among college students in mainland China, instead of studying Chinese international students in the U.S.. Similarly, there is no study mainly focus on this group of students in the U.S.. Therefore, study on Chinese international students is in demand.

Additionally, the number of Chinese students studying in the United States is increasing according to the data published by the U.S. Department of Homeland Security. Nearly 100,000 Chinese students came to U.S. universities between 2009 and 2012, which contributed to a quarter of all foreign students in the U.S..

With an increasing number and high-susceptibility of being infected by HIV, Chinese students in the United States deserve research to learn their KAP, and develop effective preventions.


Photo credit: https://top5ofanything.com/list/ecdb3c65/Countries-with-The-Highest-HIV-AIDS-Prevalence-Rates


He et al.. (2008). Analysis to the effect of health education for college students’ AIDS-related knowledge and attitude. Chinese Journal of Health Education 24 (2): 102-104

(贺莉萍, et al. “健康教育对大学生艾滋病相关知识态度的影响.” 中国健康教育 24.2 (2008): 102-104.)

Liu, L.R.. (2006). Summary of health education of AIDS prevention in Beijing. Chinese Journal of Health Education 22 (2): 146-148

(刘利容. “北京地区预防艾滋病健康教育研究综述.” 中国健康教育 22.2 (2006): 146-148.)

Wang, Q.L.. (2002). 全球艾滋病流行进展. 中国艾滋病性病, 1, 000.