In backyards, on front lawns: examining informal risk communication and communicators

Risk communicators are often envisioned as government officials, public relations practitioners, or health workers. Yet much of the public's risk information comes from informal messages and unofficial carriers. Referred to in this study as "informal risk communicators" (IRCs), these individuals are often service workers who relay risk information to public audiences, though often outside of their formal job descriptions. Literatures in the health communication, science and technology studies, and risk communication fields have considered ideas relevant to explaining these individuals, and the risk communication work they perform. To further explore this category of individuals, this study examines the communicative practices of commercial pesticide applicators, using both in-depth interviews and surveys. Through their interactions with clients, these individuals offer care, as well as project expertise and identity; however, the extent to which this work is recognized and validated is less clear. Both applied and theoretical implications of this research are considered.

Examining the presence of problem gambling awareness messages on college counseling center websites

College students are more at-risk for developing a gambling problem than the general adult U.S. population. Information behavior and information seeking theories, as well as empirical evidence, indicate that one resource that may provide guidance for students dealing with this issue is the college counseling center website (CCW). This study addressed the presence and nature of problem gambling messages on CCWs. As a random sample, 203 CCWs were selected to assess how frequently they provided any information about problem gambling, as well as the specific types of communications CCWs offered on this topic. Results showed that CCWs rarely included any messages about problem gambling. Specifically, only 15% of all CCWs contained information about problem gambling. Furthermore, messages about problem gambling were presented significantly less frequently than messages involving alcohol abuse, substance abuse, depression, anxiety/stress, and psychological struggles with food. Given the prevalence of problem gambling among college students, as well as the value that college students place on information provided on CCWs, it is important that these sites offer more information concerning this issue.

Use of the internet for health information: United States, 2009

Research has shown that 74% of all U.S. adults use the Internet, and 61% have looked for health or medical information on the Internet. Additionally, 49% have accessed a website that provides information about a specific medical condition or problem. In 2009, the National Health Interview Survey (NHIS) became the first nationally representative household survey to collect data on the use of health information technology when the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation sponsored 10 questions that asked about use of the Internet to look up health information, refill a prescription, schedule a medical appointment, learn about health topics in online chat groups, and e-mail a health care provider. This report provides estimates, using 2009 NHIS data, about adult use of the Internet for health information in the past 12 months, by selected sociodemographic characteristics.

What kind of cancer information do Internet users need?

PURPOSE

The Internet becomes one of the most effective communication media in healthcare. This study aimed to evaluate the cancer information sources and the needs of various types of Internet users.

METHODS

We conducted a survey on the National Cancer Information Center website from April 2007 to December 2007. Of the 170,746 visitors, 507 responded to the survey, and the data were analyzed according to self-identified user types.

RESULTS

The participants identified themselves as patients (17%), caregivers (32%), healthcare professionals (21%), or general public (30%). Different user groups looked for different cancer information. Totally, 72.1% patients and 82% caregivers wanted the information about treatment, and 71.3% of healthcare professionals and 88.2% of the general public wanted the information related to 'prevention & diagnosis.' Healthcare professionals had a higher need for "statistics & research" information compared to other Internet user groups. The Internet was reported as the most common source of cancer information for all user groups.

CONCLUSIONS

The type of cancer information needed and the usefulness of the information acquired on the Internet varied among the different types of user groups, suggesting that Web-based cancer information should be tailored to each type of user.

Effects of emotional tone and visual complexity on processing health information in prescription drug advertising

This experiment explored how the emotional tone and visual complexity of direct-to-consumer (DTC) drug advertisements affect the encoding and storage of specific risk and benefit statements about each of the drugs in question. Results are interpreted under the limited capacity model of motivated mediated message processing framework. Findings suggest that DTC drug ads should be pleasantly toned and high in visual complexity in order to maximize encoding and storage of risk and benefit information.

"User-testing" as a method for testing the fitness-for-purpose of written medicine information

OBJECTIVE

Written medicine information is essential to support spoken information from pharmacists, but must be fit-for-purpose. This study applied "user testing" to the booklet supplied to UK patients taking anticoagulant medicines.

METHODS

"User testing" uses mixed-methods, applied iteratively, to assess document performance - can people find and understand key points of information through a questionnaire and short semi-structured interview. The booklet was tested in 3 rounds of 10 people. After each round it was revised according to participants' responses, and re-tested.

RESULTS

The first round questionnaire identified problems with 6/18 information points (booklet purpose; other information; what affected daily doses; effect of ibuprofen; tablet colour; drinking alcohol); interviews raised further issues. The booklet was revised and, in the second testing round, one problem identified (changing doses of other medicines); the interviews raised fewer issues. After further re-wording and re-design, a third round showed all questions found and understood by at least 8/10 participants.

CONCLUSION

User testing assesses whether people can find and understand key information and can be applied using small numbers of participants. Application to medicine information can markedly improve performance.

PRACTICE IMPLICATIONS

Information producers should consider user testing to ensure documents are 'fit for purpose' in informing patients.

Promise of and potential for patient-facing technologies to enable meaningful use

Patients are using healthcare technologies for a variety of reasons. Recently, the Meaningful-Use rule was released by the Centers for Medicare and Medicaid Services, providing some initial guidance for patient-facing technologies. There needs to be more of an understanding of patients' needs and how these technologies can be utilized effectively. This article provides a framework for organizing patient-facing technologies into categories of meaningful use, and how these technologies can improve healthcare quality, safety, and population health. Barriers to achieving meaningful use of HIT and unintended consequences of patient-facing technologies are discussed. The success of healthcare reform is predicated on achieving improved health outcomes and reduced costs, which can be accomplished only by activating patients to become more engaged in their own care. Patient-facing technologies are likely to play a critical role in supporting patients to become more informed and activated and may also improve efficiencies. Further research is needed to identify the most useful and effective technologies for patients.

Survey of consumer informatics for palliation and hospice care

CONTEXT

Palliation in patient care is under-utilized in part because many patients have insufficient knowledge about this management option. Information technology can improve awareness by providing access to numerous sources of trustworthy information.

EVIDENCE ACQUISITION

To estimate what a patient interested in palliation might find online, online resources were searched in July 2010, using terms relevant to palliation. PubMed was searched for publications relevant to discussed topics.

EVIDENCE SYNTHESIS

Search engines returned vast numbers of hits, and identifying trustworthy sites was difficult. Products judged as trustworthy were classified as information, decision tool, or extended interaction tool. Sites with useful educational material were relatively plentiful; decision guides or interactive tools were much rarer. Available consumer informatics did not address some terminal illnesses very well, and some subpopulations such as children, nor was there sufficient attention to literacy levels or principles of instructional design. Online or published information about usage numbers, effectiveness, and cost/benefit considerations was scant. Many sectors, including commercial, government, healthcare, research, and wellness/advocacy groups, have created consumer informatics for palliation.

CONCLUSIONS

Online information about palliation is available, although identifying trustworthy sources can be problematic. General information sites are relatively plentiful, but more tools for decision making, and interaction would increase value of web resources. More attention to literacy levels, instructional principles, and needs of special populations would improve products. Research to measure usage of such tools, ability to influence behavior, and cost/benefit issues is needed.

Roles of interpersonal and media socialization agents in adolescent self-reported health literacy: a health socialization perspective

This study proposes a health socialization model and applies it to examine direct, relative and mediating roles of interpersonal and media health socialization agents in predicting adolescent self-reported health literacy. We conducted a paper-and-pencil survey among 452 seventh graders in rural and urban school districts. Our regression analysis results show that both interpersonal and media socialization agents are significantly and positively related to adolescent health literacy. Media socialization agents seem to play a strong role in health literacy orientation, not much weaker than those of interpersonal socialization agents. The proposed health socialization model could contribute to the literature on how adolescents acquire health-related information and channels through which they are most receptive.

Reporting diet-related health issues through newspapers: portrayal of cardiovascular disease and Type 2 diabetes

This study identifies (i) the extent to which newsprint media communicate to their readers the lifestyle factors associated with the development of cardiovascular disease and Type 2 diabetes and (ii) newspaper portrayal of social determinants affecting onset of disease. A content analysis of five leading UK national newspapers and their Sunday equivalents was conducted over a 3-month period between January and March 2008. This study shows that cardiovascular disease had much higher press interest than Type 2 diabetes. 'Middle-market' and 'Quality' papers had higher levels of reporting than the 'Popular' press, but the patterns were more complex when the comprehensiveness of reporting was measured within each article. Social determinants affecting disease onset were poorly reported by newspapers, supporting similar research conducted in other countries. This research identifies that there is potential for newspapers to improve their reporting of lifestyle diseases, by including individual and social determinants of disease onset. Lower social classes who read the popular press receive the lowest frequency of reporting and could benefit most from this information. While the research identifies that newspapers are missing the potential to actively communicate and reinforce government health policy, it recognises that the commercial context of the print media may counter such behaviour.

After the injury: initial evaluation of a web-based intervention for parents of injured children

The purpose of this study was to survey parent knowledge of child injury reactions (including post-traumatic stress symptoms) and to evaluate parent satisfaction and learning outcomes following a video- or web-based intervention. Fifty parents of children ages 6-17 years who were injured within the past 2 months were recruited from emergency and inpatient settings. A repeated-measures experimental design was employed in which participants were assigned to either a web-based or video intervention. Parent knowledge was assessed pre- and post-intervention. Learning outcomes and satisfaction were evaluated post-intervention. Parents showed high levels (∼70% accuracy) of knowledge about potential psychological injury reactions at baseline and post-intervention. In addition, post-intervention parents were able to generate new positive strategies to help their child recover and became more specific about types of reactions to monitor (e.g. avoidance). Participants reported high levels of satisfaction with both web and video interventions. While parents possess high levels of basic knowledge about child recovery from injury, the Web site and video tools provided concrete guidance that was useful in enhancing parent understanding of specific traumatic stress reactions to monitor in children post-injury.

GotFlu channel: an online syndromic surveillance tool supporting college health practice and public health work

OBJECTIVE

Develop a tool to ease the burden of H1N1 influenza on a campus clinic by promoting self-care, generating medical notes, and identifying vulnerable students.

PARTICIPANTS

Students at Brock University, a mid-sized urban campus; Brock's Student Health Services; and Niagara Public Health.

METHODS

Students accessed a controlled portal of Brock's Web site and self-identified onset/offset of influenza-like symptoms. Daily sign-in numbers were monitored and nonidentifiable aggregate data transferred to the local public health unit.

RESULTS

There was concordance among the number of college students signing in, local school absenteeism rates, and local rates of laboratory-confirmed influenza. Many visits to the campus health clinic were averted, 1,432 students used the tool.

CONCLUSION

The online, real-time surveillance tool was effective in monitoring influenza activity on campus, providing timely health advice, decreasing unnecessary visits to the campus medical clinic, and assisting local public health in surveillance activities.

Health information-seeking in the digital age

OBJECTIVE

The authors examined the sources of health information among first-year university students and whether the predictors of information-seeking varied by information source.

PARTICIPANTS

First-year students in a required course at a midwestern public university were eligible to participate, and 82% (n = 1,060) completed the study.

METHODS

Students completed a survey questionnaire regarding information-seeking behaviors and Internet uses in domains including health. The authors used regression analyses to examine predictors of source-specific health information-seeking.

RESULTS

Young women are much more likely than young men to seek health information. The characteristics associated with looking online for health information are different than those for using other information sources, and students who look online for health information also report greater use of other information sources.

CONCLUSIONS

Although the Internet is an important source of health information for students, health professionals should be aware that not all students equally utilize this resource.

'One wants to know what a chromosome is': the internet as a coping resource when adjusting to life parenting a child with a rare genetic disorder

The internet has democratised access to health and diagnostic information, enabling patients to mobilise social support from peers and advocate their interests in encounters with medical personnel. Research has shown that these possibilities are particularly important for patients and caregivers confronting a rare medical condition. However, little research has focused on how the act of searching for and accumulating information via the internet can be important for coping emotionally with a situation characterised by uncertain prospects and inadequate information from health personnel. This paper explores the experiences of 10 Norwegian parents whose children have different rare genetic disorders and who used the internet as a resource. The analysis draws on the theoretical framework of the medical sociologist Aaron Antonovsky, who emphasises people's inherent ability to manage extremely stressful life experiences. Analysing the process of adjusting to and coping with life parenting a child suffering from a rare genetic disorder, this study shows that becoming knowledgeable about a child's condition is essential for gradually comprehending and managing a situation that initially seems unmanageable and distressful. It also suggests that as parents adjust, so do the frequency and purpose of their internet searches.

What do deaf high school students know about HIV?

Deaf adolescents who use American Sign Language (ASL) as their main communication mode are, like their hearing age peers, at risk for acquiring HIV. Many sources of HIV information (radio and television) are not accessible to these adolescents. Little is known about HIV knowledge base and risk behaviors of this group. The objective of this study was to develop and administer, on laptop computer, an HIV knowledge and risk survey in ASL. Findings among 700 deaf adolescent participants attending high schools for the deaf throughout the United States showed that, on average, students knew correct answers to approximately half (x = 7.2) of 14 knowledge items (median: 7.0; range: 0-14; sd = 3.8) on a highly reliable knowledge scale (α = .83). Knowledge score was found in multivariable analysis to be strongly related to receiving HIV information in school. This population is clearly in need of linguistically and culturally accessible HIV prevention education delivered in school.

Evaluating housing quality, health and safety using an Internet-based data collection and response system: a cross-sectional study

BACKGROUND

Typically housing and health surveys are not integrated together and therefore are not representative of population health or national housing stocks. In addition, the existing channels for distributing information about housing and health issues to the general public are limited. The aim of this study was to develop a data collection and response system that would allow us to assess the Finnish housing stock from the points of view of quality, health and safety, and also to provide a tool to distribute information about important housing health and safety issues.

METHODS

The data collection and response system was tested with a sample of 3000 adults (one per household), who were randomly selected from the Finnish Population Register Centre. Spatial information about the exact location of the residences (i.e. coordinates) was included in the database inquiry. People could participate either by completing and returning a paper questionnaire or by completing the same questionnaire via the Internet. The respondents did not receive any compensation for their time in completing the questionnaire.

RESULTS

This article describes the data collection and response system and presents the main results of the population-based testing of the system. A total of 1312 people (response rate 44%) answered the questionnaire, though only 80 answered via the Internet. A third of the respondents had indicated they wanted feedback. Albeit a majority (>90%) of the respondents reported being satisfied or quite satisfied with their residence, there were a number of prevalent housing issues identified that can be related to health and safety.

CONCLUSIONS

The collected database can be used to evaluate the quality of the housing stock in terms of occupant health and safety, and to model its association with occupant health and well-being. However, it must be noted that all the health outcomes gathered in this study are self-reported. A follow-up study is needed to evaluate whether the occupants acted on the feedback they received. Relying solely on an Internet-based questionnaire for collecting data would not appear to provide an adequate response rate for random population-based surveys at this point in time.

[European Antibiotic Awareness Day educational campaign--has it changed public attitudes to antibiotic use in Poland?]

Widespread inappropriate antibiotic use is a global concern for public health care. That is why national and international antibiotic resistance control strategies recommend education of health-care professionals and the public to promote prudent antibiotic use. This paper show the effect of the 2009 public antibiotic campaign in Poland on the knowledge and social attitudes towards use of antibiotics. The aim of this study was to assess the level of knowledge and behaviour models of Polish people regarding antibiotics, recommendations for their use as well as sources of information on antibiotics. At the same time the study was aimed at assessing whether actions undertaken during educational campaigns resulted in growing knowledge on the subject of antibiotic use or a change in attitudes towards this group of medicines.

MATERIAL AND METHODS

A two-stage survey was carried out from October to December 2009 based on 14 self prepared questions. The survey was carried out by Millward Brown SMG/KRC on the representative sample of 1000 people using CATI - Computer Assisted Telephone Interviews.

RESULTS

In Poland there is still a high percentage of people taking antibiotics. 37% of Polish people used an antibiotic in the last 12 months. Most Polish people--88% use an antibiotic prescribed by a doctor. At the same time Polish people receive antibiotics due to viral infections which should not be treated thus. The results of the survey show that almost half of adult Poles would expect to have an antibiotic prescribed in case of a flu. Over half of Polish people believe that antibiotics kill viruses. Over 1/3 of recipients, who have come across information on prudent use of antibiotics (mostly due to National Program for Antibiotics Protection) claimed to have changed their behavior model regarding this group of medicines.

CONCLUSIONS

The results of this study show that further and systematic education regarding appropriate antibiotic use is needed.

Student reception, sources, and believability of health-related information

OBJECTIVE

The purpose of this study was to identify the health topics students received information about, how students obtained health-related information, and perceived believability of those sources.

PARTICIPANTS AND METHODS

Students (N = 1202) were surveyed using the National College Health Assessment (NCHA) of the American College Health Association.

RESULTS

Nearly half (46%) of the sample reported not receiving any information, whereas only 0.5% received information on all health topics. The Internet was the most common source of health-related information, but, conversely, was perceived as the least believable source. Health center medical staff and university health educators were perceived to be the most believable sources.

CONCLUSIONS

Future practice at the university setting should focus on delivering health information through believable messengers utilizing the most commonly reported sources of information. This may have implications towards how students shape their health-related social cognitions and subsequent behaviors.

Applying the health belief model to examine news coverage regarding steroids in sports by ABC, CBS, and NBC between March 1990 and May 2008

The investigation described here examined ABC, CBS, and NBC news coverage of steroids in sports between March 1990 and May 2008. Employing a framing analysis guided by the health belief model (HBM), coverage of the barriers and benefits of using steroids is reported. Overall, the trend by these three news affiliates was to emphasize the illegality of using steroids, whereas considerably less coverage was devoted to the health costs, in terms of both severity and susceptibility, of using steroids. Furthermore, of the health costs reported, the specific consequences of steroid use varied considerably. The results are reported across four timeframes: 1990-2008, 1990-1996, 1997-2002, and 2003-2008.

Organ donation on Web 2.0: content and audience analysis of organ donation videos on YouTube

This study examines the content of and audience response to organ donation videos on YouTube, a Web 2.0 platform, with framing theory. Positive frames were identified in both video content and audience comments. Analysis revealed a reciprocity relationship between media frames and audience frames. Videos covered content categories such as kidney, liver, organ donation registration process, and youth. Videos were favorably rated. No significant differences were found between videos produced by organizations and individuals in the United States and those produced in other countries. The findings provide insight into how new communication technologies are shaping health communication in ways that differ from traditional media. The implications of Web 2.0, characterized by user-generated content and interactivity, for health communication and health campaign practice are discussed.