Public Education and Cancer Control

Framing diabetes public health information during Ramadan - a newspaper content analysis

Objective

To evaluate health-related messages in printed media pertaining to diabetes care in Qatar during Ramadan.

Methods

Qatar national newspapers (Arabic and/or English) published 6 weeks prior to and 4 weeks during Ramadan 2012 were reviewed. Health-related content was identified and characterized according to four different categories including presence of messages pertaining to both diabetes and Ramadan. Articles describing diabetes and Ramadan combined were further evaluated according to specific features of prominence (surrogates for perceived reader importance). Newspapers were grouped by language, and volume and content of coverage were compared between groups.

Results

A total of 1 467 newspaper issues published during the 2012 review period (781 in Arabic and 686 in English) were analysed. Health-related articles appeared consistently throughout the study period, but few were specifically diabetes-related (66/1095 [6%] Arabic articles versus 34/1250 [2.7%] English articles; P = 0.008). Only 34/1095 (3.1%) Arabic and 23/1 250 (1.8%) English (P = 0.05) articles pertaining specifically to diabetes management during Ramadan were published. Twenty/34 (59%, Arabic) and 6/23 (26%, English) were published in high prominence positions.

Conclusions

Opportunity exists to augment the relatively low coverage of diabetes health-related messages in print media during Ramadan.

Standard definitions of adherence for infrequent yet repeated health behaviors

OBJECTIVE

To present common language for defining adherence of infrequent yet repeated health behaviors.

METHODS

We illustrate methodological and conceptual issues using human papillomavirus (HPV) vaccination and screening mammography study data as examples.

RESULTS

Adherence rates of infrequent, repeated behaviors varied widely depending on how adherence was defined and measured. We advocate use of 3 standard definitions of adherence: initiation of behavior (initiation), adherence to most recent opportunity (on-schedule), and timely adherence across multiple opportunities (maintenance or completion).

CONCLUSIONS

The proposed framework has cross-cutting implications for research and practice. Standardizing adherence metrics may facilitate comparisons across studies of health behaviors practiced at infrequent yet repeated intervals.

Diffusion theory and knowledge dissemination, utilization, and integration in public health

Legislators and their scientific beneficiaries express growing concerns that the fruits of their investment in health research are not reaching the public, policy makers, and practitioners with evidence-based practices. Practitioners and the public lament the lack of relevance and fit of evidence that reaches them and barriers to their implementation of it. Much has been written about this gap in medicine, much less in public health. We review the concepts that have guided or misguided public health in their attempts to bridge science and practice through dissemination and implementation. Beginning with diffusion theory, which inspired much of public health's work on dissemination, we compare diffusion, dissemination, and implementation with related notions that have served other fields in bridging science and practice. Finally, we suggest ways to blend diffusion with other theory and evidence in guiding a more decentralized approach to dissemination and implementation in public health, including changes in the ways we produce the science itself.

Estimation of mammographic density on an interval scale by transillumination breast spectroscopy

Transillumination breast spectroscopy (TiBS) uses nonionizing optical radiation to gain information about breast tissue morphological and structural properties. TiBS spectra are obtained from 232 women and compared to mammographic density (MD) quantified using Cumulus. The ability of TiBS to estimate MD is assessed using partial least-squares (PLS) regression methods, which requires TiBS spectra as input (X) and Cumulus MD as target (Y) data. Multiple PLS models are considered to determine the optimal processing technique(s) for the input (X) and target (Y) data. For each model, the association between TiBS estimated MD (Y) and Cumulus MD (Y) is established using Spearman's rank correlation and linear regression analysis. The model that best estimates MD has the fewest assumptions regarding target (Y) and spectral (X) processing. The Spearman's correlation coefficient between predicted MD and Cumulus MD for this model is 0.88, with a regression slope (beta) of 0.93 (95% CI 0.83-1.02) and an R(2) of 0.78. The approximation of individual MD was within 10% of Cumulus MD for the majority of women (80%), without stratification on age, body mass index (BMI), and menopausal status. TiBS provides an alternative to mammography assessed MD enabling frequent and earlier use of MD as a risk marker in preventive oncology.

Using a site visit to a contaminated location as a focus for environmental health education for academic and public health nurses

We describe a conference initiative that is distinguished by the use of a "community case study" to increase the knowledge and skills of nursing faculty and public health nurses in environmental health and to provide networking support to facilitate infusion of environmental health into nursing curricula and public health nursing practice. The Institute of Medicine's (1995) general environmental health competencies for nurses provided the conference framework. Woburn, Massachusetts, a Superfund site, served as the community case study to illustrate a complex environmental health problem. Over an extended period of time, Woburn was contaminated with multiple chemicals that eventually contaminated the drinking water supply; a cluster of childhood leukemia cases was linked subsequently to the Superfund site contaminants. A 6-hr interpreted walking and bus tour of the Superfund site enabled us to visit the premises of responsible parties, the vapor extraction fields, the capped Well H in the wooded wetlands, and to tour the affected neighborhood. This intensive, hands-on approach to learning environmental health content and skills that incorporated multiple learning strategies serves as a model for developing future conferences for public health nurses and nursing faculty.

The effectiveness of Teratology Information Services (TIS)

BACKGROUND

Women and their health care providers have few reliable sources of information regarding the safety of exposures in pregnancy and lactation. Evidence-based information on these topics is provided by Teratology Information Services (TIS). Access to TIS, however, is limited in many regions, and many services have difficulty maintaining ongoing funding. The objective of this review is to highlight published reports of the effectiveness of TIS in improving maternal and neonatal health.

METHODS

A search of the Pub Med and Econ Lit databases was performed with no date restriction, using the search terms teratology, information, counseling, pregnancy, effectiveness, birth defects.

RESULTS

Information disseminated from TIS has been shown to prevent congenital malformations, unnecessary pregnancy terminations, and occupational risks. TIS support optimal nutritional supplementation in pregnancy and optimal drug therapy in pregnancy and breast-feeding. In addition, they correct misperceptions of risk and facilitate knowledge transfer and translation. TIS have the potential to provide health care cost savings.

CONCLUSIONS

TIS are vital services in supporting optimal maternal and neonatal health. A formal economic evaluation of TIS is required in order to inform resource allocation decision-making and continued funding of these services.