Who is making lifestyle changes due to preventive health care information? A demographic analysis

Utilization of Mammography During the Last Year of Life Among Older Breast Cancer Survivors

Background: Mammography is generally recommended for breast cancer survivors. However, discussion is ongoing about stopping surveillance mammography when life expectancy is <5-10 years as the benefit of screening might be diminished toward the end of life. The utilization pattern of mammography in the last year of life among this population has not been well studied. Methods: We identified 58,736 females diagnosed with breast cancer between January 2002 and December 2015, who died at the age of at least 67, from the SEER-Medicare database. We examined the utilization patterns of mammography during their last year of life and investigated factors associated with the use of mammography at the end of life using a multivariable logistic regression model. Results: Overall, 28.5% of the patients received mammography during the last year of life. Multivariable logistic regression showed that older age (OR = 0.31, 95% CI = 0.29-0.34, p < 0.001 for 95 vs. 85 years old), more advanced cancer stage (OR = 0.22, 95% CI = 0.20-0.24 p < 0.001 for distant vs. localized disease), and higher comorbidity score (OR = 0.92, 95% CI = 0.91-0.93, p < 0.001 for every 1-point increase) were associated with less mammography use. Age was nonlinearly associated with mammography use, with a steady proportion of patients receiving a mammography until approximately age 80 and then a sharp decrease thereafter. Conclusion: This population-based study found that a sizable proportion of older breast cancer survivors received mammography during the last year of life.

The use of positive and negative appeals in social advertising: a content analysis of television ads for preventing HIV/AIDS

Effectiveness of positive and negative appeals in social advertising depends on the target audience and the context in which the messages are applied. However, there is a dearth of research on the real use of such message appeals by social marketers. Considering the importance of practice theory in social marketing, this paper presents a longitudinal research on the use of positive and negative appeals in social advertising, since communication has been particularly relevant in social marketing practices over time. A content analysis of 375 HIV/AIDS-prevention TV ads from four European countries indicates that positive appeals had expressive and higher proportional use over the entire period under analysis. The researchers identified positive appeals, especially in rhetoric, music and voice tonality, while negative appeals are more prevalent in narratives and signs from the scenes. The results show that participation of public figures promoting coping response was low, but increasing over time. Negative appeals are mostly expressed in countries with higher uncertainty avoidance indexes and higher epidemic incidence rates. The prevalence of positive and negative appeals in social advertisements informs about practitioners’ choices when designing campaigns and allows analyzing congruity between the use of appeals and theoretical recommendations for social marketing effectiveness. The study opens the discussion about the application of social marketing theories into practice and how the analysis of social marketing practices may contribute to design innovative theoretical approaches, particularly regarding a topic plagued by inconsistent findings in the literature on message-frame effectiveness in social marketing. The practitioners’ preference for the gain-frame perspective over the protection motivation approach allows inquiring about the motivations and constraints leading to that choice.

A needs assessment study of what health care consumers seek from social media and social networking

Given that prevention is crucial to long healthy life and restraining escalating health care costs, this study examines social media and networking (SM&N) needs among health consumers regarding preventive health. Results showed the most important SM&N needs included: education about health issues, connecting to a support group, knowing the implications of health condition, opportunities and understanding of preventive health care, and tracking physical activity. Among demographic groups women, younger aged groups, and African Americans considered SM&N needs to be more important. Homemakers indicated greatest need for information about health issues and facilitating interaction with others. Full-time employees placed greater importance on managing their own health.

Effects of cognitive overweight status on food choice

Obesity is a serious concern from a personal and public health perspective. This research examines the effects of consumer cognitive overweight status (COS) on food choice. The results show that COS is a significant predictor of consumer food choices, and gender, age, and education differences are found. While the literature shows that many years of efforts by the public and private sectors do have positive influences on consumer food choices, more efforts should be made to help the public engage in weight control behaviors. Managerial and public health policy implications are provided.

Prevalence of Diabetes and Cardiometabolic Disorders in Spouses of Diabetic Individuals

Pairs of spouses share common lifestyle factors. In a cross-sectional analysis, we investigated whether spouses of diabetic individuals had a higher prevalence of diabetes and cardiometabolic disorders in a community-based population of Chinese adults aged 40 years or older between 2011 and 2012. A total of 34,805 pairs of spouses were identified. All participants underwent a standard oral glucose tolerance test and provided detailed clinical, sociodemographic, and lifestyle information. Diabetes and multiple cardiometabolic disorders were defined according to standard criteria. Compared with participants whose spouses did not have diabetes, participants whose spouses had diabetes had higher odds of having diabetes (for men, odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.22, 1.45; for women, OR = 1.35, 95% CI: 1.24, 1.47), obesity (for men, OR = 1.34, 95% CI: 1.13, 1.59; for women, OR = 1.19, 95% CI: 1.05, 1.35), metabolic syndrome (for men, OR = 1.31, 95% CI: 1.21, 1.42; for women, OR = 1.12, 95% CI: 1.04, 1.20), and cardiovascular disease (for men, OR = 1.18, 95% CI: 1.03, 1.34; for women, OR = 1.18, 95% CI: 1.03, 1.35). The associations were independent of age, body mass index, education, family history of diabetes, cigarette smoking, alcohol drinking, physical activity, and diet. Spousal diabetes was simple and valuable information for identifying individuals at risk for diabetes and cardiometabolic disorders.

Patient proactivity: behaviors, attitudes, and its relationship with satisfaction with the American health care delivery system

A sample of 1,031 U.S. adult residents provided information regarding actions that fall within the realm of patient proactivity, that is to say efforts that are overtly designed to maintain or regain one's health. An assessment of consumers revealed that they engage in, or at least support, behaviors that would be characterized as proactive. Furthermore, there is a significant relationship between some elements of patient proactivity and the level of satisfaction with the American health care system. The relationships are modest, but they offer managerial insight that will benefit those responsible for both delivering and marketing health care.

Inhibitions and implications associated with celebrity participation in health-related social marketing: an exploratory research focused on HIV prevention in Portugal

This article discusses motivations and inhibitions among celebrities to participate in health-related social marketing. The research identifies the implications that this involvement may have upon their lives. Results from in-depth interviews with 27 Portuguese celebrities show that they expect a fee for endorsements of commercial and government social marketing, despite the positive image they may gain from endorsing public health. The results demonstrate an absence of celebrity prejudice against HIV because of its serious nature and the social stigma attached to AIDS. This research suggests there is a positive bias and presents helpful information for negotiations between institutions and celebrities.

Physicians' perception of demand-induced supply in the information age: a latent class model analysis

This paper introduces a concept called 'demand-induced supply' that reflects the excess supply of services due to an increase in demand initiated by patients. We examine its association with the proportion of information-savvy patients in physicians' practice. Using data from a national representative physician survey, we apply latent class models to analyze this association. Our analyses categorize physicians into three 'types' according to the frequency with which they provided additional medical services at their patients' requests: frequent, occasional, and rare. The proportion of information-savvy patients is significantly and positively correlated with demand-induced supply for the frequent or occasional type, but not among physicians in the rare type. Efforts to contain healthcare costs through utilization control need to recognize the pattern of responses from physicians who treat an increasing number of information-savvy patients.

Evaluation of a brief intervention designed to increase CPR training among pregnant pool owners

This study evaluated whether a brief videotape could motivate pregnant pool owners to be trained in infant/child cardiopulmonary resuscitation (CPR). Women were recruited from prenatal classes in South Florida. Eligible volunteers were randomized to view a video or receive standard treatment, after completing a questionnaire. The video explained toddler drowning risk, as well as the value of isolation pool fencing and CPR training. Women were contacted by phone 6 months after giving birth to complete a follow-up survey. Sixty-one percent of eligible mothers agreed to study enrollment and 92% of those completed a follow-up interview (n = 101). At baseline, there was no significant difference between the proportion of mothers with current CPR training in the treatment and control groups. At follow-up, 48% of those in the intervention group reported CPR instruction versus 28% of the control group (x(2) = 3.93, P = 0.03). Video viewers were also more likely to report significant changes in perceptions that favored CPR training. Health care facilities located in communities with high rates of toddler drowning may want to screen prenatal students for pool ownership and encourage at-risk families to be trained in infant/child CPR. Such programs should, however, emphasize the primacy of isolation fencing as a preventive measure.