Health Communication Commons^™

Assessment Of The Perceived Role And Function Of A Community Advisory Board In A Nih Center Of Excellence: Lessons Learned, Margaret L. Walsh, Desiree Rivers, Maria Pinzon, Nina Entrekin, Emily M. Hite, Julie A. Baldwin

Journal of Health Disparities Research and Practice

Background: The Community Advisory Board (CAB) was a vital component of the Center for Equal Health. The center addressed health disparities through community-based research and educational outreach initiatives. Objectives: To evaluate the perceived relationship of the CAB and Center, explore members’ perceptions of the CAB’s role, and elicit feedback on how to enhance the relationship between the Center and the CAB. Methods: Ten in-depth, semi-structured interviews were conducted. All interviews were transcribed verbatim and analyzed with a focus on predetermined codes. Results: Main themes focused on perception of CAB roles and need for utilization of board members; overall center challenges; …

Understanding Access To Health Information: The Role And Measurement Of Social Location, Megan S. Kelley

Theses & Dissertations

The purpose of this research is to explore how application of social location theory may improve data collection on health information access in order to better inform and improve the effectiveness of health communication and messaging. This dissertation proposes a framework to understand how people obtain health information based on the idea of social location, Ritzer and Bell’s (1981) levels of social reality, and Dahlberg & Krug’s (2002) social ecological model. This research addressed the extent to which three studies of health information access support the use of such a framework, and if so, how its application could improve our …

Implementing Shared Decision-Making: Consider All The Consequences, Glyn Elwyn, Dominick L. Frosch, Sarah Kobrin

Dartmouth Scholarship

The ethical argument that shared decision-making is “the right” thing to do, however laudable, is unlikely to change how healthcare is organized, just as evidence alone will be an insufficient factor: practice change is governed by factors such as cost, profit margin, quality, and efficiency. It is helpful, therefore, when evaluating new approaches such as shared decision-making to conceptualize potential consequences in a way that is broad, long-term, and as relevant as possible to multiple stakeholders. Yet, so far, evaluation metrics for shared decision-making have been mostly focused on short-term outcomes, such as cognitive or affective consequences in patients. The …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Swords Into Stethoscopes: How The U.S. Military Could Conduct Medical Diplomacy, Oliver Kendall

Political Science Honors Projects

Since the early 1960’s, Cuba and China have won international appreciation by sending doctors abroad to help where they are needed. While there was surprise in some quarters when U.S. military personnel were deployed to combat Ebola in the last months of 2014, the Department of Defense actually has a long history of medical activity. In its current form, DoD medical outreach cannot likely garner soft power in the way that the Chinese and Cuban programs can, but with a few modifications, the U.S. military could be a serious conductor of medical diplomacy that would save countless lives and benefit …

Attitudes Toward A Cancer Coalition: Implications For Coalition Health Communication, Chervin Lam Shih Kian

Open Access Theses

A cancer coalition is a communication hub for cancer patients that may help address cancer by promoting health and mitigating health issues. Attitudes toward a cancer coalition may be important in determining whether or not patients participate or utilize a coalition. However, little is known about the attitudes of cancer patients toward a cancer coalition, its services, and toward participation. This study addresses this gap by investigating these attitudes. The results encourage the development of a cancer coalition in states that do not yet have a coalition. Effective coalition health communication was found to be a pivotal service that cancer …

Effect Of Females In Leadership Roles On Menstrual Sanitation In Rural Jamkhed, India, Kirsten Hughes

Independent Study Project (ISP) Collection

Introduction: Menstruation is integral to puberty and maturation of adolescent girls. Education about menstruation and menstrual hygiene effects a woman’s physical and psychosocial health through the majority of her life.

Purpose: This study seeks to answer the following questions: Who is providing information to girls before or after their first menstruation? Is this information timely, appropriate and accurate? Is the information effective enough to see changes in menstrual practices through a family and community? In answering these questions, the study attempts to determine the pathways of communications regarding menstruation and menstrual health in the Jamkhed area of the Ahmednagar district …

The Gas Cylinder, The Motorcycle And The Village Health Team Member: A Proof-Of-Concept Study For The Use Of The Microsystems Quality Improvement Approach To Strengthen The Routine Immunization System In Uganda, Dorothy A. Bazos, Lea R. Ayers Lafave, Gautham Suresh, Kevin C. Shannon, Fred Nuwaha, Mark E. Splaine

Dartmouth Scholarship

Although global efforts to support routine immunization (RI) system strengthening have resulted in higher immunization rates, the World Health Organization (WHO) estimates that the proportion of children receiving recommended DPT3 vaccines has stagnated at 80% for the past 3 years (WHO Fact sheet-Immunization coverage 2014, WHO, 2014). Meeting the WHO goal of 90% national DPT3 coverage may require locally based strategies to support conventional approaches. The Africa Routine Immunization Systems Essentials-System Innovation (ARISE-SI) initiative is a proof-of-concept study to assess the application of the Microsystems Quality Improvement Approach for generating local solutions to strengthen RI systems and reach those unreached …

Validating Estimates Of Prevalence Of Non-Communicable Diseases Based On Household Surveys: The Symptomatic Diagnosis Study, Spencer L. James, Minerva Romero, Dolores Ramírez-Villalobos, Sara Gómez

Dartmouth Scholarship

Easy-to-collect epidemiological information is critical for the more accurate estimation of the prevalence and burden of different non-communicable diseases around the world. Current measurement is restricted by limitations in existing measurement systems in the developing world and the lack of biometry tests for non-communicable diseases. Diagnosis based on self-reported signs and symptoms (“Symptomatic Diagnosis,” or SD) analyzed with computer-based algorithms may be a promising method for collecting timely and reliable information on non-communicable disease prevalence. The objective of this study was to develop and assess the performance of a symptom-based questionnaire to estimate prevalence of non-communicable diseases in low-resource areas.

A Comparison Of Sexual Health And Sexual Pressure Among Young African American And Caucasian Women, Ann Gakumo

Journal of Health Disparities Research and Practice

Introduction. Condom self-efficacy, positive attitudes toward condom use, condom negotiation skills, HIV knowledge, and self-esteem have been associated with decreased HIV risk behavior among young women, but few studies have examined racial disparities that may exist in these social health indicators. Moreover, sexual pressure (inclusive of both coercive and non-coercive pressures to engage in unwanted or unprotected sex) has been understudied in women of different racial groups.

Study Purpose. The purpose of this study was to compare racial similarities and disparities in indicators of sexual health and sexual pressure in an urban sample of young African American and Caucasian women …

Are There Gender Differences In Perceived Sexual Self-Efficacy Among African-American Adolescents?, Michelle L. Redmond, Rhonda K. Lewis

Journal of Health Disparities Research and Practice

Background: African American adolescents accounted for more than half of all HIV/AIDS cases in 2009. Behavioral Strategies are needed to help lessen the incidence of HIV/AIDS among this population.

Purpose: The aim of his study was to examine sexual self-efficacy practices and beliefs among African American adolescents. We also examined gender differences between African American adolescents to better understand their perceptions of sexual self-efficacy, condom use intention, and other safer sex practices and beliefs.

Methods: A cross-sectional study was conducted with 214 African American adolescents using survey instruments to examine their beliefs, perception and intentions on the use of condoms, …

Assessments Of The Extent To Which Health‐Care Providers Involve Patients In Decision Making: A Systematic Review Of Studies Using The Option Instrument, Nicolas Couët, Sophie Desroches, Hubert Robitaille, Hugues Vaillancourt, Annie Leblanc, Stéphane Turcotte, Glyn Elwyn, France Légaré

Dartmouth Scholarship

Background: We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. Objective: To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking.

Use Of Craigslist.Org To Hook Up: Age Differences In Sex Requests, Hiv Disclosure And Negotiated Safety Among Men-Seeking-Men, Kristen Clements-Nolle, Aliya Buttar, Lindsey Dermid-Gray, Tyler Peterson, Andrea Esp

Nevada Journal of Public Health

Data from 984 “men-seeking-men” Craigslist.org postings in five cities were analyzed to assess differences in sexual requests, HIV status disclosure, and negotiated safety between young (18-24 years) and older (25 years and older) men who have sex with men (MSM). Young MSM were less likely than older MSM to post their HIV status or the preferred status of a partner (p=0.04), disclose and/or request a partner who was disease and drug free (p=.01), and request use of a condom in their posting (p=0.01). Interventions aimed at changing the culture and content of postings on Craigslist.org by encouraging HIV status disclosure …

Evaluating Obesity Prevention Efforts: What Have We Learned? Highlights From A Conversation Of Funders And Evaluators, Sumner M. Redstone Global Center For Prevention And Wellness

Sumner M. Redstone Global Center for Prevention and Wellness

Table of contents:

Executive Summary

Introduction

State of the Obesity Epidemic

The Community Context for Interventions and Evaluations

Investments to Date: Where Is the Strongest Agreement About What Works?

Early Care and Education Environments

Schools/Learning Environments

Parks, Trails, Open Spaces, and Recreation

Land Use and Transportation

The Next Tier: Mixed or Promising Results for Healthy Food Retail Interventions

Implementing Interventions: The Crucial Role of "How"

Other Topics

Summary and Next Steps

Appendix A: Citations and Resources for Key Elements/Components

College Students’ Use Of Social Media To Communicate About Alcohol And Drinking Behaviors, Jenna E. Reno

Theses and Dissertations--Communication

Social networking sites (SNSs) are an increasingly popular channel for communication among college students. Often students disclose more freely via social networking sites than they would in other situations. These disclosures commonly include information about engaging in risky health behaviors (e.g., binge drinking). Study 1 examined students’ impression management goals and self-presentation tactics specifically related to self-disclosures of drinking behavior on SNSs. Findings suggest that students use differing self-presentation tactics across various SNSs in order to achieve their impression management goals and to avoid consequences associated with disclosing about risky health behaviors to certain audiences. Study 2 sought to develop …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The Asset Cards are to be printed out and cut in half. Blank Asset Cards are provided to create customized assets. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, …

Baseline Survey Instruments: Adolescent Girls Initiative–Kenya, Population Council

Poverty, Gender, and Youth

This document contains various AGI-K survey instruments, including: Household Characteristics Survey (English), Respondent’s Schooling History (English), Respondent’s Work in Last Year (English), Respondent’s Spending in Last Year (English), Respondent’s Savings in Last Year (Kiswahili), Respondent’s Savings in Last Year (English).

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of Contents and Instruction …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Resource Manual, Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

This document contains the Building Assets Toolkit’s Resource Manual, which includes valuable information about building meaningful program content as well as detailed notes on each asset for use in the toolkit’s “Asset Building Exercise.” This exercise is designed to involve multiple stakeholders in determining what assets girls need in order to survive and thrive. The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels …

Impact Of E-Cigarettes On Physician Recommendations Of Tobacco Use Cessation Pharmacotherapy, Omar El Shahawy

Theses and Dissertations

Introduction: E-cigarettes have been marketed as smoking cessation aids and harm reduction strategies. Prior regional surveys found that physicians are recommending them to patients despite the lack of evidence supporting these industry claims. Yet, little is known about physicians’ beliefs regarding e-cigarettes and whether these beliefs are associated with them recommending e-cigarette use in clinical practice. Methods: This three-manuscript dissertation used a mixed-methods approach including both qualitative and quantitative research methods. The aims were to: (1) Uncover the factors associated with primary care physicians’ (PCPs) decisions to recommend e-cigarettes to their patients for tobacco use cessation; (2) Estimate the prevalence …

She Got Her Period: Men's Knowledge And Perspectives On Menstruation, Ishwari Rajak

All Graduate Theses, Dissertations, and Other Capstone Projects

Research show that men and women often do not converse freely about menstruation. Shame, taboos and myths associated with menstruation silence the conversation. Silencing conversations about menstruation have negative consequences on women, including: objectification of women's bodies, stereotyping of women as physically, morally and emotionally inferior to men and to extreme cases women losing their uterus due to unhygienic means of menstrual management. On the one hand, not addressing menstruation openly has devastating consequences on women but on the other hand, most men seem oblivious about the impacts on women. Therefore, it is important to engage in open dialogues about …

Dancing Around Infertility: The Use Of Metaphors In A Complex Medical Situation, Angela L. Palmer-Wackerly, Janice L. Krieger

Department of Communication Studies: Faculty Publications

People use metaphors to cognitively frame their experiences as well as to explain those experiences to others, especially in complex medical situations. However, previous research has not fully explored the extent to which metaphors may be helpful or harmful to achieving well-being. This investigation fills this gap by identifying and explaining metaphor use in the context of infertility. Guided by self-determination theory, in-depth interviews were conducted with 22 women and men who had experienced an inability to conceive a child. Analysis of participant narratives yielded 10 prominent metaphors that reflect how participants’ need for competence, autonomy, and relatedness were (and …

Comprehension Of Randomization And Uncertainty In Cancer Clinical Trials Decision Making Among Rural, Appalachian Patients, Janice L. Krieger, Angela L. Palmer-Wackerly, Phokeng M. Dailey, Jessica L. Krok-Schoen, Nancy E. Schoenberg, Electra D. Paskett

Department of Communication Studies: Faculty Publications

Comprehension of randomization is a vital, but understudied, component of informed consent to participate incancer randomized clinical trials(RCTs). Thisstudy examines patient comprehension of the randomization process as well as sources of ongoing uncertainty that may inhibit a patient’s ability to provide informed consent to participate in RCTs. Cancer patients living in rural Appalachia who were offeredanopportunitytoparticipateinacancertreatmentRCT completed in-depth interviews and a brief survey. No systematic differences in randomization comprehension between patients who consented and those who declined participation in a cancer RCT were detected. Comprehension is conceptually distinct from uncertainty, with patients who had both high and low comprehension experiencing …

Combating Hiv/Aids In Marginalized Communities: Papua And West Papua Provinces, Indonesia, Bani Cheema

Master's Theses

My study focuses on foreign aid and local initiatives for HIV/AIDS prevention in eastern Indonesia using the provinces of Papua and West Papua as a case study. The two provinces are home to indigenous tribal groups that are socioeconomically marginalized and most affected by the epidemic. My research investigates behavior change communication as a principal strategy undertaken by multiple organizations for HIV/AIDS prevention in this region. I take a qualitative approach by examining the effectiveness of this strategy in local communities and by revealing social and cultural barriers that impede success. Obstacles that negatively impact prevention efforts include structural violence, …

Assessing Technologies For Information-Seeking On Prostate Cancer Screening By Low-Income Men, Susan W. Mcroy, Emily M. Cramer, Hayeon Song

Journal of Patient-Centered Research and Reviews

Purpose: This paper presents a multipart investigation of the benefits and challenges in deploying automated question-answering as an alternative to web-based searching to provide information about prostate cancer screening for low-income men age 40 years and older.

Methods: The study comprised: 1) a survey assessing current use of the Internet, mobile phones and texting; 2) a controlled observational study of both web-based searching and automated question-answering for information about prostate cancer; and 3) a formative field study in which subjects interacted with a health department nurse using text messages.

Results: Survey results suggest the target population has greater access to, …

Policymakers Identify Priorities For Phssr, Katherine Froeb Papa

Frontiers in Public Health Services and Systems Research

A major goal for the health services research community is to provide evidence policymakers can use to improve the public’s health. However, it can be difficult to know what evidence policymakers want and how they decide what research to fund.

In order to understand where policymakers turn for evidence and how they make funding decisions amid fiscal and political constraints, AcademyHealth conducted a 3-part Fireside Chat series in the spring of 2014. This editorial summarizes the evidence gaps identified, and provides strategies for communicating with decision makers.

The Politics Of Hpv Vaccination Advocacy: Effects Of Source Expertise On Effectiveness Of A Pro-Vaccine Message, Roger Gans

Proceedings of the New York State Communication Association

The Politics of HPV Vaccination Advocacy:

Effects of Source Expertise on Effectiveness of a Pro-Vaccine Message

Persistent public resistance to an apparently safe, effective and life-saving public health practice such as HPV vaccination illustrates a significant issue in the communication of behavioral recommendations based on evidence-based scientific data and consensus views of scientific and medical experts. This study examines the influence of source expertise on pro-HPV-vaccine advocacy messaging effectiveness among audiences of differing political ideologies. The findings support prior research indicating greater resistance to HPV vaccination among political conservatives. Subjects who self-identified politically as Centrists and Conservatives were significantly less …

Neglected Or Non-Compliant? Assessing The Difficulties Of Tuberculosis Patients In Salvador-Ba, Brazil, Erin Slatery

Independent Study Project (ISP) Collection

Objective: The aim of this study is to analyze how Instituto Brasileiro para Investigação da Tuberculose (IBIT), a philanthropic tuberculosis clinic in Salvador, Brazil, maintains treatment abandonment rates much lower than those of surrounding public clinics. This study also aims to evaluate how professionals conceptualize and address the difficulties faced by patients.

Methods: Interviews were conducted with 8 IBIT professionals and 16 patients in treatment for tuberculosis in the aforementioned institution via semi-structured and structured questionnaires, respectively. Participant observation guided the analysis of relationships between patients and professionals.

Results: Patients found varying aspects of treatment difficult depending on personal circumstances, …

Physicians' Attitudes About Recommending Surgery For Early Stage Lung Cancer And Possible Reasons For Racial Disparities, Franklin R. Mcguire

Journal of Health Disparities Research and Practice

PHYSICIANS’ ATTITUDES ABOUT RECOMMENDING SURGERY FOR EARLY STAGE LUNG CANCER AND POSSIBLE REASONS FOR RACIAL DISPARITIES

ABSTRACT

Purpose: Patient refusal for lung cancer surgery is significant, but other factors, such as negative framing of the treatment discussion, may be involved. Physician attitudes could influence the nuances of and therefore the conclusions of these discussions. We determined physicians’ attitudes and the influence it has on possible decisions against lung cancer surgery, particularly surgical rates for blacks, using a companion survey.

Methods: The study is a prospective, multicenter observational trial conducted at five sites in North and South Carolina from December …

A Rhetorical Analysis Of The Rethinking Aids Website, Jennifer Dettmann

Journal of Undergraduate Research at Minnesota State University, Mankato

A group of scientists known as the Group for Scientific Reappraisal of the HIV-AIDS hypothesis created a web site title, Rethinking AIDS. The group behind the web site argues that AIDS is not a sexually transmitted disease. They even question the existence of the virus entity. My analysis is driven by the critical question: Does the web site construct a reality that affectively alters our perception of HIV-AIDS? In order to answer this question, Goodnight and Poulakos 1981 article, Conspiracy rhetoric: from pragmatism to fantasy to public discourse (Western Journal of Speech), will be utilized.