Examining the Health Disparities Research Plan of the National Institutes of Health Unfinished Business (2006) / Chapter Skim
Currently Skimming:
Appendix G Public Communications and Its Role in Reducing and Eliminating Health Disparities--Kasisomayajula Viswanath, Ph.D.
Appendix G Public Communications and Its Role in Reducing and Eliminating Health Disparities--Kasisomayajula Viswanath, Ph.D.
Pages 215-253
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 215... ...
Combined with revolutionary developments in the biomedical sciences and telecommunications, plenty of health information and delivery channels now exist. The number of health-related news stories on television and in both the mainstream and ethnic printed news media has been steadily increasing over the last 25 years (Figures G-1 to G-3)
|
From page 216... ...
7 6 5 thousands) 4 (in 3 Stories 2 of # 1 0 1980-4 1985-9 1990-4 1995-9 2000-4 Years Heart Disease Tobacco/Smoking Obesity HIV/AIDS FIGURE G-2 Ethnic print media coverage of leading health issues.
|
From page 217... ...
SOURCE: See Footnote 1. obesity.2 In addition, the number of Internet sites offering health information of varying quality is increasing rapidly.
|
From page 218... ...
. What are some of the major challenges to disseminating evidence-based health information to different stakeholders, particularly in bridging health dis
|
From page 219... ...
The focus of this essay is to address these twin challenges of the dissemination of health information and communication inequality through a delineation, clarification, and amplification of their dimensions insofar as they are relevant to reducing and eliminating health disparities. This assessment will be followed by a discussion of how the objectives of NIH's National Center on Minority Health and Health Disparities (NCMHD)
|
From page 220... ...
Two related communication strategies are worth considering in accelerating knowledge transfer: public health communication and research dissemination. Public health communication may be defined as the strategic communication of evidence-based health information on primary and secondary prevention, detection, diagnosis, and treatment to lay or nonprofessional audiences.
|
From page 221... ...
We will briefly discuss the opportunities and challenges in public health communications and research dissemination and their relevance to health disparities. PUBLIC COMMUNICATION, OUTREACH, AND COMMUNICATION INEQUALITIES Functions of Health Communication Communication in health may serve several functions: informational, instrumental, social control, and communal.
|
From page 222... ...
access to and use of information channels and services, (b) attention to and processing of health information, and (c)
|
From page 223... ...
Health Information National Trends Survey (HINTS) tellingly demonstrate differential access and exposure to information services among different social groups.4 Income, education, and employment are positively associated with subscription to cable or satellite TV and the Internet -- services that allow for access to diverse information sources (Table G-1)
|
From page 224... ...
Employed 82.03 73.52 Not employed 78.70 47.36 Race (n = 5,372) White 82.56 66.02 African American 77.30 55.81 Ethnicity (n = 5,666)
|
From page 225... ...
Their exposure, use, and access to English-language mass media are likely limited and perhaps nonexistent. Media access, in the case of non-English-speaking minority groups, must take into account ethnic media that are widely prevalent both in print and online versions (Viswanath and Lee, in press)
|
From page 226... ...
(We do not have an idea of how those groups with limited proficiency in English pay attention to health content, either in English or ethnic media.) This suggests a strong interest in health information among all racial and ethnic groups despite their differential access.
|
From page 227... ...
SOURCE: See Footnote 4. SES, Race, and Ethnicity and Their Relation to Inequalities in the Comprehension of and Action on Health Information A significant dimension of health inequality is the ability of the individual or the capacity of a community group to process and act on health information.
|
From page 228... ...
Lastly, the recommendations and instructions are dynamic and change over time depending on one's age and life course. Acting on obtained health information is subject to opportunity structure, particularly the built environment.
|
From page 229... ...
APPENDIX G 229 100 90 80 70 60 Smoking (%) Exposure to Sun 50 Percent 40 30 20 10 0 HS or Less Some College Plus Education FIGURE G-9 Percent saying risk of cancer increases by "a lot/some" with exposure, by education.
|
From page 230... ...
include: providing research-based information to health care providers; influencing the curricula of medical schools, allied health professionals, and continuing medical education; and maintaining a dialogue with community groups that serve medically underserved populations. In addition, although the target audience is not clear, one objective explicitly identifies the establishment of an informatics infrastructure to disseminate scientific information regarding health disparities.
|
From page 231... ...
Health Disparities and Research Dissemination: Some Issues for Consideration It was recently commented that findings from clinical research take as long as 17 years before they find their way into practice (Balas et al., 2000; Isaacson, 2004)
|
From page 232... ...
· It is still the case that institutions take the "if you build it, they will come" approach to knowledge transfer. Within academic medical centers and federal and state agencies, research dissemination often is an afterthought -- and not a very systematic one at that.
|
From page 233... ...
We need more information on how academic medical centers, in collaboration with other groups, can enhance community capacity to use existing resources such as Cancer PLANET. Here is one place where academic medical centers can build linkages with community groups and networks by offering information, training, and modest resources.
|
From page 234... ...
Patients, for example, draw support from their providers, family and friends, and mass media. In addition, they are also likely to be members of social groups, community networks, and faith-based and secular organizations.
|
From page 235... ...
Sustained efforts could potentially be fruitful over the long term and may also result in reaching groups that are traditionally difficult to reach. A PLANNING MATRIX TO ADVANCE PUBLIC COMMUNICATION AND OUTREACH Public communication to a general audience or research dissemination to health professionals, community groups, or policy and decision makers can be effective, if preceded by systematic and strategic planning, careful execution, and rigorous evaluation.
|
From page 236... ...
236 / screening Tracking Evaluation Adoption of Track screening rates Time Line 16 months Exemplar an clinical as Impact Sought Change in practice news- local Screening Channels Targeted mailings and letters Meetings with professional associations One-on-one meetings Cancer local local Tactics Training of providers Frequent contacts with members of professional associations Cervical Using the care Strategy Target providers of usual source of Planning, of American Partners Local chapter the Cancer Society Campaign for cervical Message Promote screening for cancer Matrix care care Suggested A Audiences Health providers Primary providers Clinics G-2 Institutes Centers TABLE Primary Sponsor NIH and
|
From page 237... ...
Lessons learned from such experiences could come in handy to develop and study outreach programs to eliminate health disparities. The Audience Any information outreach must start with a close identification, definition, and characterization of the target audience, and the same principle applies to the information outreach objectives of NCMHD.
|
From page 238... ...
Segmentation is also useful in channel selection, and, in fact, many commercial providers of audience measurement and market research services offer information on different audience segments that a given channel could potentially reach. Despite the apparently successful track record of segmentation strategies, certain caveats are warranted and worthy of future investigations: · The segmentation philosophy sometimes makes the naïve assumption that segments are mutually exclusive.
|
From page 239... ...
If a product or service is a broad public information campaign -- say, a campaign on obesity that is aimed at African Americans who suffer disproportionately from its consequences -- there is first a need to understand the behavioral and environmental determinants that may reduce the barriers to physical activity. Both individual-level and structural-level factors are likely to mediate the effect of public communication efforts on different groups of people.
|
From page 240... ...
This ability of stories to engender deeper involvement and learning has been used to study the message effects of narratives. Narrative messages are stories with persuasive health content (Slater, 2002)
|
From page 241... ...
For example, campaigns to reduce HIV among African Americans could be done through federal partners such as the National Institute of Allergy and Infectious Diseases, CDC, and state health departments. A number of community groups that work with minority audiences and that are sensitive to the culture of the minority community may lend credibility to the program.
|
From page 242... ...
Optimal channel selection is a critical and essential factor in the dissemination of health information to different publics, as it will make the difference between reaching the right target audience and missing them completely. Channel selection is done by careful formative research, either through custom research done by individual sponsors or by subscription to commercial providers of information such as Nielsen Media Research.
|
From page 243... ...
American society is becoming increasingly diverse with more than 32.5 million Americans identifying themselves as foreign-born. Hispanics constitute about 13 percent of the population and African Americans another 13 percent.
|
From page 244... ...
These organizations are optimal vehicles for the release of state-of-theart information on prevention, screening, diagnoses, and treatment through their professional meetings, newsletters, and workshops. Some professional organizations are fruitful avenues for national research dissemination, including the Association of American Indian Physicians, the National Medical Association (African Americans)
|
From page 245... ...
One possible goal could be a periodic survey of specific groups to do needs assessment surveys to understand the barriers in obtaining access to, and the use of, health information. Such specificity will help to clarify exactly what objectives are being pursued and will aid in developing appropriate products, target audiences, and message strategies.
|
From page 246... ...
This will also provide the necessary feedback loop discussed earlier so that NIH can ascertain and incorporate the needs of different publics into programming. SOME RECOMMENDATIONS TO HELP NCMHD ACHIEVE ITS OUTREACH OBJECTIVES The current NCMHD objectives for public information and outreach appropriately identify challenges in identifying target audiences that may help in bridging the deep chasm between research discovery and delivery, when it comes to health disparities.
|
From page 247... ...
It is strongly recommended that NCMHD develop a surveillance system that will track the health information needs, sources, and information-seeking patterns of different audience subgroups, as well address the needs of providers and institutions working with medically underserved groups. The NCI's HINTS study could serve as one model in developing a surveillance system on information needs of health disparities groups.
|
From page 248... ...
The objectives for public information and community outreach suggest two broad strategies to reduce health disparities: (a) ensuring the dissemination of health information to individuals and community groups that are suffering from health disparities and (b)
|
From page 249... ...
A welldeveloped system can track health information needs, media use, seeking behaviors, and knowledge of low-SES and minority groups and can contribute to both the science of surveillance as well as program planning. · To be successful, NCMHD should set aside a budget for both doing and studying public information efforts.
|
From page 250... ...
Journal of Health Communication 1(1)
|
From page 251... ...
2005. Dissemination research and research dissemination: How can we close the gap?
|
From page 252... ...
2005. Health Information Online.
|
From page 253... ...
In, Hornik R, ed. Public Health Communication: Evidence for Behavior Change.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.