Category: Health Communication

Transparency during Outbreaks-a Balancing Act?

Communicating about a potential public health concern can put a national voice in a tricky position. This was the situation the Indian government found itself in earlier this year when isolated cases of Zika broke out in the state of Gujarat.

Some argue that it is absolutely essential for the government to keep the public aware of even threats deemed low, as a step towards increased preparedness in the event of an outbreak (Scroll.In). The New York Times cites Dr. Swaminathan, the director-general of the Indian Council of Medical Research, as justifying the lack of communication as rooted in a need to prevent undue panic. Similarly, the Wire interviewed Dr. Ravindran, the director of emergencies in the Ministry of Health and Welfare , who reports that as the WHO did not declare ZIKA as a continued PHEIC (Public Health Emergency of International Concern), the government was not obligated to report these cases, as noted in the International Health Regulations. The cases were reported after being further investigated.

Which brings us back to a question of responsibility: What guides risk communication?

A document published in March 2016 by the WHO provides some guidance. They define risk communication as “the real-time exchange of information, advice, and opinions between experts, community leaders, or officials and the people who are at risk”. It goes on to identify who the at-risk populations are, the best channels for communication, and guidelines on content. By and large, it stresses the point that risk communication has the goal of empowering, above and beyond informing.

Social media have had a significant positive impact in real-time health communication in recent years. For instance, SMS/Tweets were used to identify vaccination locations during the 2009 H1N1 outbreak. On the other hand, such a large volume of information can be difficult to manage. An example of this chaos was witnessed in the Fall of 2014, when the United States saw an Ebola outbreak (Ratzan, 2014).

All to say…risk communication requires deliberation and thoughtful consideration. While the Zika cases in India continue to be a story that sparks a lot of push-back, rightfully so, it’s important to see the flip side of that coin.

 

 

 

 

Next Level Data Presentation

By Arshya Gurbani

It’s probably safe to guess that lot of people studying Health Communication feel strongly about data, how it’s presented, and the “story” it has to tell. I thought it was about time to re-watch this, one of my favorite TED talks, about using statistics effectively. Hans Rosling presents data on child mortality, but in doing so he layers it with context and bias and paints a picture that is remarkably clear and moving.  It’s good stuff–seriously, get some popcorn and a handkerchief before you watch/re-watch it!

Meditation and Stress Relief

Earlier this semester, I heard about Transcendental Meditation (TM) for the first time. It’s defined as a technique that trains one to turn “attention inwards towards the subtler levels of a thought until the mind transcends the experience of the subtlest state of the thought and arrives at the source of the thought” (Mahesh Yogi, 1969). A distinguishing characteristic of this form of meditation is the carefulness with which the pedagogy is preserved–requiring a training process to certify preservation of fidelity to the method. (Wallace, 1970).

An early and foundational study noted physiological changes attributed to practicing TM.  These included decreased heart rate and oxygen uptake, and changes in EEG frequency (Wallace, 1970). Generally, as we’ve heard in class from various individuals who practice, these manifest themselves as lower stress levels, in creased focus, and increased clarity and decision-making power.

Other positive benefits have been described in a variety of populations. TM has been suggested to facilitate decreased drop-out rates from urban schools, improve quality of life in children living with Autism Spectrum Disorder ,  boost immunity levels , and generally improve mental health and well-being.

This New York Times article chronicles the experiences of schools implementing TM in classrooms around NY, largely featuring success stories, while still noting that research on the use of TM in an academic setting is not yet conclusive.

There is room to speculate whether TM is radically different form other forms of inward reflection. Surely, there are many ways to reduce stress and enhance productivity, of which TM is just one. With TM on my radar, I look forward to seeing if research can discern TM as a distinctively beneficial.

 

Non-linked References:

M. Mahesh Yogi, The Science of Being and Art of Living (International SRM, – London, rev. ed., 1966), pp. 180-209.

Wallace, R. K. (1970). Physiological effects of transcendental meditation. Science, 167(3926), 1751-1754.

*credit for articles/reference guidance to EPID799c course resources made available to students

Why our perception of beauty is skewed

My friend asked me last night, seemingly out of the blue, “Do you ever wonder why stores separate their plus size clothes?”

The truth is, it didn’t cross my mind until she asked it. But I haven’t stopped thinking about it since because, really,  it seems like a classic microagression–a small, perhaps mundane but not insignificant–manner by which to separate people who lie outside of what, at some point, became considered the norm. Not that it should matter, but a 2016 VCU article cited data claiming that over 60% of women in the US wear clothes that are plus or extended sized. Another article notes that plus size women account for 28% of the clothing market (Binkley, 2013). With an affected population that substantial, it’s even more glaring how insensitive we can be.

A 2016  article published in Body Image links anti-fat attitudes, body shaming, self-compassion, and fat-talk in female college students. They found that internalizing body-shaming led to engaging in fat-talk, among other negative anti-fat attitudes. They found the converse to be true as well–that self-compassion leads to better psychological well-being and less engagement with objectification and self-denigration. The health education and communication implication of all this, is to promote self-compassion (Webb, 2016).  It isn’t hard to imagine that segregated stores don’t play into a healing cycle very well.

Though there has been a recent movement for models to that match all body types, the retail industry still largely caters to a frankly thinner than average body type. Consider the last mannequin you saw that wasn’t unrealistically proportioned. I can’t recall a single one…

One article says these social pressures, among others like harsh lighting and narrow spaces in dressing rooms,  are driving plus-sized women to opt towards online shopping (Money, 2017).  Despite some small successes, Money says, men and women of size “are clearly tired of limited options and unwelcome shopping experience”.

The thing is, it wasn’t a question out of the blue. She had gone shopping with her cousin. It should have been a fun  outing– bonding, enjoying rare time together, catching up and picking out clothes for each other. Instead, they parted ways near the entrance of the store.

References:

Binkley, Christina (2013, June 12), “On plus side: New fashion choices for size 18,” The Wall Street Journal, Retrieved from http://online.wsj.com/news/articles/SB100014241278873 23949904578540002476232128.

Money, C. N. (2017). Do the Clothes Make the (Fat) Woman: The Good and Bad of the Plus-Sized Clothing Industry. Siegel Institute Ethics Research Scholars, 1(1), 1.

Webb, J. B., Fiery, M. F., & Jafari, N. (2016). “You better not leave me shaming!”: Conditional indirect effect analyses of anti-fat attitudes, body shame, and fat talk as a function of self-compassion in college women. Body image, 18, 5-13.

http://www.hercampus.com/school/vcu/problems-womens-plus-size-clothing

 

Networking the New Normal: Confronting Illness through Social Media

GUEST BLOGGER: Terri Beth Miller, PhD

This is not how you expected life to be. You’re run down. You’re hurting. You’re physically and emotionally drained. And it feels as though those closest to you are a million miles away, as though you’ve suddenly found yourself stranded on a desert island with no hope of rescue.

This is what it can feel like when you are confronting illness, when a diagnosis suddenly transports you to a new world you never wanted to visit, let alone permanently inhabit.

The truth is that illness, whether physical or psychological, chronic or acute, can be one of the most frightening, disorienting, and isolating experiences a person can face. And yet, if we live long enough, we will all confront this experience. After all, ain’t none of us getting out of this life alive.

But diagnosis doesn’t have to mean disaster. Our 21st century world offers resources once unimaginable to those seeking health information and support. Few are more potent than the vast social media networks available to connect people in the most far-flung corners of the globe with the simple click of a button.

This seemingly limitless connection can be an infinite comfort for those who are suffering from illness, allowing survivors to reach out to fellow survivors, who often can understand illness in a way that those who haven’t experienced it simply cannot. After all, family and friends may empathize. They certainly can provide a love and comfort that the virtual world cannot replace. But there is a special and necessary connection shared by those have felt the gnawing at the bones, the torment of the mind—by those who have the visceral, intimate experience of real, bloody, hand-to-hand combat with illness. This is the connection that social media can offer to those suffering from illness, a means to overcome the isolation that can cut as deeply as sickness itself.

In addition to the opportunity to connect with fellow survivors, social media is an exceptional outlet for sharing health information and resources, from exploring treatment options to connecting with care-providers. After all, an informed patient is an empowered patient. Because those who are suffering from ill health often feel a tremendous lack of control and a vast feeling of uncertainty for the future, this access to knowledge can restore the sense of self-determination and understanding that survivors knew before diagnosis. These resources can restore some normalcy, or at least something of a return of the survivor’s sense of self.

Nevertheless, extreme caution must be practiced. We are perhaps never more vulnerable than when we are battling illness, and unfortunately those who would prey on the hopes and fears of the desperate are legion. So while it is healthy—and, indeed, essential—to seek out all the knowledge and resources possible when battling illness, it is equally essential to be wary of promises that are simply too good to be true. Vet the company you keep and the treasures you store up in the virtual world just as you do in the physical one.  Avail yourself of the immense resources available to you online as you wage your battle with sickness. But do so from a position of strength and discernment. This is your body. This is your mind. This is your spirit and your life. Harness the best and highest powers of social media. There is tremendous solace, solidarity, and support to be found online for those battling illness, but only for those who use it wisely.

For more information on the most beneficial mental health online resources, please visit: https://openforest.net/4-best-mental-health-bloggers-period/

Terri Beth Miller completed a PhD in English Language and Literature at the University of Virginia. She has taught writing and literature courses for more than a decade and is a regular contributor to the http://openforest.net mental health self-help portal. View her profile on LinkedIn at https://www.linkedin.com/in/drterribethmiller.

What’s culture got to do with it?

By: Courtney Luecking MPH, MS, RD Doctoral candidate: Nutrition

What happens when a cultural and political sociologist teams up with health researchers? Answer: some really fascinating work and advancement of how we think about the influence of culture on health.

Meet Andrew Perrin, Ph.D. He is a professor in the Department of Sociology at the University of North Carolina in Chapel Hill.

perrin

While his work focuses mostly on “what people need to know, be and do to make democracy work”, his family has opened up the opportunity to share his expertise with the public health arena. Does culture influence health? If so, how, and to what extent?

Dr. Perrin suggests that although the public health and health communication world may be able to measure certain aspects of culture well, there is a lack of breadth and depth of conceptualizing culture. This could mean we, public health and communication groups, are missing or misinterpreting a big piece of the health puzzle. He offered context of the contemporary synthesis of culture as presented by Johnson-Hanks and colleagues. A cyclical interaction between culture in the world and culture in our mind influences our individual and collective decisions and actions, but how can we robustly measure this?

culture

Fortunately, Dr. Perrin and an interdisciplinary crew are working to develop tools to measure culture in the world and culture in the mind within the context of obesity. Once measured, they will work to interpret the effects of culture on health. One project looks to explain variations and health outcomes in a county in North Carolina using a combination of geocoded photographs (culture in the world) and focus groups (culture in the mind). Results for this are forthcoming. Another project looked at obesogenic behaviors and stigma in children’s movies. You may or may not be surprised to learn that unhealthy behaviors are represented more than healthy behaviors, and movies contain messages that encourage weight-related teasing or bullying. For more information and results about this, review the paper on Pass the Popcorn.

Thanks to Dr. Perrin for sharing his time and expertise with our class! He highlighted the value interdisciplinary teams bring to thinking about problems in a more holistic manner that could ultimately benefit the public’s health.

 You can learn more about Dr. Perrin’s work at his website.

Dr. Clinton vs. Dr. Trump

By: Shauna Ayres MPH: Health Behavior candidate 2017

Who would you rather have as a doctor? Hillary Clinton? Or, Donald Trump? Yale researchers found that primary care physicians address politically sensitive health issues different depending on political affiliation. They surveyed 20,000 primary care physicians across the nation to obtain their political affiliation and professional recommendations for nine patient vignettes. These vignettes highlighted real-life situations related to abortion, marijuana, helmet use, obesity, cigarette use, alcohol use, depression, sex work, and firearm safety. Republicans and Democrats did not significantly differ regarding helmet use, obesity, cigarette use, alcohol use, depression, and sex work. However, Republican were more concerned about abortion and marijuana use, and Democrats were more concerned about firearm safety (Hersh, 2016). This makes sense as these health issues are the most hotly-contested, politically-charged health topics right now in the US.

What does this mean as a patient? Should a doctor’s political affiliation be a factor when a patient is determining who will provide them healthcare? Do patients have a right to know their doctor’s political leanings? The research suggests that in respect to politicized health issues, patients should be cognizant of their doctor’s reactions and recommendations, and if necessary, seek a second opinion. There is no algorithm for healthcare and what works for one patients, does not mean is will work for another. I would argue the most important factors in a patient-doctor relationship are mutual respect and trust, not necessarily political homogeneity.

What does this mean as a doctor? Should a doctor disclose his/her political affiliation to patients? Researchers suggest that doctors should be aware of their political biases on health issues. Doctors should attempt to provide the best treatment in the interest of each patient and not in the interest of a political agenda. Likewise, doctors who cannot do this should recommend that patients seek a second opinion or direct patients to informational resources with depoliticized facts, recommendations, and healthcare options.

Political bias in healthcare is not to be feared or overly criticized, just recognized and responsibly examined by both the provider and patient. After all, doctors are humans just like the rest of us.

Remember to vote next Tuesday, November 8th!

 

Resources:

Cummings, M. (2016, Oct 4) Care differs if your doctor is a democrat or republican. Futurity. http://www.futurity.org/politics-doctors-patients-1262862-2/

Hersh, E. D., & Goldenberg, M. N. (2016). Democratic and republican physicians provide different care on politicized health issues. Proceedings of the National Academy of Sciences of the United States of America, doi:201606609 [pii]

It’s Not Me, It’s You: Signs that its time to Break Up With Your Doctor

By: Aria Gray MPH: Maternal and Child Health candidate 2017

I recently broke up with one of my doctors, and while it was a difficult decision, I felt much better once I decided not to see that provider anymore. The doctor was recommended to me as a great expert in the field, but I never felt that they were truly listening to me, which is why I ultimately left.

However, finding a new doctor can be difficult. Learn more below to see if it is time to make a change in your health care.

Poor Communication: It is important to understand your condition and diagnosis as well as the recommended course of treatment. Make sure to ask follow-up questions and to communicate to your doctor that you do not understand. However, if communication issues are still not resolved, it may be time to make a change.

Poor Listening Skills: Patient care should be adjusted based on the needs and experiences of each individual patient. If there is a medication or treatment plan you have tried without success or are not willing to pursue, your doctor should listen to your thoughts and feelings and make a treatment plan accordingly. If you feel your doctor isn’t listening to you, find one that will.

Long Wait Times & Limited Access to Care: If it commonly takes you weeks or months to get an appointment with your doctor or if you consistently face long wait times in the office, it may be time to find a new doctor. It is important to receive prompt treatment and also to have your valuable time respected.

As I mentioned, making the decision to change doctors is not easy, and the process of finding a new doctor is often not easy (not to mention all of the paperwork!). Follow these tips for an easy transition to a new provider.

Fearful of Food?

By: Courtney Luecking MPH, MS, RD Doctoral candidate: Nutrition

I started following the Conscienhealth blog years ago. The organization aims to “advance sound approaches to health and obesity…(and) advocate evidence-based prevention and treatment”. Part of their approach is to provide a daily reflection about how a hot topic might influence our view of obesity or health policy.

A recent post got me thinking about whether fear-based messages are an effective or appropriate way to speak to consumers about food and nutrition. A meta-analysis published last year pooled 127 articles to look at the effect of fear appeals on attitudes, intentions, and behaviors. [Notes: Meta-analysis is a technique that aims to provide a conclusion based on statistical evidence about a large number of studies. Fear appeals are messages designed to persuade people to take action by sparking fear.]

Interestingly enough, fear appeals were found to have generally positive effects but less so for repeated behaviors. We eat multiple times each day, definitely a repetitive behavior, so perhaps fear-based messages are not the best way to communicate food-related lifestyle messages.

conversation-545621_1280

So how should talk about food? Headlines often pose negative or sensational statements to entice us to read. An example of this: Why Sitting is Killing You. But evidence suggests it might be more useful to share gain-framed messages. That is, focus on action people can take and what the positive outcome would be.An example of this: Review suggests eating oats can lower cholesterol as measured by a variety of markers.

Two decades ago, a study reported that Americans perceived food to be mostly associated with health and least associated with ple
asure. Americans reported more action to change diet to support health, yet they were also less likely to consider themselves healthy eaters. What would it look like if we talked in a more positive, less fearful or restrictive manner about food?

 

Resources:

Rozin P, Fischler C, Imada S, Sarubin A, Wrzesniewski A. Attitudes to food and the role of food in life in the U.S.A., Japan, Flemish Belgium and France: possible implications for the diet-health debate. Appetite, 1999 Oct; 33(2): 163-180.

Tannenbaum MB, Hepler J, Zimmerman RS, Saul L, Jacobs S, Wilson K, Albarracin D. Appealing to fear: a meta-analysis of fear appeal effectiveness and theories. Psychol Bull, 2015 Nov; 141(6): 1178-204.

Wansink B, Pope L. When do gain-framed health messages work better than fear appeals? Nutr Rev, 2015 Jan; 73(1): 4-11.

October is Domestic Violence Awareness Month

By: Aria Gray MPH: Maternal and Child Health candidate 2017

What is Domestic Violence? Domestic violence is the willful intimidation, physical assault, battery, sexual assault, or other abusive behavior as part of a systematic pattern of power and control perpetrated by one intimate partner against another. It can include physical violence, sexual violence, psychological violence, and emotional abuse. Domestic violence affects individuals in every community regardless of age, economic status, sexual orientation, gender, or other demographic factors. However, domestic violence is most commonly experienced by  women between the ages of 18-24.

Domestic violence is preventable. Part of domestic violence prevention includes talking about this issue and reducing the stigma associated with it as a community. While all of October is Domestic Violence Awareness Month, the National Network to End Domestic Violence is hosting a week of action from October 16-October 22.

Here are some ways that you can get involved during the week of action and throughout all of October. You can also search for events that may be happening in your community with local organizations.

  • Wear purple for #PurpleThursday on Thursday October 20
  • Speak Out: Talk with a friend, family member, or colleague about domestic violence to help eliminate stigma and show survivors that they are supported.
  • Follow the National Network to End Domestic Violence on social media (Facebook, Twitter, and Instagram and change

For anonymous, confidential help available 24/7, call the National Domestic Violence Hotline at 1-800-799-7233 (SAFE) or 1-800-787-3224 (TTY) now.