Category: Health Communication

UNC alumnus writes about journalism’s role in stopping stigma against obesity

Chioma Ihekweazu is a recent doctoral graduate from our very own School of Media and Journalism here at UNC. Not only was I thrilled to see a kind peer’s work showcased in my newsfeed, I was also drawn in by her accurate criticism of how we talk about weight–obesity in particular.

She makes the very important point that while it’s not likely to hear patients who are suffering from cancer referred to as “cancerous” or “diseased”, it is quite common, even among respected news sources, to see the descriptor “obese people”. Chioma advises us to avoid playing into shaming language and “put the person before the condition”.

Please read her article here, though a few key takeaways are outlined below:

  • Avoid headless imagery (this is a form of shaming)–if needed, use non-stigmatizing stock photos
  • Recognize that weight loss is influenced by many factors–such as location, time, and access to food/physical activity
  • Do not use value-laden language; use “classes”, based on BMI, defined by CDC and NIH to talk about obesity
  • Have an appropriate headline
  • Report on facts

Chioma also provides some great examples and resources in her article, to not only help writers and reporters change their words, but also to recognize the flaws in our perspective.

 

 

Cigarette package

Federal Courts Take on Big Tobacco

It’s been a big week in terms of wins for public health and tobacco control. On November 26, 2017, tobacco companies such as Phillip Morris USA and RJ Reynolds were mandated by the US federal court to place full page corrective statements about the negative health effects of tobacco products. These ads will be placed in newspapers, magazines and television ads. The corrective statements are black and white ads that detail effects of smoking, addictiveness of smoking and lack of significant health benefit of switching to low tar and light from regular cigarettes. The tobacco companies have been advertising false information for years about their products which lead to these mandated statements.

These mandated statements came out of lawsuit that began in 1999 where the Justice department sued these major companies of civil fraud and racketeering violations. For those of us (myself included) not familiar with the legal jargon it means lying (or misrepresenting) information to the public and when organizations run illegal businesses. Now eighteen years later, these companies are required to make up for these actions.

As a current health communication student though my initial thoughts are these basic ads enough? It seems very intentional by these companies who have developed colorful and intricate ads to sell their products are using plain black and white ads for their corrective statements. It definitely is a step in the right direction but will be interesting to see how these simple ads impact attitudes towards their products.

 

Interactions

Could a lack of communication between older Americans and their healthcare providers increase the likelihood of a bad interaction? And by “bad interaction,” I don’t just mean interpersonally. The University of Michigan conducted a national poll of 1,690 Americans ages 50 to 80 and found that only 35% of those taking multiple medications had discussed possible drug interactions with a health professional in the past two years.

This lack of open-dialogue may be due to the transient nature of where we get our medication. Of the sample, 20% had used more than one pharmacy in the past two years. And even so, only 36% reported that their pharmacist definitely knew of all the medications they were taking. Alcohol, supplements, and certain foods can affect how the body responds to medication as can other medications.

Older adults especially may also be under the care of many different doctors and specialists, with 60% seeing more than one doctor. Addressing medication interactions can be challenging even when all the information is presented but when doctors don’t have the whole picture of which medications are at play, they very well could miss something. Electronic records and medical computer systems may be of assistance in flagging potential interactions, but a complete list of a patient’s medications is still necessary.

Patient-provider communication in recent years has been supplemented with patient portals and electronic paper trails, and I wonder if this older age group is slipping through the gap between interpersonal and electronic communication.

 

World AIDS Day 2017

Friday, December 1st marks the annual observation of World AIDS day. Since starting in 1988, World AIDS Day has provided an opportunity to support those living with HIV, and to commemorate individuals who have died from AIDS-related illnesses. It is estimated that there are nearly 37 million people worldwide living with HIV, and more than 35 million people have died of HIV or AIDS.

The theme for this year’s World AIDS Day is Let’s End It, to promote ending isolation, stigma, and HIV transmission. With advances in HIV treatment and prevention continuing to increase, the fight against stigma and discrimination that people living with HIV experience. This stigma also discourages people from getting tested for HIV. Regular HIV testing is important, since early detection of the virus, and subsequent early treatment, are vital from both an individual and a public health perspective. Those with an undetectable viral load, where the amount of HIV in their blood cannot be detected with current technologies, are unable to transmit the virus to others.

Here at UNC, the Student Health Action Coalition (SHAC) HIV is partnering with Student Wellness to provide Free HIV testing on Friday. The event will be in the Great Hall in the Student Union from 10:00 am – 4:30 pm, testing in confidential and quick. Stop by, get tested, know your status, and help fight HIV stigma! #LetsEndIt #TarHeelsGetTested

 

Sources –

World AIDS Day – https://www.worldaidsday.org/

 

Coffee… Good or Bad for Health?

I recently read an article that was published a few days ago in The BMJ regarding coffee consumption and health. I was curious to learn what the findings were, considering that I have heard mixed reviews over the years about the health benefits of coffee.

After conducting an umbrella review of over 200 meta-analyses regarding coffee consumption and health outcomes, Poole et al. (2017) found that drinking three to four cups of coffee a day was associated with lower risk of a variety of health outcomes. According to the article, researchers found that drinking three cups of coffee a day lowered risk for death and cardiovascular disease, compared to non-coffee drinkers. Coffee consumption was also found to lower risk of various cancers, as well as neurological, liver, and metabolic diseases. In women who are pregnant, however, high levels of coffee consumption were associated with higher risk of low birth weight, pregnancy loss, as well as preterm births. Additionally, coffee consumption was found to be associated with an increased risk of fracture in women.

A note that this study mentions is that current evidence on the topic of coffee consumption and health is mainly observational and of lower quality in nature. That said, researchers recommend that randomized controlled trials be used in future research to better understand causal associations between coffee consumption and various health outcomes.

Eliseo Guallar, professor of epidemiology and medicine at the Johns Hopkins Bloomberg School of Public Health published an editorial in response to Poole et al. (2017). Dr. Guallar comments that while coffee drinking is generally safe, people should not start drinking coffee for health reasons. Dr. Guallar continues in stating that “some population subgroups may be at higher risk of adverse effects” of coffee consumption. Additionally, Dr. Guallar expressed the importance of the amount of coffee consumption, asserting that there remains uncertainty regarding the effects of higher levels of coffee consumption. However, Dr. Guallar expressed that moderate coffee consumption is safe and can be a part of a healthy diet.

References:

Poole, R., Kennedy, O.J., Roderick, P., Fallowfield, J.A., Hayes, P.C., & Parkes, J. (2017). Coffee consumption and health: umbrella review of meta-analyses of multiple health outcomes. BMJ 2017; 359:j5024. doi: https://doi.org/10.1136/bmj.j5356 

Guallar, E. (2017). Coffee gets a clean bill of health. BMJ 2017; 359:j5356. doi: https://doi.org/10.1136/bmj.j5356 

Research Spotlight: Dr. Noel Brewer

Last week, Upstream Writers were joined by Noel Brewer, PhD, professor of Health Behavior in the UNC Gillings School of Global Public Health and affiliated scholar with UNC’s Interdisciplinary Health Communication program. Dr. Brewer gave an interesting and informative talk about his recent tobacco research involving the effect of cigarette pack messages. His findings showed that pictorial cigarette pack warnings increased smoking quit attempts and 7-day quitting. Additionally, the pictorial warnings were found to work better than text warnings, as they led to more attention, negative affect, social interactions and thinking about the warnings. Finally, because the study’s findings did not fit existing models of health behavior, Dr. Brewer developed the new Tobacco Warnings Model.

Dr. Brewer received his PhD in psychology from Rutgers University and joined the faculty in the Department of Health Behavior at the University of North Carolina at Chapel Hill in 2004. He studies how people make risky health decisions, and he currently directs the UNC Health Cognition & Behavior Lab where he conducts his research. Furthermore, in addition to Dr. Brewer’s tobacco research involving smoking risk communication, his work also focuses on HPV vaccine communication and increasing HPV vaccine uptake, and he currently serves as Chair of the National HPV Vaccination Roundtable. More information about his research can be found here.

In the spirit of Public Health Thank You Day, thank you, Dr. Brewer, for the work that you do to promote and protect public health! 

A Blueprint to “Win” the War on Drugs

What can the United States learn from Portugal about the war on drugs?

A Guest Post by Becca Fritton.

On October 26, 2017, Trump declared the opioid crisis a National Public Health Emergency. As Andrew Bradford discussed in his October 27 post, while a first step, this announcement does not immediately open up additional funding for the crisis, but instead gives access to funding that already exists. Unfortunately, this funding is almost running out. [1] It is important to note that while this announcement raises the voice of the conversation around opioid use in the United States, many do not even consider this a beginning of a plan to address the epidemic.

Any discussion or solution proposed around addiction is remiss without discussing criminalization. Nicholas Kristof of the New York Times put forth a stunning summary of how Portugal has managed to “win” the war drugs. While drug dealers still go to prison in Portugal, they have made it an “administrative offense” to possess or purchase a small quantity of drugs. Instead of going to jail or to trial, offenders attend a meeting with social workers who work towards preventing a casual user from becoming dependent on drugs. Rather than viewing an individual as a criminal, officials in Portugal focus on the individual’s health and help them find resources they need to stay healthy.

Those who are dependent on drugs need medical care, not punishment. The Health Ministry of Portugal also targeted certain neighborhoods and populations for passing out clean needles and encouraging methadone instead of heroin. At large events or concerts, the ministry would offer to test individuals’ drugs to advise if they were safe or not. Portugal’s government has also funded widespread use of methadone vans that supply users with a free and controlled amount of methadone.

This approach has worked extremely well for Portugal and now they have the lowest drug mortality rate in Western Europe, and one-fiftieth the latest count in the United States. [2] The United States should take note and begin moving in a different direction. Instead of funding prisons and jails, the government should place more funding and infrastructure in place to address addiction from a mental and public health standpoint.

Becca can be contacted via email at: rfritton [@] berkeley [dot] edu

 

[1] Allen, G. and Kelly, A. (2017). Trump Administration Declares Opioid Crisis a Public Health Emergency. National Public Radio. Retrieved from: https://www.npr.org/2017/10/26/560083795/president-trump-may-declare-opioid-epidemic-national-emergency

[2] Kristof, N. (2017). How to “Win” the War on Drugs. New York Times. Retrieved from: https://www.nytimes.com/2017/09/22/opinion/sunday/portugal-drug-decriminalization.html

Using Mass Communication to Curb Obesity

Internationally we continue to see substantial increases in overweight and obesity rates. In 2016, the World Health Organization reported that about 39% of all adults were overweight. Since overnutrition seems to traverse cultures, languages and international waters many people are looking for the most effective and efficient way of promoting positive health behaviors that promote a healthy weight. I believe mass media campaigns could serve as a solution to the problem. Health professionals can use mass media to improve the dietary habits of populations through multimedia-based communication efforts.

Over the past ten years, we have seen considerable changes in mass media communication largely due to increased use of mobile technology, especially social media. As access to mobile technology increases and people use smart-technology at increasing rates, health professionals have increased opportunities to address the importance of nutrition and physical activity. I believe that no other intervention approach has the potential for as wide a reach as mass media. Mass media campaigns that target individual dietary behaviors like increasing vegetable intake or reducing sodium are effective at promoting those behaviors (1). The “5-A-Day” campaign was successful in its efforts to increase fruit and vegetable intake. It was associated with a significant increase in fruit and vegetable consumption and increased awareness of health benefits associated with consuming fruits and vegetables. The success of mass communication in campaigns and interventions is not exclusive to increasing fruit and vegetable intake. This method has also proven effective at promoting folic acid supplementation and the maintenance of weight loss The Community Guide (2). I believe mass media campaigns advance nutrition efforts to reduce overweight and obesity rates because of the extent to which media is incorporated into people’s daily lives. Mobile technology gives health professionals a chance to engage in dialogue with individuals outside of clinical settings. I believe engaging with individuals in spaces they already visit may help people feel more comfortable and make them more receptive to adopting health-promoting behaviors.

November is American Diabetes Month

Diabetes is a chronic disease in which the body is unable to properly process blood sugar levels due to an inability to either produce or use insulin properly. There are more than 30 million Americans living with diabetes, and 7.2 million of those individuals are undiagnosed.

There are three main types of diabetes:

 Type 1 diabetes. With type 1 diabetes, the body does not produce insulin, and as a result, individuals living with type 1 diabetes require insulin injections in order to survive.

 Type 2 diabetes. This is the most common type of diabetes. With type 2 diabetes, the body is unable to produce or use insulin properly. Those living with prediabetes are at an increased risk for developing type 2 diabetes. Approximately 84.1 million adults ages 18 years or older have prediabetes, and 90% of those individuals do not know they have it.

 Gestational diabetes. This type of diabetes can occur in women during pregnancy. Women with gestational diabetes are at an increased risk for developing type 2 diabetes.

While there is no cure for diabetes, it can be managed with the proper medication, by monitoring blood sugar levels, managing stress, and/or with lifestyle changes to diet and exercise. And for people living with prediabetes, type 2 diabetes can be prevented with weight loss, physical activity, and/or healthy eating.

To learn more about diabetes, check out the following resources:

American Diabetes Association

Diabetes – Centers for Disease Control

References

About Diabetes. (2017, June 1). Retrieved from https://www.cdc.gov/diabetes/basics/diabetes.html

Diabetes [PDF]. (N.d.) Retrieved from https://www.cdc.gov/media/presskits/aahd/diabetes.pdf

Diabetes Statistics. (2017, September). Retrieved from https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics

Facts about Type 2. (2015, October 27). Retrieved from http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html

Living with Type 1 Diabetes. (2016, November 21). Retrieved from http://www.diabetes.org/living-with-diabetes/recently-diagnosed/living-with-type-1-diabetes.html

Managing Diabetes. (2016, November). Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/managing-diabetes

Prediabetes. (2017, July 25). Retrieved from https://www.cdc.gov/diabetes/basics/prediabetes.html

Preventing Type 2 Diabetes. (2016, November). Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-type-2-diabetes

What is Diabetes? (2016, November). Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes

Coming Full Circle: Carmina Valle, PhD, MPH

It’s not every day we get the opportunity to hear from distinguished alumnae of our Interdisciplinary Health Communication Certificate program. But last week, we had the pleasure of welcoming back Carmina Valle, PhD, MPH to share her past, present, and future.

As a graduate student beginning to consider next steps, it is inspiring to see how Dr. Valle has connected, and applied, her past experiences in a way that has led to a well-rounded, meaningful portfolio of work.

Dr. Valle’s past experiences as a biology undergrad turned epidemiologic biostatistician master student led to a prestigious Presidential Management Fellowship with the National Cancer Institute (NCI). Her time at NCI and Livestrong opened her eyes to the need for more widespread sharing of proven solutions for helping the increasing numbers of cancer survivors, particularly young adults who are in critical, transitional life periods.

After completing pre- and post-doctoral training at the University of North Carolina, Dr. Valle is now an Assistant Professor in the Department of Nutrition at the Gillings School of Global Public Health and a member of the UNC Lineberger Comprehensive Cancer Center and UNC Weight Research Program. Her resource portfolio focuses on accelerating research on technology-based behavioral interventions for cancer control, particularly novel strategies to improve lifestyle behaviors of cancer survivors.

Previous projects have included a Facebook-based physical activity intervention for young adult cancer survivors and use of a sophisticated study design (Multiphase Optimization Strategy) to identify the most effective messages for a tailored health assessment tool. Her ongoing projects include serving as a Co-Principal Investigator for a Gillings Innovation Lab that focuses on JITAIs. No this is not a Star Wars term, JITAIs are Just-In-Time Adaptive Interventions to identify optimal timing, content, and need for intervention messages to help people in the moment when they need it most.

Dr. Valle, your passion for what you do is evident, and we are proud to call you one of our own.

 

Key Publications:

Preventing weight gain in African American breast cancer survivors using smart scales and activity trackers: A randomized controlled pilot study. Valle C.G., Deal A.M., & Tate D.F (2017). Journal of Cancer Survivorship, 11(1), 133-148.

Engagement of young adult cancer survivors within a Facebook-based physical activity intervention. Valle CG & Tate DF (2017). Translational Behavioral Medicine.

Exploring mediators of physical activity in young adult cancer survivors: Evidence from a randomized trial of a Facebook-based physical activity intervention. Valle CG, Tate DF, Mayer DK, Allicock M, Cai J. (2015). Journal of Adolescent and Young Adult Oncology, 4(1), 26-33.