HPV is the most common STI, and 9 of every 10 people will have an infection at some point in their lives (1). This virus can cause cancers in the cervix, penis, mouth, and oropharynx (2), and it also causes genital warts (3). Even though a vaccine exists against HPV, less than half of teens are up to date on all of their doses of these shots (2).
Part of the reason behind these low vaccination rates are due to parents concerns regarding vaccine safety and fear that vaccination will encourage sexual activity (4). Though all vaccines, including this one, have potential side effects, the HPV vaccine is considered safe (4). Additionally, studies have shown that the HPV vaccine does not make teens more likely to start having sex (4).
The way providers approach talking about the HPV has also influenced vaccine rates, and strong provider endorsement seems to improve vaccinations (5). On Monday, March 19, Chris Noronha spoke with the Interdisciplinary Health Communications Class about the work he is doing with Noel Brewer on provider communication regarding the HPV vaccine. They have found that when providers mention the HPV vaccine in the same list as other vaccines that are due at age 11, vaccination rates increase.
If you’re interested in the HPV vaccine, it may not be too late. You can receive the series through age 26 (1). Contact your provider if you’re interested.
- Centers for Disease Control and Prevention. Human Papillomavirus (HPV) Vaccine Safety. Centers for Disease Control and Prevention. [Online] January 30, 2018. https://www.cdc.gov/vaccinesafety/vaccines/hpv-vaccine.html.
- Aubrey, Allison. This Vaccine Can Prevent Cancer, But Many Teenagers Still Don’t Get It. National Public Radio. [Online] February 19, 2018. https://www.npr.org/sections/health-shots/2018/02/19/586494027/this-vaccine-can-prevent-cancer-but-many-teenagers-still-dont-get-it.
- Centers for Disease Control and Prevention. What is HPV. Centers for Disease Control and Prevention. [Online] December 20, 2016. https://www.cdc.gov/hpv/parents/whatishpv.html.
- —. Talking to Parents About HPV vaccine. Centers for Disease Control and Prevention. [Online] December 2016. https://www.cdc.gov/hpv/hcp/for-hcp-tipsheet-hpv.pdf.
- Narula, Tara. HPV vaccine: Why aren’t children getting it? CBS News. [Online] July 23, 2017. https://www.cbsnews.com/news/hpv-vaccination-cancer-prevention-dr-tara-narula/.
In this day of age celebrities dominate our world. They hold elected office, they are activists, they are social media entrepreneurs, they are everywhere. Whether we like to believe it or not they have influence over our behaviors and how we make decisions. I’m guilty that most of the accounts I follow on Instagram are former Bachelor contestants and catch myself wanting to mimic their fashion and fitness routines. In fact, there has been research that has examined this phenomenon. Back in 2013, esteemed actress Angelina Jolie announced that she carries the a genetic mutation that greatly increases your risk of breast and ovarian cancer (BRCA1). In her New York Times opt ed piece, Jolie reveals that she lost her mom, aunt and grandmother to cancer and that influence her decision to undergo preventive surgery to remove both of her breasts (mastectomy) and ovaries. After this announcement, several researchers explored what came to be known as “The Angelina Effect” and how her decision influenced other women’s decisions about their own health. In a study published in Health Services Research journal, hospital data from both New York and the UK revealed that three months after Jolie’s announcement there was a significant increase in preventive mastectomies prior to the announcement. This trend has been seen with other celebrities after announcements of diagnoses and provides incentives for both public figures and healthcare providers to use these instances as teachable moments and bring awareness to employ preventive healthcare.
To learn more about the BRCA1 gene visit the following site: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1
Lowering tobacco use has been one of the great successes of public health in the past 50 years, and continues to be a focus of research and intervention. This was achieved through policy and health communication. This journey has shown us that it is possible to change the culture and narrative around behavior, despite steady corporate influence. While tobacco is still a significant public health hurdle in the U.S., there is confidence in the direction we’re headed given what we’ve accomplished.
Unfortunately, tobacco companies are infiltrating other countries with less developed infrastructure for tackling this issue. Currently, low and middle income countries represent 80% of the world’s smokers, as well as smoking-related deaths. Africa in particular is falling victim to extremely powerful tobacco marketing campaigns – smoking prevalence in Lesotho rose from 15% to 52% just between 2004 and 2015, and the industry even manipulated public health policy in Nigeria. Big tobacco is no stranger to targeting advertising strategies to vulnerable groups.
In order to reverse this, we need to support strategies that African countries have already begun to administer. Ghana and Madagascar have implemented tobacco advertising bans; several nations have introduced graphic labels on cigarette packs; South Africa has increased tax on tobacco products; and Kenya has implemented a system for tracking and tracing illicit tobacco product sales.
Already having the knowledge of the danger of tobacco will hopefully help other countries prevent the industry’s hold from strengthening. We must support their efforts before it’s too late.
On Monday, our class had the pleasure of hearing UNC’s own Stephanie Brown discuss her most recent article “New Stories Credible or Clickable: Schema of Fake News to Corrections” featured in Communication: Journalism Education Today. Stephanie Brown is the director of the Parks Library at UNC’s School of Media and Journalism and is expert in news literacy and how to detect false news. Her presentation focused on the best ways to detect if an article is considered credible or in today’s newly coined phrase “fake news”. She began her presentation with an exercise “Would you share” to get our class thinking about the creditability of articles and if we would feel comfortable sharing them on our own social media platforms. This lively discussion brought up some of the consequences of sharing inaccurate news information and how we go addressing others who share these types of stories. Then she moved on how ways to identify articles that are “fake news” and unreliable sources through a comprehensive checklist. She went through the checklist with a few example articles that captive our class’s attention. The checklist was originally developed by the News Literacy Project and includes about seven items. A few examples of the items on the checklist include looking out for articles that are overly emotional, that use excessive punctuation, make a claim about a secret that the media is hiding from you and the types of sources the article cites. One interesting item on the checklist that she harped on was looking at the advertisements and sponsored content on the sides of the article. That can be a telling item if the advertisement is featuring “Lose 5 lbs in a week with this new pill” vs. “Visit Florida” in determining the credibility of the content.
Here is the full News Literacy project checklist: http://www.thenewsliteracyproject.org/sites/default/files/DontGetFooled_FINAL_020518.pdf
As the United States continues to be embattled in an ongoing opioid overdose epidemic, new research is showing the benefits that Medicaid expansion has had under the Patient Protection and Affordable Care Act (ACA). According to a recent study out of the Center on Budget and Policy Priorities, the rate in which patients who were hospitalized due to opioid-related health issues, who were uninsured dropped in states that expanded Medicaid, from 13.4% in 2013 to 2.9% the following year. The same study also showed that Medicaid expansion had not contributed to the ongoing opioid crisis, showing that opioid-related hospitalizations were higher in states that expanded Medicaid three years before expansion occurred, and that the rates had been steady in expansion and non-expansion states. As we can see, Medicaid expansion has had a profound impact in reducing the rate of uninsured, and in the case of the ongoing Opioid epidemic, Medicaid plays a key and vital role in working to help curb the epidemic. For more information on this study from the Center on Budget and Policy Priorities, please check out the link below.
Center on Budget and Policy Priorities, Medicaid Expansion Dramatically Increased Covered for People with Opioid-Use Disorders, Latest Data Shows – https://www.cbpp.org/research/health/medicaid-expansion-dramatically-increased-coverage-for-people-with-opioid-use
Let’s talk about these persuasion techniques from the fields of PR and advertising. They don’t just need to apply to consumer marketing or branding—they can inform health campaigns.
Mendelsohn’s Three Assumptions for a Successful Campaign
- Target your messages
- Assume target audience is uninterested in messages
- Set reasonable, mid-range goals & objectives
How to best “assume” (without making an a** out of you and me):
- Research to understand target audience & inform goals
- Theory to develop strategies
Thankfully these receiver-oriented sequential steps are based on dominos and not a house of cards:
McGuire’s Hierarchy of Effects (aka Domino Model)
- Exposure: Get the message out; alas, if only was enough
- Attention: Production values; color; involuntary (orienting response) vs. voluntary (enjoyment)
- Interest: Perception of relevance; throw in novelty/something unusual
- Comprehension: More attention, more learning; misinterpretation a barrier
- Skill Acquisition: Intention doesn’t matter if don’t know how to do the thing
- Attitude Change: Opinion-based; attitudes and behaviors don’t always correspond
- Memory Storage: Key takeaways of message need to stand out
- Information Retrieval: Provide reminders/memory devices (e.g. jingles, slogans, miscellaneous swag)
- Motivation: More likely to act if behavior perceived as easy/important/realistic/beneficial
- Behavior: Facilitate (e.g. supply, access) brand/behavior loyalty
- Reinforcement: Minimize buyer’s remorse/behavior regret
- Routine: Assimilate into target audience’s preexisting worldview; become a part of their life (i.e. ultimate goal, difficult)
BRB, I’m going to keep these in mind forever.
The new Apple Watch commercial “Dear Apple” has the world talking after its debut during this year’s Winter Olympics. It’s personal, heart wrenching and most importantly highlights the incredible impacts of it’s less advertised features. This commercial emphasizes that this technology could revolutionize healthcare and provide life-changing health support. It features anecdotes of a car accident survivor using the feature on the watch to call 911 after their phone was thrown from the vehicle and a child with Type 1 diabetes pairing the watch with her glucose monitor that alerts her when her blood sugars are at low levels. While the ad still features its more traditional feature of tracking physical activity, it was nice to see that the more innovative features of its products and it’s direct benefits. While I love a good selfie, it’s reassuring to know that Apple and other technology companies are using their technology for just more than just three dimensional emojis and higher quality selfies. I look forward to seeing what other technology these companies come up with in the future to help us lead healthier lives.
If you haven’t seen the commercial check it out here: https://www.youtube.com/watch?v=N-x8Ik9G5Dg
In the past few weeks, I have illustrated how trust (or lack thereof) shapes the relationship between individuals and healthcare, and how mistrust is historically justified. In this last segment, I want to talk about potential solutions from a social justice standpoint.
Trust is often cited in public health from the angle of paternalism, something that public health is often associated with. When we think of optimal paternalism – using scientific knowledge to influence the health decisions of the general public – we ask ourselves: are we abusing trust, or using it for good?
Public health, while sometimes paternalistic, already stresses to its students the importance of working with oppressed communities as equals to identify and solve problems. Medicine needs to catch up. Many medical students already participate in racial and cultural training, but they need to be trained from a structural angle – to gain an understanding of oppression and policy – too.
We need to support training for healthcare providers that doesn’t shy away from the tough stuff. Hands-on learning, such as tactful poverty simulations, can help. This will allow them to understand things like how the cycle of poverty makes some patients less talkative with authority figures (such as doctors) than others. We need to support minority students in medicine, so that patients can see representation of themselves and feel understood. We need to provide incentives for students to stay in their own communities for residencies. Of course, broad class mobility-enabling policy is the ultimate solution.
Many times, our work seeks to increase trust, but that puts the burden on the patient instead of addressing the reasons behind mistrust. Teaching trust in and of itself is a paternalistic objective: we should instead focus on deserving it.
In 1993, the National Highway Traffic Safety Administration launched the catchy “Click It or Ticket” campaign to increase seat belt usage by emphasizing the legal consequences of “freeriding” (which is also catchy and I just coined). The campaign was considered largely successful.
In our 21st century, the CDC puts 18-24 year olds as less likely to wear seat belts than older age groups, especially in the backseat. I painfully point out that these youths were likely not cognizant, maybe not even born yet, at the height of “Click It or Ticket.” It may be time for a reboot.
Enter “Buckle Up, Backseat,” a campaign idea to increase seat belt usage in backseat passengers. Tyler Lee, a first-year master’s student studying Strategic Communication, was kind enough to present this proposal to our class today. He described how a strong focus would be on ridesharing vehicles (like Uber, Lyft, or your average taxi) since they are widely used by 18-24 year olds. Tyler and team’s formative research found that attitudes on backseat passenger seat belt usage were notably laxer when in the context of rideshares.
So don’t “freeride” (wink wink, trademark pending), and instead remember to “Click It or Ticket” and “Buckle Up, Backseat.” Catchy phrases have power.
“You can’t health care-access your way out of this problem. There’s something inherently wrong with the system that’s not valuing the lives of black women equally to white women.” -Raegan McDonald-Mosley
Last week, my post scratched the surface of the history of oppression disguised as medical treatment. Today, I want to talk about how this mistreatment, and the historical trauma that ensues, exhibits itself in patient-practitioner relationships.
Many of us have experienced the helplessness of not knowing how much a medical procedure will cost until it’s over. It’s a terrible feeling: it feels like everyone is communicating without you; ‘above’ you. For many non-white and immigrant patients, this feeling lasts for the entire appointment: from scheduling to decision-making to discharge.
Traditionally, there are four types of patient-physician relationships, each with varying levels of patient power and involvement in decision-making. There is also a distinction between patients preferring an active or passive role in decision-making. Acknowledging the relationship between trust and decision-making preference, these researchers suggest that, for black patients, race may impact both: such that a patient who trusts her individual physician “may have residual mistrust of the health care system that limits [her] ability to relinquish decision-making control.” Cultural differences, as well as fear that the doctor does not have one’s best interests at heart, can influence the relationship between patients and their physicians in Hispanic populations as well.
Racial bias, conscious or otherwise, has been found to influence treatment decisions. Black patients are systematically under-treated for pain due to false beliefs of biological differences between blacks and whites: such as black people’s skin being thicker, or blood coagulating more quickly. This is exacerbated by existing power structures between whites and non-whites, as well as between doctors and patients. In over 200 personal stories from black women of their childbirth experiences, NPR found a constant theme of being devalued and dismissed by medical providers.
Read Part IV here.