Health Communication Interventions Research Articles

Strengthening global health content in health professions curricula

Background: Health professionals should be prepared to lead and contribute to initiatives that mitigate emerging global health risks to target communities. Health professions education, however, has inconsistently incorporated essential global health topics into curricula despite growing interest among health professional students. Objective: To identify targeted strategies that health professions educators can integrate into coursework to strengthen global health training. Method: A narrative review of the literature was conducted to describe clinical and non-clinical skills that are indispensable to strong global health leadership. Results: Five strategies were highlighted that health professions educators can utilise to empower health professional students to strengthen their scientific knowledge base, develop ethical and culturally-appropriate community health interventions and effectively communicate health messages to stakeholders. Conclusion: Incorporating global health topics into health professions curricula can provide health professional students with a repertoire of evidence-based resources to apply in their clinical and community health initiatives. A trained global health workforce is essential to help nations achieve established national and international health objectives, such as the Sustainable Development Goals.

Insomnia and psychological reactions during the COVID-19 outbreak in China.

Citation:Li Y, Qin Q, Sun Q, Sanford LD, Vgontzas AN, Tang X. Insomnia and psychological reactions during the COVID-19 outbreak in China. J Clin Sleep Med. 2020;16(8):1417–1418.

Patients' perceived barriers to discussing sexual health with breast cancer healthcare providers.

We characterized barriers reported by women with breast cancer (BC) regarding clinical discussions of sexual health, clustered women by their endorsement of these barriers, and compared these groups. BC outpatients (N = 144; M age = 56, 67% White) in a sexual health communication intervention study provided baseline data. Exploratory factor analysis characterized sexual health communication barriers on a standardized measure. Hierarchical cluster analysis detected patient groups with similar response patterns on these factors. ANOVAs, Chi-Square and Fisher's Exact tests compared groups on socio-demographic/medical factors, sexual health communication self-efficacy and outcome expectancies, general clinical self-efficacy, sexual concerns, emotional distress, and discussion about sexual health with an oncology provider. Two factors emerged: patients' own beliefs about or perceived inability to discuss sexual health (self-centered barriers), and patients' perceptions of providers' reactions to discussing sexual health (provider-centered barriers); self-centered barriers were endorsed more than provider-centered (P < .001). Three clusters emerged: women who endorsed (a) high self-centered and high provider-centered (n = 19; 13%), (b) high self-centered and low provider-centered (n = 95; 66%), and (c) low self-centered and low provider-centered (n = 30; 21%). Women endorsing more barriers reported lower sexual communication self-efficacy, outcome expectancies, and general clinical self-efficacy (P's ≤ .001); no differences in sexual concerns, emotional distress, or discussing sexual health were found. Women more strongly endorsed self-centered barriers than provider-centered. When grouped according to these barriers, women differed in their confidence and expectations for sexual health communication, regardless of degree of sexual or emotional distress. Interventions are needed to improve both patients' and providers' skills for discussing sexual health.

Low risks for spiritual highs: Risk-taking behaviours and the protective benefits of spiritual health among Saskatchewan adolescents.

Adolescent risk-taking behaviours, such as substance use and early sexual activity, can adversely impact physical health and psychosocial development. A connection to spiritual health may buffer against the negative health impacts of several risk-taking behaviours. The aim of this study was to determine if higher spiritual health was associated with lower risk-taking behaviours among school-attending adolescents in Saskatchewan, Canada. A representative sample of 4,751 adolescents in the Canadian province of Saskatchewan completed the Health Behaviour of School-aged Children (HBSC) questionnaire during the 2014 to 2015 school year. The main risk-taking behavioural outcomes were self-reported: smoking; alcohol; and cannabis use; as well as sexual intercourse. The main exposures related to spiritual health included four factors: connectedness to (1) one's self; (2) others; (3) nature; and (4) notions of the transcendent. Multivariable logistic regression analyses were used to test for associations between exposures and outcome measures. The sample was balanced across gender, primarily Caucasian (71%), and primarily ages 11 to 15 years (48%). Adolescents indicated a high prevalence of spiritual health. Across all adjusted models, the results demonstrated that adolescents who value the various components of spiritual health showed a decreased likelihood of engaging in cigarette smoking, alcohol and marijuana use, and sexual intercourse. The findings indicate the potential for spiritual health to be considered as the basis for public- and community-health interventions, pending further evidence from experimental studies.

Burden and Gender inequalities around Informal Care.

This work comes from the interest and need to understand the problems arising from the activity of caring for dependent people, in the world and particularly in the European region. Altogether, it seeks to understand the consequences of informal care on the caregiver adding to the debate a gender perspective. Through a multidisciplinary bibliographic review, the current care crisis becomes clear. The demographic and socio-cultural changes in recent years are causing dependency to increase dramatically, while putting at risk the availability of informal caregivers. Several studies have shown that women are the ones on whom the burden of care mainly falls. Therefore, under the gender perspective, it becomes clear that the consequences of caregiver burden increase gender inequalities worldwide. The study analyzes the current situation and underlines the need to promote alternatives and opportunities so that care is shared and does not fall only on the female gender. Solutions need to be included in public and community health interventions and policies, and to this respect, nurses play an important role in changing the care paradigm.

Mass media campaigns to reduce unnecessary caesarean sections: a systematic review

IntroductionThe worldwide increase in unnecessary caesarean sections (CSs) is a major global health issue. Mass media campaigns have been used in several countries to reduce this trend. The objectives of...

Impact of the Rochester LARC Initiative on adolescents’ utilization of long-acting reversible contraception

Preventing unintended teen pregnancy is a national public health priority, and increasing access to long-acting reversible contraception is part of the recommended strategy for the achievement of this goal. Nevertheless, adolescent long-acting reversible contraceptive use across the nation has remained low, even after national and state-level programs increased coverage for no-cost contraception. One persistent barrier is misinformation about the safety, efficacy, and availability of long-acting reversible contraception for teens. To overcome this barrier, the Hoekelman Center, in collaboration with multiple partners, designed and implemented a community health intervention. The Greater Rochester LARC Initiative disseminated accurate information about contraceptive options with a focus on long-acting reversible methods by delivering interactive lunch-and-learn talks throughout the Greater Rochester, NY area. Audiences included both healthcare providers and adults who work with adolescents in nonmedical community-based organizations. The primary purpose of this study was to evaluate the community-level impact of the Greater Rochester LARC Initiative on adolescent long-acting reversible contraception use. Our evaluation design was pre-post with a nonrandomized control group. We used publicly available Youth Risk Behavior Surveillance System data from the years 2013, 2015, and 2017 for our intervention site of Rochester, NY, New York City, New York State, and the United States overall. These years cover the time before and after the intervention began in 2014. We used z-statistics in investigating the hypothesis that long-acting reversible contraception use increased more in Rochester than in the comparison populations. Between 2013 and 2017, long-acting reversible contraception use in Rochester rose from 4-24% of sexually active female high school students (P<.0001). Over the same period, long-acting reversible contraception use in New York State rose from 1.5-4.8%, and in New York City long-acting reversible contraception use rose from 2.7-5.3%. In the United States overall, long-acting reversible contraception use rose from 1.8-5.3%. Thus, the increase in long-acting reversible contraception use in Rochester was larger than the secular trend in the control groups (P<.0001). Adolescent long-acting reversible contraceptive use increased significantly more in Rochester than in the nation as a whole. This finding is consistent with a substantial positive impact of the Greater Rochester LARC Initiative, which implies that similar interventions could be useful complements to unintended teen pregnancy prevention programs elsewhere and might be helpful more generally for the diffusion of evidence-based health-improvement practices.

The Partnership to Improve Diabetes Education Trial: a Cluster Randomized Trial Addressing Health Communication in Diabetes Care.

Effective type 2 diabetes care remains a challenge for patients including those receiving primary care in safety net settings. The Partnership to Improve Diabetes Education (PRIDE) trial team and leaders from a regional department of health evaluated approaches to improve care for vulnerable patients. Cluster randomized controlled trial. Adults with uncontrolled type 2 diabetes seeking care across 10 unblinded, randomly assigned safety net clinics in Middle TN. A literacy-sensitive, provider-focused, health communication intervention (PRIDE; 5 clinics) vs. standard diabetes education (5 clinics). Participant-level primary outcome was glycemic control [A1c] at 12months. Secondary outcomes included select health behaviors and psychosocial aspects of care at 12 and 24months. Adjusted mixed effects regression models were used to examine the comparative effectiveness of each approach to care. Of 410 patients enrolled, 364 (89%) were included in analyses. Median age was 51years; Black and Hispanic patients represented 18% and 25%; 96% were uninsured, and 82% had low annual income level (< $20,000); adequate health literacy was seen in 83%, but numeracy deficits were common. At 12months, significant within-group treatment effects occurred from baseline for both PRIDE and control sites: adjusted A1c (- 0.76 [95% CI, - 1.08 to - 0.44]; P < .001 vs - 0.54 [95% CI, - 0.86 to - 0.21]; P = .001), odds of poor eating (0.53 [95% CI, 0.33-0.83]; P = .01 vs 0.42 [95% CI, 0.26-0.68]; P < .001), treatment satisfaction (3.93 [95% CI, 2.48-6.21]; P < .001 vs 3.04 [95% CI, 1.93-4.77]; P < .001), and self-efficacy (2.97 [95% CI, 1.89-4.67]; P < .001 vs 1.81 [95% CI, 1.1-2.84]; P = .01). No significant difference was observed between study arms in adjusted analyses. Both interventions improved the participant's A1c and behavioral outcomes. PRIDE was not more effective than standard education. Further research may elucidate the added value of a focused health communication program in this setting.

Depression Is Real: Developing a Health Communication Campaign in an Urban African American Community

Depression Is Real:Developing a Health Communication Campaign in an Urban African American Community Baraka Muvuka, PhD, MPH, Ryan M. Combs, PhD, MA, Nida M. Ali, PhD, MPH, Hazel Scott, and Monnica T. Williams, PhD, MA, ABPP What Is the Purpose of the Study? • To describe the use of Boot Camp Translation, a community-based participatory method, in designing a health communication campaign on depression in a predominantly African American community. • To describe the "Depression Is Real" health communication campaign and its effectiveness in improving the use of depression screening and treatment services in a predominantly African American community. • To discuss lessons learned from using the Boot Camp Translation method in developing a health communication campaign. What Is the Problem? • Depression is a main cause of disability worldwide and in the United States. • African Americans have higher rates of depression and experience more serious depression and disability than other racial/ethnic groups. • Public awareness campaigns on depression often lack community input and are not always responsive to minority populations' unique cultural needs and preferences. What Are the Findings? • Boot Camp Translation offered a structured process for engaging diverse community stakeholders. • Boot Camp Translation enabled the development and dissemination of a culturally tailored health communication campaign addressing depression in an urban African American community. • Boot Camp Translation activated community members to become health champions/advocates. • Depression is still stigmatized in the African American community, including faith communities. Who Should Care Most? • Community members. • Community leaders. • Mental/behavioral health professionals. • Faith leaders. • Researchers and academics interested in Community-Based Participatory Research, mental health, and health disparities. [End Page 143] • Public health practitioners and researchers should establish collaborative partnerships between community members and other stakeholders to develop culturally informed health communication campaigns or interventions. • Efforts to address depression in the African American community should actively engage the faith community. [End Page 144] Baraka Muvuka University of Louisville, School of Public Health and Information Sciences Ryan M. Combs University of Louisville, School of Public Health and Information Sciences Nida M. Ali University of Louisville, School of Public Health and Information Sciences Hazel Scott Community Member Monnica T. Williams University of Ottawa, School of Psychology Copyright © 2020 Johns Hopkins University Press

Community and public health interventions for fall prevention in Brunei

Community and public health interventions for fall prevention in Brunei

Child abuse and neglect in a rapidly developing country: Parents' perspectives

Purpose:To identify parental awareness and knowledge regarding child abuse and neglect in the State of Qatar.Methods:A cross-sectional study using a questionnaire was conducted at Hamad Medical Corporation, the only tertiary pediatric hospital in the State of Qatar at the time of the study. Parents of children of all ages were offered a questionnaire that included demographic details, parental knowledge, and awareness of child abuse and neglect.Results:300 questionnaires were completed (response rate = 95%). More than 70% of parents were older than 30 years of age, 60% of them were females, and 66% were college graduates. The majority of the participants stated their familiarity about child abuse, and 6% witnessed morbidity or mortality due to child abuse in the society. Despite the identified laws, only 50% of the parents were aware of laws restricting child abuse. In regards to children with special needs, only 16% of the participants agreed that disabled children are at a higher risk of abuse compared to healthy children, while 33% were neutral and 52% disagreed. In addition, one-fifth of the respondents stated that hitting is discipline, while 63% disagreed. Almost one-third of the respondents agreed that hitting hands and buttock or hitting with soft objects is acceptable form of discipline. Unexpectedly, one-quarter of participants stated that it is okay to hit a child as long as no damage incurs. As for verbal abuse, around one-third of parents stated that yelling is not a form of child abuse, and that yelling does not affect growth and development. Comparing both corporal and verbal abuse, approximately 70% of parents stated that yelling is less harmful than hitting. In terms of child neglect, around half of the respondents agreed with the statement “Leaving a child (<5 years) unattended at home is a form of neglect,” while 42% were neutral. Finally, approximately 50% of the participants believed that it is okay to depend on nannies in assisting their children in eating and using the bathroom.Conclusion:Parents residing in the State of Qatar believe that they have a good knowledge regarding child abuse and neglect. However, this study shows many deficiencies in parental knowledge of child abuse and neglect. Parents’ attitudes and perceptions are considered indispensable targets for community health intervention.

Associations of Childhood Experiences and Methamphetamine Use Among Akha and Lahu Hill Tribe Youths in Northern Thailand: A Cross-Sectional Study

Background: Methamphetamine (MA) is a commonly used substance among youths, particularly those who are living in poor economic conditions with low levels of education and who have had bad childhood experiences. The Akha and Lahu hill tribe youths living on the Thailand-Myanmar-Laos Republic border are identified as the group most vulnerable to MA use in Thailand. The study aimed to estimate the prevalence of MA use and determine its associations with childhood experiences among Akha and Lahu youths aged 15-24 years in northern Thailand. Methods: A cross-sectional study was conducted to estimate the prevalence of MA use and determine its association with childhood experiences among Akha and Lahu youths living in northern Thailand. Validated and sealed questionnaires were used to gather information from participants after obtaining the informed consent form. Questionnaires were completed by participants and their parents at home. Logistic regression was used to identify the associations between variables at the α=0.05 level. Findings: A total of 710 participants participated in the study: 54.2% were Akha, 52.5% were females, 50.6% were aged 15-17 years (mean=18.1, SD=2.7), and 11.4% did not have Thai ID cards. The prevalence of MA use at least once among Akha and Lahu youths was 14.5%. In multivariate analysis, eight variables were found to be associated with MA use among Akha and Lahu youths in northern Thailand: sex, age, a family member who uses MA, smoking, a close friend who uses alcohol, highly confident personality, history of physical assault from a family member at an age of 0-5 years, and history of physical assault from a family member while aged 6-14 years. Males had a 4.97-fold (95% CI=2.08-10.23) greater likelihood of MA use than females. Participants aged 18-20 years and 21-24 years had a 1.96-fold (95% CI=1.03-3.71) and 2.50-fold (95% CI=1.23-5.10) greater likelihood of MA use than those aged 15-17 years, respectively. Those who had a family member who used MA had a 5.80-fold (95% CI=1.99-16.91) greater risk of MA use than those who did not. Those who smoked had a 8.9-fold (95% CI=4.88-16.29) greater likelihood of MA use than those who did not. Those who had a close friend who used alcohol had a 2.21-fold (95% CI=1.17-4.18) greater risk of MA use than those who did not. Those who had a highly confident personality had a 2.08-fold (95% CI=1.07-4.06) greater risk of MA use than those who did not. Those who had been physically assaulted by a family member while aged 0-5 years had a 2.37-fold (95% CI=1.18-5.21) greater chance of MA use than those who had not, and those who had been physically assaulted by a family member while aged 6-14 years had a 3.28-fold (95% CI=1.38-7.77) greater risk of MA use than those who had not. Interpretation: All relevant government and nongovernment agencies together with the Ministry of Public Health Thailand should address MA use among Akha and Lahu youths by properly developing a community health intervention that is focused on improving family relationships, male youths, smoking, and individuals with a highly confident personality. Funding Statement: This project was supported by the National Research Council of Thailand, Mae Fah Luang University, and The Center of Excellence for the Hill Tribe Health Research. TA was awarded the research grant from the National Research Council of Thailand (NRCT) (Grant No. 29/ 2561). Declaration of Interests: Authors declare no competing interests. Ethics Approval Statement: All research concept, procedures, and instruments were approved by the Mae Fah Luang University Research Ethic Committee on Human Research (REH-60141).

Community intervention projects as a strategy to integrate essential public health functions (EPHF) with clinical knowledge into the curriculum of medicine.

Students in medical school often do not get the opportunity to apply public health principles to their work. This can affect the likelihood that they will apply population and public health principles in practice. From 2010 to 2015, the faculty of Medicine at Fundacion Universitaria San Martin from Sabaneta Campus - Colombia, developed an educational strategy called "Community Health Intervention Projects" (CHIP) as a new way to integrate essential public health functions with clinical knowledge into the curriculum. This approach was based on Community-Based Medical Education (COME) and Community-Oriented Primary Care. Seven CHIPS were developed by 65 undergraduate students partnering with organizations as two secondary schools, one clinic, two community-based groups, one nongovernmental organization, and two secretaries of health in four different cities. The breastfeeding programs increased the time of breastfeeding by the mothers and the tools to measure breastfeeding have been used in other research projects (Medellin 2015, Envigado 2017). The project about increasing Knowledge, Attitudes, and Practices in Sexual and Reproductive Health (SRH) in young scholars from two cities (Caldas and Sabaneta) served as a springboard for one of the students of medicine to receive a scholarship to attend the global forum in SRH "Women Deliver" in Kuala Lumpur in 2013. The project about Comprehensive and Integrated Delivery Health-care Program, addressed to children with asthma, were adopted by the Ambulatory Clinics Organization after the results of the pilot program (2016-2017). This project won the TUFH- FAIMER student projects for health award in 2016, showing the sustainability and generalizability of the educational program. Health professions educators can use CHIPS to integrate the mission-related axes in their programs: Academia, research, and extension activities in a community setting.

Aligning Partners in Pediatric Health: Using Geographical Information Systems to Plan Community Coalitions.

Introduction: Compared with adults, children have higher emergency department (ED) utilization for asthma exacerbation. While community coalitions have been shown to prevent ED visits for asthma, there is little guidance on where to best implement these efforts. Geographical information systems (GIS) technology can help in the selection and coordination of potential coalition partners. This report proposes a model to be used by clinicians and child health equity advocates to strategize high-impact community health interventions. The aims were to identify the clusters of ED utilization for pediatric asthma, evaluate sociodemographic features of the population within the clusters, and identify potential primary care and school community partners. Methods: This model uses ED visit data from 450 nonmilitary California hospitals in 2012. We obtained ZIP code–level counts and rates for patients younger than 18 years discharged with a diagnosis code of 493 for asthma conditions from the California Office of Statewide Health Planning and Development’s Open Portal. We applied GIS spatial analysis techniques to identify statistically significant cluster for pediatric asthma ED utilization. We then locate the candidate community partners within these clusters. Results: There were 181 720 ED visits for asthma for all age groups in 2012 with 70 127 visits for children younger than 18 years. The top 3 geographic clusters for ED utilization rates were located in Fresno, Inglewood, and Richmond City, respectively. Spatial analysis maps illustrate the schools located within 0.5– and 1-mile radii of primary care clinics and provide a visual and statistical description of the population within the clusters. Conclusion: This study demonstrates a model to help clinicians understand how GIS can aid in the selection and creation of coalition building. This is a potentially powerful tool in the addressing child health disparities.

P036 Socioeconomic Disparities in IBD: Outcomes in Emergency Department Utilization and Outpatient Follow-Up

BACKGROUND: The association of socioeconomic status, emergency department (ED) utilization, and access to outpatient gastroenterology care in inflammatory bowel disease (IBD) remains underexplored. We sought to identify associations between overall socioeconomic deprivation and these outcomes in IBD patients. METHODS: Our historical cohort included 743 unique IBD patients with a total of 6,036 all-cause ED visits during a 51-month period (January 1, 2015 to April 1, 2019). Detailed demographic variables were recorded for all subjects. Zip codes were used to approximate the level of socioeconomic deprivation via the Area Deprivation Index (ADI), a comprehensive score developed at the University of Wisconsin based on a composite score including 17 different factors related to income, education, employment, and housing quality (1). ADI scores of these IBD patients were divided into quartiles (quartile 4 = most deprived) and then compared with outcomes, including average number of ED visits, average hours spent in ED per visit, acuity level of ED visits (by Emergency Severity Index levels 1–5, with level 1 = highest acuity), admission rates, total outpatient GI visits and IBD-specialist visits, percent attending any outpatient GI visit or IBD specialist visit, and initiation of any outpatient steroid-sparing therapies. Univariate comparisons were performed using analysis of variance (ANOVA) for continuous variables and chi-square tests for categorical variables. Statistical significance was set at P < 0.05. RESULTS: 743 IBD patients (60% female, age 48 ± 18 yrs, 446 with Crohn's disease (CD), 297 with ulcerative colitis (UC)) were evaluated. Basic demographics were similar overall, with significant differences noted in race (P < 0.001) and insurance coverage (P < 0.001). Increased ED visits were noted with increased ADI in IBD patients overall (P = 0.003) as well as in the subgroup with CD (P = 0.040). Patients with increased ADI averaged fewer hours in the ED (P = 0.043), although they presented with significantly higher acuity (P = 0.007). There was a trend towards decreased GI clinic visits with increased ADI, but this did not reach statistical significance (p = 0.055). There was a significant difference between ADI quartiles in terms of those who successfully attended at least one GI clinic follow-up visit for all IBD patients (P = 0.007) and specifically for those with CD (P = 0.012). Patients with increased ADI attended fewer IBD-specific clinic follow up (P = 0.044). Significant differences regarding access to outpatient steroid-sparing therapy were seen across ADI quartiles (P = 0.044). CONCLUSION(S): Our study demonstrates increased ED utilization and decreased access to outpatient gastroenterology and IBD specialty care in IBD patients with lower socioeconomic status. Limitations include minor differences in baseline demographics including race and insurance coverage, although confounding was minimized by utilization of a comprehensive assessment of socioeconomic status through the ADI model. Our findings highlight the need for better access to outpatient IBD care in more economically deprived areas, and community health intervention programs to improve awareness of specialty care.

A study protocol for testing the feasibility of a randomised stepped wedge cluster design to investigate a Community Health Intervention through Musical Engagement (CHIME) for perinatal mental health in The Gambia

BackgroundPerinatal mental health problems affect up to one in five women worldwide. Mental health problems in the perinatal period are a particular challenge in low- and middle-income countries (LMICs) where they can be at least twice as frequent as in higher-income countries. It is thus of high priority to develop new low-cost, low-resource, non-stigmatising and culturally appropriate approaches to reduce symptoms of anxiety and depression perinatally, for the benefit of both mother and child. Music-centred approaches may be particularly useful in The Gambia since a range of musical practices that specifically engage pregnant women and new mothers already exist.MethodsThis protocol is for a study to examine the feasibility of undertaking a stepped wedge trial to test how a Community Health Intervention through Musical Engagement (CHIME) could be beneficial in alleviating perinatal mental distress in The Gambia. In this study, we plan to recruit 120 pregnant women (n = 60 intervention, n = 60 control) at four antenatal clinics over two 6-week stepped sequences. Women in the intervention will participate in weekly group-singing sessions, led by local Kanyeleng singing groups, for 6 weeks. The control group will receive standard care. We will assess symptoms of anxiety and depression using the Edinburgh Postnatal Depression Scale (EPDS) and the Self-Reporting Questionnaire (SRQ-20). The feasibility of the design will be assessed through recruitment, retention and attrition rates of participants, clinics' adherence to the schedule and completeness of data by site. Qualitative interviews and video and audio recordings will be used to evaluate the acceptability of the intervention.DiscussionThis feasibility trial will allow us to determine whether a larger trial with the same intervention and target group is feasible and acceptable in The Gambia.Trial registrationRetrospectively registered (24/01/2019) with Pan African Clinical Trials Registry (PACTR): PACTR201901917619299.

Use of voice messaging via mobile phone to communicate female adolescents in Bangladeshi urban slum

Abstract Problem Utilization of available maternal health services is comparatively low among adolescent population in Dhaka urban slum areas and lack of adequate knowledge is one major contributor to low service utilization among slum dwelling adolescent mothers. Description of problem Dhaka urban slum dwelling female adolescents are difficult to reach adequately with health messages through traditional home visit by community health workers for counseling, because many of these adolescents in Dhaka urban slums have a job outside home. We designed and implemented an innovative health communication intervention “Health Boost” - an approach to provide reproductive, maternal and newborn health information for married female adolescents using the voice message system on mobile phone. Methods We delivered ‘Health Boost’ (HB) voice messages to enrolled married adolescent girls, twice a week, with re-listening option. Pregnant and non-pregnant participants received separate sets of messages. Enrollment was started after baseline survey (September 2016) and continued during October 2016 - April 2017. Pregnant participants received messages at least for 6 months before delivery. For evaluation, we followed pre-post observation study design and had the endline survey in November 2017. Results Comparing HB non-receivers at baseline (n = 321) and HB receivers at endline (n = 45), statistically significant improvement was revealed for knowledge on danger signs - (a) during pregnancy (55.5% vs. 93.3%; p &amp;lt; 0.001), (b) during child delivery (54.2% vs. 82.2%; p &amp;lt; 0.001), (c) for newborn (56.7% vs. 75.6%; p &amp;lt; 0.02). We also found significantly higher utilization of service among HB receivers: Utilization of antenatal care increased from 70.4% to 87.5% (p &amp;lt; 0.02); and use of postnatal care increased from 31.6% to 73.7% (p &amp;lt; 0.03). Lessons ‘Health Boost’ messages were instrumental and effective to increase knowledge and service utilization among married adolescent girls in Dhaka urban slum areas. Key messages Voice message is an innovative way to reach hard-to-reach population by using mobile phone technology. Voice messages were instrumental and effective to increase knowledge and service utilization among urban female adolescent population, for reproductive, maternal and newborn health.

Training on health communication and social media: European public health residents’ perceptions

Abstract Background Theoretical knowledge about health communication (HC) and expertise in planning, implementation and evaluation of HC interventions are essential tools for Public Health (PH) specialists. In the social media (SM) era, specific abilities and digital communication skills are gaining importance. Objective Our aim is to describe European PH residents’ perceptions regarding their training in the HC field, with a focus on SM. We piloted a survey using Google Forms during the European Network of Medical Residents in PH (EuroNet MRPH) meeting in Turin, April 2019. We then spread the survey to other PH residents across Europe in July 2019. The survey consists of 25 questions (Likert scales from 1=strongly disagree to 5=strongly agree, or multiple-choices) divided in 5 thematic sections (HC theory, public speaking, traditional media based HC, SM based HC, HC impact evaluation). Questions aim to map HC topics covered in residency educational programs, learning methods, and the perceived importance of HC skills. Results The study included 114 residents from 10 countries (37% Italy, 23% Portugal, 10% UK, 9% Spain, 8% France, 13% other). Participants perceived they receive the best training in the areas of public speaking, impact assessment and HC theory (median 3, IQR 2-4). Conversely, for traditional and SM based HC, training was perceived as unsatisfactory (median 2, IQR 1-4 and 1-3 respectively) with self-education as main learning method (51%). Public speaking and traditional HC were identified as the most important HC skills for PH specialists (median 5, IQR 5-5), while less importance was attributed to SM based HC (median 3,5, IQR 3,25-5). Conclusions Despite SM are playing a crucial role in public HC, specific training seems to be scarce in this sample. Although residents perceive SM based HC skills as important, they consider them less important than other HC skills. Further analysis is needed in order to explore the perceived relevance of SM in PH residents training. Key messages Training on health communication via social media is scarce among European public health residencies. Common training programs across European residencies in PH should address this educational need. European public health residents perceive social media based health communication skills as important, but not as important as traditional media based health communication skills.

How can we get more people with long-term health conditions involved in parkrun? A qualitative study evaluating parkrun\u2019s PROVE project

BackgroundPeople with long-term health conditions face barriers to physical activity and community health interventions despite potential life-changing benefits for self-management of their condition and wellbeing. A weekly mass participation running, walking and volunteering event called parkrun launched a project called PROVE in 2016 to engage people living with long-term health conditions in England. Over the 3 year project, parkrun appointed volunteer Outreach Ambassadors with a specialist interest in the health condition they represented whose role was to ensure parkrun was welcoming, supportive and inclusive. This qualitative study aimed to understand the experience of the PROVE project for people with long-term health conditions.MethodsSemi-structured interviews were conducted with 15 PROVE Outreach Ambassadors representing 13 different long-term health conditions in England. Interviews were recorded, transcribed verbatim and analysed using thematic analysis. Rigour and transparency were sought in addition to utilising independent researchers to offer alternative interpretations of the data.ResultsData analysis resulted in 4 overarching themes and 13 subthemes. Outreach Ambassadors believed that parkrun was already supportive of people with long-term health conditions, but that the PROVE project enabled the support to be delivered in a more structured way across health conditions and locations. Outreach Ambassadors believed that the PROVE project had the potential to create a welcoming, safe space for people with long-term health conditions to participate as walkers, runners or volunteers. Success of the PROVE project was believed to be dependent on being realistic about the potential to bring about change, challenging people’s perceptions of parkrun and engaging with key stakeholders and advocacy groups. Challenges for parkrun were believed to be around communication, demonstrating impact and the project’s dependence on volunteers for delivery.ConclusionsThis is the first study of its kind to explore the public health potential of parkrun for people with long-term health conditions. parkrun’s PROVE project was regarded to be important for ensuring that people with long-term health conditions can engage in physical activity and volunteering in a safe and supportive environment. The findings have important implications for parkrun, policy makers and physical activity providers looking to deliver inclusive community physical activity opportunities.

Black College Women’s Interpersonal Communication in Response to a Sexual Health Intervention: A Mixed Methods Study

ABSTRACT We investigated interpersonal communication generated from a successful sexual health intervention for Black college women attending a Historically Black College/University (HBCU). Guided by the integrative model of behavioral prediction and the theory of gender and power, the intervention combined point-of-access health messages with condom distribution via condom dispensers. Using a mixed-methods approach, we examined communication partners, content, mode, valence, and perceived impact. Data were gathered from surveys (N = 105) and interviews (n = 10) with young adult women at an HBCU campus, conducted three months after the intervention. The findings revealed that 43% of women engaged in interpersonal communication and 21% engaged in online interactions about the dispensers. Friends were the most common conversation partners, and the conversations were mainly about condoms and the dispensers themselves. In general, the discussions were positive, showing support for the dispensers. Regression analyses revealed positive, significant associations between interpersonal communication and two key outcomes: condom acceptability and condom intentions. Overall, this study adds to research linking health communication interventions to interpersonal communication and subsequent attitudes and beliefs. Health communication interventions should actively encourage young Black women to share health-promoting information within their social networks to extend both the reach and impact of those interventions.