Health Communication Messages Research Articles

Effectiveness of social marketing in improving knowledge, attitudes and practice of consumption of vitamin A-fortified oil in Tanzania.

To evaluate the effectiveness of a social marketing intervention in enhancing knowledge, attitudes and practice (KAP) related to consumption of vitamin A-fortified oil. The intervention employed community events, distribution of educational materials and radio broadcasts. The intervention was assessed in a quasi-experimental non-equivalent control group study design by collecting information on KAP regarding vitamin A-fortified oil consumption before and after 9 months of a 13-month intervention. Six districts in Manyara and Shinyanga regions in Tanzania were non-randomly selected as the intervention districts and two districts served as the control districts. At baseline, 568 lactating mothers with children aged <5 years were randomly selected from the intervention and control districts. Of these, 494 mothers were followed up at endline. After 9 months of intervention, knowledge of fortification and actual consumption of adequately fortified oil were significantly higher in the intervention districts compared with the control districts (P <0·05). Knowledge of the health benefits of vitamin A improved significantly from about 33 to 45 % in both the intervention and control districts. The major sources of information for women were health clinics and community health workers (CHW). The study showed that a social marketing intervention is effective in improving KAP regarding fortified oil consumption at the household level. Clinics and CHW are channels that should be prioritized when communicating health messages, particularly those targeting women.

Randomized Trial Evaluating Targeted Photographic Health Communication Messages in Three Stigmatized Populations: Physically-Disabled, Senior, and Overweight/Obese Individuals

The homophily principle that perceived similarities among people produce positive reactions is a cross-cultural, global phenomenon. The prediction that photographs depicting models similar to the target population improve health communication was tested. Three nationally-representative samples (n = 1,796) of adults who are disabled, seniors, or considered overweight/obese were selected from GfK’s Knowledge Panel®. Participants read a message promoting physical activity and improved diets and responded to assessments of behavioral intentions, outcome and self-efficacy expectations, and identification. Photographs from a stock photograph service versus photographs created for the research project to match the three populations, Real Health Photos (RHP), were included in the message. Structural equation modeling confirmed that RHP which matched the population increased behavioral intentions mediated by identification (p < 0.05) in the physically-disabled and overweight/obese samples. Messages with only half of the matched RHP images had these same positive indirect effects (p < 0.05). Matched visual images in health messages improved effectiveness by capitalizing on the homophily and identification processes. Health educators should leverage these hardwired, evolutionary, biological phenomena that extend to health status as well as race and ethnicity. For optimal effects, not all persons shown need to be homophilous to the target audience, reducing logistical difficulties in showing diverse persons of various types.

A first step to improving maternal mortality in a low-literacy setting; the successful use of singing to improve knowledge regarding antenatal care

Preventable maternal mortality is related to delays in recognizing the problem, transport to a facility, and receiving appropriate care on arrival. Reducing maternal mortality in low-literacy settings is particularly challenging. In the rural villages of Nepal, the maternal mortality rate is among the highest in the world; the reasons include illiteracy and lack of knowledge of the needs of pregnant women. Culturally, singing and dancing are part of Nepalese daily life and present an opportunity to transmit knowledge of antenatal care and care at birth with a view to reducing the first 2 delays. We hypothesized that health messages regarding the importance of antenatal care and skilled birth assistance would be effectively transmitted by songs in the limited literacy environment of rural Nepal. We randomly grouped 4 rural village development committees comprising 36 villages into 2 (intervention and control) clusters. In the intervention group, local groups were invited to write song lyrics incorporating key health messages regarding antenatal care to accompany popular melodies. The groups presented their songs and dances in a festival organized and judged by the community. The winning songs were performed by the local people in a song and dance progression through the villages, houses, and fields. A wall chart with the key health messages was also provided to each household. Knowledge of household decision makers (senior men and women) was assessed before and after the intervention and at 12 months using a structured questionnaire in all households that also assessed behavior change. Structured interviews were conducted at baseline, immediately postintervention in the control and intervention areas (intervention n= 735 interviews, control n= 775), and at 12 months in the intervention area only (n= 867). Knowledge scores were recorded as the number of correct items out of 36 questions at baseline and postintervention, and of 21 questions at follow-up. Postintervention, test score doubled in the intervention group from a mean of 11.60/36-22.33/36 (P < .001), with no practically significant change in the control population (17.48/36-18.26/36). Improvement was greatest among the most illiterate members of the community (6.8/36-19.8/36, P < .001). At 12 months follow-up, a majority of the participants (63.9%) indicated that they provided information learned from the songs to their neighbors and friends, and 41.3% reported still singing the songs from the intervention. The use of songs bypassed the limitations of literacy in communicating health messages that are key to improving maternal care in this low-literacy rural setting within a developing country. The improvements were maintained without further intervention for 12 months. With appropriate sociocultural adaptation to local contexts, this low-cost method of community education may be applicable to improving maternal health knowledge and behavior change in other low-resource and limited literacy settings that may lead to reductions in maternal mortality.

A Review of Global Epidemiology and Response to Meningococcal Disease Outbreaks among Men Who Have Sex with Men, 2001–2018

Men who have sex with men (MSM) have been previously shown to be at increased risk for meningococcal disease compared to other men. We summarized the global epidemiology and public health response to meningococcal disease outbreaks among MSM. At least ten outbreaks of serogroup C meningococcal disease among MSM have been reported since 2001. Investigation of and response to outbreaks among MSM have often been hampered by an inability to identify epidemiologic links among cases, and the target population recommended for vaccination has been expanded over time in many outbreaks. Unique communication methods, including the use of apps and social media, have been used during some outbreaks to identify close contacts and to communicate health messages. Although HIV-infected MSM have a higher risk of sporadic meningococcal disease in the USA, other factors are likely contributing to outbreaks among MSM. An increase in urethritis due to Neisseria meningitidis has recently been reported in US men, though its role in meningococcal disease transmission among MSM remains unclear. Meningococcal disease outbreaks among MSM raise questions regarding possible unique risk factors in this population. The role of HIV infection and mode of N. meningitidis transmission are being investigated to provide further insights into meningococcal disease and outbreaks in this population. Vaccination remains the primary prevention and control strategy during meningococcal disease outbreaks among MSM.

Primary versus secondary prevention messages: College students' perceptions of effectiveness by marijuana user status

Objective: With medical and recreational marijuana legislation expanding throughout the country, the need to educate high-risk populations is evident. The purpose of this study was to assess college students’ perceptions of health communication messages comparing primary and secondary prevention messages concerning marijuana. Participants: Participants (n = 487) included college students, ages 18–25, enrolled in a Midwestern University. Methods: Participants assessed messages based on likeability, creativity, believability, persuasiveness, relevance, and usefulness using an online questionnaire that also included open-end comments. Results: Rasch analyses indicate that nonmarijuana users rated primary prevention messages higher than secondary prevention messages, whereas marijuana users ranked secondary prevention messages more favorably than primary prevention messages. Conclusion: Interventions designed to address marijuana use among college students may be more effective if tailored toward user status. Specifically, primary prevention materials should be designed for abstainers, while secondary prevention messages that focus on harm reduction strategies should be used with marijuana users.

Developing health communication messaging for a social marketing campaign to reduce tobacco use in pregnancy among Alaska native women

ABSTRACTBackground: Despite the high prevalence of tobacco use during pregnancy among Alaska Native and American Indian (AI/AN) women, few efforts have focused on developing tobacco cessation interventions for this group. This paper describes development of messaging for a social media campaign targeting the entire community to reduce tobacco use in pregnancy (cigarette smoking and smokeless tobacco use including a homemade product known as Iqmik) among AN women, as part of a multi-component intervention.Method: The study (clinical trial registration #NCT02083081) used mixed methods with two rounds of assessments to develop and refine culturally relevant message appeals. Round 1 used qualitative focus groups and individual interviews (n = 60), and Round 2 used quantitative survey interviews (n = 52). Each round purposively sampled adult AN pregnant women, family/friends, and Elders in Western Alaska, and included tobacco users and non-users. Round 1 also assessed reasons for tobacco use in pregnancy.Results: Qualitative findings generally converged with quantitative results to indicate that many participants preferred factual, loss-framed, visual concepts on how maternal tobacco use harms the fetus, newborn, and child in contrast to spiritual or emotional appeals, or gain-framed messaging. Stress was indicated as a major reason for tobacco use in pregnancy and strategies to manage stress along with other health pregnancy targets (e.g. prenatal care) were suggested.Conclusions: This preliminary study suggests campaign messages targeting the entire community to reduce tobacco use in pregnancy among rural AN women should include factual messaging for being tobacco-free as well as focus on reducing stress and other healthy pregnancy targets.

Abstract C17: Community theater outreach to increase HPV vaccine intention among parents of Latino adolescents: A pilot test

Abstract Introduction: Although Latinos have higher HPV vaccination rates than non-Hispanic whites, coverage is far below the 80% Healthy People 2020 goal. Significant gaps in knowledge and awareness about HPV and the HPV vaccine persist. Community theater performances are an effective tool to communicate health messages to medically underserved minority populations. Here we describe the pilot test of a community theater-based intervention to increase HPV vaccination intention among Spanish-speaking parents of underserved Latino adolescents. Methods: The monologue script was written by a professional playwright and then modified in an iterative process based on recommendations from clinical and community advisory boards. The monologue performance was pilot tested in two groups, one at a charter school and another at a church in Harris County, TX. Audiences viewed a performance of the monologue and then participated in a question-and-answer session. After the intervention, they were asked questions about the performance and their comprehension of health messages. Additionally, participants answered a self-administered questionnaire. Feedback from the pilot audiences was compiled and incorporated into a revised monologue script. Results: The monologue pilot performances were attended by 36 people. They were mostly female around the average age of 41. 36% were very likely to get their children vaccinated for HPV before viewing the monologue, and 97% were very likely to get their children vaccinated for HPV after the viewing the monologue. This difference was statistically significant (p&amp;lt;0.001). Knowledge question responses revealed key messages that needed further emphasis. Specifically, messages about the vaccine's safety and efficacy and the connection between HPV and cancer were reinforced. Audiences also provided qualitative feedback about ideas they thought needed to be emphasized or clarified. Discussion: Responses to the pre- and post-performance intention-to-vaccinate item suggest that the monologue may increase Latino parents' intentions to vaccinate their adolescent children against the HPV vaccine. This suggests that community theater performances targeted to Latino parents may be an effective approach to communicate health messages and improve parents' knowledge and intentions to vaccinate their adolescent children for HPV. For the most part, audiences understood the main health messages of the monologue and were entertained by and identified with the character and scenarios depicted in the script. However, there were several key messages that audience members felt were not strongly conveyed in the original script: specifically, that the vaccine is about cancer prevention not sexual activity, why the recommended age for vaccination is 11 and 12 years, and the importance of vaccinating against HPV and other adolescent vaccines (Tdap and meningococcal). Changes made to the monologue script will be made based on the feedback from the pilot audiences. Community theater performances targeted to Latino parents may be an effective approach to communicate health messages and improve parents' knowledge and intentions to vaccinate their adolescent children for HPV. Citation Format: Veronica Landa, Jane Montealegre, Maria Jibaja-Weiss. Community theater outreach to increase HPV vaccine intention among parents of Latino adolescents: A pilot test [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr C17.

Using efficacy cues in persuasive health communication is more effective than employing threats - An experimental study of a vaccination intervention against Ebola.

Although much effort has been made to study fear appeals in persuasive health communication, there is still mixed support for the effectiveness of this approach. Therefore, this research investigated the effect of invoked fear via health communication messages on crucial components of the Extended Parallel Process Model (EPPM) by focusing on the rarely examined interaction between perceptions of threat and efficacy and their effects on fear control and danger control processes as well as health-relevant outcomes. We recruited 447 participants (Mage =32.00years; 64% female) for a 2×2 between-subjects experimental study via quota sampling. While completing an online questionnaire, subjects were randomly assigned to view one of four versions of a mock website containing information about vaccinations against Ebola virus disease (EVD), which varied in threat and efficacy. After seeing the stimulus, participants completed assessments of their perceptions of threat and efficacy, evoked fear, adaptive and defensive responses to the presented message, attitudes, and intentions. Structure equationmodelling (SEM) was used to analyse the relationships within the model (EPPM). Promoting efficacy with respect to EVD was more effective than emphasizing threat, resulting in danger control rather than fear control processes. Although threat may be effective in attracting peoples' attention, there is a comparatively small effect of evoked fear on attitudes and intentions. The data support the assumption that there is an important association between threat and coping appraisals facilitating behaviour change. Moreover, the widely held notion that people have to be scared or threatened to encourage attitude and behaviour changes should be treated with caution. Communication should instead focus on efficacy to foster adaptive responses. Statement of contribution What is already known on this subject? There is mixed support for the effectiveness of fear appeals in persuasive health communication, especially regarding the interaction of threat perceptions and coping appraisals for fear and danger control processes. The Extended Parallel Process Model - being a current and often applied model to investigate the effects of fear appeals - suggests a multiplicative relationship between threat perceptions and coping perceptions Most studies applying conventional analysis strategies (e.g., [M] ANOVAs) indicate that perceptions and appraisals of threat and efficacy are not directly related to each other. What does this study add? It demonstrates the parallelism and interaction between threat appraisal and coping appraisal processes and demonstrates the usefulness of SEM in testing associations within the EPPM. It confirms the assumption of an important multiplicative association between threat and coping appraisals within the EPPM, while related cognitive processes still seem to operate independently. Adaptive responses to persuasive messages are mainly triggered using efficacy cues, not threat, which could also be triggered by promoting positive emotional experiences (e.g., gain-framing or entertainment education).

Using the Ecological Model to understand influences on college student vaping

ABSTRACTObjective The Ecological Model was used to examine the social and environmental influences of the college environment on e-cigarette use (vaping) among college students. Participants: Undergraduate college student e-cigarette users (vapers) across three large college campuses in the southwest US from Jan 2015- Aug 2016. Methods: Thirty-three interviews were conducted. Transcribed interviews were coded then analyzed for themes. Results: College student vapers report multiple levels of influence on their vaping beyond personal beliefs and peer influences, including parents, explicit campus and community messaging, community member requests, and respect for others. College student vapers also describe constant associations with smokers in allowable public places to vape. Conclusions: Parents, community members, campus policy, and the physical environment all influence where and when college students vape. Health communication messages to prevent college student vaping should incorporate alternative messages that are important to college students, such as respect for others and social image.

Abstract P305: Psychosocial Stressors and Tobacco Use: Views of the Transgender Community in a 2016 Focus Groups Study

Background: Studies have found that cigarette smoking is higher among lesbian, gay, bisexual, transgender and queer (LGBTQ) groups compared to heterosexual individuals. However, limited research is available about factors related to tobacco initiation or continuation among transgender adults. Methods: During summer 2016, the AHA-Tobacco Regulatory and Addiction Center (A-TRAC) conducted 27 focus groups and 196 surveys among smokers and non-smokers (ages 18-64) who self-identified as lesbian, gay, bisexual, transgender, or queer (LGBTQ). Study participants were of diverse racial and ethnic backgrounds and were recruited in Chicago, New York City and San Diego. Using qualitative data analyses, we analyzed a subsample of the LGBTQ data to examine the views and experiences of transgender individuals and identified themes related to psychosocial stressors linked to tobacco use. Atlas ti.v 7.5 qualitative software was used for analysis. Results: A total of 26 participants were identified as transgender, representing 13.9% of the total LGBTQ sample. Psychosocial stressors that were often mentioned by study participants and were associated with initial and continuing tobacco use included: childhood and adulthood trauma due to family, peer and community rejection and/or exposure to partner and/or community violence; surgery and the side effects of medication; use of hormones and/or other experiences related to the process of transitioning. Structural discrimination associated with low income, housing, and employment was also mentioned. These psychosocial stressors were also associated with depression and the use of intoxicating substances (i.e., alcohol and drugs). Tobacco use was felt to provide relief from these stressors. Conclusion: Transgender individuals perceived tobacco use as a relief from everyday chronic psychosocial stressors and appears to be associated with tobacco initiation and continued use. Health communication messages stressing healthy lifestyle practices and encouraging drawing on professional and informal support systems may prevent tobacco use.

A national survey of young women's beliefs about quitting indoor tanning: implications for health communication messages.

Indoor tanning is a risk factor for melanoma among young white women. Health communications can be an effective way of reaching this population and promoting behavior change. The purpose of this study was (i) to investigate the associations between intention to quit indoor tanning and attitudes, normative pressure, and efficacy about quitting, and (ii) to identify beliefs about quitting indoor tanning that can be used to design effective health communication messages to reduce skin cancer risk. A national online survey was conducted with 279 non-Hispanic white women ages 18-25 in the USA who are indoor tanners. The survey, based on the reasoned action approach, assessed intention, attitudes, norms, and efficacy and their corresponding underlying beliefs related to quitting indoor tanning, along with other known covariates. Data were collected in November/December 2015. Intention to quit indoor tanning was significantly associated with attitudes, specifically with the beliefs that it would "reduce damage to skin" (increased intention) and "make me less happy" (decreased intention). While self-efficacy was not related to intention to quit indoor tanning, injunctive normative beliefs were with key referent groups including mothers, friends, and romantic partners. Messages aimed at discouraging indoor tanning among young, non-Hispanic, white women should highlight the salient belief that quitting indoor tanning will reduce skin damage, counter the belief that it will make them less happy, and highlight key people who would approve of them quitting indoor tanning.

Celebrating the health literacy skills of parents: A photovoice study.

Parents play a vital role in promoting children's health. The parental health literacy skills are important since the decisions they make can have an impact on other family members' health and well-being. Using an assets-based approach, this project aimed to explore the skills parents use to communicate health messages with their children and how they manage their family's health. Six adult parents of children aged 0-16 years old took part in this photovoice study. The thematic analysis suggests that tapping into the creativity of parents through the gamification of health messages and encouraging children's independence are effective ways to promote healthy behaviors. Trusting their instincts and developing good relationships with healthcare providers were also seen as important. However, there is still a need to improve confidence and skills, particularly on how to critically appraise information, especially in this digital age where sources of information are vast and conflicting messages could arise.

Health-seeking behavior and transmission dynamics in the control of influenza infection among different age groups.

BackgroundIt has been found that health-seeking behavior has a certain impact on influenza infection. However, behaviors with/without risk perception on the control of influenza transmission among age groups have not been well quantified.ObjectivesThe purpose of this study was to assess to what extent, under scenarios of with/without control and preventive/protective behaviors, the age-specific network-driven risk perception influences influenza infection.Materials and methodsA behavior-influenza model was used to estimate the spread rate of age-specific risk perception in response to an influenza outbreak. A network-based information model was used to assess the effect of network-driven risk perception information transmission on influenza infection. A probabilistic risk model was used to assess the infection risk effect of risk perception with a health behavior change.ResultsThe age-specific overlapping percentage was estimated to be 40%–43%, 55%–60%, and 19%–35% for child, teenage and adult, and elderly age groups, respectively. Individuals perceive the preventive behavior to improve risk perception information transmission among teenage and adult and elderly age groups, but not in the child age group. The population with perceived health behaviors could not effectively decrease the percentage of infection risk in the child age group, whereas for the elderly age group, the percentage of decrease in infection risk was more significant, with a 97.5th percentile estimate of 97%.ConclusionThe present integrated behavior-infection model can help health authorities in communicating health messages for an intertwined belief network in which health-seeking behavior plays a key role in controlling influenza infection.

Factors Influencing Trust in Agencies That Disseminate Tobacco Prevention Information.

Several health-related agencies administer national and targeted public education campaigns to provide health information and change health-related behaviors. The trust the public has in these agencies as the source of the message impacts the effectiveness of their communication campaigns. In this study, we explore the perceived trust of agencies that communicate health messages in the tobacco control field. As part of a larger tobacco regulatory science study, we conducted six 90-min focus groups comprising 41 participants. Five main themes emerged pertinent to the agency: (1) its integrity, (2) its competence, (3) its motives, (4) how it is portrayed in the media, and (5) skepticism and mistrust about it. Given the significant resources spent on health messaging to the public and potential benefits offered by this communication, an understanding of public trust in the agencies as the source of health messages is important. Findings suggest health information may be ignored or discounted when there is mistrust in the agency sending those messages.

Mapping the Barriers and Facilitators of HCV Treatment Initiation in Methadone Maintenance Therapy Patients: Implications for Intervention Development

An estimated 70–90% of current methadone users have Hepatitis C (HCV). Current treatments have few side effects and can cure infection in 8–12 weeks, but less than 10% of methadone patients initiate treatment. Engaging this group in treatment is an important strategy to lower both morbidity and mortality from liver disease and eliminate a significant reservoir of HCV in communities. To understand how to address this treatment gap we used commercial marketing techniques called perceptual mapping and vector message modeling to analyze survey data from 100 HCV+ methadone patients from four centers in Philadelphia. Results were used to understand barriers and facilitators to treatment initiation and to devise targeted message strategies to adapt to a mobile health communication intervention. Results indicate that focusing on how treatment can make one feel “in charge”, positive interactions with healthcare providers, the positive attributes of the new vs. old HCV treatments, and providing strategies to address tangible barriers to getting treatment, would be important to address in a communication intervention. These marketing methods allow for focusing on specific variables to “move” the group toward a treatment decision, making them an innovative technique to use in developing highly targeted health communication messages.

Image, Text and Malaria: Creative Production of a Comic Book

The comics medium is a powerful tool for communication. It employs the language of both text and images. The placement, interrelationship and transition of panels, speech balloons, gutters, lines, script and picture plane are some of the elements that evoke a sense of time and place in comics. The success of comics as an effective medium depends on experiences common to both the creator and audience. In the light of this understanding of the language of comics, and theorisation regarding the ‘production’ of culture, this article analyses the creation procedure of a comic book made to communicate health messages among schoolchildren under a health project run by the directorate of Vector Borne Disease Control Programme in India. Designing Communications 2 2 Name changed. I have used pseudo names for all the private institutes and professionals. , a private agency contracted by the government for its public health programmes, became the site for this production process. The production involved various ‘actants’ 3 3 A. J. Greimas (1983) developed the actantial model where he talked about six actants or facets that define a narrative algorithm. These actants include the subject, the object, the sender, the receiver, the helper and the opponent. This model was further used by Bruno Latour and others in the development of actor–network theory (widely known as ANT) where the focus shifted from action to systems or networks. from the field. It was also constrained by the limits set by the ‘genre’, hence a specific art world. I call the production of such a comic book a ‘creative production’ because it involves a dynamic interplay between the artists’ creativity and the bureaucratic boundaries of the profession of advertising. Following Howard Becker’s idea that artistic production is collective, I describe the detailed contribution of major actors involved in the process of comic book production.

Modeling Insect-Repellent Use for Chikungunya Disease Prevention Among US-Caribbean Travelers

Introduction: This study examined the relationship between specific psychosocial variables and the use of insect repellents on skin or clothing as a preventive behavior for Chikungunya fever among US travelers to Caribbean destinations. Methods: A cross-sectional retrospective online survey method was adopted. US residents who travelled to one of 34 Caribbean destinations within the past 12 months and expressed an awareness of Chikungunya fever were invited to participate in this study. Sociodemographic variables, perceived response efficacy, perceived self-efficacy, perceived Chikungunya severity and susceptibility, and self-reported use of insect repellents were investigated. Results: Results of direct logistic regression analysis revealed a significant association between higher levels of education and the odds of self-reported use of insect repellent on skin or clothing among study participants. Among the proximal Chikungunya-related variables, hierarchical binary logistic regression revealed a significant association between scores on perceived response efficacy, perceived self-efficacy, and perceived severity of self-reported use of insect repellents. These results support the existence of a hierarchical relationship between the more proximal Chikungunya-related variables and self-reported use of insect repellents as a personal protective measure (PPM). Conclusion: The findings of the current study have important implications for health communication messaging aimed at reducing the spread of Chikungunya among US travelers to Caribbean destinations. It seems essential to establish the use of insect repellent on skin and clothing as a personal preventive measure against Chikungunya disease within an educational context, framed along the lines of Chikungunya severity, response efficacy, and self-efficacy, for US travelers to destinations with a high risk of exposure to Chikungunya disease-carrying mosquitoes.

Use of most significant change (MSC) technique to evaluate health promotion training of maternal community health workers in Cianjur district, Indonesia

Maternal health promotion is a defined activity in the community integrated posts (Posyandu) in Indonesia. However, it is often neglected due to limited knowledge and skills of the community health workers (kader). We conducted health promotion training for the kader and village midwives in four villages in Cianjur district. This study describes the use of “most significant change” (MSC) technique to evaluate impact of health promotion to the beneficiaries and community at large. The MSC uses stories as raw data. Through interviews focused on perception of change, stories were collected from four pregnant women, eight kader and three village midwives. A Panel consisting of policy and programme managers and implementers read all the stories. The story by a pregnant woman who routinely attended Posyandu was selected as the story with most significant change. Her story highlighted changes in kader’s knowledge and communication of health messages and attitude towards pregnant women. She expressed these changes impacted community awareness about health and to seek help from kader.The MSC technique enabled stakeholders to view raw data and evaluate the impact of health promotion from the beneficiary’s perspective. At the same time, recipients of health promotion contributed to the decision process of evaluation through their stories. The different perspectives on the MSC reflected individual’s objectives of the health promotion. The application of this technique is limited in maternal health promotion programme in Indonesia, and none have been published in peer reviewed journals.

Media Reportage and Audience Perception of Hepatitis Disease in Nigeria

The growing incidence of hepatitis disease has become a perennial issue across the globe. Healthcare providers and communication experts agree that hepatitis disease is a highly infectious and deadly disease that has infected several millions of individuals in high and low-resource countries. This study examined the media reportage of hepatitis disease as well as the perception of Nigerians on the awareness and knowledge of the disease. This study was anchored on the Health Belief Model (HBM), which explains how attitude of individuals can be influenced by media and health communication messages. This study adopted a dual research method that made use of survey and content analysis to achieve the objectives of the study. The results indicated that 53.3% of the respondents had been previously informed about the hepatitis disease, with only 62 people getting to know through the mainstream media (television, radio and newspaper) and 42 people were informed through the internet (the new media). The study further revealed that just 55 stories were published in duo years of 2015 and 2016 by four national newspapers in Nigeria. This study recommends that the media in Nigeria need to urgently align with the Health Belief Model (HBM) by positively affecting the perception of the people to live a sensitive and conscious life against the hepatitis disease.

Identifying Communication Barriers to Colorectal Cancer Screening Adherence among Appalachian Kentuckians

ABSTRACTUtilizing data from 40 in-depth interviews, this article identifies both barriers and facilitators to colorectal screening guideline adherence among Appalachian Kentucky adults recruited through a community-based research network. Key findings identify (a) varying levels of knowledge about screening guidelines, (b) reticence to engage in screening processes, and (c) nuanced communication with healthcare providers and family members regarding screening adherence. What participants knew about the screening process was often derived from personal stories or recalled stories from family members about their screening experiences. Reticence to engage in screening processes reflected reports of cumbersome preparation, privacy issues, embarrassment, medical mistrust, fear of receiving a cancer diagnosis, and lack of symptoms. Participants cited many ways to enhance patient-centered communication, and the findings from this study have implications for health communication message design and communication strategies for healthcare practices in Appalachian Kentucky clinics.