Key Health Messages Research Articles

Community-made mobile videos as a mechanism for maternal, newborn and child health education in rural Uganda; a qualitative evaluation.

In Uganda, the maternal, newborn and child mortality is highest in rural areas, which are least served by health services and are also least reached by effective behavior change communication for health. Though maternal and child health related messages are available, they are still not culture and context specific for effective behaviour change. This study aimed at evaluating the feasibility of using locally made videos by local community groups in local languages as a channel for increasing knowledge, practices, demand and use of maternal and child health messages among women living in rural communities in Eastern Uganda. This paper describes the qualitative findings from a quasi experimental study targeting the rural semi-illiterate populations in hard to reach areas. Videos were developed and implemented based on Ministry of Health. Focus group discussions and KIs targeted pregnant and post natal mothers. Data transcription and content analysis was done. Local mobile community videos were effective in communicating knowledge about key maternal and child health messages to both women and their male partners. Locally made mobile community videos are effective in improving knowledge, attitudes, practices and use of maternal and child health messages among rural semi-illiterate communities.

A behavioral economics intervention to encourage epinephrine-carrying among food-allergic adults: a randomized controlled trial

BackgroundAdolescents and young adults with food allergies are at increased risk of adverse events, including death from anaphylaxis. Epinephrine is the cornerstone of emergency response, yet few individuals with serious food allergies consistently carry their emergency medication. Behavioral economics offers promising, previously untapped opportunities for behavior change in this arena. ObjectiveTo test the effectiveness of modest financial incentives in promoting the carrying of epinephrine and to evaluate the acceptability of text messaging for delivering reminders and key health messages to young adults with food allergies. MethodsA mixed-methods randomized controlled trial in young adults with food allergies investigated the carrying of epinephrine auto-injectors using financial incentives plus text message reminders vs text message reminders alone. Epinephrine carriage was assessed 10 times during the 49-day intervention using rapid-reply cell phone photographs plus daily code words. ResultsThe intervention (financial incentive) group had their epinephrine auto-injectors at 54% of check-ins vs 27% of check-ins in the control (text-only) group (P = .023). Participants in the 2 groups consistently reported favorable impressions of text messaging as a desirable, unobtrusive way to receive information and support for food allergy management. ConclusionAlthough the intervention and control groups reported favorable impressions of text message-based reminder systems, the intervention group performed significantly better than the control group on a photograph-based measurement of epinephrine carriage. There remained ample room for improvement in the 2 groups given the goal of consistent, uninterrupted epinephrine carriage by people with potentially life-threatening food allergies. Trial Registrationhttps://clinicaltrials.gov; NCT02354729.

Using interactive family science shows to improve public knowledge on antibiotic resistance: does it work?

The public plays an important role in controlling the emergence and spread of antibiotic resistance. A large British survey showed that there is still public misunderstanding about microbes and antibiotics. e-Bug, a European DG Sanco sponsored project, aims to disseminate a school antibiotic and hygiene educational pack and website across Europe. Interactive science shows based on the e-Bug educational packs were developed to take the key health and hygiene messages from the e-Bug school resources to families. The science show was evaluated to assess public knowledge and understanding of antibiotics and antibiotic resistance pre and post intervention. An interactive stall comprised of a 3×2 m backing stand with background information, an interactive activity and discussions with a trained demonstrator was on display at a family holiday resort. Pre-piloted knowledge questionnaires were completed by parents and children pre and post intervention. Adult (≥19 years) baseline knowledge regarding antibiotics and antibiotic resistance was high although significant knowledge improvement was observed where baseline knowledge was low. Children's (5–11 years) knowledge around antibiotics and antibiotic resistance was significantly improved for all questions. The science show can be viewed as a success in improving parents' and children's knowledge of antibiotic use thereby highlighting the importance of educating the public through interaction.

Summary of: Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public

The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.

Mind the gap! A comparison of oral health knowledge between dental, healthcare professionals and the public

The importance of consistent, accurate and unambiguous messages are well documented in oral health promotion literature. Whether the reality of delivering messages in the field fulfils these principle is questionable. This paper explores the perceptions of dental professionals, healthcare professionals and lay community members with regard to key oral health messages in order to highlight any inconsistencies and knowledge gaps between and within groups for disease risk factors. A questionnaire was administered to individuals who belonged to three groups: dental professionals, healthcare professionals and lay community members. The questionnaire established knowledge regarding risk factors for caries, periodontal disease and erosion. Thirty-five (57.4%) of the dental group answered the whole questionnaire correctly, with 22 (27.8%) and 9 (5.1%) of the healthcare and lay community group answering the whole questionnaire correctly, respectively. The question of fluoride levels in children's toothpaste was the main reason for incorrect answers in the dental group. The results of this survey demonstrate a knowledge gradient from dental professionals through to healthcare professionals and then to lay members of the community. The knowledge base observed in the dental group is reflected in the other two groups as would be expected albeit with a significant gap between each group. As expected the dental professionals are generally well informed, but not as well informed as could be expected.

Growing Right Onto Wellness (GROW): A family-centered, community-based obesity prevention randomized controlled trial for preschool child–parent pairs

Growing Right Onto Wellness (GROW) is a randomized controlled trial that tests the efficacy of a family-centered, community-based, behavioral intervention to prevent childhood obesity among preschool-aged children. Focusing on parent–child pairs, GROW utilizes a multi-level framework, which accounts for macro (i.e., built-environment) and micro (i.e., genetics) level systems that contribute to the childhood obesity epidemic.Six hundred parent–child pairs will be randomized to a 3-year healthy lifestyle intervention or a 3-year school readiness program. Eligible children are enrolled between ages 3 and 5, are from minority communities, and are not obese. The principal site for the GROW intervention is local community recreation centers and libraries.The primary outcome is childhood body mass index (BMI) trajectory at the end of the three-year study period. In addition to other anthropometric measurements, mediators and moderators of growth are considered, including genetics, accelerometry, and diet recall.GROW is a staged intensity intervention, consisting of intensive, maintenance, and sustainability phases. Throughout the study, parents build skills in nutrition, physical activity, and parenting, concurrently forming new social networks. Participants are taught goal-setting, self-monitoring, and problem solving techniques to facilitate sustainable behavior change. The GROW curriculum uses low health literacy communication and social media to communicate key health messages. The control arm is administered to both control and intervention participants.By conducting this trial in public community centers, and by implementing a family-centered approach to sustainable healthy childhood growth, we aim to develop an exportable community-based intervention to address the expanding public health crisis of pediatric obesity.

Fruit and vegetables on prescription: a brief intervention in primary care

Increasing fruit and vegetable consumption is a goal for the U.K. Therefore, the effectiveness of a fruit and vegetable voucher scheme coupled with key 'five-a-day' consumption messages as a brief intervention in primary care consultations was assessed in the present study. One thousand one hundred and eighty-eight vouchers as a prescription for fruits and vegetables were routinely distributed to patients attending a primary healthcare centre in a deprived area, and 124 volunteer patients routinely attending the centre were included. Telephone-based questionnaires were used to examine changes in consumption over the short and medium term. Other key aspects assessed in the evaluation related to fruit and vegetable purchasing behaviour, knowledge relating to what constitutes a portion size, the relationship between food and health, and barriers to consumption. Although 76.2% of participants used the prescription vouchers when purchasing fruits and vegetables, a significant change in the consumption or purchasing behaviour was not observed (P > 0.05). Participants' level of knowledge relating to the number of portions recommended and the portion size of different fruits and vegetables showed a moderate increase from baseline over the short and medium term. The primary barriers to fruit and vegetable consumption were reported as 'the quality of fresh fruits and vegetables' and 'the money available to spend on food'. The use of 'the fruit and vegetable on prescription' scheme was an effective method of engaging participants in improving awareness of key diet-related health messages. However, further intervention is required to produce a significant impact on the actual behaviour change.

Health literacy in schools: prioritising health and well-being issues through the curriculum

Health literacy (HL) is a relatively new concept in health promotion and is concerned with empowering people through enhancing their knowledge of health issues and improving their ability to make choices about their health and well-being. Schools are seen increasingly as key settings for the dissemination of health messages through curricula and other on-site provision. However, such opportunities are amongst many demands being placed on educational providers and finding space in the school day to support the health agenda is a challenge. This practice-based, qualitative study examines the current practices in three schools in the UK. In total 34 pupils (n=16 from Year 9 and n = 18 from Year 11) were interviewed in six focus groups (3 in each school), with up to 6 pupils in each focus group. School staff (n = 8) were also interviewed individually. Findings suggest that pupils and staff have an understanding of health and a capacity for HL, though health education (via taught subjects) is not statutory across the four Key Stages of the National Curriculum. In order to engender health literate young people, with a view to reducing health inequalities, it is recommended that key health messages are delivered through an agenda that integrates current provision for health via the curriculum and other school-based practices, such as the Healthy Schools Programme.

Social circumstances that drive early introduction of formula milk: an exploratory qualitative study in a peri‐urban South African community

Breastfeeding is widely endorsed as the optimal strategy for feeding newborns and young infants, as well as improving child survival and achieving Millennium Development Goal 4. Exclusive breastfeeding (EBF) for the first 6 months of life is rarely practised in South Africa. Following the 2010 World Health Organization (WHO) infant feeding recommendations (EBF for HIV-positive mothers with maternal or infant antiretroviral treatment), South Africa adopted breastfeeding promotion as a National Infant Feeding Strategy and removed free formula milk from the Prevention of Mother-to-Child Transmission of HIV programme. This study aimed to explore the perceptions of mothers and household members at community level regarding the value they placed on formula feeding and circumstances that drive the practice in a peri-urban community. We conducted in-depth interviews with HIV-positive and HIV-negative mothers in a community-randomised trial (Good Start III). Focus group discussions were held with grandmothers, fathers and teenage mothers. Data were analysed using thematic analysis. The following themes were identified; inadequate involvement of teenage mothers; grandmothers who become replacement mothers; fear of failing to practise EBF for 6 months; partners as formula providers and costly formula milk leading to risky feeding practices. The new South African Infant Feeding Strategy needs to address the gaps in key health messages and develop community-orientated programmes with a focus on teenage mothers. These should encourage the involvement of grandmothers and fathers in decision-making about infant feeding so that they can support EBF for optimal child survival.

Prevalence of body-focused repetitive behaviors in three large medical colleges of karachi: a cross-sectional study

BackgroundBody-focused repetitive behaviors (BFRBs) that include skin picking (dermatillomania), hair pulling (trichotillomania) and nail biting (onychophagia), lead to harmful physical and psychological sequelae.The objective was to determine the prevalence of BFRBs among students attending three large medical colleges of Karachi. It is imperative to come up with frequency to design strategies to decrease the burden and adverse effects associated with BFRBs among medical students.MethodsA cross-sectional study was conducted among 210 students attending Aga Khan University, Dow Medical College and Sind Medical College, Karachi, in equal proportion. Data were collected using a pre tested tool, “Habit Questionnaire”. Diagnoses were made on the criteria that a student must be involved in an activity 5 times or more per day for 4 weeks or more. Convenience sampling was done to recruit the participants aged 18 years and above after getting written informed consent.ResultsThe overall prevalence of BFRBs was found to be 46 (22%). For those positive for BFRBs, gender distribution was as follows: females 29 (13.9%) and males 17 (8.1%). Among these students, 19 (9.0%) were engaged in dermatillomania, 28 (13.3%) in trichotillomania and 13 (6.2%) in onychophagia.ConclusionsHigh proportions of BFRBs are reported among medical students of Karachi. Key health messages and interventions to reduce stress and anxiety among students may help in curtailing the burden of this disease which has serious adverse consequences.

Community responses to communication campaigns for influenza A (H1N1): a focus group study

BackgroundThis research was a part of a contestable rapid response initiative launched by the Health Research Council of New Zealand and the Ministry of Health in response to the 2009 influenza A pandemic. The aim was to provide health authorities in New Zealand with evidence-based practical information to guide the development and delivery of effective health messages for H1N1 and other health campaigns. This study contributed to the initiative by providing qualitative data about community responses to key health messages in the 2009 and 2010 H1N1 campaigns, the impact of messages on behavioural change and the differential impact on vulnerable groups in New Zealand.MethodsQualitative data were collected on community responses to key health messages in the 2009 and 2010 Ministry of Health H1N1 campaigns, the impact of messages on behaviour and the differential impact on vulnerable groups. Eight focus groups were held in the winter of 2010 with 80 participants from groups identified by the Ministry of Health as vulnerable to the H1N1 virus, such as people with chronic health conditions, pregnant women, children, Pacific Peoples and Māori. Because this study was part of a rapid response initiative, focus groups were selected as the most efficient means of data collection in the time available. For Māori, focus group discussion (hui) is a culturally appropriate methodology.ResultsThematic analysis of data identified four major themes: personal and community risk, building community strategies, responsibility and information sources. People wanted messages about specific actions that they could take to protect themselves and their families and to mitigate any consequences. They wanted transparent and factual communication where both good and bad news is conveyed by people who they could trust.ConclusionsThe responses from all groups endorsed the need for community based risk management including information dissemination. Engaging with communities will be essential to facilitate preparedness and build community resilience to future pandemic events. This research provides an illustration of the complexities of how people understand and respond to health messages related to the H1N1 pandemic. The importance of the differences identified in the analysis is not the differences per se but highlight problems with a "one size fits all" pandemic warning strategy.

SP4-10 Prevalence and factors associated with irritable bowel syndrome among medical students of Karachi: a cross-sectional study

IntroductionIrritable bowel syndrome is commonly reported among university students, however few analytical based studies are available on IBS from Pakistan. We investigate the prevalence and pattern of symptoms of IBS...

Motivating intentions to adopt risk-reducing behaviours for chronic diseases: Impact of a public health tool for collecting family health histories

In the genomics era the use of valid and reliable tools for the collection of family health histories is proposed as a strategy for identifying those at higher risk of chronic disease and increasing the adoption of risk-modifying behaviours.This study investigated the impact of a collection tool for a Family Health History Program in Western Australia upon uptake of key health messages and intentions to adopt risk-reducing behaviours for chronic diseases. Initially a baseline population survey (n=1009) was undertaken to assess the collection of family health histories among adults and identify target populations for the tool. A targeted intercept survey (n=606) was then conducted with women to assess the tool. Around half the respondents indicated they were motivated to adopt one or more risk-reducing behaviours as a result of their exposure to the tool.The odds of being motivated to do something related to family health history were significantly greater for women who liked the too (AdjOR=3.1,95%Cl 2.1 4.5 ), thought it conveyed useful information (AdjOR=5.0, 95%Cl 2.6-9.6), perceived family history to be more important than before they read the tool (AdjOR=3.4, 95%Cl 2.3-4.9) and had not previously collected family health history information (AdjOR=1.8, 95%Cl 1.1-3.0). At a whole-of-population level most adults consider family health history important, but few have actually recorded this information. The tool raised awareness of the importance of family health histories to personal health and was considered personally useful by most respondents.

Readability levels of health pamphlets distributed in hospitals and health centres in Athens, Greece

Health literacy is important in the medical and social sciences due to its impact on behavioural and health outcomes. Nevertheless, little is known about it in Greece, including patients' level of understanding health brochures and pamphlets distributed in Greek hospitals and clinics. Observational study in the greater metropolitan area of Athens, Greece. Pamphlets and brochures written in the Greek language were collected from 17 hospitals and healthcare centres between the spring and autumn of 2006. Readability of pamphlets using the Flesch-Kincaid, Simple Measure of Gobbledygook (SMOG) and Fog methods was calculated based on a Greek readability software. Out of 70 pamphlets collected from 17 hospitals, 37 pamphlets met the criteria for the study. The average readability level of all scanned pamphlets was ninth to 10th grade, corresponding to a readability level of 'average'. A highly significant difference (P<0.001) was found between private and public hospitals using the Flesch-Kincaid and SMOG readability scales. Pamphlets from private hospitals were one grade more difficult than those from public hospitals. Approximately 43.7% of the Greek population aged ≥20 years would not be able to comprehend the available pamphlets, which were found to have an average readability level of ninth to 10th grade. Further research examining readability levels in the context of health literacy in Greece is warranted. This effort paves the way for additional research in the field of readability levels of health pamphlets in the Greek language, the sources of health information, and the level of understanding of key health messages by the population.

Media Gave Incomplete Story on Antidepressant Warnings

Media Gave Incomplete Story on Antidepressant Warnings

News Coverage of FDA Warnings on Pediatric Antidepressant Use and Suicidality

In 2004, after an 18-month investigation, the Food and Drug Administration (FDA) directed pharmaceutical manufacturers to add a black box warning to antidepressants regarding increased risk of suicidality in children. Our objective was to evaluate the quality and content of and overall impression conveyed in news coverage of this issue. We collected all news stories on pediatric antidepressant use and suicidality published in a convenience sample of 10 of the highest-circulation print newspapers in the United States, the 3 major television networks, and a major cable news network in 2003 and 2004 (N = 167). Two researchers coded news articles by using a 9-item instrument. The quality of news reporting on key health messages included in FDA warnings was mixed. The overwhelming majority of news stories correctly described a risk of suicidality associated with pediatric antidepressant use, as opposed to suicide itself. However, other key health messages highlighted in FDA warnings often were absent from news coverage. News stories were more likely to include anecdotes of children harmed versus children helped by antidepressants, whereas expert sources quoted were more likely to emphasize the benefits of antidepressants over their risks. However, the majority of news stories conveyed neither the overall impression that the risks of pediatric antidepressant use outweighed the benefits nor the impression that the benefits outweighed the risks, and coverage became increasingly neutral over time. Inclusion of key health messages in FDA safety warnings was not sufficient to ensure their communication to the public through the lay press.

Vital guide to Oral health education

Welcome to the eighth article in the Vital Guide Series. At the end of the article are some CPD questions , which are designed to get you thinking about the article and to help you remember some of the key points. The answers to the questions in the summer issue can be found here . Here, Cathy Stillman-Lowe and Ronnie Levine OBE update you on the key oral health messages for patients and describe new developments in smoking cessation and supporting behaviour change.

Editorial

Editorial

Can audiovisual presentations be used to provide health education at primary health care facilities in South Africa?

This study assessed the feasibility and potential effectiveness of using audiovisual presentations in the waiting rooms of busy South African primary health care clinics, to educate patients about STD prevention and treatment. A 24-minute episode of South Africa's popular soap opera, Soul City was played continuously during three consecutive days in the clinic waiting areas. The storyline of the episode chosen was intended to convey key health messages regarding the prevention and treatment of STDs. The research was conducted at four primary health care clinics serving large, poor peri-urban townships in South Africa. Observations of patient behaviour were made, and a random selection of patients were interviewed on exit. A focus-group discussion was held with all of the clinic staff at each clinic site, to assess staff atti tudes towards the use of such audiovisual presentations as part of their future routine duties. The mean proportion of patients who were observed watching the video at any one time varied from 34 to 64 per cent at all four clinics. Based on exit inter views, the presentation was seen by 88.2 per cent of patients attending all four clinics, and its STD content was recognised by 91.5 per cent of those who had seen it. Over 90 per cent of patients found the presentation helpful and interesting. Clinic staff described the use of video-mediated education as a solution to the problem of inad equate health education, and there was unanimous support for it. In future, it will be important to evaluate whether such audiovisual presentations can be effective in improving patients' knowledge and attitudes, and changing their behaviour, without compromising important interactions between clinicians and patients.

The use of television series in health education.

This paper reviews evidence of the impact which television generally, and drama series in particular, can have on health beliefs, attitudes and behaviours. It describes how a television series, The Family House, was planned in Egypt to disseminate key health messages in an entertaining context. As only a very small number of television series were specifically developed to address health issues, and even fewer were evaluated, this paper presents important new data derived from focus group discussions and survey interviews which help in understanding the potential television series can have for health education. Finally, the paper presents data on the cost-effectiveness of The Family House series.