Receiving Health Messages Research Articles

A focus group study of fish consumption behaviors among Asian women in Milwaukee, Wisconsin

Consumption of locally caught fish provides health benefits but can be a route of exposure to methylmercury and other persistent environmental contaminants. Previous studies found that Asian women of childbearing age (WCBA) in the Milwaukee area have high levels of exposure through fish consumption but limited awareness of fish advisories. We conducted a focus group project to understand the influence of culture, attitudes, and beliefs on the fish consumption habits of Chinese, Hmong, and Karen WCBA who reside in the Milwaukee area to develop culturally appropriate educational materials.A total of 19 women aged 18–50 years identifying as Chinese, Hmong, or Karen were recruited. Three focus groups were held, each consisting of 6–7 participants from one ethnicity. Focus group transcripts were thematically analyzed and coded based on the integrated behavioral model.Nutritional benefits and availability were the most common reasons to eat locally caught fish. All participants were aware of risks associated with eating fish, yet few knew ways to mitigate risk and maximize benefits. Participants expressed interest in receiving health messages from trusted sources and recommended that messaging target families rather than just individuals. Participants who were confident in their self-efficacy expressed a greater likelihood of following health message guidelines.Results suggest providing culturally appropriate educational materials in preferred languages to Asian communities via local community organizations may increase self-efficacy and adherence to fish advisories. Future projects will evaluate the effectiveness of self-affirmation messaging among Asian WCBA and assess changes in fish consumption based on message content.

Communicating Health to Young Adults Using Social Media: How, Where, and When?

Communication with young adults about healthy lifestyle behaviours needs to result in improvements in dietary choices to impact the prevalence of diet-related diseases. This paper presents the health beliefs, behaviours, and communication practices in young Australian adults (n = 2019) by their pre-defined psycho-behavioural characteristics: Lifestyle Mavens, Health-Conscious, Aspirational Healthy Eaters, Balanced-All Rounders, Contemplating Another Day, or Blissfully Unconcerned. The Lifestyle Mavens and Health-Conscious groups were more likely to actively seek out health information on social media (p < 0.05). Lifestyle Mavens were the most likely to engage with health and food content on social media, whereas the Blissfully Unconcerned were the least likely to engage (p < 0.05). Lifestyle Mavens are more likely to report creating food and health-related content for social media, whereas Aspirational Healthy Eaters are more likely to report searching for food and health-related content online, but are less likely to share or create content. Contemplating Another Day are more likely to report interactions with commercial content. This paper defines how psycho-behavioural segments communicate about health, where they look for information, how they may prefer to receive health messages, and when they are most receptive to messages. By applying existing robust market segmentation techniques, this paper provides nuanced information that challenges the assumption that online social media health information is preferred by all young adults.

Technology for Healthy Independent Living: Creating a Tailored In-Home Sensor System for Older Adults and Family Caregivers.

Sensing technologies hold enormous potential for early detection of health changes that can dramatically affect the aging experience. In previous work, we developed a health alert system that captures and analyzes in-home sensor data. The purpose of this research was to collect input from older adults and family members on how the health information generated can best be adapted, such that older adults and family members can better self-manage their health. Five 90-minute focus groups were conducted with 23 older adults (mean age = 80 years; 87% female) and five family members (mean age = 64; 100% female). Participants were asked open-ended questions about the sensor technology and methods for interacting with their health information. Participants provided feedback regarding tailoring the technology, such as delegating access to family and health care providers, receiving health messages and alerts, interpreting health messages, and graphic display options. Participants also noted concerns and future likelihood of technology adoption. [Journal of Gerontological Nursing, 46(7), 35-40.].

Women's Perceptions of Using Mobile Phones for Maternal and Child Health Support in Afghanistan: Cross-Sectional Survey.

BackgroundGrowing rates of global mobile subscriptions pave the way for implementation of mobile health (mHealth) initiatives, especially among hard-to-reach populations.ObjectiveThis study aimed to determine the perceptions of Afghan women regarding the use of mobile phones for maternal and child health services.MethodsA cross-sectional survey was conducted in both rural and urban districts of Nangarhar Province, Afghanistan. The interviewer-administered questionnaire was used to assess participants’ demographic profile, mobile phone usage, and perception of respondents toward different aspects of health care delivery via mobile phones.ResultsOf the 240 participants, 142 (59.2%) owned mobile phones and 220 (91.7%) routinely used mobile phones. Approximately 209 (87.1%) of participants were willing to receive health messages via a mobile phone. Automated voice call was the most preferred method for sending health messages. More than 90% of the women reported that they would like to receive reminders for their children’s vaccinations and antenatal care visits.ConclusionsUsers’ perception was associated with mobile phone ownership, literacy level, and experience using mobile phones. In the study area, where the literacy rate is low, mHealth was well perceived.

Assessing the Potential Use of Narrative and the Entertainment Education Strategy In an mHealth Text-Message Intervention

As the use of mobile phones for health promotion continues to grow, more work needs to be done to determine which health communication strategies are influential on mobile devices. In two studies conducted with college women in the United States, we assessed the potential for the use of narratives, a strategy found successful in a number of communication channels, in a text-message intervention. The first study consisted of seven focus groups with young women (n = 31) about their perceptions of narrative storylines in a text-message intervention about alcohol and casual sexual encounters. In a second study, we then used an experiment (n = 137) to test the potential of narrative messages to influence transportation, counter-arguing, identification, attitudes toward the intervention type, and attitudes toward the messages. Results showed that women were interested in the possibility of receiving health messages, including narrative health messages, via text message. However, the experiment found limited differences between narrative, non-narrative, and control conditions. Transportation was greater in the narrative condition than in the control, but did not significantly differ from the non-narrative condition. Counter-arguing was also greater in the narrative condition than in the non-narrative condition. Participants who viewed the narrative messages had more positive attitudes toward the messages. Based on both studies, we found that the use of narratives in text messages may be a promising strategy, but it may be a challenge to craft effective content.

Integrating social media into routine midwifery services: Maternity Direct+

The use of social media to disseminate and receive health messages has increased over the past ten years, and many women use social media to access pregnancy information. However, the NHS has been slow to integrate consumer facing Internet technologies into routine care services. This article describes an innovative social media project, Maternity Direct+, an Internet midwife employed by Basildon and Thurrock University Hospitals NHS Foundation Trust. The Internet midwife uses Facebook to disseminate health messages and answer non-urgent questions from pregnant women, mothers up to 28 days after birth, and women planning a pregnancy. Findings from the project evaluation demonstrated a high level of demand for a responsive, evidence-based, non-urgent information and advice service for pregnant women and new mothers, and high levels of user satisfaction. The authors conclude that social media can be integrated into routine midwifery services and used to complement existing communication channels.

Abstract A26: Culturally Grounded HPV Vaccine Decision Narratives and Communication Channel Preferences among African-American, Vietnamese, and Latina Young Adult Women attending Planned Parenthood Clinics

Abstract Prevention of cervical cancer is of utmost importance to women's health given that it accounts for the second most common cancer death among women worldwide with an estimated 19,000 HPV related cancer cases in women annually in the U.S., 12,200 newly diagnosed cervical cancer cases, and 4,290 deaths. HPV associated cervical cancer disparities remain with highest incidence of cervical cancer among U.S. Latina, African American, and Vietnamese young adults coupled with lowest screening rates. HPV is a necessary contributor to cervical cancer as well as anogenital, penile, and orophayngeal cancers. The point prevalence among U.S. women aged 14-59 is 45% among young adult women particularly minority women. The purpose of this study was to adapt an HPV vaccine intervention, originally designed for college women, to the community setting. Three pilot studies are in the process (Vietnamese and Latina women are being interviewed summer 2016 in Orange County, CA and will be reported on at conference) or completed (Muslim African American women were interviewed in Philadelphia, PA, summer 2015) – at Planned Parenthood. All interviews focus on two aspects of adapting the HPV vaccine intervention: eliciting vaccine decision narratives and collecting preferences on communication channels to effectively reach young adult women. In a collaboration between Planned Parenthood of Orange County (PPOC), UCI, and CSUF, a pilot study (N=50; 25 Vietnamese and 25 Latina women aged 18-26) will be implemented during the summer of 2016. We report at this time, on an ongoing collaboration with Planned Parenthood of Philadelphia with the aim of developing a culturally targeted intervention for African American young adult women (including Muslim African American). A Narrative Engagement Framework (NAF) guided interviews eliciting vaccine decision narratives. Semi-structured interviews (N=26 young adult women) elicited HPV vaccine decision narratives and asked about communication channel preferences for receiving vaccine reminder messages. Interviews were conducted over a month between June 18-July 16 2015. Purposive sampling was used to interview a majority vaccinated (N=15) and minority unvaccinated (N=9) to uncover barriers as well interview two PP staff to gain a clinic staff perspective on prevalence of HPV and vaccination. Women were spontaneously recruited from the waiting room and received $20 cash card as compensation for their time (a 30 minute interview). A grounded theory, inductive approach was used to analyze data for vaccination decision themes, motivation for vaccinating, and/or critical sources or events that led to vaccinating. Three independent coders read and re-read data for emerging decision stories and channel preferences. Memo writing occurred during and within days of the interviews. A majority of women (92%) were sexually active with few using condoms (67% did not use). Results on decision stories revealed several key themes: Stories of staying healthy (I really care about my health), keeping female reproductive parts healthy (so that you can have children), stories of experiencing an abnormal Pap smear, stories of family or co-workers getting cancer and HPV, getting the word out about vaccination (stories of “unawareness”), Planned Parenthood providers not bringing up vaccinating for HPV among young adults, HPV as an invisible disease that can damage your insides, the need to talk with your male friends and with your doctor to raise awareness, and stories about protecting yourself from cancer. Emergent themes on communication channels and health kiosk use included: How time is spent in the waiting room, familiarity with food but not health kiosks, the importance of having health kiosks be interactive and engaging, unfamiliarity with QR codes, and willingness to receive health messages via texting. An interactive, engaging health kiosk with four decision story one-minute videos is in development. The intervention was adapted on several dimensions: visual adaptation (some actresses in videos wear hijab/veil); stylistic language adaptation; using a Philadelphia accent; content adaptation: Linking vaccine messages with health child bearing messages. Interviews with PP staff revealed the lack of policy and financial incentives for PP clinics to offer HPV vaccination. Themes and challenges from Philadelphia pilot work inform the OC pilot study. Policy implications of this research include exploring the role for expansion of the Family PACT to cover HPV vaccination at Planned Parenthood clinics in OC that serve as the number one provider of women's health and serve communities of lower socioeconomic status. Citation Format: Suellen Hopfer, Samantha Garcia, Huong Duong. Culturally Grounded HPV Vaccine Decision Narratives and Communication Channel Preferences among African-American, Vietnamese, and Latina Young Adult Women attending Planned Parenthood Clinics. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A26.

Health Literacy pada Mahasiswa Kesehatan, Sebuah Indikator Kompetensi Kesehatan yang Penting

Health literacy Competency is important for health students since they will be a role model for people to do healthy behavior and provide health services to the community. Previous research results in 2014 on students of Faculty of Health Sciences Dian Nuswantoro University showed 31.9% of respondents had low level of health literacy (inadequate and problematic).This research aims to design a program for intervening student health literacy. Data was collected by filling questionnaire, focused group discussion and developing SMS Gateway program. Population was second semester students of Undergraduate Program of Public Health, however the number of students who participated in this study was 82 student from three classes.The results showed low health literacy was experienced by 40.2% of respondents; it was higher than previous study because the number of respondents was bigger. In addition, there were 95.9% of respondents could not answer correctly questions of nutritional fact in NVS measurement. FGD results showed that respondents prefer to use social media and SMS Gateway to receive health messages. Health messages that they need were: reproductive health, nutrition, smoking, drugs, cosmetics, and diet. The recommendation is using social media such as Blackberry Messengers, Line, Instagram, Twitter to broadcast health messages besides SMS Gateway that has been developed. Keywords: health literacy, health student.

A pilot study to assess perceptions of using SMS as a medium for health information in a rural setting

Information and Communication Technologies (ICTs) in health is not merely about technology but a means to reach various optimal outcomes across the entire health system. The objective of this pilot study is to assess the perceptions of receiving health messages through SMS among individuals living in rural Indian settings. A convenient sample of 100 individuals aged 18 years and above and living in rural settings of Kuthampakkam village in Chennai, a Southern part of India were enrolled during September 2013. Individuals having the mobile phone and agreeing to participate were enrolled in the study. Individuals with physical and mental challenges or involved in other clinical trials were excluded from the study. Information was gathered on the variables including socio-demographics, individual familiarity with use of technology, mobile phone usage and the perceptions of using SMS for obtaining health information. Information was gathered using a series of quantitative assessments. Descriptive analysis was performed to report means and standard deviations for the continuous variables and frequency analysis was reported for the categorical variables. Analysis of variance (ANOVA) was used to compare the means of the various continuous variables as compared to the chi-square analysis that was performed to compare the frequency distribution for the categorical variables. All analysis was performed using SAS v9.1. A convenient sample of 100 rural individuals was enrolled. The average age of the study participants was 34 years (SD=17), with more than half of them being males (54%; n=54), and 47% (n=47) of them had education less than high school. Results showed that more than half of the individuals had no computers either at home (61%; n=61) or work (68%; n=68). 100{\%} of them had mobile phones in their household. Text messaging was common in more than half of the study participants. Results showed that the majority of the study participants agreed that receiving calls on the mobile phones for receiving health messages would be the most preferred method. Results showed that the individuals in the age group of 21-40 years, males, with some college education, and in the income category of 50,000-1,00,000 were most likely to obtain SMS based health messages. ICT based health programs need to be established so that the audience receives the optimal technological platform program necessary to obtain health messages. This also suggests that future research is needed to determine the population that would actually adopt the use of SMS based health interventions rather than using SMS as a tool for delivery of health information to all.

Image versus Health: The Role of Perceptions of Masculinity on Sexual Risk Behaviors among HIV-Positive African American Men who have Sex with Men and Women

HIV prevention has rarely explored the impact of childhood sexual abuse (CSA) across health domains among African American men who have sex with men and women (MSMW). Early sexual experiences may influence perceptions of gender roles, sexual identity, and risks for HIV/AIDS. The attribute of masculinity is commonly associated with strength and success. However, a legacy of racism and oppression may pose challenges for African American men in achieving gender-based milestones. Instead, proxies for success may include masculinity constructs with hypersexual posturing and prowess that contradict sexual health messages. Two groups, each meeting twice for 90-minutes, of HIV-positive African American MSMW participated in discussions focusing on masculinity and sexual experiences. Participants were bisexual HIV-positive African American men who engaged in unprotected sex and had histories of CSA. Discussions were recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method. Participant mean age was 40.5 years (n=16). Majority had a high school education (69%), half were unemployed, and almost two-thirds earned less than $20,000 annually. Three themes, each with two subthemes, emerged that described the sociocultural context for engaging in high-risk sexual behaviors, and included: 1) the importance of inhabiting a "traditional" masculine gender role with: a) general and b) sexual masculine traits; 2) the influence of conceptions of masculinity on sexual identity with the associations: a) between being gay and being effeminate and b) between being gay and being HIV-positive, and; 3) CSA experiences with: a) appraisal of CSA and b) early sexual experiences as rites of passage. Attempts to be masculine may contribute to high-risk sexual behaviors. Research needs to explore how early sexual experiences shape perceptions of masculinity and masculinity's influence on receiving health messages for African American MSMW who may prioritize a specific image over sexual risk reduction.

Addressing Research Priorities for Prevention of HIV Infection in the United States

More than half a million Americans became newly infected with human immunodeficiency virus (HIV) in the first decade of the new millennium. The domestic epidemic has had the heaviest impact on men who have sex with men and persons from racial and ethnic minority populations, particularly black persons. For example, black men who have sex with men represent <1% of the US population but 25% of new HIV infections, according to Centers for Disease Control and Prevention estimates published in 2008. Although black and Hispanic women constitute 24% of all US women, they accounted for 82% of HIV infections among women in 2005, according to data from 33 states with confidential name-based reporting. There is a nearly 23-fold higher rate of AIDS diagnoses among black women (45.5 diagnoses per 100,000 women) and a nearly 6-fold higher rate among Hispanic women (11.2 diagnoses per 100,000 women), compared with the rate among white women (2.0 diagnoses per 100,000 women). Investigators from the HIV Prevention Trials Network, a National Institutes of Health-sponsored collaborative clinical trials group, have crafted a domestic research agenda with community input. Two new domestic studies are in progress (2009), and a community-based clinical trial feasibility effort is in development (2010 start date). These studies focus on outreach, testing, and treatment of infected persons as a backbone for prevention of HIV infection. Reaching persons not receiving health messages and services with novel approaches to both prevention and treatment is an essential priority for control of HIV infection in the United States; our research is designed to guide the best approaches and assess the impact of bridging treatment and prevention.

The interplay of socioeconomic status and ethnicity on Hispanic and white men's cardiovascular disease risk and health communication patterns.

In this article, we seek to confirm past studies that document increased levels of cardiovascular disease (CVD) risk factors among White men with lower educational attainment. Second, we include a population of Hispanic men (89% Mexican American) to examine the separate and interactive effects of ethnicity and education (our measure of socioeconomic status) on CVD risk factors. Third, we examine how education and ethnicity are related to receiving health messages from print media and interpersonal channels, with the hypothesis that less educated, higher CVD risk Hispanic and White men receive fewer messages than more educated men. Finally, we examine other psychosocial variables (e.g. knowledge, self-efficacy and motivation) that may help explain observed differences in CVD risk and health communication. The study sample included 2029 men, 25-64 years of age, from three population-based, cross-sectional surveys conducted from 1979 to 1990 as part of the Stanford Five-City Project. Hispanic and White men with lower educational attainment had higher levels of CVD risk factors, and received less health information from print media and interpersonal channels than Hispanic and White men with higher educational attainment. Furthermore, less educated men from both ethnic groups reported less CVD knowledge, lower self-efficacy and lower motivation to reduce CVD risk factors than higher educated men. These results highlight the need for effective intervention programs that target low educated Hispanic and White men to decrease their disproportionate risk of CVD.