It’s Time to Stop Failing Our Young People and Start Empowering Them

The Journal of Behavioral Health Services & Research -     

Do Perceptions of Direct-to-Consumer Pharmaceutical Advertising Vary Based on Urban Versus Rural Living?

This study explores the connection between perceptions of direct-to-consumer (DTC) advertising based on where people live and shop. Urban consumers were found to be more skeptical of DTC advertising, but more likely to believe that physicians select pharmaceuticals based on the efficacy of the product. Those living in rural areas were more motivated to visit a doctor and more likely to feel an equal doctor?patient relationship after exposure to DTC advertising. Interaction effects among gender, income, and education were detected, as well as an interaction effects between location and income on views of DTC advertising.     

Is It Time to “Bang The Shoe” on Preconception Care

Maternal and Child Health Journal -     

Alcohol Advertising: What Makes It Attractive to Youth?

ABSTRACT

This paper investigates the affective responses of youth toward specific elements featured in television alcohol advertisements (i.e., people character, animal character, music, story, and humor). It also examines the associations between advertising likeability and its potential influence. Respondents were 253 children and adolescents in California (47% male; aged 10–17). Data were collected using self-administered questionnaires in group settings. Respondents were shown a stimulus tape containing television advertisements for beer and soft drinks. The tape was stopped at the end of each advertisement to allow respondents to answer questions about that advertisement before viewing the next. Perceived likeability of beer advertisements is a function of the positive affective responses evoked by the specific elements featured in the advertisements. Liking of specific elements featured in beer advertisements significantly contributed to the overall likeability of these advertisements and subsequently to advertising effectiveness indicated by purchase intent of product and brand promoted by these advertisements. Advertisements that focus primarily on product qualities or send a message of legal drinking age were rated less favorably and evoked less desire to purchase the product. Implications for countering the effects of alcohol advertising on young people are discussed.     

Metabolic Syndrome: Is It Time to Add the Central Nervous System?

Metabolic syndrome (MS) is a set of cardio-metabolic risk factors that includes central obesity, hyperglycemia, hypertension, and dyslipidemias. The syndrome affects 25% of adults worldwide. The definition of MS has evolved over the last 80 years, with various classification systems and criteria, whose limitations and benefits are currently the subject of some controversy. Likewise, hypotheses regarding the etiology of MS add more confusion from clinical and epidemiological points of view. The leading suggestion for the pathophysiology of MS is insulin resistance (IR). IR can affect multiple tissues and organs, from the classic “triumvirate” (myocyte, adipocyte, and hepatocyte) to possible effects on organs considered more recently, such as the central nervous system (CNS). Mild cognitive impairment (MCI) and Alzheimer’s disease (AD) may be clinical expressions of CNS involvement. However, the association between MCI and MS is not understood. The bidirectional relationship that seems to exist between these factors raises the questions of which phenomenon occurs first and whether MCI can be a precursor of MS. This review explores shared pathophysiological mechanisms between MCI and MS and establishes a hypothesis of a possible MCI role in the development of IR and the appearance of MS.     

Factors Affecting Osteoarthritis Patients' Self-Reported Goal-Directed Drug Information–Seeking Behaviors After Exposure to Direct-to-Consumer Advertising from Physicians and the Internet

Abstract

Objective: The objective of this study was to investigate appraisal of means (ie, self-efficacy, outcome expectancy, and affect) in predicting patients' goal-directed behaviors of direct-to-consumer advertising (DTCA)–prompted drug-information search from physicians and the internet. Methods: One thousand patients were randomly selected from a nationwide sample frame of 3000 osteoarthritis patients. A self-administered survey assessed exposure to DTCA, drug-information search as goal, self-efficacy, outcome expectancy, affect, and osteoarthritis pain. After 6 weeks, another survey measured the behavior of drug-information search for respondents to the first survey. Study subjects were those who were exposed to DTCA in the previous month, and who set drug-information search as their goal. For each information source, a multiple regression analysis was conducted in which drug-information search was the dependent variable, and self-efficacy, outcome expectancy, affect, and osteoarthritis pain were the independent variables. Results: Among 454 patients who were exposed to DTCA, 174 patients set drug-information search as their goal and were the study subjects. The regression for physicians was not statistically significant. The regression for the internet was significant, accounting for 15% of behavior variance. Self-efficacy was a strong predictor of goal-directed drug-information search from the internet. Conclusions: Appraisal of means was useful to predict the goal-directed behavior of DTCA-prompted drug-information search from the internet. For patients who set drug-information search as a goal, actions to promote drug-information search from the internet need to focus on self-efficacy.     

‘It’s more funner than doing work’: children’s perspectives on using tablet computers in the early years of school

There is a clamour of voices around the contemporary issue of tablet computers in early years education. A growing body of research presents the potential of tablet computers to transform education, provide unprecedented learning opportunities and positive outcomes for young children and offer rich opportunities for independent learning and collaborative interaction. However, this is tempered with disquiet from a number of sources which posit that digital devices are diminishing children’s play and are an affront to childhood. Many of these polemic debates come from adult perspectives yet children are the key users in the dizzying advancement of technology and their views are a crucial element in understanding the conceptualisation of tablet devices as pedagogical tools. This paper takes a children’s rights approach in acknowledging that children have the right to have their voices heard and their experiences understood. Therefore, this paper seeks to add further insights to the debates on digital technology in early years education by presenting the views of one of the central players within this debate – young children.     

“It’s up to the Woman’s People”: How Social Factors Influence Facility-Based Delivery in Rural Northern Ghana

To explore the impact of social factors on place of delivery in northern Ghana. We conducted 72 in-depth interviews and 18 focus group discussions in the Upper East Region of northern Ghana among women with newborns, grandmothers, household heads, compound heads, community leaders, traditional birth attendants, traditional healers, and formally trained healthcare providers. We audiotaped, transcribed, and analyzed interactions using NVivo 9.0. Social norms appear to be shifting in favor of facility delivery, and several respondents indicated that facility delivery confers prestige. Community members disagreed about whether women needed permission from their husbands, mother-in-laws, or compound heads to deliver in a facility, but all agreed that women rely upon their social networks for the economic and logistical support to get to a facility. Socioeconomic status also plays an important role alone and as a mediator of other social factors. Several “meta themes” permeate the data: (1) This region of Ghana is undergoing a pronounced transition from traditional to contemporary birth-related practices; (2) Power hierarchies within the community are extremely important factors in women’s delivery experiences (“someone must give the order”); and (3) This community shares a widespread sense of responsibility for healthy birth outcomes for both mothers and their babies. Social factors influence women’s delivery experiences in rural northern Ghana, and future research and programmatic efforts need to include community members such as husbands, mother-in-laws, compound heads, soothsayers, and traditional healers if they are to be maximally effective in improving women’s birth outcomes.     

It’s hard work,but it’s worth it: the task of keeping children adherent to isoniazid preventive therapy

Setting:

Isoniazid preventive therapy (IPT) offers children protection against tuberculosis (TB), but it has been difficult to implement, particularly in developing countries.

Objective:

To understand what encourages or inhibits children from adhering to IPT.

Design:

In-depth interviews were conducted with two parents of children adherent to IPT and two staff members from three primary health care clinics in high TB prevalence communities. Themes explored were knowledge and attitudes towards IPT, problems in accessing and adhering to treatment, and community responses.

Results:

Parents administering treatment valued it positively, realised their children’s risk of TB, and were positive about the clinic. Nurses acknowledged that resistance to treatment remained, with some parents not wanting to acknowledge risk nor willing to make the effort for their children; there was also considerable misinformation about IPT. Clinic nurses acknowledged problems of staff shortages, lengthy waiting times and conflict between staff and community members. Adherence was affected by social problems, stigma about TB and its link to the human immunodeficiency virus, and the extended treatment period.

Conclusion:

Parents who maintained adherence to the IPT regimen showed that it was possible even in very difficult circumstances. Further effort is required to improve some of the clinic services, correct misinformation, reduce stigma and provide support to parents.     

‘It’s one of those “It’ll never happen to me” things’: young women’s constructions of smoking and risk

In this article, we examine how young women make sense of the risks associated with smoking cigarettes. We recruited young women smokers and ex-smokers living in Australia in 2014 and 2015 to participate in semi-structured interviews and a participant-produced photography activity on young women’s experiences of smoking and smoking-related risk. We analysed the data using discourse analysis to examine how young women positioned themselves in relation to smoking-related risk, and how this was shaped by discourses of health, risk and femininity. We identified four dominant interpretative repertoires: ‘the risks of smoking are self-evident’, ‘it’s not going to happen to me’, ‘smoking as a lesser evil’ and ‘smoking to cope with stress and emotion’. Through our analysis, we found that by drawing on these repertoires, participants were able to position the risks of smoking as both acceptable and unacceptable. Participants also made use of several of these repertoires to position anti-smoking messages as ineffective. We place these findings in the context of broader health and risk discourses surrounding young women’s use of smoking to reinforce and subvert representations of ‘respectable’ femininity. We identify ways in which public health approaches could and should be developed to recognise the complexity and contradiction inherent in young women’s lay accounts of smoking-related risk and situate smoking risks in the context of young women’s everyday lives.     

Sexual Minority Women’s Sexual Motivation Around the Time of Ovulation

We investigated whether motivation for same-sex sexual contact was related to mid-cycle peaks in estrogen levels (typically associated with ovulation) among women with consistent versus inconsistent patterns of same-sex sexuality. Twenty women (M age = 30 years), all of whom have been providing data on their sexual behavior and identities since 1995, completed daily diaries assessing sexual motivation and provided 10 days of salivary estrogen samples. During the 3 consecutive days on which estrogen levels peaked, women who had consistently identified as lesbian since 1995 (n = 5) showed increased motivation for sexual contact with women. This change in same-sex motivation was significantly smaller among women who consistently identified as bisexual (n = 7) and women who had given up their lesbian or bisexual identities at some point since 1995 (n = 8). Women who ascribed a role for “choice” in their same-sex sexuality also showed smaller increases in same-sex motivation. The findings suggest that women with consistent versus inconsistent patterns of same-sex sexuality might be experiencing different types of same-sex desires influenced by different factors.     

Dietary Assessment Tools and Metabolic Syndrome: Is It Time to Change the Focus?

Metabolic syndrome (MS) is associated with a range of chronic diseases, for which lifestyle interventions are considered the cornerstone of treatment. Dietary interventions have primarily focused on weight reduction, usually via energy restricted diets. While this strategy can improve insulin sensitivity and other health markers, weight loss alone is not always effective in addressing all risk factors associated with MS. Previous studies have identified diet quality as a key factor in reducing the risk of MS independent of weight loss. Additionally, supporting evidence for the use of novel strategies such as carbohydrate restriction and modifying the frequency and timing of meals is growing. It is well established that dietary assessment tools capable of identifying dietary patterns known to increase the risk of MS are essential for the development of personalised, targeted diet and lifestyle advice. The American Heart Association (AHA) recently evaluated the latest in a variety of assessment tools, recommending three that demonstrate the highest evidence-based and clinical relevance. However, such tools may not assess and thus identify all dietary and eating patterns associated with MS development and treatment, especially those which are new and emerging. This paper offers a review of current dietary assessment tools recommended for use by the AHA to assess dietary and eating patterns associated with MS development. We discuss how these recommendations align with recent and novel evidence on the benefits of restricting ultra-processed food and refined carbohydrates and modifying timing and frequency of meals. Finally, we provide recommendations for future redevelopment of these tools to be deployed in health care settings.     

Surgeon General’s Report on Addiction: What Does It Mean?

A new Congress and a new President-elect mean changes are in store for 2017. But one topic that remains bipartisan is addiction. The Surgeon General’s first-ever report on substance misuse and related disorders, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health, reminds us of the inequities in treatment of addictions and opens new opportunities for change.     

‘It’s not the government’s responsibility to get me out running 10 km four times a week’ - Norwegian men’s understandings of responsibility for health

The individualization of health has been extensively discussed in the last few decades. Empirical work, however, has mainly had its origins within neoliberal societies. Norway, as a social democratic welfare state based on universal social rights and egalitarianism is thus of interest in understanding how people’s talk reflects national policies. Through a series of 18 in-depth interviews with a heterogeneous group of middle-aged and elderly men in rural Norway, this paper explores lay men’s understandings of individuals’ responsibility for health vis-à-vis the state’s. The men in this study expressed complex but shared notions of the state’s and the individual’s responsibility for health. The individual’s main responsibility was to act in specific ways in order to maintain good health. However, little blame was placed on those who did not act in the expected way. The state’s main responsibilities were to facilitate the healthy lifestyle of individuals and act as a safety net for those in need. The state was also viewed as being responsible for providing universal health care free of charge, regardless of the reason for the need. We argue that the political and societal values of Norway are reflected in the men’s talk about responsibility for health, alongside neoliberal ideas found in other Western societies. Importantly, however, we conclude that a social democratic welfare state system supports and facilitates agency with regard to health, lifestyle and one’s life more broadly.