Effects of Media Messages on Parent–Child Sexual Communication

Parent–child communication about sex is an important reproductive health outcome. Consistent, positive perceptions of communication by parents and children can promote behavioral outcomes such as delaying sexual debut and increasing contraceptive use. The authors investigated whether exposure to messages from the Parents Speak Up National Campaign (PSUNC), a social marketing campaign to promote increased parent–child sexual communication, led to increased children's self-reports of communication. Also, the authors examined whether PSUNC message exposure increased agreement about communication between parents and their children. In a randomized experimental design, the authors surveyed children of parents exposed and not exposed to PSUNC messages. Parents and children completed online instruments asking matched questions about sexual attitudes, beliefs, and communication. The authors matched 394 parents and children for analysis. They used ordinal logistic regression modeling and kappa statistics. Children of parents exposed to PSUNC messages were more likely to (a) report sexual communication than were those not exposed and (b) agree with their parents about extent and content. Parent–child pairs of the same gender, younger pairs, and non-White pairs were more likely to agree. Overall, PSUNC message exposure appears to have promoted more extensive sexual communication. Future research should examine behavioral mechanisms and message receptivity among subgroups of parents and children.     

Epidemiologic Features of Kawasaki Disease in Japan: Results of the 2007–2008 Nationwide Survey

Background

The most recent epidemiologic features of Kawasaki disease (KD) are unknown.

Methods

The 20th nationwide survey of KD was conducted in 2009, and included patients treated for the disease in 2007 and 2008. Hospitals specializing in pediatrics, and hospitals with pediatric departments and 100 or more beds, were asked to report all patients with KD during the 2 survey years.

Results

From a total of 1540 departments and hospitals, 23 337 patients (11 581 in 2007 and 11 756 in 2008) were reported: 13 523 boys and 9814 girls. The annual incidence rates were 215.3 and 218.6 per 100 000 children aged 0–4 years in 2007 and 2008, respectively. These were the highest annual KD incidence rates ever recorded in Japan. The monthly number of patients peaked during the winter months; smaller increases were noted in the summer months. The age-specific incidence rate showed a monomodal distribution with a peak at age 9–11 months. The prevalences of both cardiac lesions during the acute phase of the disease and cardiac sequelae were higher among infants and older age groups.

Conclusions

The incidence rate and number of patients with KD in Japan continue to increase.Key words: mucocutaneous lymph node syndrome, incidence, cardiovascular diseases, immunoglobulin, intravenous, epidemiology     

Epidemiologic Features and Risk Factors of Crimean–Congo Hemorrhagic Fever in Samsun Province,Turkey

Background

Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne infectious disease that has a considerable mortality risk and is a challenge for the population of endemic rural areas and health care workers. This study investigated the epidemiologic features and main risk factors of CCHF in Samsun Province, Turkey, using CCHF cases diagnosed from 2007 to 2011 recorded by the Samsun Provincial Health Directorate.

Methods

In the study area, 126 cases were evaluated statistically and spatially. Minitab 16 software was used for statistical analysis of the data, and ArcGIS 9.3 software was used for spatial analysis.

Results

Among those who received a diagnosis of CCHF, 69 (54.7%) were male, 57 (45.3%) were female, 114 (90.5%) were discharged, and 12 (9.5%) died. A total of 112 of the 126 (88.9%) cases occurred at an altitude higher than 600 m. In addition, 84.1% of cases were reported during May through July, which are the busiest months for those working in the agriculture and animal husbandry sectors.

Conclusions

CCHF causes severe disease and has a high mortality rate (about 10% in Turkey). Early diagnosis of CCHF can be improved by periodic education of people at high risk, ie, men and women working in agriculture and animal husbandry in rural areas and those working in health care.Key words: Crimean-Congo hemorrhagic fever, epidemiology, geographical information systems, Turkey     

A Strategic Plan for the Second Phase (2013–2015) of the Korea Biobank Project

The Korea Biobank Project (KBP) was led by the Ministry of Health and Welfare to establish a network between the National Biobank of Korea and biobanks run by university-affiliated general hospitals (regional biobanks). The Ministry of Health and Welfare started the project to enhance medical and health technology by collecting, managing, and providing researchers with high-quality human bioresources. The National Biobank of Korea, under the leadership of the Ministry of Health and Welfare, collects specimens through various cohorts and regional biobanks within university hospitals gather specimens from patients. The project began in 2008, and the first phase ended in 2012, which meant that there needed to be a plan for the second phase that begins in 2013. Consequently, professionals from within and outside the project were gathered to develop a plan for the second phase. Under the leadership of the planning committee, six working groups were formed to formulate a practical plan. By conducting two workshops with experts in the six working groups and the planning committee and three forums in 2011 and 2012, they have developed a strategic plan for the second phase of the KBP. This document presents a brief report of the second phase of the project based on a discussion with them.During the first phase of the project (2008–2012), a network was set up between the National Biobank of Korea and 17 biobanks at university-affiliated hospitals in an effort to unify informatics and governance among the participating biobanks. The biobanks within the network manage data on their biospecimens with a unified Biobank Information Management System. Continuous efforts are being made to develop a common standard operating procedure for resource collection, management, distribution, and personal information security, and currently, management of these data is carried out in a somewhat unified manner. In addition, the KBP has trained and educated professionals to work within the biobanks, and has also carried out various publicity promotions to the public and researchers. During the first phase, biospecimens from more than 300,000 participants through various cohorts and biospecimens from more than 200,000 patients from hospitals were collected, which were distributed to approximately 600 research projects.The planning committee for the second phase evaluated that the first phase of the KBP was successful. However, the first phase of the project was meant to allow autonomy to the individual biobanks. The biobanks were able to choose the kind of specimens they were going to collect and the amount of specimen they would set as a goal, as well as being allowed to choose their own methods to manage their biobanks (autonomy). Therefore, some biobanks collected resources that were easy to collect and the resources needed by researchers were not strategically collected. In addition, there was also a low distribution rate to researchers outside of hospitals, who do not have as much access to specimens and cases as those in hospitals. There were also many cases in which researchers were not aware of the KBP, and the distribution processes were not set up to be convenient to the demands of researchers.Accordingly, the second phase of the KBP will be focused on increasing the integration and cooperation between the biobanks within the network. The KBP plans to set goals for the strategic collection of the needed human bioresources. Although the main principle of the first phase was to establish infrastructure and resource collection, the key objective of the second phase is the efficient utilization of gathered resources. In order to fully utilize the gathered resources in an efficient way, distribution systems and policies must be improved. Vitalization of distribution, securing of high-value resource and related clinical and laboratory information, international standardization of resource management systems, and establishment of a virtuous cycle between research and development (R&D) and biobanks are the four main strategies. Based on these strategies, 12 related objectives have been set and are planned to be executed.     

Underage Drinkers' Responses to Negative-Restrictive Versus Proactive-Nonrestrictive Slogans in Humorous Anti–Alcohol Abuse Messages: Are Humorous Responsible Drinking Campaign Messages Effective?

This study examined underage drinkers' responses to negative-restrictive versus proactive-nonrestrictive slogans in humorous anti–alcohol abuse advertisements. The authors conducted a posttest-only control group experiment with 91 teenagers and college-aged participants. For underage moderate drinkers, the negative-restrictive slogans (e.g., “Don't drink”) increased participants' perceived risk of excessive drinking and increased a level of intention to change their drinking behavior. However, for underage binge drinkers, the negative-restrictive slogans lowered participants' risk perception of excessive drinking and intention to change their drinking behavior.     

Do Sororities Promote Members’ Health? A Study of Memorable Messages Regarding Weight and Appearance

This study examines the relationship between sorority communication practices and members’ body images through the lens of organizational socialization and identification. Specifically, we analyzed 210 sorority members’ memorable messages concerning weight and physical appearance using an inductive coding method. While many of the messages examined were affirming or complimentary in nature, the results of the analysis suggest that these types of messages may positively as well as negatively influence members’ body images, behaviors regarding physical appearance, and social identities. These findings contribute to scholarly and practical understandings of the influences on college women’s body image and health and the potentially powerful role that organizations play in shaping members’ attitudes and actions concerning their eating, exercise, and other aspects of their appearance. Implications for future health communication research in other organizational contexts outside of sororities are also discussed. Additionally, the findings of the current study indicate the broad utility of a memorable messages approach and suggest the need for further examination of the ways in which differing organizational dynamics may demonstrate divergence from traditional sources of memorable messages.     

The Effectiveness of Gain-Framed Messages for Encouraging Disease Prevention Behavior: Is All Hope Lost?

This commentary is a response to O'Keefe and Jensen's (2007/this issue) meta-analysis of the persuasive effects of gain- and loss-framed messages encouraging disease prevention behaviors. We suggest that the future of message framing is promising with newly emerging approaches to increasing message effectiveness.     

General Practitioners’ Empathy and Health Outcomes: A Prospective Observational Study of Consultations in Areas of High and Low Deprivation

PURPOSE

We set out to compare patients’ expectations, consultation characteristics, and outcomes in areas of high and low socioeconomic deprivation, and to examine whether the same factors predict better outcomes in both settings.

METHODS

Six hundred fifty-nine patients attending 47 general practitioners in high- and low-deprivation areas of Scotland participated. We assessed patients’ expectations of involvement in decision making immediately before the consultation and patients’ perceptions of their general practitioners’ empathy immediately after. Consultations were video recorded and analyzed for verbal and non-verbal physician behaviors. Symptom severity and related well-being were measured at baseline and 1 month post-consultation. Consultation factors predicting better outcomes at 1 month were identified using backward selection methods.

RESULTS

Patients in deprived areas had less desire for shared decision-making (P <.001). They had more problems to discuss (P = .01) within the same consultation time. Patients in deprived areas perceived their general practitioners (GPs) as less empathic (P = .02), and the physicians displayed verbal and nonverbal behaviors that were less patient centered. Outcomes were worse at 1 month in deprived than in affluent groups (70% response rate; P <.001). Perceived physician empathy predicted better outcomes in both groups.

CONCLUSIONS

Patients’ expectations, GPs’ behaviors within the consultation, and health outcomes differ substantially between high- and low-deprivation areas. In both settings, patients’ perceptions of the physicians’ empathy predict health outcomes. These findings are discussed in the context of inequalities and the “inverse care law.”     

Helpful or Harmful? The Impact of Strategic Change on the Performance of U.S. Urban Hospitals

OBJECTIVE: To contribute to the debate as to whether strategic change helps or harms organizations by empirically examining how strategic change influences performance change in urban hospitals. DATA SOURCES: AHA Annual Survey (1994 and 1996), Health Care Financing Administration's Medicare Cost Reports (1994 and 1996) and Medicare HMO Files (1994), U.S. Bureau of the Census' County Business Patterns Files (1994), and Area Resources File (1994). STUDY DESIGN: This work employed a longitudinal approach using a panel design to study the effect of environmental and organizational characteristics on urban hospital strategic behavior and performance. A path analytic model was used to examine the simultaneous effects of environmental and organizational characteristics (1994) on strategic behavior (change in strategies to enhance HMO business and change in strategies to control costs 1994-96), as well as the effects of all of these variables on change in urban hospital performance (change in market share, change in operational efficiency, change in financial performance 1994-96). PRINCIPAL FINDINGS: (1) Environmental context exerts a greater influence on urban hospitals' HMO business enhancement strategies, whereas organizational characteristics have more influence on cost-control strategies. (2) Between the two strategies, HMO business enhancement and cost control, strategic change to enhance business with HMOs is much more complex. (3) Strategic change observed across the 1994 to 1996 time period can be either helpful or harmful to urban hospitals. A strategic change that contributes positively to one type of performance can negatively impact the other. CONCLUSIONS: Although differences of opinion persist in the strategic change debate, results of this study indicate that strategic change can be helpful or harmful to urban hospitals, and its consequences are far more complex than previously thought. Strategic rationality has its own limitations and cannot always be relied on to yield expected results. Hospital strategic changes require coordination to achieve greater performance results.     

“Where Is the Love?” Expanding and Theorizing With LGBTQ Memorable Messages of Sex and Sexuality

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) women exist as a population with an increased complexity in the relationship between themselves and their sexuality. For the LGBTQ community, sexual behaviors are often silenced or erased. This exploratory qualitative research examines 186 memorable messages that emerged from 91 LGBTQ women and gender minorities who participated in a national study. Each participant was asked to share memorable messages they received about sex, sexuality, and sexual health. Consistent with past research, “advice” was a common memorable messages form; however, negative attributes and media-derived messages emerged. The results contribute to understanding the messages that LGTBQ individuals confront on topics of sex and sexuality.     

“Choose Today,Live Tomorrow”: A Content Analysis of Anti-Substance Use Messages Produced by Adolescents

Adolescent-produced anti-substance use messaging is an increasingly popular and effective prevention strategy. However, little is known about the content of these messages and the production elements adolescents use to bring that content to life. In this article, we present a content analysis of 95 anti-substance use messages developed by 4-H club members across nine U.S. states as part of their participation in the media literacy program REAL media. Posters and videos were content-analyzed for target substance, prevention goal, message form, message content, persuasion strategies, and production elements. Results of the content analysis revealed that combustible tobacco (smoking) was the most popular target substance in the sample among the choices of alcohol, marijuana, e-cigarettes, and chewing tobacco. More youth developed messages with the goal of preventing substance use, rather than stopping current use. Slogans were used in the majority of messages, and nearly all messages took an informational form, rather than narrative or statistical form. Persuasion strategies covered in the curriculum, including fun with the group, unexpected, style, and endorsement were scantily used. Finally, results showed that production value was high in this sample, reflected by the extensive use of color and variety of fonts and font sizes. Implications for future media literacy interventions and research are discussed.     

Should We Be Afraid of Simple Messages? The Effects of Text Difficulty and Illustrations in People With Low or High Health Literacy

It is often recommended that health information should be simplified for people with low health literacy. However, little is known about whether messages adapted to low health literacy audiences are also effective for people with high health literacy, or whether simple messages are counterproductive in this group. Using a two (illustrated vs. text-only) by two (nondifficult vs. difficult text) between-subjects design, we test whether older adults with low (n = 279) versus high health literacy (n = 280) respond differently to colorectal cancer screening messages. Results showed that both health literacy groups recalled information best when the text was nondifficult. Reduced text difficulty did not lead to negative attitudes or less intention to have screening among people with high health literacy. Benefits of illustrations, in terms of improved recall and attitudes, were only found in people with low health literacy who were exposed to difficult texts. This was not found for people with high health literacy. In terms of informed decisions, nondifficult and illustrated messages resulted in the best informed decisions in the low health literacy group, whereas the high health literacy group benefited from nondifficult text in general, regardless of illustrations. Our findings imply that materials adapted to lower health literacy groups can also be used for a more general audience, as they do not deter people with high health literacy.     

The Effects of Self-Efficacy Statements in Humorous Anti-Alcohol Abuse Messages Targeting College Students: Who Is In Charge?

This study examined the effect of self-efficacy statements in humorous anti-alcohol abuse television advertisements on college students. A posttest only group design experiment was conducted with 124 college students. It was found that highly rebellious individuals who watched ads with a self-efficacy statement (i.e., “You Are in Control of the Situation”) indicated lower alcohol expectancies, higher risk perceptions, and higher intentions to change their drinking behaviors than those in the non-self-efficacy condition. The findings suggest that health promotional messages should be tailored to rebellious college students, particularly those who are at risk, in a manner that not only gains their attention but also minimizes possible defensive reactions to the given messages. Humorous messages with self-efficacy statements could offer ways to communicate with rebellious college students regarding their drinking problems.