Practicing what they preach: health behaviors of those who provide health advice to extensive social networks

Demand of and Access to Health Messages Through Mass Media in the Rural Community of Eastern Ethiopia: A Mixed Method Study

Background

The demand for health-related information has increased dramatically in recent years. Media is crucial in reaching health messages to audiences, especially those who are distant and rural. Therefore, the study aimed to assess demands, access, and factors associated with access to health messages through mass media in the rural community of Kersa District of East Hararghe, Eastern Ethiopia.

Methods

A mixed-methods study was conducted from October 15 to November 20, 2020. A quantitative cross-sectional and a qualitative phenomenological study design were applied. A total of 578 participants were included by using a systematic sampling technique. Collected data were entered into Epidata version 3.1 and analyzed using SPSS version 22.0. A multivariate logistic regression analysis model was used and reported using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). Statistical significance was set at p <0.05. For qualitative, six-focused group discussions (FGDs) were used and then analyzed thematically.

Results

Overall, the demand of and access to health messages through mass media was 32.5% (95% CI=28.5-34.2%) and 26.6% (95% CI=24.6-28.7%), respectively. Factors such as having electric services (AOR=2.36, 95% CI=2.13-5.41), having a mobile phone (AOR=4.56, 95% CI=4.32-8.73), exposure to TV (AOR=4.73, 95% CI=1.03-11.62), and exposure to social media and printed media (AOR=5.24, 95% CI=1.07-15.63), a preference for programs such as news, current affairs, entertainment, health and educational were 2.37, 9.47, 4.75 and 7.55 times more likely to access health messages (AOR=2.37, 95% CI=1.00-5.61; AOR=9.47, 95% CI=3.54-25.34; AOR=4.75, 95% CI=1.23-18.38; and AOR=7.55, 95% CI=3.12-8.66, respectively). Qualitative findings, participants demand for health messages from health workers, radio, and the main source for accessing the message was the radio.

Conclusion

Approximately one in every three and one in every four rural communities in the study area had demand, and access to health messages through mass media, respectively. As a result, all stakeholders should emphasize and strengthen expanding methods of reaching health messages using mass media.

Contexts and Outcomes of Proxy Online Health Information Seeking: Mixed Studies Review With Framework Synthesis

Background

High-quality online health information (OHI) can reduce unnecessary visits to health professionals and improve health. One of the ways that people use OHI is to support others with health conditions through proxy OHI seeking. Members of a person’s social circle may help them overcome information-seeking barriers and illness challenges. There are several models on proxy information seeking. Yet, we know little about the use and outcomes of OHI on behalf of someone else.

Objective

The objectives of this paper are to explore and revise a framework on the context and outcomes of proxy OHI seeking

Methods

We conducted a mixed studies literature review integrating qualitative and quantitative evidence with thematic analysis of the findings of 28 studies, followed by framework synthesis incorporating the derived themes.

Results

We explored 4 main themes: (1) characteristics of proxy seekers, (2) context of proxy OHI seeking, (3) use of OHI to provide social support, and (4) outcomes of proxy OHI seeking. Our conceptual framework incorporates these themes and builds on previous work.

Conclusions

By better understanding how people use information together, information providers can adapt the information to meet all users’ needs.

Building and experimenting with an agent-based model to study the population-level impact of CommunityRx, a clinic-based community resource referral intervention

CommunityRx (CRx), an information technology intervention, provides patients with a personalized list of healthful community resources (HealtheRx). In repeated clinical studies, nearly half of those who received clinical "doses" of the HealtheRx shared their information with others ("social doses"). Clinical trial design cannot fully capture the impact of information diffusion, which can act as a force multiplier for the intervention. Furthermore, experimentation is needed to understand how intervention delivery can optimize social spread under varying circumstances. To study information diffusion from CRx under varying conditions, we built an agent-based model (ABM). This study describes the model building process and illustrates how an ABM provides insight about information diffusion through in silico experimentation. To build the ABM, we constructed a synthetic population ("agents") using publicly-available data sources. Using clinical trial data, we developed empirically-informed processes simulating agent activities, resource knowledge evolution and information sharing. Using RepastHPC and chiSIM software, we replicated the intervention in silico, simulated information diffusion processes, and generated emergent information diffusion networks. The CRx ABM was calibrated using empirical data to replicate the CRx intervention in silico. We used the ABM to quantify information spread via social versus clinical dosing then conducted information diffusion experiments, comparing the social dosing effect of the intervention when delivered by physicians, nurses or clinical clerks. The synthetic population (N = 802,191) exhibited diverse behavioral characteristics, including activity and knowledge evolution patterns. In silico delivery of the intervention was replicated with high fidelity. Large-scale information diffusion networks emerged among agents exchanging resource information. Varying the propensity for information exchange resulted in networks with different topological characteristics. Community resource information spread via social dosing was nearly 4 fold that from clinical dosing alone and did not vary by delivery mode. This study, using CRx as an example, demonstrates the process of building and experimenting with an ABM to study information diffusion from, and the population-level impact of, a clinical information-based intervention. While the focus of the CRx ABM is to recreate the CRx intervention in silico, the general process of model building, and computational experimentation presented is generalizable to other large-scale ABMs of information diffusion.

Social networking sites: a new source of child feeding information for parents in Thailand

Social networking sites (SNSs) provide opportunities for health and nutrition communication. Data are lacking on whether these SNSs influence Thai parent's food provisioning to young children. In the current study, we examined the prevalence and characteristics of Thai parents who reported participating in child food and nutrition-SNSs and investigated the association between participation in these sites and parents' perceptions and feeding practices. A sample of 379 Thai parents completed a survey about the use of child food and nutrition-SNSs, and feeding practices and child eating behavior. Around 70% of participants, especially female millennials with their first child, have participated in SNSs that provide information about children's diets. High engagement was more common among younger and less educated participants, as well as rural dwellers and those with abnormal body mass index. Among these SNSs' participants, those with higher engagement had higher levels of trust in the nutritional information shared on SNSs. Further analyses showed that parents who have joined these sites had positive associations with not only providing children with more fresh fruits and vegetable but also more processed meats. Further investigations are needed to explore the information these SNSs provided and what influences they have on parents' perceptions around feeding children.

Information Sources on Healthy Eating Among Community Living Older Adults

Information about nutrition and health are important to empower older adults on what their food choice is concerned. The present research aims to study the perceived need and preferences regarding sources of information about healthy eating among older adults and to relate them with sociodemographic characteristics. A sample of 602 older adults (≥65 years old) living in the community (Vila Nova de Gaia, Portugal) was assessed by trained nutritionists using a structured questionnaire developed within the Pronutrisenior project. Most participants (87.5%) are concerned about healthy eating, and 69.3% would like to receive more information about the subject, mainly as audiovisual material (49.8%). Women prefer to receive information through practical cooking sessions and audiovisual material. Highly educated individuals prefer leaflets with text as well as audiovisual material, while more independent individuals prefer a wide range of media, such as booklets with pictures, informational posters, and food education and practical cooking sessions. Those with an adequate social support network prefer booklets with text. Age was not related to these preferences. These results can inform stakeholders about the most effective means of transmitting information on food and nutrition to older adults and are therefore useful in tailoring community and clinical interventions.

Men's knowledge about prostate cancer: a case study of rural Mhondoro-Ngezi, Kadoma District, Zimbabwe

Men in Zimbabwe, like elsewhere in the world, suffer from prostate cancer. Yet ironically, men's awareness of the disease and comprehensive knowledge about the signs and symptoms, screening methods and the age groups predisposed to the risk of the diseases has remained poorly understood. Utilising a survey of 500 men aged between 15 and 79 years, 12 key informant interviews and seven focus group discussions in Mhondoro-Ngezi, the study established that men's awareness and comprehensive knowledge about prostate cancer is very low and marred with misconceptions. Informal sources of communication, especially friends, continue to be the major sources of information about prostate cancer, while formal sources are passive. The aforementioned findings imply that playmakers in the health delivery programmes have an overdue responsibility to rescue men from the catastrophic trap so that they freely enjoy their rights to good health. There is also need for accelerated information, education and communication regarding male reproductive cancers to cater for the future welfare of men given that they are drivers of national economies in their various capacities. Failure to do so would mean that men's reproductive health-seeking behaviour regarding early screening and treatment of prostate cancer will forever remain compromised.

A qualitative analysis of how elders seek and disseminate health information

This study documents older adults' sources of health information, describes the purposes for health information seeking, and delineates gender and ethnic variation in health information seeking. Sixty-two African American and White adults aged 65 and older completed qualitative interviews describing their use of complementary therapies. Interviews identified how individuals obtained and shared health information. Friends, not family, were the dominant source of health information. Participants ranged from active seekers to passive consumers of health information. Information seeking was common for benign symptoms. More women than men discuss health information with others. Friends are the primary source of health information for rural older adults. There is substantial passivity in the pursuit of health information. Identifying health information sources of rural older adults can support the dissemination of information to those who share it with others.

Is there health out there in the afrosphere? An analysis of health-related content posted by black bloggers

We explored the extent to which Blacks use online blogs to communicate health information. We content analyzed blogs' main pages for: health-related text, badges, subject lists, and tag clouds. Half of the blogs possessed one of the aforementioned items referencing or depicting health. Violence/crime and health/healthcare were referenced most frequently. We also analyzed health-related posts by coding for presumed posting purpose. We found that bloggers most often posted health content in order to share information; very few promoted healthier behavior. We assert that blogs have the potential to be an important health communication tool for reaching Black Americans.

Screening tests among family doctors: do we do as we preach?

OBJECTIVE

To assess the attitudes and practices of family doctors from Southern Israel and their relatives concerning screening tests and disease prevention.

STUDY DESIGN

Cross-sectional survey.

METHODS

Personal interview using a questionnaire that included sociodemographic data and questions related to family doctors' compliance with screening tests for early detection.

RESULTS

One hundred and thirty-eight of 226 eligible doctors (61%) participated in the study, and 81 of them were female (58.7%). Most of the doctors (n = 82; 59.4%) reported a strong belief in the importance of screening tests, but only 27.5% (n = 38) actually underwent these tests themselves. The main reason for non-compliance was lack of time (n = 50; 55.6%). Older doctors (age ≥50 years) were more likely to have undergone lipidograms than younger doctors (P = 0.013). There were no significant differences in the attitudes of family medicine residents and experts in attitudes to screening tests. Only 64 (46.4%) doctors had received an influenza vaccination over the previous year, and this was significantly more common among residents than experts (P = 0.01).

CONCLUSIONS

Family doctors, who are supposed to be role models, believe that screening tests for disease prevention and health promotion are important, but do not undergo most of the recommended tests themselves.

Understanding how mothers of adolescent girls obtain information about the human papillomavirus vaccine: associations between mothers' health beliefs, information seeking, and vaccination intentions in an ethnically diverse sample

We examined factors associated with information seeking about the human papillomavirus vaccine among mothers of adolescent girls by testing whether information seeking and vaccination intentions for their daughters are associated with perceived vulnerability, severity, and vaccine benefits in an ethnically diverse sample. Mothers (N = 256) of unvaccinated girls living in Dallas, Texas, were surveyed (49% Black, 29% Hispanic, and 18% White). Perceived vulnerability to human papillomavirus was associated with talking with others (odds ratio = 1.71, 95% confidence interval = 1.09, 2.66) and talking with a doctor about the vaccine (odds ratio = 1.42, 95% confidence interval = 1.01, 1.99), and perceived vaccine benefits were associated with vaccination intentions (odds ratio = 2.96, 95% confidence interval = 1.98, 4.42), but the perceived severity was not associated with any dependent measure. Beliefs about human papillomavirus risk are associated with seeking information from a doctor and interpersonal sources, but ethnic minorities are less likely to talk with others about the vaccine.

Methods in public health services and systems research: a systematic review

CONTEXT

Public Health Services and Systems Research (PHSSR) is concerned with evaluating the organization, financing, and delivery of public health services and their impact on public health. The strength of the current PHSSR evidence is somewhat dependent on the methods used to examine the field. Methods used in PHSSR articles, reports, and other documents were reviewed to assess their methodologic strengths and challenges in light of PHSSR goals.

EVIDENCE ACQUISITION

A total of 364 documents from the PHSSR library met the inclusion criteria as empirical and based in the U.S. After additional exclusions, 327 of these were analyzed.

EVIDENCE SYNTHESIS

A detailed codebook was used to classify articles in terms of (1) study design; (2) sampling; (3) instrumentation; (4) data collection; (5) data analysis; and (6) study validity. Inter-coder reliability was assessed for the codebook; once it was found reliable, the available empirical documents were coded.

CONCLUSIONS

Although there has been a dramatic increase in the amount of published PHSSR recently, methods used remain primarily cross-sectional and descriptive. Moreover, although appropriate for exploratory and foundational work in a new field, these approaches are limiting progress toward some PHSSR goals. Recommendations are given to advance and strengthen the methods used in PHSSR to better meet the goals and challenges facing the field.

Sources of health information related to preventive health behaviors in a national study

BACKGROUND

Current literature suggests that certain sources of information are used in varying degrees among different socioeconomic and demographic groups; therefore, it is important to determine if specific classes of health information sources are more effective than others in promoting health behaviors.

PURPOSE

This study aims to determine if interpersonal versus mass media sources of health information are associated with meeting recommendations for health behaviors (nonsmoking, fruit/vegetable intake, and exercise) and cancer screening.

METHODS

Multivariable logistic regression models were used to examine the relationship of health information sources (mass media sources including print, TV, Internet; and interpersonal sources including friends and family, community organizations, and healthcare providers) with meeting recommendations for healthy behaviors and cancer screening in the 2005 and 2007 Health Information National Trends Surveys (HINTS). Analyses were conducted in 2009.

RESULTS

In the 2005 HINTS, participants reporting use of print media and community organizations as sources of health information over the past year were mostly likely to meet recommendations for health behaviors. In the 2007 HINTS, utilization of healthcare providers for health information was associated with meeting recommendations for health behaviors, particularly cancer screening.

CONCLUSIONS

Use of print media and interpersonal sources of health information are most consistently associated with self-reported health behaviors. Additional research should explore the relationship of health information sources to clinical outcomes. Social network interventions to promote adoption of health behaviors should be further developed.