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Adamson A, Portas L, Accordini S, Marcon A, Jarvis D, Baio G, Minelli C. Communication of personalised disease risk by general practitioners to motivate smoking cessation in England: a cost-effectiveness and research prioritisation study. Addiction 2022; 117:1438-1449. [PMID: 34859521 DOI: 10.1111/add.15773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 11/03/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND AIMS Communication of personalised disease risk can motivate smoking cessation. We assessed whether routine implementation of this intervention by general practitioners (GPs) in England is cost-effective or whether we need further research to better establish its effectiveness. DESIGN Cost-effectiveness analysis (CEA) with value of information (VoI) analysis from the UK National Health Service perspective, using GP communication of personalised disease risk on smoking cessation versus usual care. SETTING GP practices in England. STUDY POPULATION Healthy smokers aged 35-60 years attending the GP practice. MEASUREMENTS Effectiveness of GP communication of personalised disease risk on smoking cessation was estimated through systematic review and meta-analysis. A Bayesian CEA was then performed using a lifetime Markov model on smokers aged 35-60 years that measured lifetime costs and quality-adjusted life-years (QALYs) assigned to the four diseases contributing the most to smoking-related morbidity, mortality and costs: chronic obstructive pulmonary disease, lung cancer, myocardial infarction and stroke. Costs and QALYs for each disease state were obtained from the literature. VoI analysis identified sources of uncertainty in the CEA and assessed how much would be worth investing in further research to reduce this uncertainty. FINDINGS The meta-analysis odds ratio for the effectiveness estimate of GP communication of personalised disease risk was 1.48 (95% credibility interval, 0.91-2.26), an absolute increase in smoking cessation rates of 3.84%. The probability of cost-effectiveness ranged 89-94% depending on sex and age. VoI analysis indicated that: (i) uncertainty in the effectiveness of the intervention was the driver of the overall uncertainty in the CEA; and (ii) a research investment to reduce this uncertainty is justified if lower than £27.6 million (£7 per smoker). CONCLUSIONS Evidence to date shows that, in England, incorporating disease risk communication into general practitioners' practices to motivate smoking cessation is likely to be cost-effective compared with usual care.
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Affiliation(s)
- Alexander Adamson
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Laura Portas
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Simone Accordini
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Alessandro Marcon
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Deborah Jarvis
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Gianluca Baio
- Department of Statistical Science, University College London, London, UK
| | - Cosetta Minelli
- National Heart & Lung Institute, Imperial College London, London, UK
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Rowbotham S, Astell-Burt T, Barakat T, Hawe P. 30+ years of media analysis of relevance to chronic disease: a scoping review. BMC Public Health 2020; 20:364. [PMID: 32192448 PMCID: PMC7083065 DOI: 10.1186/s12889-020-8365-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Chronic, non-communicable diseases are a significant public health priority, requiring action at individual, community and population levels, and public and political will for such action. Exposure to media, including news, entertainment, and advertising media, is likely to influence both individual behaviours, and attitudes towards preventive actions at the population level. In recent years there has been a proliferation of research exploring how chronic diseases and their risk factors are portrayed across various forms of media. This scoping review aims to map the literature in this area to identify key themes, gaps, and opportunities for future research in this area. METHODS We searched three databases (Medline, PsycINFO and Global Health) in July 2016 and identified 499 original research articles meeting inclusion criteria: original research article, published in English, focusing on media representations of chronic disease (including how issues are framed in media, impact or effect of media representations, and factors that influence media representations). We extracted key data from included articles and examined the health topics, media channels and methods of included studies, and synthesised key themes across studies. RESULTS Our findings show that research on media portrayals of chronic disease increased substantially between 1985 and 2016. Smoking and nutrition were the most frequent health topics, and television and print were the most common forms of media examined, although, as expected, research on online and social media channels has increased in recent years. The majority of studies focused on the amount and type of media coverage, including how issues are framed, typically using content analysis approaches. In comparison, there was much less research on the influences on and consequences of media coverage related to chronic disease, suggesting an important direction for future work. CONCLUSIONS The results highlight key themes across media research of relevance to chronic disease. More in-depth syntheses of studies within the identified themes will allow us to draw out the key patterns and learnings across the literature.
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Affiliation(s)
- Samantha Rowbotham
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia. .,The Australian Prevention Partnership Centre, Sydney, Australia.
| | - Thomas Astell-Burt
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia.,Population Wellbeing and Environment Research Lab (PowerLab), School of Health and Society, University of Wollongong, Wollongong, Australia.,School of Public Health, Peking Union Medical College and The Chinese Academy of Medical Sciences, Beijing, China.,National Institute of Environmental Health, Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Tala Barakat
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia.,The Australian Prevention Partnership Centre, Sydney, Australia
| | - Penelope Hawe
- Menzies Centre for Health Policy, Sydney School of Public Health, University of Sydney, Sydney, Australia.,The Australian Prevention Partnership Centre, Sydney, Australia.,O'Brien Institute of Public Health, University of Calgary, Calgary, Canada
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Berry TR, Courneya KS, Norris CM, Rodgers WM, Spence JC. Automatic associations of breast cancer and heart disease with fruit and vegetables and physical activity. SAGE Open Med 2019; 7:2050312119871183. [PMID: 31452887 PMCID: PMC6700862 DOI: 10.1177/2050312119871183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 07/30/2019] [Indexed: 11/21/2022] Open
Abstract
Objectives: This exploratory research examined if breast cancer or heart disease is automatically associated with physical activity compared to fruit and vegetable stimuli; if reading messages about reducing risk of breast cancer or heart disease through physical activity and fruit and vegetable consumption would affect automatic associations; and if automatic associations were related to intentions to be physically active or consume fruit and vegetables. Methods: Participants were 80 women who completed pretest measures of automatic associations, then read a breast cancer, heart disease, or control message, followed by posttest measures. Results: There was a significant association of breast cancer–related words with fruit and vegetables compared to physical activity. Heart disease was also more strongly associated with fruit and vegetables than physical activity at pretest but not at posttest. There were no other significant findings. Conclusion: This research highlights that fruit and vegetables rather than physical activity are more strongly associated with perceptions of breast cancer and heart disease. Automatic associations are an attitudinal construct, and the strength of association between fruit and vegetables, rather than physical activity, indicates how messages may be processed.
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Affiliation(s)
- Tanya R Berry
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | | | - Wendy M Rodgers
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
| | - John C Spence
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, AB, Canada
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Podzolkov VI, Bragina AE, Podzolkovа NM. Menopausal hormone therapy and heart disease prevention: desired or valid? КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2019. [DOI: 10.15829/1728-8800-2019-3-94-106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Cardiovascular diseases are the main cause of death for women in older age groups. For many decades, specialists have tried to prevent their development by the use of estrogen. The review of the literature presents current data on the effect of menopausal hormone therapy (MHT) on the risk of cardiovascular complications. The results of the main randomized clinical and observational studies in this area, conducted over several decades, are discussed. We described the concept of “window of opportunities”, in accordance with which an improvement in cardiovascular prognosis can be expected only at the onset of MHT in women under the age of 60 years in early postmenopause (menopause duration <10 years). There are experimental and clinical data explaining the different effects of estrogen on the cardiovascular prognosis in women of various age groups and different duration of postmenopause. The recommendations given in the review on the use of MHT are based on modern international guidelines.
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Affiliation(s)
| | - A. E. Bragina
- I. M. Sechenov First Moscow State Medical University
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Social Network, Surgeon, and Media Influence on the Decision to Undergo Contralateral Prophylactic Mastectomy. Am J Clin Oncol 2019; 41:519-525. [PMID: 27465657 PMCID: PMC5976223 DOI: 10.1097/coc.0000000000000321] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVES The rate of contralateral prophylactic mastectomy (CPM) has risen sharply in the past decade. The current study was designed to examine social network, surgeon, and media influence on patients' CPM decision-making, examining not only who influenced the decision, and to what extent, but also the type of influence exerted. METHODS Patients (N=113) who underwent CPM at 4 Indiana University-affiliated hospitals between 2008 and 2012 completed structured telephone interviews in 2013. Questions addressed the involvement and influence of the social network (family, friends, and nonsurgeon health professionals), surgeon, and media on the CPM decision. RESULTS Spouses, children, family, friends, and health professionals were reported as exerting a meaningful degree of influence on patients' decisions, largely in ways that were positive or neutral toward CPM. Most surgeons were regarded as providing options rather than encouraging or discouraging CPM. Media influence was present, but limited. CONCLUSIONS Patients who choose CPM do so with influence and support from members of their social networks. Reversing the increasing choice of CPM will require educating these influential others, which can be accomplished by encouraging patients to include them in clinical consultations, and by providing patients with educational materials that can be shared with their social networks. Surgeons need to be perceived as having an opinion, specifically that CPM should be reserved for those patients for whom it is medically indicated.
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Li W, Watts J, Tan N. From Screen to Screening: Entertainment and News Television Media Effects on Cancer Screening Behaviors. JOURNAL OF HEALTH COMMUNICATION 2019; 24:385-394. [PMID: 31033423 DOI: 10.1080/10810730.2019.1607954] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The complementary effects of genre-specific media use and information-seeking behaviors on cancer prevention behaviors have been understudied in cancer communication literature. A secondary analysis of the Annenberg National Health Communication Survey (ANHCS) was conducted to investigate the effects of two types of televised media content (i.e., news and entertainment programs) on three types of cancer screening behaviors through active health information seeking behavior (HISB) from other mass media. The results show that routine entertainment and news television viewing significantly predicted HISB above and beyond demographic variables and perceived health status. HISB partially mediated the effects of entertainment and news television viewing on colon cancer and breast cancer screening behaviors (i.e., sigmoidoscopy and colonoscopy, mammogram) while fully mediating their effects on prostate cancer screening behavior (PSA). Future advocacy efforts should continue to use mass media like television to raise awareness of various types of cancer and preventative measures. Additionally, more collaborations should be conducted between public health professionals and content creators to design effective health content on promoting cancer prevention behaviors on mass media platforms.
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Affiliation(s)
- Wenbo Li
- a School of Communication , The Ohio State University , Columbus , OH , USA
| | - Judy Watts
- a School of Communication , The Ohio State University , Columbus , OH , USA
| | - Naomi Tan
- a School of Communication , The Ohio State University , Columbus , OH , USA
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Gonsalves CA, McGannon KR, Schinke RJ, Pegoraro A. Mass media narratives of women’s cardiovascular disease: a qualitative meta-synthesis. Health Psychol Rev 2017; 11:164-178. [DOI: 10.1080/17437199.2017.1281750] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Kerry R. McGannon
- School of Human Kinetics, Laurentian University, Sudbury, ON, Canada
| | - Robert J. Schinke
- School of Human Kinetics, Laurentian University, Sudbury, ON, Canada
| | - Ann Pegoraro
- School of Human Kinetics, Laurentian University, Sudbury, ON, Canada
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