Effect of advertising on awareness of symptoms of diabetes among the general public: the British Diabetic Association Study

Responses to direct-to-consumer advertising in Australia: Comparing experience

AbsractThis paper examines the potential effect of Direct-to-Consumer (DTC) advertising on consumers' behavioral intentions in relation to a medical issue. Using an online experiment, 1295 people were randomized to two information conditions. One group watched an advertisement for a hypothetical cold sore medicine, while a second (control) group did not view the advertisement, before both groups answered questions on symptoms. The responses were analyzed based on group allocation and the respondents' experience with cold sores. Results indicate that those who viewed the advertisement were more likely to choose the product, and the advertisement had larger effects based on consumer experience.

Patient perceptions of their glycemic control and its influence on type 2 diabetes outcomes: an international survey of online communities

PURPOSE

This study aimed to assess awareness of glycated hemoglobin (A1C) testing and targets, perceived level of glycemic control and risk of complications, attitudes toward medications and self-management, and regimen-related distress in an international sample of patients with type 2 diabetes (T2D).

METHODS

The descriptive study used a single time-point survey of adults in online health communities in the USA, Canada, the UK, Germany, Spain, and Mexico, who self-reported T2D diagnosed by a physician.

RESULTS

In total, 661 patients participated. Awareness of their A1C value at last test varied considerably between countries (42%-89%), as did awareness of having an A1C target (26%- 70%). Self-reported A1C values were similar across US, Canadian, and European respondents (mean, 6.8%-7.3%). Approximately two-thirds of respondents from these countries (66%-71%) reported that their T2D was very or fairly well controlled, and few (5%-15%) expected to experience serious complications within 1 year. However, many respondents expected to experience microvascular (rather than macrovascular) complications in this time frame (eg, nerve pain, 5%-47%). Self-reported adherence to oral medication was generally high, with most respondents (86%-98%) taking their pills or tablets as directed by their healthcare provider, although for insulin injections adherence was lower in the USA (71%) and Mexico (78%) than in the other countries (86%-95%). The majority of respondents across countries (71%-79%) reported that taking injectable medications was not at all or a little burdensome. Respondents across countries appeared to be reasonably confident that they could adequately manage their blood sugar levels; despite this, a sizeable minority (21%-35%) had clinically significant levels of regimen-related distress.

CONCLUSION

Limited patient awareness of their A1C value and the potential complications of poorly controlled T2D, particularly regarding cardiovascular complications, may be a widespread problem. Furthermore, greater patient support may be needed to improve self-management of T2D and to reduce regimen-related distress.

Cultural variations in attitudes towards family risk of diabetes

AIMS

To examine differences in attitudes and behaviours towards familial risk of type 2 diabetes in populations in Ireland and Bahrain.

METHODS

Cross-sectional ecological study. Questionnaires were developed and administered to patients with diabetes and their first degree relatives in both Bahrain and Ireland. Data was analysed using non-parametric tests of association.

RESULTS

Responses were compared between 297 patients with diabetes from Ireland and 201 from Bahrain and between 364 relatives of patients with diabetes in Ireland and 244 from Bahrain. Relatives in Bahrain had more knowledge of risk factors for diabetes and an increased perception of the seriousness of diabetes but a more external, chance locus of control and perceived more barriers to changing lifestyles than those in Ireland. There was no difference in perception of personal risk of diabetes.

CONCLUSIONS

Knowledge of risk factors and seriousness of diabetes are higher in Bahrain than in Ireland but perception of personal risk of diabetes and intention to adopt risk reducing behaviours are no different. There is a need to develop models of behavioural change that are more relevant to the needs of the Bahraini population in reducing their risk of diabetes.

YouTube: a gauge of public perception and awareness surrounding epilepsy

Epilepsy is a common neurological disorder. Despite advances in research and epilepsy education campaigns, there remains significant misinformation and persistent stigma. The Internet is a widely used source for information and communication. Therefore, we sampled the video-sharing website YouTube (www.youtube.com) to see how epilepsy is being perceived. The top 10 videos are being viewed 3200 times daily. All videos showed statistically significant differences for within-variable analysis in at least one variable: empathy or knowledge (P<0.001). Further assessment revealed that "real-life" epilepsy videos generated the most hits and comments, had the most favorable empathetic scoring, but provided little to no information to viewers. Conversely, videos providing information had largely neutral or negative empathy scores. Video-sharing websites, like YouTube, have the potential to remediate the significant misinformation and persistent stigma surrounding epilepsy. This study underscores the importance of recognizing the significant attributes of videos that engage the viewers.

Diabetes-related symptoms and negative mood in participants of a targeted population-screening program for type 2 diabetes: The Hoorn Screening Study

OBJECTIVE

To determine the level of diabetes-related symptom distress and its association with negative mood in subjects participating in a targeted population-screening program, comparing those identified as having type 2 diabetes vs. those who did not.

RESEARCH DESIGN AND METHODS

This study was conducted within the framework of a targeted screening project for type 2 diabetes in a general Dutch population (age 50-75 years). The study sample consisted of 246 subjects, pre-selected on the basis of a high-risk profile; 116 of whom were subsequently identified as having type 2 diabetes, and 130 who were non-diabetic subjects. Diabetes-related symptom distress and negative mood was assessed approximately 2 weeks, 6 months, and 12 months after the diagnosis of type 2 diabetes, with the Type 2 Diabetes Symptom Checklist and the Negative well-being sub scale of the Well-being Questionnaire (W-BQ12), respectively.

RESULTS

Screening-detected diabetic patients reported significantly greater burden of hyperglycemic (F = 6.0, df = 1, p = 0.015) and of fatigue (F = 5.3, df = 1, p = 0.023) symptoms in the first year following diagnosis type 2 diabetes compared to non-diabetic subjects. These outcomes did not change over time. The total symptom distress (range 0-4) was relatively low for both screening-detected diabetic patients (median at approximately 2 weeks, 6 months, and 12 months; 0.24, 0.24, 0.29) and non-diabetic subjects (0.15, 0.15, 0.18), and not significantly different. No average difference and change over time in negative well-being was found between screening-detected diabetic patients and non-diabetic subjects. Negative well-being was significantly positive related with the total symptom distress score (regression coefficient beta = 2.86, 95% CI 2.15-3.58).

CONCLUSIONS

The screening-detected diabetic patients were bothered more by symptoms of hyperglycemia and fatigue in the first year following diagnosis type 2 diabetes than non-diabetic subjects. More symptom distress is associated with increased negative mood in both screening-detected diabetic patients and non-diabetic subjects.

Mass media interventions: effects on health services utilisation

BACKGROUND

The mass media frequently cover health related topics, are the leading source of information about important health issues, and are targeted by those who aim to influence the behaviour of health professionals and patients.

OBJECTIVES

To assess the effects of mass media on the utilisation of health services.

SEARCH STRATEGY

We searched the Cochrane Effective Practice and Organisation of Care Group specialised register (1996 to 1999), MEDLINE, EMBASE, Eric, PsycLit (to 1999), and reference lists of articles. We hand searched the journals Communication Research (February 1987 to August 1996), European Journal of Communication (1986 to 1994), Journal of Communication (winter 1986 to summer 1996), Communication Theory (February 1991 to August 1996), Critical Studies in Mass Communication (March 1984 to March 1995) and Journalism Quarterly (1986 to summer 1996).

SELECTION CRITERIA

Randomised trials, controlled clinical trials, controlled before-and-after studies and interrupted time series analyses of mass media interventions. The participants were health care professionals, patients and the general public.

DATA COLLECTION AND ANALYSIS

Two reviewers independently extracted data and assessed study quality.

MAIN RESULTS

Twenty studies were included. All used interrupted time series designs. Fifteen evaluated the impact of formal mass media campaigns, and five of media coverage of health-related issues. The overall methodological quality was variable. Six studies did not perform any statistical analysis, and nine used inappropriate statistical tests (ie not taking into account the effect of time trend). All of the studies apart from one concluded that mass media was effective. These positive findings were confirmed by our re-analysis in seven studies. The direction of effect was consistent across studies towards the expected change.

REVIEWER'S CONCLUSIONS

Despite the limited information about key aspects of mass media interventions and the poor quality of the available primary research there is evidence that these channels of communication may have an important role in influencing the use of health care interventions. Although the findings of this review may be affected by publication bias, those engaged in promoting better uptake of research information in clinical practice should consider mass media as one of the tools that may encourage the use of effective services and discourage those of unproven effectiveness.

Early detection of type 2 diabetes: the role of the community nurse

Recent changes to the diagnostic criteria for type 2 diabetes have raised concerns that if steps are not taken to address relevant issues, the number of diagnosed sufferers will escalate in future years, with a similar increase in the prevalence of associated complications. Research suggests that for many patients, complications are evident at the time of diagnosis, and may have been present for several years before a diagnosis was made. Late presentation is the cause of considerable morbidity and mortality among these patients, largely because undiagnosed complications are often irreversible by the time the underlying diabetes is discovered. The current emphasis on public health augments the need for community nurses to recognize warning signs, particularly in patients who are at an increased risk of developing diabetes. This article aims to raise awareness of early signs and symptoms, and gives a brief insight into some of the associated health problems. If community nurses are to play a significant role in reducing the potentially devastating effects of this disease, they will need to be involved tin educating patients and implementing screening and intervention programmes.

Impaired glucose tolerance and unidentified diabetes

The epidemiology of impaired glucose tolerance and undiagnosed non-insulin-dependent diabetes mellitus is reviewed and the implications for screening strategies discussed.

Pharmacoeconomics of diabetes surveillance and detection programmes

Primary prevention of insulin-dependent diabetes mellitus (IDDM, type I diabetes) remains a research goal. Primary prevention of non-insulin-dependent diabetes mellitus (NIDDM, type II diabetes) is likely to remain part of general health education on healthy lifestyles. However, the often delayed diagnosis of type II diabetes, accompanied by early development of complications, offers opportunities for detection programmes, provided that these can overcome the hurdle of the low annual incidence of this disease. By contrast, programmes for the detection of arterial risk factors and treatable complications of previously diagnosed diabetes are well established as an integrated, and thus efficient, annual review. The results of such review guide the different forms of management programmes such as educational programmes for foot care and smoking, drug therapy for hypertension, dyslipidaemia and early nephropathy, and crisis management (laser photocoagulation) of proliferative retinopathy. Such annual review, additional to review of lifestyle and metabolic control, offers opportunities for on-going preventive education and is now the basis of quality development and needs assessment technologies.