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Davis A, Stringer KL, Drainoni ML, Oser CB, Knudsen HK, Aldrich A, Surratt HL, Walker DM, Gilbert L, Downey DL, Gardner SD, Tan S, Lines LM, Vandergrift N, Mack N, Holloway J, Lunze K, McAlearney AS, Huerta TR, Goddard-Eckrich DA, El-Bassel N. Community-level determinants of stakeholder perceptions of community stigma toward people with opioid use disorders, harm reduction services and treatment in the HEALing Communities Study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104241. [PMID: 37890391 PMCID: PMC10841835 DOI: 10.1016/j.drugpo.2023.104241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/16/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Community stigma toward people with opioid use disorder (OUD) can impede access to harm reduction services and treatment with medications for opioid use disorder (MOUD). Such community OUD stigma is partially rooted in community-level social and economic conditions, yet there remains a paucity of large-scale quantitative data examining community-level factors associated with OUD stigma. We examined whether rurality, social inequity, and racialized segregation across communities from four states in the HEALing Communities Study (HCS) were associated with 1) greater perceived community stigma toward people treated for OUD, 2) greater perceived intervention stigma toward MOUD, and 3) greater perceived intervention stigma toward naloxone by community stakeholders in the HCS. METHODS From November 2019-January 2020, a cross-sectional survey about community OUD stigma was administered to 801 members of opioid overdose prevention coalitions across 66 communities in four states prior to the start of HCS intervention activities. Bivariate analyses assessed pairwise associations between community rural/urban status and each of the three stigma variables, using linear mixed effect modeling to account for response clustering within communities, state, and respondent sociodemographic characteristics. We conducted similar bivariate analyses to assess pairwise associations between racialized segregation and social inequity. RESULTS On average, the perceived community OUD stigma scale score of stakeholders from rural communities was 4% higher (β=1.57, SE=0.7, p≤0.05), stigma toward MOUD was 6% higher (β=0.28, SE=0.1, p≤0.05), and stigma toward naloxone was 10% higher (β=0.46, SE=0.1, p≤0.01) than among stakeholders from urban communities. No significant differences in the three stigma variables were found among communities based on racialized segregation or social inequity. CONCLUSION Perceived community stigma toward people treated for OUD, MOUD, and naloxone was higher among stakeholders in rural communities than in urban communities. Findings suggest that interventions and policies to reduce community-level stigma, particularly in rural areas, are warranted.
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Affiliation(s)
- Alissa Davis
- Columbia University School of Social Work, New York, NY, United States.
| | - Kristi Lynn Stringer
- Department of Health and Human Performance, Community and Public Health, Middle Tennessee State University, Murfreesboro, TN, United States
| | - Mari-Lynn Drainoni
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedesian School of Medicine/Boston Medical Center, Boston, MA, United States; Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, United States
| | - Carrie B Oser
- Department of Sociology, Center on Drug & Alcohol Research, Center for Health Equity Transformation, University of Kentucky, Lexington, KY, United States
| | - Hannah K Knudsen
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, Lexington, KY, United States
| | - Alison Aldrich
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Hilary L Surratt
- Department of Behavioral Science, Center on Drug & Alcohol Research, University of Kentucky, Lexington, KY, United States
| | - Daniel M Walker
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Louisa Gilbert
- Columbia University School of Social Work, New York, NY, United States
| | - Dget L Downey
- Columbia University School of Social Work, New York, NY, United States
| | - Sam D Gardner
- Columbia University School of Social Work, New York, NY, United States
| | - Sylvia Tan
- RTI International, Research Triangle Park, NC, United States
| | - Lisa M Lines
- RTI International, Research Triangle Park, NC, United States
| | | | - Nicole Mack
- RTI International, Research Triangle Park, NC, United States
| | - JaNae Holloway
- RTI International, Research Triangle Park, NC, United States
| | - Karsten Lunze
- Section of Infectious Diseases, Department of Medicine, Boston University Chobanian & Avedesian School of Medicine/Boston Medical Center, Boston, MA, United States
| | - Ann Scheck McAlearney
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States
| | - Timothy R Huerta
- CATALYST, Center for the Advancement of Team Science, Analytics, and Systems Thinking, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Family and Community Medicine, College of Medicine, The Ohio State University, Columbus, OH, United States; Department of Biomedical Informatics, College of Medicine, The Ohio State University, Columbus, OH, United States
| | | | - Nabila El-Bassel
- Columbia University School of Social Work, New York, NY, United States
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O'Leary A, Willis LA, Henny KD, Madden M, Koenig LJ. Development of a Video-Delivered Serial Drama Designed to Reduce Community Homophobia and HIV Stigma, Decrease Sexual Risk Behavior, and Increase HIV Testing Among Black Youth. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2023; 35:439-451. [PMID: 38096457 PMCID: PMC10877481 DOI: 10.1521/aeap.2023.35.6.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
This article describes the development of a video serial drama intervention that was designed to address factors that influence HIV in the United States among Black youth. These include HIV testing, sexual behaviors not protected by condoms, negative attitudes towards sexual minorities, and HIV stigma. Behavior-change principles (social learning theory and education-entertainment) and input from members of the priority audience formed the basis of this 27-episode (3 minutes each) drama for dissemination on multiple platforms, including in public spaces or privately online. The developmental process, specifically involving members of the population of interest and use of behavioral theory, enriched the narrative elements and likely ensured intervention acceptability, enhancing effectiveness. Public health practitioners and prevention programmers may want to consider using this intervention and/or the narrative communication approach when intervening to change behavior.
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Affiliation(s)
| | - Leigh A Willis
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kirk D Henny
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Linda J Koenig
- Division of HIV Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Suresh S, Demetriades SZ, Walter N, Montoya JA, Plant A, Barker K, Orvañanos C, Carranza J. From Watching to Calling: Linking Variations in an Entertainment-Education Storyline with Calls to a Health Hotline. HEALTH COMMUNICATION 2023:1-12. [PMID: 37904280 DOI: 10.1080/10410236.2023.2275923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Substantial gaps exist in the theoretical conceptualization and practical development of entertainment-education, as studies often fail to account for the ways in which intrinsic message characteristics influence subsequent behavior. These gaps served as the impetus for an international collaborative project that evaluated Vencer el Miedo ("Overcome the Fear"), a Spanish-language program that aired in Mexico from January to March 2020. The telenovela was produced with the aim of improving sexual and reproductive health knowledge and behaviors by modeling effective ways to discuss and negotiate safer sex practices. The show was accompanied by a telephone hotline called OrientaSEX operated by professional counselors from MEXFAM, Planned Parenthood's Mexican affiliate. Utilizing an interrupted time series analysis of calls made to OrientaSEX (N = 11,878) and focusing on changes in the volume of calls and the identity of callers following key moments in the storyline, the findings support the central role played by transitional characters and their similarity to audience members. Implications of these results for the theory and practice of entertainment-education are discussed.
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Affiliation(s)
- Sapna Suresh
- Department of Communication Studies, Northwestern University
| | | | - Nathan Walter
- Department of Communication Studies, Northwestern University
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Murdoch R, Mihov B, Horne AM, Petrie KJ, Gamble GD, Dalbeth N. Impact of Television Depictions of Gout on Perceptions of Illness: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2023; 75:2151-2157. [PMID: 37038965 DOI: 10.1002/acr.25130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/06/2023] [Accepted: 04/04/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Gout is a chronic disease that can be effectively managed with long-term urate-lowering therapy. However, it is frequently portrayed on screen as an acute disease caused by a poor diet that should be managed with lifestyle changes. This study was undertaken to investigate the impact of a fictional television depiction of gout on perceptions of the disease and its management. METHODS In a randomized controlled single-blind study, 200 members of the public watched either a 19-minute commercial television comedy episode that depicted gout as an acute disease caused by poor diet and managed with lifestyle changes, or a control episode from the same television series that did not mention gout or other diseases. Participants completed a survey regarding their perceptions of gout, its likely causes, and management strategies. RESULTS Participants randomized to watch the gout-related episode believed gout had greater consequences (mean score of 7.1 versus 6.2 on an 11-point Likert scale; P < 0.001) and were more likely to rank the most important cause as poor eating habits compared to the control group (70% versus 38%; P < 0.001). They were also less likely to believe it is caused by genetic factors or chance. Participants watching the gout-related episode believed a change in diet would be a more effective management strategy (9.0 versus 8.4; P = 0.004) and long-term medication use would be less effective (6.9 versus 7.6; P = 0.007) compared to participants in the control group. CONCLUSION Television depictions of gout can perpetuate inaccurate beliefs regarding causes of the disease and underemphasize effective medical strategies required in chronic disease management.
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Massey PM, Kearney MD, Rideau A, Peterson A, Gipson JD, Nianogo RA, Bornstein M, Prelip ML, Glik DC. Measuring impact of storyline engagement on health knowledge, attitudes, and norms: A digital evaluation of an online health-focused serial drama in West Africa. J Glob Health 2022; 12:04039. [PMID: 35567587 PMCID: PMC9107188 DOI: 10.7189/jogh.12.04039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background "Cest la Vie!" (CLV) is a serial drama that entertains, educates, and promotes positive health behaviors and social change for West African audiences. The purpose of this study was to evaluate if watching the CLV Season 2 series online had an impact on people's health knowledge, attitudes, and norms, focusing on populations in francophone West Africa. Methods Between July 2019 and October 2019, viewers of CLV and non-viewers were recruited from Facebook and YouTube. We conducted an online longitudinal cohort study that assessed changes in health knowledge, attitudes, and norms (KAN) between these groups. Participants completed a baseline survey prior to the online airing and up to three follow-up surveys corresponding to specific health stories in the series, including sexual violence, emergency contraception, and female circumcision. We used descriptive statistics to describe viewers and non-viewers, and an item response theory (IRT) analysis to identify the effect of viewing CLV on overall KAN. Results A total of 1674 respondents participated in the study. One in four participants (23%, n = 388) had seen one of the three storylines from CLV Season 2 (ie, CLV viewers). At follow-up, viewers were more likely than non-viewers to know when to correctly use emergency contraception (P < 0.001) and to believe that the practice of female circumcision should end (P = 0.001). Compared to people who did not see CLV, viewers of the series had 26% greater odds of answering pro-health responses at follow-up about sexual assault, emergency contraception, and female circumcision. Further, the level of engagement with specific storylines was associated with a differential impact on overall outcome questions. Conclusions As internet access continues to grow across the globe and health education materials are created and adapted for new media environments, our study provides a novel approach to examining the impact of online entertainment-education content on health knowledge, attitudes, and norms.
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Affiliation(s)
- Philip M Massey
- Department of Health, Human Performance, and Recreation, College of Education and Health Professions, University of Arkansas, Fayetteville, Arkansas, USA
| | - Matthew D Kearney
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Adam Peterson
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Jessica D Gipson
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Roch A Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Marta Bornstein
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
| | - Michael L Prelip
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Deborah C Glik
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
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6
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Martin-Plank L, Davis MP, Williams DK, May JT, Ortiz-Dowling EM, Núñez A, Reyes Z, Heasley BJ, Crist JD. Graphic Novela: Mexican American Families' Use of Community Services for Older Adults. Clin Nurs Res 2021; 31:624-631. [PMID: 34719963 DOI: 10.1177/10547738211057006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Knowledge gaps exist about how to help Mexican American (MA) families seek assistance when their capacity to assist older family members is challenged. MA families may resist confronting unpleasant but real situations with the older adult, for example, the need to access long term support services (LTSS), because of cultural and structural barriers. The purpose was to describe stakeholders' reactions to a culturally focused graphic novela created in partnership with a community advisory council. Qualitative description with content analysis of a focus group's reactions to the graphic novela was used. Results included positive reactions as well as suggestions for improvement and dissemination. Graphic novelas can be an effective medium for modeling conversations about older adults' needing additional care, and demonstrating how to identify and access available LTSS or other services. Included is a description of the researchers' process of partnering with diverse stakeholders, which is essential for creating new solutions.
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Bunn C, Kalinga C, Mtema O, Abdulla S, Dillip A, Lwanda J, Mtenga SM, Sharp J, Strachan Z, Gray CM. Arts-based approaches to promoting health in sub-Saharan Africa: a scoping review. BMJ Glob Health 2021; 5:bmjgh-2019-001987. [PMID: 32444361 PMCID: PMC7247409 DOI: 10.1136/bmjgh-2019-001987] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 03/17/2020] [Accepted: 03/27/2020] [Indexed: 12/01/2022] Open
Abstract
Introduction Arts-based approaches to health promotion have been used widely across sub-Saharan Africa (SSA), particularly in public health responses to HIV/AIDS. Such approaches draw on deep-rooted historical traditions of indigenous groups in combination with imported traditions which emerged from colonial engagement. To date, no review has sought to map the locations, health issues, art forms and methods documented by researchers using arts-based approaches in SSA. Methods Using scoping review methodology, 11 databases spanning biomedicine, arts and humanities and social sciences were searched. Researchers screened search results for papers using predefined criteria. Papers included in the review were read and summarised using a standardised proforma. Descriptive statistics were produced to characterise the location of the studies, art forms used or discussed, and the health issues addressed, and to determine how best to summarise the literature identified. Results Searches identified a total of 59 794 records, which reduced to 119 after screening. We identified literature representing 30 (62.5%) of the 48 countries in the SSA region. The papers covered 16 health issues. The majority (84.9%) focused on HIV/AIDS-related work, with Ebola (5.0%) and malaria (3.3%) also receiving attention. Most studies used a single art form (79.0%), but a significant number deployed multiple forms (21.0%). Theatre-based approaches were most common (43.7%), followed by music and song (22.6%), visual arts (other) (9.2%), storytelling (7.6%) and film (5.0%). Conclusions Arts-based approaches have been widely deployed in health promotion in SSA, particularly in response to HIV/AIDS. Historically and as evidenced by this review, arts-based approaches have provided a platform to facilitate enquiry, achieved significant reach and in some instances supported demonstrable health-related change. Challenges relating to content, power relations and evaluation have been reported. Future research should focus on broadening application to other conditions, such as non-communicable diseases, and on addressing challenges raised in research to date.
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Affiliation(s)
- Christopher Bunn
- College of Social Sciences, University of Glasgow, Glasgow, UK .,Social Sciences, Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Chisomo Kalinga
- Centre of African Studies, University of Edinburgh, Edinburgh, UK
| | | | - Sharifa Abdulla
- Department of Fine and Performing Arts, Chancellor College, Zomba, Malawi
| | - Angel Dillip
- Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, United Republic of Tanzia
| | - John Lwanda
- College of Social Sciences, University of Glasgow, Glasgow, UK
| | - Sally M Mtenga
- Health Systems, Impact Evaluation and Policy, Ifakara Health Institute, Dar es Salaam, United Republic of Tanzia
| | - Jo Sharp
- School of Geography and Sustainable Development, University of St Andrews, St Andrews, UK
| | - Zoë Strachan
- School of Critical Studies, University of Glasgow, Glasgow, UK
| | - Cindy M Gray
- College of Social Sciences, University of Glasgow, Glasgow, UK
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Elafros MA, Belessiotis-Richards C, Birbeck GL, Bond V, Sikazwe I, Kvalsund MP. Lumbar Puncture-Related Knowledge, Attitudes, and Practices among Patients, Caregivers, Doctors, and Nurses in Zambia. Am J Trop Med Hyg 2021; 104:1925-1931. [PMID: 33755588 PMCID: PMC8103467 DOI: 10.4269/ajtmh.20-0509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 01/18/2021] [Indexed: 11/07/2022] Open
Abstract
Lumbar puncture (LP) is underused for neuroinfectious disease diagnosis in Zambia, but reasons for poor uptake remain speculative. This cross-sectional study assessed LP knowledge, attitudes, and practices among patients/caregivers and healthcare workers (HCWs) and predictors of LP completion. Patients with suspected central nervous system infection, caregivers, and HCWs at the University Teaching Hospitals in 2016 were eligible. Questions adapted from the existing literature were used for a LP knowledge score. Predictors of knowledge scores were assessed independently for patients/caregivers and HCWs. Predictors of LP completion were assessed using multivariable logistic regression. Among 123 patients/caregivers, LP knowledge was poor. Pediatric caregivers were more likely than adult patients/caregivers to report LP could be replaced by neuroimaging (90% versus 78%, P < 0.001) and cause paralysis (57% versus 39%, P = 0.01). There were no significant predictors of the knowledge score among patients/caregivers. Among HCWs, 28% said LP makes patients clinically worse, and 60% reported it could cause paralysis. The increased knowledge score was associated with greater wealth (P = 0.03) and personally knowing someone who underwent LP (P < 0.001). Lumbar puncture was completed on 67/112 (57%) patients and was associated with an increased knowledge score (OR: 1.62 [95% CI: 1.19-2.23]). Pediatric patients (OR: 0.18 [95% CI: 0.07-0.47]) and those with a fear of paralysis (OR 0.29 [95% CI: 0.11-0.77]) were less likely to undergo LP. Improving LP-related knowledge may improve uptake. Healthcare workers sense of LP risk may also play a role in encouraging/discouraging use.
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Affiliation(s)
- Melissa A. Elafros
- Department of Neurology, University of Michigan, Ann Arbor, Michigan;,Address correspondence to Melissa A. Elafros, Department of Neurology, University of Michigan, F2647 UH South SPC 5223, 1500 E Medical Center Dr., Ann Arbor, MI 48109. E-mail:
| | - Clara Belessiotis-Richards
- Department of Psychiatry, University College London, London, United Kingdom;,Camden and Islington NHS Foundation Trust, London, United Kingdom
| | - Gretchen L. Birbeck
- Department of Neurology, University of Rochester, Rochester, New York;,Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia;,University Teaching Hospitals, Children’s Hospital, Lusaka, Zambia
| | - Virginia Bond
- ZAMBART, University of Zambia, Lusaka, Zambia;,Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Izukanji Sikazwe
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Michelle P. Kvalsund
- Department of Internal Medicine, University of Zambia School of Medicine, Lusaka, Zambia;,Department of Neurology, Michigan State University, East Lansing, Michigan
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Leman MA, Claramita M, Rahayu GR. Factors influencing healthy role models in medical school to conduct healthy behavior: a qualitative study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:1-11. [PMID: 33491661 PMCID: PMC7883803 DOI: 10.5116/ijme.5ff9.9a88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/09/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aimed to identify the factors that support or inhibit medical teachers as healthy role models in medical school to conduct healthy behavior. METHODS This qualitative study involved semi-structured in-depth interviews with medical teachers categorized as healthy role models in a medical school from a previous survey. Ten medical teachers were selected using purposive sampling. Three medical teachers were interviewed by direct meetings, and the remaining were phone interviewed, with one interview facilitated by chat using WhatsApp. Transcribed interviews were coded openly. Themes were finalized through discussion and debate to reach a consensus. RESULTS Two themes were identified: perceived facilitators and perceived barriers, which were classified into four categories and 13 subcategories: intrinsic facilitators (motivation, conscious awareness, having physical limitations, knowledge, and economic reasons); extrinsic facilitators (the impact on doing a particular job, feedback, time, and environment); intrinsic barriers (the lack of self-motivation and having physical limitations); and extrinsic barriers (the burden of responsibilities for being medical teachers and environment). CONCLUSIONS Factors that support and inhibit medical teachers as healthy role models in medical school are influenced by intrinsic and extrinsic factors. This result could be used by medical schools to design appropriate interventions to help medical teachers as healthy role models in conducting healthy behavior. More studies are needed to explore other factors that influence medical teachers to conduct healthy behavior. During the COVID-19 pandemic, healthy role models in medical schools are vitally important and significantly contribute to the overall health of a nation.
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Affiliation(s)
- Michael A. Leman
- School of Dentistry, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia
| | - Mora Claramita
- Department of Medical, Health Professions Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gandes R. Rahayu
- Department of Medical, Health Professions Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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Siem B, Neymeyer L, Rohmann A. Entertainment Education as a Means to Reduce Anti-Muslim Prejudice – For Whom Does It Work Best? SOCIAL PSYCHOLOGY 2021. [DOI: 10.1027/1864-9335/a000432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The present research aimed to replicate and extend findings by Murrar and Brauer (2018) , who demonstrated that an entertainment education intervention (a music video) effectively reduced US residents’ anti-Muslim prejudice. Using a German sample ( N = 203), we confirmed that watching the video significantly reduced recipients’ prejudice toward Muslims compared to a control condition and two alternative interventions. Unlike in Murrar and Brauer, however, the intervention’s advantageous effect was driven by recipients’ feelings of intergroup anxiety and perceptions of outgroup malleability rather than their identification with Muslims. Extending Murrar and Brauer’s findings, our results also suggest for whom entertainment education interventions may work best, namely for recipients high in right-wing authoritarianism. The findings’ theoretical and practical implications are discussed.
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Affiliation(s)
- Birte Siem
- Department of Psychology, FernUniversität in Hagen, Germany
| | - Lisa Neymeyer
- Department of Psychology, FernUniversität in Hagen, Germany
| | - Anette Rohmann
- Department of Psychology, FernUniversität in Hagen, Germany
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11
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Moyer-Gusé E, Woods K, Rader K, Luong KT. Talking about TV: Mother-Daughter Viewing and Discussion of an Entertainment Narrative about Teen Pregnancy. HEALTH COMMUNICATION 2020; 35:1200-1209. [PMID: 31181976 DOI: 10.1080/10410236.2019.1623642] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Narratives can bring about related discussions, which can influence narrative comprehension and future conversations - though little is known about how these processes interact. This study considers the interplay of exposure to a teen pregnancy narrative and subsequent mother-daughter discussion in an experiment with mothers and their teenage daughters. Participants watched a teen pregnancy narrative or a control narrative. After watching, they either participated in a mother-daughter discussion of sexual health or completed a distractor activity. The teen pregnancy narrative led to greater endorsement of teen pregnancy myths on the part of daughters - particularly when identifying with the pregnant teen character - but maternal discussion mitigated their effects on overall attitudes toward pregnancy prevention. Moreover, participants who viewed the teen pregnancy narrative were more satisfied with their discussions afterwards than were those who discussed sexual health without first watching the teen pregnancy narrative. This conversational satisfaction, in turn, led to more frequent mother-daughter conversations about sexuality in the following weeks.
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Affiliation(s)
| | - Kelsey Woods
- School of Communication, The Ohio State University
| | - Kara Rader
- School of Communication, The Ohio State University
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12
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Kemp CG, Jarrett BA, Kwon CS, Song L, Jetté N, Sapag JC, Bass J, Murray L, Rao D, Baral S. Implementation science and stigma reduction interventions in low- and middle-income countries: a systematic review. BMC Med 2019; 17:6. [PMID: 30764820 PMCID: PMC6376798 DOI: 10.1186/s12916-018-1237-x] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 12/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interventions to alleviate stigma are demonstrating effectiveness across a range of conditions, though few move beyond the pilot phase, especially in low- and middle-income countries (LMICs). Implementation science offers tools to study complex interventions, understand barriers to implementation, and generate evidence of affordability, scalability, and sustainability. Such evidence could be used to convince policy-makers and donors to invest in implementation. However, the utility of implementation research depends on its rigor and replicability. Our objectives were to systematically review implementation studies of health-related stigma reduction interventions in LMICs and critically assess the reporting of implementation outcomes and intervention descriptions. METHODS PubMed, CINAHL, PsycINFO, and EMBASE were searched for evaluations of stigma reduction interventions in LMICs reporting at least one implementation outcome. Study- and intervention-level characteristics were abstracted. The quality of reporting of implementation outcomes was assessed using a five-item rubric, and the comprehensiveness of intervention description and specification was assessed using the 12-item Template for Intervention Description and Replication (TIDieR). RESULTS A total of 35 eligible studies published between 2003 and 2017 were identified; of these, 20 (57%) used qualitative methods, 32 (91%) were type 1 hybrid effectiveness-implementation studies, and 29 (83%) were evaluations of once-off or pilot implementations. No studies adopted a formal theoretical framework for implementation research. Acceptability (20, 57%) and feasibility (14, 40%) were the most frequently reported implementation outcomes. The quality of reporting of implementation outcomes was low. The 35 studies evaluated 29 different interventions, of which 18 (62%) were implemented across sub-Saharan Africa, 20 (69%) focused on stigma related to HIV/AIDS, and 28 (97%) used information or education to reduce stigma. Intervention specification and description was uneven. CONCLUSION Implementation science could support the dissemination of stigma reduction interventions in LMICs, though usage to date has been limited. Theoretical frameworks and validated measures have not been used, key implementation outcomes like cost and sustainability have rarely been assessed, and intervention processes have not been presented in detail. Adapted frameworks, new measures, and increased LMIC-based implementation research capacity could promote the rigor of future stigma implementation research, helping the field deliver on the promise of stigma reduction interventions worldwide.
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Affiliation(s)
| | - Brooke A. Jarrett
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD USA
| | - Churl-Su Kwon
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, NY USA
| | - Lanxin Song
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD USA
| | - Nathalie Jetté
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York City, NY USA
| | - Jaime C. Sapag
- Departments of Public Health and Family Medicine, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada
- Office of Transformative Global Health, Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON Canada
| | - Judith Bass
- Department of Mental Health, Johns Hopkins University, Baltimore, MD USA
| | - Laura Murray
- Department of Mental Health, Johns Hopkins University, Baltimore, MD USA
| | - Deepa Rao
- Department of Global Health, University of Washington, Seattle, WA USA
| | - Stefan Baral
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD USA
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Orozco-Olvera V, Shen F, Cluver L. The effectiveness of using entertainment education narratives to promote safer sexual behaviors of youth: A meta-analysis, 1985-2017. PLoS One 2019; 14:e0209969. [PMID: 30753185 PMCID: PMC6372167 DOI: 10.1371/journal.pone.0209969] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 12/16/2018] [Indexed: 11/22/2022] Open
Abstract
Background Risky sexual behaviors are associated with the transmission of sexually transmitted infections (STIs) and unwanted pregnancies, both major health concerns for youth worldwide. This review studies the effectiveness of narrated mass media programs in promoting safer sexual practices among youth in developed and developing countries. Methods Electronic and manual searches were conducted to identify experimental and quasi-experimental studies with robust counterfactual designs published between 1985 and the first quarter of 2017. Effect sizes were meta-analyzed using mixed-effects models. Results Eight experimental and two quasi-experimental studies met our inclusion criteria. The aggregated sample size was 23,476 participants, with a median of 902 participants per study. Entertainment education narratives had small but significant effects for three sexual behaviors. It reduced the number of sexual partners [standardized mean difference, (SMD) = 0.17, 95% confidence interval (CI) = 0.02–0.33, three effect sizes], reduced unprotected sex (SMD = 0.08, 95% CI = 0.03–0.12, nine effect sizes), and increased testing and management for STIs (SMD = 0.29, 95% CI = 0.11–0.46, two effect sizes). The interventions were not effective in reducing inter-generational sex, measured through the age-gap with sexual partners (SMD = 0.06, 95% CI = -0.06–0.19, four effect sizes). Entertainment education had medium-size effects on knowledge outcomes (SMD = 0.67, 95% CI = 0.32–1.02, seven effect sizes), where a time-decay relationship is observed. No effects were found on attitudes. Conclusion Although mass media entertainment had small effects in promoting safer sexual practices, its economies of scales over face-to-face interventions suggest its potential to be a cost-effective tool above an audience threshold. The use of study participants from the general youth population and the use of mostly effectiveness trials mitigate concerns regarding its scalability. The overall paucity of high-quality studies affirms the need for strengthening the evidence base of entertainment education. Future research should be undertaken to understand the moderator effects for different subgroups and intervention characteristics.
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Affiliation(s)
- Victor Orozco-Olvera
- Development Research Group, The World Bank, Washington DC, United States of America
- * E-mail:
| | - Fuyuan Shen
- Bellisario College of Communications, The Pennsylvania State University, State College, Pennsylvania, United States of America
| | - Lucie Cluver
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
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Thapa S, Hannes K, Cargo M, Buve A, Peters S, Dauphin S, Mathei C. Stigma reduction in relation to HIV test uptake in low- and middle-income countries: a realist review. BMC Public Health 2018; 18:1277. [PMID: 30453923 PMCID: PMC6245520 DOI: 10.1186/s12889-018-6156-4] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 10/26/2018] [Indexed: 11/20/2022] Open
Abstract
Background This realist review was conducted to understand how stigma is reduced in relation to HIV test uptake in low- and middle-income countries (LMICs). Methods A systematic search of eight databases resulted in 34 articles considered for synthesis. Data synthesis was guided by a preliminary programme theory and included coding the meaning units to develop themes or intervention pathways that corresponded to context-mechanism-outcome configurations. Results We found that the interventions produced an effect through two pathways: (a) knowledge leads to changes in stigmatizing attitudes and increases in HIV test uptake and (b) knowledge and attitudes lead to changes in stigmatizing behaviours and lead to HIV test uptake. We also found one competing pathway that illustrated the direct impact of knowledge on HIV test uptake without changing stigmatizing attitudes and behaviour. The identified pathways were found to be influenced by some structural factors (e.g., anti-homosexuality laws, country-specific HIV testing programmes and policies), community factors (e.g., traditional beliefs and practices, sexual taboos and prevalence of intimate partner violence) and target-population characteristics (e.g., age, income and urban-rural residence). Conclusions The pathways and underlying mechanisms support the adaptation of intervention strategies in terms of social context and the target population in LMICs.
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Affiliation(s)
- Subash Thapa
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, 5000, Denmark.
| | - Karin Hannes
- Social Research Methodology Group, Faculty of Social Sciences, KU Leuven, Parkstraat 45, 3000, Leuven, Belgium
| | - Margaret Cargo
- Health Research Institute, University of Canberra, University Drive, 22-B17, Bruce, ACT, 2601, Australia
| | - Anne Buve
- Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Sanne Peters
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Stephanie Dauphin
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Catharina Mathei
- Department of Public Health and Primary care, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
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Perrier MJ, Martin Ginis KA. Narrative interventions for health screening behaviours: A systematic review. J Health Psychol 2017; 22:375-393. [PMID: 26359288 DOI: 10.1177/1359105315603463] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Health information can be presented in different formats, such as a statistically-based or a story-based (e.g. narrative) format; however, there is no consensus on the ideal way to present screening information. This systematic review summarizes the literature pertaining to narrative interventions' efficacy at changing screening behaviour and its determinants. Five psychology and public health databases were searched; 19 studies, 18 focused on cancer and 1 on sexual health, met eligibility criteria. There is consistent evidence supporting the efficacy of narratives, but mixed evidence supporting an advantage for narratives over statistical interventions for screening behaviour and its determinants. Further investigation is warranted.
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Houghton F, Toms J, Meratnia G, Loney K, Hopkins E, Del Monte K. Concerns With Entertainment-Education: Zombie Pandemic Preparedness and the Unanticipated Promotion of a Weapons Culture. HEALTH EDUCATION & BEHAVIOR 2016; 44:519-523. [PMID: 27837014 DOI: 10.1177/1090198116677280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Entertainment-education has proved to be an engaging medium through which to explore health and social issues in populations. Given the popularity of the zombie theme in popular culture it is no surprise therefore that the Centers for Disease Control and Prevention adopted this theme in an effort to engage youth and young adults in emergency preparedness. However, an earlier observational study involving elementary school children based on this premise raised concerns that it may have unexpectedly promoted a focus on firearms. A randomized control study involving 89 children (average age 10.4 years) was therefore conducted to explore this possibility in more depth. One group was exposed to a natural disaster scenario, while the other group was exposed to the zombie pandemic theme. When subsequently asked to prepare emergency kit lists, participants in the zombie themed scenario were 15.84 times as likely to include firearms in their lists compared with participants who were exposed to the natural disaster scenario. Although the sample size in this study was small, it is suggested that future interventions using entertainment-education need to explore all aspects of the messages implicit in their chosen medium, rather than just focusing on one element.
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Affiliation(s)
| | - Jeremy Toms
- 1 Eastern Washington University, Spokane, WA, USA
| | | | - Krista Loney
- 1 Eastern Washington University, Spokane, WA, USA
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Sunguya BF, Munisamy M, Pongpanich S, Yasuoka J, Jimba M. Ability of HIV Advocacy to Modify Behavioral Norms and Treatment Impact: A Systematic Review. Am J Public Health 2016; 106:e1-8. [PMID: 27310343 PMCID: PMC4940638 DOI: 10.2105/ajph.2016.303179] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND HIV advocacy programs are partly responsible for the global community's success in reducing the burden of HIV. The rising wave of the global burden of noncommunicable diseases (NCDs) has prompted the World Health Organization to espouse NCD advocacy efforts as a possible preventive strategy. HIV and NCDs share some similarities in their chronicity and risky behaviors, which are their associated etiology. Therefore, pooled evidence on the effectiveness of HIV advocacy programs and ideas shared could be replicated and applied during the conceptualization of NCD advocacy programs. Such evidence, however, has not been systematically reviewed to address the effectiveness of HIV advocacy programs, particularly programs that aimed at changing public behaviors deemed as risk factors. OBJECTIVES To determine the effectiveness of HIV advocacy programs and draw lessons from those that are effective to strengthen future noncommunicable disease advocacy programs. SEARCH METHODS We searched for evidence regarding the effectiveness of HIV advocacy programs in medical databases: PubMed, The Cumulative Index to Nursing and Allied Health Literature Plus, Educational Resources and Information Center, and Web of Science, with articles dated from 1994 to 2014. Search criteria. The review protocol was registered before this review. The inclusion criteria were studies on advocacy programs or interventions. We selected studies with the following designs: randomized controlled design studies, pre-post intervention studies, cohorts and other longitudinal studies, quasi-experimental design studies, and cross-sectional studies that reported changes in outcome variables of interest following advocacy programs. We constructed Boolean search terms and used them in PubMed as well as other databases, in line with a population, intervention, comparator, and outcome question. The flow of evidence search and reporting followed the standard Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. DATA COLLECTION AND ANALYSIS We selected 2 outcome variables (i.e., changing social norms and a change in impact) out of 6 key outcomes of advocacy interventions. We assessed the risk of bias for all selected studies by using the Cochrane risk-of-bias tool for randomized studies and using the Risk of Bias for Nonrandomized Observational Studies for observational studies. We did not grade the collective quality of evidence because of differences between the studies, with regard to methods, study designs, and context. Moreover, we could not carry out meta-analyses because of heterogeneity and the diverse study designs; thus, we used a narrative synthesis to report the findings. MAIN RESULTS A total of 25 studies were eligible, of the 1463 studies retrieved from selected databases. Twenty-two of the studies indicated a shift in social norms as a result of HIV advocacy programs, and 3 indicated a change in impact. We drew 6 lessons from these programs that may be useful for noncommunicable disease advocacy: (1) involving at-risk populations in advocacy programs, (2) working with laypersons and community members, (3) working with peer advocates and activists, (4) targeting specific age groups and asking support from celebrities, (5) targeting several, but specific, risk factors, and (6) using an evidence-based approach through formative research. Author conclusions. HIV advocacy programs have been effective in shifting social norms and facilitating a change in impact. PUBLIC HEALTH IMPLICATIONS The lessons learned from these effective programs could be used to improve the design and implementation of future noncommunicable disease advocacy programs.
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Affiliation(s)
- Bruno F Sunguya
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Murallitharan Munisamy
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Sathirakorn Pongpanich
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Junko Yasuoka
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
| | - Masamine Jimba
- Bruno F. Sunguya is with the School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences in Dar es Salaam, Tanzania, and the Department of Community and Global Health, The University of Tokyo, Japan. Murallitharan Munisamy is with the College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand, and the London School of Hygiene and Tropical Medicine and the London School of Economics and Political Sciences, London, England. Sathirakorn Pongpanich is with the College of Public Health Sciences, Chulalongkorn University. Junko Yasuoka and Masamine Jimba are with the Department of Community and Global Health at the University of Tokyo
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Reinsma K, Bolima N, Fonteh F, Okwen P, Siapco G, Yota D, Montgomery S. Bobbi Be Best: the development and evaluation of an audio program and discussion guide to promote exclusive breastfeeding in Cameroon, Central Africa. Glob Health Promot 2015; 23:14-26. [PMID: 25564250 DOI: 10.1177/1757975914556786] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Accepted: 09/01/2014] [Indexed: 11/15/2022]
Abstract
One risk factor for infant and childhood morbidity is not exclusive breastfeeding (EBF) during the first six months of life. Entertainment Education (EE) is a communication strategy consisting of placing educational information into television, movies, and radio programs. In developing countries this form of behavioral change communication has proven effective in addressing health-related issues; however, no research has determined if EE is effective in promoting EBF. The objective of this research was to develop an EE audio program and discussion guide and to determine if a series of four 15-minute episodes and post-listening discussion improved knowledge, perceived benefits, self-efficacy, and intention and decreased misconceptions and perceived barriers toward EBF in the Kumbo West Health District, Cameroon. Pregnant women and their partners were assigned to either the control group (N = 116; 74 women, 42 partners) or intervention group (N = 148; 99 women, 49 partners) based on expected date of delivery. All control and intervention group participants completed a questionnaire prior to listening to the first and after the last episode. Pre- and post-listening questionnaires were used to determine changes in the EBF knowledge, misconceptions, perceived barriers, self-efficacy, and intention variables as a result of exposure to the audio program. The Wilcoxon Sign Rank test showed significant improvement in all of the variables, except perceived barriers, within the intervention group (p < 0.05) and the Mann-Whitney test indicated significant differences between the control and intervention group in all of the variables (p < 0.05), indicating that using an audio program and discussion guide based on the EE model is an effective tool for promoting EBF in this setting. The strength of this approach is that it goes beyond simply telling women about what constitutes EBF, but addresses misconceptions and perceived barriers that may prevent women from practicing EBF for six months.
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Affiliation(s)
- Kathryn Reinsma
- School of Health Sciences, Liberty University, USA Cameroon Baptist Convention Health Services, Cameroon
| | - Nancy Bolima
- National Coordinator for Health Education and Development Consultancy Services, Bamenda, Cameroon
| | - Florence Fonteh
- Department of Biomedical Sciences, University of Dschang, Cameroon
| | - Patrick Okwen
- Northwest Special Fund for Health, Bamenda, Cameroon
| | - Gina Siapco
- Nutrition Department, School of Public Health, Loma Linda University, USA
| | - Daniel Yota
- Kumbo West Health District Medical Officer, Cameroon
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Jaganath D, Mulenga C, Hoffman RM, Hamilton J, Boneh G. This is My Story: participatory performance for HIV and AIDS education at the University of Malawi. HEALTH EDUCATION RESEARCH 2014; 29:554-565. [PMID: 24047713 PMCID: PMC4155417 DOI: 10.1093/her/cyt074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 06/10/2013] [Indexed: 06/02/2023]
Abstract
University students represent a subset of young men and women at risk for HIV in high prevalence settings. Innovative programs are needed to raise awareness on the unique issues around HIV and AIDS in the university campus, while training student leaders for peer-based education. The Process and Collaboration for Empowerment and Discussion (PACED) method engages artists and people living with HIV and AIDS (PLWHA) to create a performance that encourages community dialog about HIV and AIDS and empowers PLWHA. 'This is My Story' was a program at the University of Malawi, Chancellor College, which adapted the PACED approach for university students. A qualitative evaluation conducted 1 year later among students and PLWHA participants and audience members demonstrated retention of the following themes: (i) trust in a relationship and how it affects women,(ii) equality for PLWHA and (iii) life after HIV and AIDS. All of the PLWHA and 90.9% of student participants reported a greater sense of empowerment. Of the audience members, 82.1% discussed the performance with friends and family. We thus present the PACED approach as a valuable tool in HIV and AIDS education and prevention among university students in Malawi.
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Affiliation(s)
- D Jaganath
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Program in Global Health, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA and Department of Fine and Performing Arts, Chancellor College, University of Malawi, Zomba, Malawi
| | - C Mulenga
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Program in Global Health, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA and Department of Fine and Performing Arts, Chancellor College, University of Malawi, Zomba, Malawi
| | - R M Hoffman
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Program in Global Health, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA and Department of Fine and Performing Arts, Chancellor College, University of Malawi, Zomba, Malawi
| | - J Hamilton
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Program in Global Health, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA and Department of Fine and Performing Arts, Chancellor College, University of Malawi, Zomba, Malawi
| | - G Boneh
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Program in Global Health, Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA and Department of Fine and Performing Arts, Chancellor College, University of Malawi, Zomba, Malawi
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20
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Bekalu MA, Eggermont S. Aligning HIV/AIDS communication with the oral tradition of Africans: a theory-based content analysis of songs' potential in prevention efforts. HEALTH COMMUNICATION 2014; 30:441-450. [PMID: 24945716 DOI: 10.1080/10410236.2013.867004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Despite a growing recognition of songs as a useful HIV/AIDS campaign strategy, little research has investigated their potential and/or actual impact. In this study, through a theory-based content analysis, we have assessed the prevention domains covered and the health-relevant constructs promoted by 23 AIDS songs widely used to aid prevention efforts in Ethiopia. To identify the health-relevant constructs and reveal their potential to facilitate or inhibit positive changes, the Extended Parallel Process Model (EPPM) has been used. The findings revealed that the songs cover most of the prevention domains that constitute the current agenda of behavior change communication in Sub-Saharan Africa. However, although all the EPPM variables have been found in almost every song, there were significantly more efficacy messages than threat messages. This suggests that although the songs may lead to positive changes in HIV/AIDS-related outcomes among audiences who have already perceived the threat posed by HIV/AIDS, they are less likely to motivate and thereby generate responses from audiences who have less or no threat perceptions. It is argued that given their potential as a culturally appropriate strategy in Sub-Saharan Africa where oral channels of communication play significant roles, songs could be harnessed for better outcomes through a theory-based design.
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Affiliation(s)
- Mesfin Awoke Bekalu
- a Leuven School for Mass Communication Research , Katholieke Universiteit Leuven
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21
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Huebner DM, Rullo JE, Thoma BC, McGarrity LA, Mackenzie J. Piloting Lead with Love: a film-based intervention to improve parents' responses to their lesbian, gay, and bisexual children. J Prim Prev 2014; 34:359-69. [PMID: 23943135 DOI: 10.1007/s10935-013-0319-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Lesbian, gay, and bisexual youth are at increased risk for a variety of poor health outcomes, relative to their heterosexual counterparts, and recent research implicates family responses to a child's sexual orientation as an important predictor of these health difficulties. Lead with Love is a 35-min documentary-style preventive intervention created to improve parents' behaviors toward their lesbian, gay, and bisexual (LGB) children, by providing parents with support, information, and concrete behavioral guidance. The film was made available free online, and was promoted widely with a multi-media marketing campaign. In this paper we describe the theoretical and empirical rationale for the intervention, and report findings from pilot data collected in the first year after the film's release. Specifically, we gathered data to examine the feasibility of reaching parents of LGB youth with this intervention, to determine whether it was acceptable, and to provide preliminary indicators of its potential efficacy. In the first 12 months after launch, 10,949 individuals viewed the film online. The film successfully reached parents of LGB youth (n=1,865), including the hardest to reach parents: 21% had only learned about their child's sexual orientation in the past month, 36% reported having an LGB child was "very" or "extremely" hard for them, and 86% had never obtained any other formal support for having an LGB child. Parents who completed a follow-up assessment immediately after the film reported significant pre- to post-film increases in self-efficacy for parenting an LGB child.
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Affiliation(s)
- David M Huebner
- Department of Psychology, University of Utah, 380 South 1530 East, Room 502, Salt Lake City, UT, 84122, USA,
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Munene E. Drumming away HIV/AIDS: Burundian drummers in Utah take HIV prevention to another level. Am J Public Health 2012; 103:250. [PMID: 23237158 DOI: 10.2105/ajph.2012.300907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Esther Munene
- Public Health Informatics Office, Utah Department of Health, Salt Lake City, UT 84114, USA.
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Nabi RL, Thomas J. The effects of reality-based television programming on diet and exercise motivation and self-efficacy in young adults. HEALTH COMMUNICATION 2012; 28:699-708. [PMID: 23046177 DOI: 10.1080/10410236.2012.711510] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Grounded in social cognitive theory, this research examines the effects of reality entertainment programming and embedded commercials on viewers' perceived motivations and efficacy to exercise and consume a healthy diet as well as on food preference. In a 3 (program type) × 2 (advertisement type) study design, 253 female undergraduates were randomly assigned to watch an episode of a health-oriented reality program, a non-heath-oriented reality program, or a health-themed sitcom in which commercials for either healthy or unhealthy foods were embedded. Results indicated that perceived realism of the health-oriented reality program generated greater confidence to eat more healthily and exercise, as well as greater motivation to exercise. Additionally, program viewing differentially affected motivations to eat healthily and to exercise, but only when type of advertisement (high vs. low calorie food ads) was taken into consideration. Finally, women who watched the health-oriented reality program were more likely to choose a healthy snack at the conclusion of the experiment than those exposed to other programs, thus supporting the assertion that reality programming may potentiate positive health behaviors. The role of the embedded advertisements in altering the interpretation and health impact of the programming is also discussed.
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Affiliation(s)
- Robin L Nabi
- a Department of Communication , University of California , Santa Barbara
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Bekalu MA, Eggermont S. Advancing HIV/AIDS Combination Prevention through mass media: a review of practices in sub-Saharan Africa. INFORMATION DEVELOPMENT 2012. [DOI: 10.1177/0266666911433156] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This paper presents an assessment of the literature on the use of mass media campaigns to advance biomedical, structural and behavioural approaches to HIV/AIDS prevention in sub-Saharan Africa over the past decade (2000–2010). Studies on the use of mass media in HIV/AIDS prevention efforts were searched from two main electronic databases – Web of Science and PubMed. Studies meeting selection criteria were examined for the themes of the mass media programs studied in a content analytic approach. The findings suggest that while there are several biomedical and structural issues which the mass media could well have been instrumental for, their utilization in sub-Saharan Africa seems to be limited to behavioural interventions. It is concluded that at a time when recommendations for Combination Prevention are prevailing, the utilization of the mass media largely limited to a certain domain of HIV/AIDS prevention appears to be worthy of attention.
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Gray N, Oré de Boehm C, Farnsworth A, Wolf D. Integration of creative expression into community-based participatory research and health promotion with Native Americans. FAMILY & COMMUNITY HEALTH 2010; 33:186-192. [PMID: 20531099 PMCID: PMC2902194 DOI: 10.1097/fch.0b013e3181e4bbc6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Involvement in creative expression has the potential of engaging individuals in personal- and community-level change through reflection, empowerment, and the facilitation of connectedness. It is a process that can be a powerful component of community-based participatory research, as it can facilitate and support the principles of co-learning, egalitarian relationships, and respect for nonacademic knowledge. It is also a valuable means of appreciating culture and strengthening identity, which enhances health. This article reviews and discusses methods and benefits of incorporating creative expression into health promotion programs and community-based participatory research with Native Americans.
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Affiliation(s)
- Norma Gray
- University of Arizona Mel & Enid Zuckerman College of Public Health; Tucson, AZ
| | | | - Angela Farnsworth
- University of Arizona Mel & Enid Zuckerman College of Public Health; Tucson, AZ
| | - Denise Wolf
- North Public Health Center, King County Department of Public Health; Seattle, WA
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