Latin America and the Caribbean Code Against Cancer 1st edition: Building capacity on cancer prevention to primary healthcare professionals

INTRODUCTION

Every year 1.5 million new cancer cases are diagnosed in Latin America and the Caribbean (LAC). Of these, about 40 % could be prevented. Health illiteracy has been identified as a main barrier for cancer prevention. Primary healthcare professionals (HCP) are key in cancer prevention as they are the first entry point of the population into the healthcare system. The LAC Code Against Cancer 1st edition aims to improve health literacy and awareness of cancer prevention in the LAC population, through building capacity of primary HCP.

METHODS

The definition and development of the learning objectives, curriculum, structure, and evaluation of an online learning program for primary HCP was led by a dedicated group of experts from the LAC Code Against Cancer project. A pedagogical guideline and a template to ensure harmonization across topics were produced to guide the program development. Two rounds of internal revisions and an editorial process were performed.

RESULTS

An online competency-based microlearning program for primary HCP was produced, taking the LAC Code Against Cancer as a basis. The competences addressed in the curriculum are core knowledge, communication skills, decision-making and applying knowledge to real-world situations. A comprehensive evaluation to assess acquisition of these competences, based on the Miller's Pyramid, was designed with three data collection points: a) immediately before, to assess baseline knowledge and skills; b) immediately after, to determine acquired competences; and c) at 3-6 months follow-up, to assess performance in daily practice. The e-learning will be freely available in the Virtual Campus for Public Health of the Pan American Health Organization in Spanish, English, and Portuguese.

CONCLUSION

Primary HCP, perceived as trustworthy sources of information, are key actors to increase the population's awareness and literacy on cancer prevention. Building capacity of these professionals has the potential to increase dissemination and impact of the LAC Code Against Cancer by prompting communication with the public and offering personalized actionable preventive messages through counselling.

Latin America and the Caribbean Code Against Cancer 1st edition: Formative research on the comprehension and persuasiveness of the recommendations by the general population

BACKGROUND

Cancer prevention is the most efficient and cost-effective strategy in cancer control. One prevention strategy is giving credible, clear, and evidence-based recommendations to the individual; however, it is key that these messages are accepted and understood properly by the public. This study aimed to pilot the draft recommendations developed as part of the Latin America and the Caribbean (LAC) Code Against Cancer 1st edition, in terms of comprehension and persuasion of each message.

METHODS

A mixed method two-wave study, in which two versions of the messages were presented to the general population in five LAC countries. We used an ad-hoc questionnaire and interviews that followed the cognitive-pretesting methodology.

RESULTS

Findings suggest that the messages were generally well understood, especially in Spanish speaking countries, and that the messages were generally more understandable than persuasive. We adapted and revised the recommendations based on the findings of the first Wave and held a second iteration in the Spanish speaking countries. We observed a better understanding of most messages in Wave 2.

CONCLUSION

The LAC Code Against Cancer is a valuable tool of well understood messages for the public, with concrete actions everyone can take to prevent cancer. Further research should assess particularities of the region for further efficient dissemination of these important health messages, identify key messages for certain population groups and future interventions that strengthen health literacy in rural and less educated populations to increase behavior change.

Political quarrel overshadows vaccination advocacy: How the vaccine debate on Brazilian Twitter was framed by anti-vaxxers during Bolsonaro administration

Despite Brazil's tradition of successful mass immunization programs, the country has been experiencing alarming declines in vaccination coverage, especially among children. That is aggravated by the growth of anti-vaccine movements and the spread of health misinformation in social media in the last decade, which have worsened during the COVID-19 outbreak. Several reports link populism and far-right politicians to anti-vaccination support worldwide, which was also the case in Brazil during president Jair Bolsonaro's administration. This project aimed to identify the circulating pro and anti-vaccine narratives in Portuguese on Twitter, during a crucial decision-making period regarding childhood vaccination in Brazil, from December 9, 2021, until February 9, 2022. From the over one million tweets and four million retweets collected, we identified two well-defined groups, one in favor and another against vaccination. Within the sample, we selected 1500 influencer tweets with the highest impact (>500 retweets) and conducted content analysis. Although the pro-vaccine influencers were more retweeted than anti-vaxxer ones, we observed that anti-vaccine movements were more succesful in framing discussions on Twitter. The subject of COVID-19 was the target of political polarization embedded in populist, anti-science and anti-traditional media discourses promoted by anti-vaxxers. As a counterpart, the pro-vaccine influencers reacted inarticulately, focusing on criticizing the anti-vaccination actors, attitudes, and policies instead of promoting vaccines. Based on reults, we claim that a well-coordinated network of health communicators from science centers and health institutions, in partnership with properly briefed social media influencers and fact-checking sources, would more efectively pre-tempt the public about vaccine misinformation.

Misinformation on social networks during the novel coronavirus pandemic: a quali-quantitative case study of Brazil

BACKGROUND

One of the challenges posed by the novel coronavirus pandemic is the infodemic risk, that is, a huge amount of information being published on the topic, along with misinformation and rumours; with social media, this phenomenon is amplified, and it goes faster and further. Around 100 million people in Brazil (50% of the inhabitants) are users of social media networks - almost half of the country's population. Most of the information on the Internet is unregulated, and its quality remains questionable.

METHODS

In this study, we examine the main characteristics of misinformation published on the topic. We analysed 232 pieces of misinformation published by the Brazilian fact-checking service "Agência Lupa". The following aspects of each news item were analysed: a) In what social media has it circulated?; b) What is the content classification, sentiment and type of misinformation?; d) Are there recurrent themes in the sample studied?

RESULTS

Most were published on Facebook (76%), followed by WhatsApp, with 10% of total cases. Half of the stories (47%) are classified as "real-life", that is, the focus is on everyday situations, or circumstances involving people. Regarding the type of misinformation, there is a preponderance of fabricated content, with 53% of total, followed by false context (34%) and misleading content (13%). Wrong information was mostly published in text format (47%). We found that 92.9% of misinformation classified as "fabricated content" are "health tips", and 88.9% of "virtual scams" are also fabricated.

CONCLUSION

Brazilian media and science communicators must understand the main characteristics of misinformation in social media about COVID-19, so that they can develop attractive, up-to-date and evidence-based content that helps to increase health literacy and counteract the spread of false information.

Spreading Ideas: TED Talks' Role in Cancer Communication and Public Engagement

Technology, Entertainment, Design (TED) Talks have represented a broad source of health communication since 1984. However, to date, no studies exist on how this tool addresses the question of cancer. In this paper, we aim to illuminate two major issues: (1) Are TED Talks a good source for cancer communication? (2) How does the public respond to cancer-related TED Talk lectures? To this end, we searched for the keyword 'cancer' on the TED.com website in January 2018. All transcripts were obtained along with related information such as numbers of views, like and dislike rates. We also analysed a sample of 938 comments, corresponding to the 10 most relevant (if existing) regarding each video on TED.com and YouTube platforms. From the 49 videos pertaining to cancer, 33 were scientific-related, whereas 11 focused on speakers' personal experiences. Only three videos approached prevention themes of major relevance for cancer communication to broad audiences. Instead, they brought more therapy (16) and diagnosis (12) issues and often promoted exaggerated extrapolations of research results (20). Scientific lectures also made frequent use of a 'bad vs. good' duality discourse by criticizing current science/policies and then offering a solution/hope. Regarding the public response, non-scientific lectures had more negative votes than scientific counterparts. Moreover, the audience exhibited two major motivations to provide a comment: to judge the lectures and to share personal stories. We believe that our observations are of considerable relevance for helping in enhancing this tool as a substantial cancer communication source.

Communities of practice on WhatsApp: A tool for promoting citizenship among students with visual impairments

Visual impairments (VIs) impose many barriers to people when it comes to information access, and educational processes may offer tools for people to overcome these barriers and, consequently, develop autonomy and an active sense of citizenship. In these processes, information and communication technologies (ICTs) improve accessibility. Our aim was to use ICT, especially social media, in pedagogical activities developed for students with VI (blindness and low vision). Focus group interviews about technology use showed us that these students are heavy users of WhatsApp, an instant messenger app. We then established an online discussion group, as a community of practice, using WhatsApp as a discussion environment. This online group helped Brazilian students with VI develop social skills and discuss health issues they considered important to them.

Imprensa versus Opinião Pública: o Câncer na Capa de Cinco Jornais Brasileiros

Introdução: O câncer é uma das doenças mais temidas da atualidade. Pesquisa realizada pelo Instituto Nacional de Câncer José Alencar Gomes da Silva mostrou que o brasileiro associa câncer à dor e a sofrimento. A Organização Mundial da Saúde afirma que as chances de cura são elevadas, se houver um diagnóstico precoce. Nesse sentido, a imprensa pode desempenhar um papel importante, pois contribui na formação de opiniões e atitudes. Objetivo: Este trabalho objetiva investigar como cinco jornais do Brasil divulgam a temática “câncer” em suas primeiras páginas. Método: Esta é uma pesquisa de caráter descritivo-exploratória e foi desenvolvida apoiada no paradigma quanti-qualitativo. Foram analisadas 45 notícias que contêm o termo câncer e apresentam chamadas na primeira página de cinco jornais brasileiros, entre janeiro e julho de 2010. Essas reportagens foram agrupadas em referência mínima e foco em câncer. Desenvolveu-se uma avaliação de caráter otimista/neutro/pessimista do câncer em todas as reportagens estudadas, a partir do estudo de palavras-chave. Resultados: 17,77% das reportagens apresentavam caráter otimista, 66,66% eram neutras e 15,55%, negativas. Das reportagens que fazem referência mínima à doença, 81,5% têm caráter neutro ou otimista; e, entre aquelas sobre câncer, 88% têm caráter neutro ou otimista. Conclusão: A maior parte dessas reportagens possui um enfoque que contrasta com a visão negativa predominante na população. Políticas de saúde pública devem estar atreladas a uma cobertura pela imprensa mais ampla e regular sobre a doença.

How to Optimize Health Messages About Cancer on Facebook: Mixed-Methods Study

BACKGROUND

Incidence rate of cancer is increasing worldwide, with longer life expectancy being one of the main causes. Yet, between 30% and 50% of cancer cases are preventable, and early detection contributes to a better prognosis. This makes health communication strategies essential. Facebook, the world's most used social networking site in 2017 and 2018, can be a useful tool for disseminating powerful messages on health promotion, prevention, and early detection.

OBJECTIVE

We aimed to (1) offer ways of optimizing health messages about cancer on Facebook, focusing on topics, such as risk factors, prevention, treatment, early diagnosis, and cure, and (2) investigate which aspects of these messages generate greater engagement.

METHODS

To verify what generates greater engagement in topics related to cancer on Facebook, we analyzed 16 Brazilian pages with the main theme of cancer. We performed a manual analysis of texts, content, and engagement rates. Finally, we developed a software program to operationalize the analysis of Facebook posts. The tool we devised aims to automate the analysis of any Facebook page with cancer as the main theme.

RESULTS

We analyzed 712 posts over a 1-month period. We divided the posts into the following 8 categories: "Testimonies or real-life stories," "Solidarity," "Anniversaries," "Science and health," "Events," "Institutional," "Risk factors," and "Beauty." The pages were also organized into groups according to the type of profile to which they belonged (ie, hospitals or foundations, informative, nongovernmental organizations, and personal pages).The results showed that the categories generating greater engagement in Brazil were not those with the highest percentage of cancer-related content. For instance, in the "Informative" group the "Testimonies or real-life stories" category generated an engagement of 79.5%. However, only 9.5% (25/261) of the content within the relevant time period dealt with such topics. Another example concerns the category "Science and health." Despite being the one with the highest number of posts (129/261, 49.4%), it scored 5th in terms of engagement. This investigation served as the basis for the development of a tool designed to automate the analysis of Facebook pages. The list of categories and keywords generated by this analysis was employed to feed the system, which was then able to categorize posts appearing on a Facebook page. We tested the system on 163 posts and only 34 were classified incorrectly, which amounts to a 20.8% error rate (79.2% accuracy).

CONCLUSIONS

The analysis we conducted by categorizing posts and calculating engagement rates shows that the potential of Facebook pages is often underutilized. This occurs because the categories that generate the greatest engagement are often not those most frequently used. The software developed in this research may help administrators of cancer-related pages analyze their posts more easily and increase public interest as a result.

Beyond the Drama: the Beautiful Life in News Feeds on Cancer

Facebook is one of the main communication tools in the world nowadays. In Brazil, it is used for almost half of the population. Knowing what is conveyed about cancer by this social network can be an important step for the development of efficient health communication strategies. We evaluate Facebook user's comments on pages about cancer; verify if there is a pattern of public awareness on the disease and compare it with results from other studies. Three pages about cancer on Facebook were selected among those with more followers in Brazil. For 6 months, from January to June 2014, all posts were selected and evaluated, and we created eight categories. On each page, the categories that generated most comments were elected for the second analysis. The behavior of empowered citizens by new communication tools is the target of this study. Similarities and differences between 12,926 comments coming from 1243 posts in three different Facebook pages on cancer were analyzed. Four new categories were identified: "religion," "positive," "negative," and "information." Despite the differences among the three pages selected for this study, we observed the predominance of positive speeches associated with religious terms. Following public perceptions on cancer is an important step for the development of efficient health communication strategies.

Teenagers with visual impairment and new media: A world without barriers

Mobile communication technology is an essential part of life of adolescents nowadays, and those with visual impairments are no exception. In focus group interviews with students from a school for the blind and the visually impaired in Rio de Janeiro, Brazil, we found that, despite the visual nature of social media, they use and enjoy these resources as much as their sighted peers. These students are aware of the possibilities and constraints that social media might bring to them but, with the help of assistive technology, make the most of it. After listening to their voices, we noticed that it is high time we incorporate social media in our pedagogical practice, in order to develop their learning process and life skills.

Voices About a Stigma: Cancer in the Opinion of Three Different Segments in Brazilian Society

The viewpoints of Brazilian opinion leaders regarding cancer are not yet well defined. Examining public perceptions of three segments of society through a qualitative study may provide clues to understanding the negative view that the population still has about the disease. Journalists, scientists and teachers participated in discussions in six focus group sessions. The findings were studied using the content analysis method, showing similar elements among these professionals, regardless of area of operation. We identified a negative view that may be contributing to or mirroring the vision of society that associates the illness with death and suffering. Although these opinion leaders believe they are able to filter certain negative aspects of media dissemination about cancer, when the disease affects them personally, the feeling of despair resembles common sense. Words such as "cure" are viewed with prejudice. On the other hand, a morbid approach arouses interest on the subject. It was also noted that the disclosure of a celebrity with cancer stands out as a decoy in the consumption of news. Such distortions may support actions that enhance communication about cancer, structured on pillars such as prevention, early diagnosis and cure.

[Training for what? What health counselors in the Southeastern region think about the topic]

Community of Practice (CoP) is a recent term that applies to individuals who share a common goal that can range from a specific theme, a problem or a passion, whereby learning together and the feeling of belonging to the differentials of this theory can reflect positively on the acquisition of knowledge as a participatory process. This article seeks to ascertain the relevance of building a community of practice for health counselors within the policy of the Brazilian Unified Health System (SUS) to enhance popular participation. In this respect, the opinions of 108 health counselors with Internet access in the Southeast of the country were investigated. What are their views on the structure and training within the Health Councils? And what do they consider to be important in order to enhance their performance within the Councils?

“Encruzilhadas. O Jogo da sua Vida”: Desenvolvimento de Instrumento Lúdico na Prevenção ao Câncer

Introdução: Segundo o Instituto Nacional de Câncer José Alencar Gomes da Silva, cerca de 80% dos casos de câncer estão atrelados a fatores de risco extrínsecos e, de acordo com pesquisas aplicadas pelo Instituto Brasileiro de Geografia e Estatística em todo o território nacional, é alto o número de adolescentes que se expõem a esses fatores. Outros estudos mostram que os adolescentes sabem muito pouco sobre câncer e os fatores de risco mais associados ao seu desenvolvimento. Objetivo: Descrever a criação e a avaliação de um instrumento lúdico para esclarecimento dos jovens acerca da importancia da prevenção ao câncer. Método: Foi desenvolvido um livro jogo do tipo role-playing game, intitulado “Encruzilhadas. O jogo da sua vida”, e avaliada sua utilização como instrumento educacional alternativo através da aplicação da técnica de grupos focais. Resultados: O livro jogo “Encruzilhadas” contem 332 referências que narram situações comuns do dia a dia dos jovens, evidenciando os diversos momentos em que esses se expõem a fatores de risco em câncer. Para avaliar a eficácia desse instrumento, foram realizados seis grupos focais com jovens de uma escola municipal do Rio de Janeiro. Conclusão: A avaliação mostrou que o material desenvolvido e capaz de provocar o questionamento dos jovens no que diz respeito ao câncer, aos fatores de risco e aos meios de prevenção, além de facilitar o entendimento e a assimilação do conteúdo apresentado.  

Perfis das Notícias sobre o Câncer no Correio da Manhã e no The New York Times nos Anos 1931-1932 e 1948-1949

Introdução: No início do século passado, o câncer já se caracterizava como uma das doenças crônico-degenerativas mais letais e começou a demandar mais atenção dos governos. Portanto, alguns países empreenderam novas medidas políticas, como o aumento de investimentos científicos em busca de uma cura. Objetivo: Este artigo procura evidenciar as características dos conteúdos das matérias jornalísticas sobre o câncer nos jornais brasileiro e norte-americano Correio da Manhã e The New York Times, nas décadas de 1930 e 1940, através da análise das notícias publicadas em quatro anos selecionados (1931, 1932, 1948 e 1949). Método: Foram realizadas pesquisas no acervo documental da Biblioteca Nacional e no acervo digital do The New York Times. Em paralelo, também foi realizada uma análise do que foi publicado sobre o tema câncer nos periódicos científicos, acessível através do portal do PubMed, durante a mesma época. Resultados: Enquanto, no Correio da Manhã, foram identificadas 56 reportagens sobre o tema no período estudado, no jornal americano, foram identificadas 540 notícias, ou seja, quantidade praticamente dez vezes superior. Conclusão: Os achados demonstram uma imprensa brasileira tímida e, por vezes ingênua, diante de promessas de curas milagrosas, como pomadas contra o câncer de pele. Enquanto isso, a mídia norte-americana priorizava abordagens sobre investimentos para a pesquisa da doença, destacava as conferências de cientistas especialistas no assunto e até o uso de experimentação animal na pesquisa do câncer; embora, em certas ocasiões, também tenha apostado em inovações científicas que a história mostrou como iniciativas infrutíferas.  

A importância da abordagem contextual no ensino de biossegurança

A biossegurança é um campo do conhecimento que insere questões voltadas para organismos geneticamente modificados e relacionadas à proteção social e ocupacional do trabalhador. O seu processo educativo visa à formação de um agente participativo-transformador e, portanto, deve ultrapassar a simples ideia da normalização. Dessa forma, é importante contextualizar a biossegurança dentro de uma estratégia de ensino construtivista com a identificação dos seus conceitos estruturantes - risco, perigo e acidente - que permitam ao indivíduo compreender como o risco é percebido na sociedade e enfocado na academia para, em seguida, agregar múltiplas competências e enfrentá-lo. Conhecer como as relações de trabalho-saúde, suas implicações e impactos vem sendo construídas ao longo do tempo, pode formar um cidadão mais crítico e preparado para participar das decisões de ordem político-social que podem influenciar o seu futuro.

Construção do conhecimento em biossegurança: uma revisão da produção acadêmica nacional na área de saúde (1989-2009)

Este artigo refere-se a uma revisão bibliográfica realizada através do portal da Biblioteca Virtual de Saúde com objetivo de identificar os artigos científicos relacionados à biossegurança, publicados em periódicos nacionais, visando a conhecer inicialmente de que forma esse tema vem sendo abordado no Brasil e como está inserido no nexo trabalho e na educação do profissional da área de saúde. Foram identificados inicialmente 126 artigos publicados durante o período de 1989 a outubro de 2009, em periódicos nacionais na área de saúde. Do total de artigos, 46 estavam relacionados diretamente à temática educação, mas apenas oito abordaram a prática educacional em biossegurança. Identificou-se também que a região Sudeste concentrou o maior número de publicação (77 artigos) acerca do tema biossegurança. Apesar da abrangência dos artigos analisados, ainda existe muito que pesquisar sobre o assunto, de forma a ampliar o debate sobre a educação profissional para o setor saúde, onde o trabalhador seja considerado como sujeito da aprendizagem, capaz de ter uma postura crítica-reflexiva do seu ambiente ocupacional.

A estruturação do Programa de Capacitação Profissional de Biossegurança no contexto do Projeto de Modernização da Gestão Científica do Instituto Oswaldo Cruz

O presente artigo apresenta as etapas de estruturação do Programa de Capacitação Profissional de Biossegurança (PCPB), em consonância com o Projeto de Modernização da Gestão Científica do Instituto Oswaldo Cruz (IOC), detalhando o ciclo planejamento-desenvolvimento-avaliação, em especial do Curso de Biossegurança em Laboratório de Pesquisa Biomédica. Inicialmente, para o ciclo diagnóstico foram aplicados questionários aos interlocutores dos laboratórios do IOC, os quais revelaram interesse de participação no PCPB para ambas as categorias profissionais (níveis médio e superior), indicando como temáticas preferenciais biossegurança e boas práticas de laboratório. Na fase de planejamento foi definido que o PCPB seria subdivido em dois projetos (Boas Práticas de Laboratório de Saúde Pública para os profissionais de nível médio e Curso de Biossegurança para Laboratórios de Pesquisa Biomédica para profissionais de nível superior). A seguir, na fase de estruturação do curso, os módulos contemplados incluíram: introdutório; riscos químico, físico e biológico; gestão da qualidade e experimentação animal. Assim, no período 2006-2008, foram capacitados 315 profissionais e realizadas avaliações segundo o modelo de David Kirkpatrick. O primeiro nível, chamado de reação, foi aferido e demonstrou que 54,03% dos profissionais declararam que o curso foi excelente; 39,59% classificaram como bom e os demais 6,38% acharam que foi regular ou não opinaram. Para a avaliação do aprendizado foram realizados, a cada módulo, pré e pós-testes. Foi verificado que todos os módulos tiveram acréscimos nas médias do pós-teste em relação ao pré-teste. Os resultados obtidos apontaram estratégias a serem seguidas no aperfeiçoamento desse modelo de educação continuada em biossegurança.

Na mira do câncer: o papel da mídia brasileira

Este estudo procura traçar um panorama sobre o tema câncer na mídia brasileira on-line e impressa. Foram analisadas 195 reportagens de 54 diferentes jornais das regiões Norte, Nordeste, Sudeste, Centro-Oeste e Sul, entre os anos 2003 e 2005. Vários aspectos foram observados durante a análise, dentre os quais foram verificados: se as produções das reportagens foram realizadas por jornalistas brasileiros ou se eram originárias de agências de notícias internacionais; quais os tumores malignos foram mais noticiados; qual o enfoque principal das matérias: prevenção, diagnóstico, tratamento, epidemiologia e/ou cura; o uso de fenômenos de linguagem como as analogias para explicar determinados processos; a seriedade no tratamento dos temas versus os erros mais freqüentes cometidos por jornalistas; e a referência a periódicos internacionais e nacionais nos estudos divulgados.