Showing papers in "Journal of Health Communication in 2002"

Factors influencing medical information seeking among African American cancer patients.

Abstract: Qualitative research methods were used to explore factors that may affect medical information seeking, treatment engagement, and emotional adjustment among African American cancer patients. Focus group findings suggest that an array of cultural and socioeconomic factors plays important roles in the behavior of African American cancer patients. Participants described a number of important barriers and facilitators of medical information seeking and treatment participation. Factors linked to the health care-related behaviors and adjustment of African American cancer patients included limited knowledge and misinformation about cancer, mistrust of the medical community, concerns about privacy, lack of insurance, religious beliefs, and emotional issues such as fear and stigma associated with seeking emotional support. Recommendations are made that may assist mental and physical health providers in improving patient information and mental and physical health outcomes of African American cancer patients.

Can we measure encoded exposure? Validation evidence from a national campaign.

Abstract: Exposure is often cited as an explanation for campaign success or failure. A lack of validation evidence for typical exposure measures, however, suggests the possibility of either misdirected measurement or incomplete conceptualization of the idea. If whether people engage campaign content in a basic, rudimentary manner is what matters when we talk about exposure, a recognition-based task should provide a useful measure of exposure, or what we might call encoded exposure, that we can validate. Data from two independent sources, the National Survey of Parents and Youth (NSPY) and purchase data from a national antidrug campaign, offer such validation. Both youth and their parents were much more likely to recognize actual campaign advertisements than to claim recognition of bogus advertisements. Also, gross rating points (GRPs) for a campaign advertisement correlated strikingly with average encoded exposure for an advertisement among both youth (r = 0.82) and their parents (r = 0.53).

Exploring antismoking ads: appeals, themes, and consequences.

Abstract: In this study we seek a descriptive understanding of antismoking television advertising in light of the problem cigarette consumption poses for society today. We establish relationships between ad characteristics and whether ads have a youth or adult orientation, based on a content analysis of 197 antismoking television advertisements produced between 1991 and 1999. The study finds that youth-oriented ads have youth characters, sociability, and humor as common appeals, and social and short-term consequences. In contrast, adult-oriented ads relied on fear appeals and long-term, health-related consequences.

Indirect exposure to a family planning mass media campaign in Nepal.

Abstract: It is often noted that some individuals become aware of a mass media program's messages through discussions with other individuals. However, the extent to which indirect exposure occurs, and its influence on behavior, are somewhat unclear. This study examines the role of indirect exposure in extending the reach of a family planning mass media campaign in Nepal. Sociometric data, gathered from nearly all women between the ages of 15 and 49 years living in six villages in Dang District, Nepal (N = 667), assessed indirect exposure to the radio program. Indirect exposure was extensive; half of all respondents were indirectly exposed to the program's messages and the overall reach of the program increased from 50% to 75% when indirect exposure was considered. Members of community groups had higher levels of direct exposure to the radio program and more extensive and diverse social networks, allowing them to serve as a conduit for these messages into the wider community. While direct exposure to the radio program appeared to influence family planning knowledge, indirect exposure was more strongly associated with contraceptive use. These findings suggest that program evaluations that ignore indirect exposure underestimate the impact of a mass media program on behavior.

The effects of news stories that put crime and violence into context: testing the public health model of reporting.

Abstract: The purpose of this study is to examine whether changing the way newspaper stories report crime and violence can induce shifts in readers' perceptions of the problem. Using an experiment that manipulates the framing and graphic presentation of newspaper stories on crime and violence, we seek to discover whether the public health model that calls for news stories to incorporate information on context, risk factors, and prevention strategies will help readers learn more about the context in which crime and violence occurs, endorse prevention strategies in addition to punishment, and become more attuned to societal risk factors and causes of crime and violence.

Perceived barriers to Internet-based health communication on human genetics.

Abstract: The Internet has emerged as potential vehicle for distributing health communication to millions of individuals because it is interactive, user controlled, and offers breadth and depth of information. However, its widespread use by the public may be limited due to three overarching concerns: privacy and confidentiality, information accuracy and perceptions of credibility, including limited credibility of some government-sponsored web sites. To explore the potential of using the Internet, especially for delivering information on human genetics communication, 15 focus groups and one interview were conducted with African American and European American adult males and females in a southeastern town. We found that the participants recognized great potential in the Internet for health communication on human genetics, but they also voiced concerns about the credibility and accuracy of online information, lack of trust in many web sites, and fear of safeguarding privacy. Their concerns are summarized here, along with potential remedies health communicators could implement and should research further. The Internet cannot achieve its full potential for human genetics communication until the public's concerns are addressed and resolved.

Youth performing arts entertainment-education for HIV/AIDS prevention and health promotion: practice and research.

Abstract: Entertainment-education approaches to health promotion and disease prevention are a popular method for many interventions that target adolescents and young adults. This article documents how this approach is used to educate and influence young people about HIV/AIDS, other sexually transmitted diseases (STDs), and other health issues in the United States. A review of the literature is followed by a two-phase descriptive study of American youth performing arts entertainment-education programs. First, a quantitative survey was conducted among youth performing arts participants who were attending a national conference on the subject. This was followed by a qualitative survey among adult and youth conference attendees from established HIV/AIDS prevention youth performing arts programs. These two approaches provided detailed insight into the characteristics, approaches, and frameworks used to create, implement, and evaluate these entertainment-education efforts. Nine domains that define the effects and effectiveness of youth HIV prevention entertainment-education interventions are identified and described, including those related to performances, intervention management, and audiences. Given the importance of evaluation for the success and effectiveness of intervention programs, these domains are used to construct a framework for entertainment-education research and evaluation efforts.

Unweaving the Web: an exploratory study of low-literate adults' navigation skills on the World Wide Web.

Abstract: For traditionally underserved populations, the Web can potentially unlock resources that could fundamentally improve health and wellbeing. However, there are many barriers to using Web-based content. While physical access issues are well documented, there is little understanding of how nonmainstream populations use or will use the Web. Based on an ethnographic study of a group of low-literate adults, we have identified specific navigational and content issues that present barriers to this population. We discuss preliminary assumptions that can be used to inform the development of Web tools for this target audience, and directions for future applied research.

eHealth Research and Evaluation: Challenges and Opportunities

Abstract: (2002). eHealth Research and Evaluation: Challenges and Opportunities. Journal of Health Communication: Vol. 7, No. 4, pp. 267-272.

HIV/AIDS coverage in black newspapers, 1991-1996: Implications for health communication and health education

Abstract: HIV/AIDS coverage in five African American newspapers ( Amsterdam [New York] News , Oakland [California] Post , Washington [District of Columbia] Afro American , Atlanta Inquirer , and Chicago Citizen ) was analyzed from 1991 to 1996. During this period, HIV / AIDS became the leading cause of death of young adult African Americans. This study found that coverage of the disease was most prominent in the New York, Oakland, and Washington, D.C., African American newspapers. Although most of the 201 articles analyzed framed the story primarily as a health issue, a large proportion also exhibited a critical attitude toward the government and the "AIDS establishment" about their commitment to saving the lives of minorities. Articles often conveyed the message that fighting HIV/AIDS first requires substantial action regarding the larger contextual issues--economic, political, and social--that cause health inequities. Alternative theories of cause and treatment, such as the possibility that AIDS was created as an...

Enhancing Health Knowledge, Health Beliefs, and Health Behavior in Poland through a Health Promoting Television Program Series

Abstract: This study examined the impact of a health promoting television program series on health knowledge and the key factors of the health belief model (HBM) that have led people to engage in healthy behavior (exercising, losing weight, changing eating habits, and not smoking/quitting smoking). Using data from a posttest comparison field study with 15) viewers and 146 nonviewers in Poland, we found that hierarchical regression analysis showed stronger support for the HBM factors of efficacy, susceptibility, seriousness, and salience in their contribution toward health behavior among television viewers compared with nonviewers. Cues to action variables (including television viewing) and health knowledge boosted efficacy among viewers. Without the advantage of receiving health information from the television series, nonviewers relied on their basic disease fears on one hand, and interest in good health on the other to take steps toward becoming healthier. A health promoting television series can increase health knowledge and enhance health beliefs, which in turn contribute to healthy behaviors.

Receptivity to protobacco media and its impact on cigarette smoking among ethnic minority youth in California.

Abstract: Adolescents from different ethnic groups show different cigarette smoking prevalence rates, suggesting potential differences in receptivity to and influences from protobacco media. Understanding these differences will be helpful in tailoring smoking prevention and cessation programs for diverse adolescent populations in the United States. Data from cross-sectional surveys of 20,332 randomly sampled California boys and girls, 12-17 years of age, were analyzed. Results indicate that receptivity to protobacco media was lower among African Americans, Asian Americans, and Hispanics than among White youth. There was a consistent dose-response relationship between receptivity to protobacco media and 30-day cigarette smoking across ethnic groups. Having a cigarette brand preference was associated with the highest risk for cigarette smoking, having a favorite tobacco ad showed the lowest risk, while having received or being willing to use tobacco promotional items was associated with a moderate risk. After controlling for 13 covariates, the odds ratio for receptivity to protobacco media and 30-day cigarette smoking was significant for Whites (RR = 1.38, p 0.05) and Asian American (RR = 1.17, p > 0.05) youth. African American, Asian American, and Hispanic adolescents have a lower level of receptivity to protobacco media than do Whites. The association between media receptivity and 30-day cigarette smoking exists for all four ethnic groups without controlling for other smoking predictor variables, but only for Hispanics and Whites when other variables are controlled. Protecting adolescents from protobacco advertising influences is an important element in tobacco control among ethnic minority youth.

Presence of pro-tobacco messages on the Web.

Abstract: Ignored in the finalized Master Settlement Agreement (National Association of Attorneys General, 1998), the unmonitored, unregulated World Wide Web (Web) can operate as a major vehicle for delivering pro-tobacco messages, images, and products to millions of young consumers. A content analysis of 318 randomly sampled pro-tobacco Web sites revealed that tobacco has a pervasive presence on the Web, especially on e-commerce sites and sites featuring hobbies, recreation, and "fetishes." Products can be ordered online on nearly 50% of the sites, but only 23% of the sites included underage verification. Further, only 11% of these sites contain health warnings. Instead, pro-tobacco sites frequently associate smoking with "glamorous" and "alternative" lifestyles, and with images of young males and young (thin, attractive) females. Finally, many of the Web sites offered interactive site features that are potentially appealing to young Web users. Recommendations for future research and counterstrategies are discussed.

STD/HIV prevention for teenagers: a look at the Internet universe.

Abstract: The objective was to determine how the Internet is used to promote sexual health among adolescents. Six key words were entered into three search engines producing 87,180 results. Three percent (n = 36) were educational Web sites targeted at teenagers and covered a range of sexually transmitted diseases (STDs). These were content analyzed using sexuality education and usability guidelines. All sites addressed some STD information, but only two covered negotiation. Navigability results were mixed; only one third offered a site map. Sexual health educators may need to include more information on how to negotiate safe sex and improve Web navigability for teenagers.

Association of point-of-purchase tobacco advertising and promotions with choice of usual brand among teenage smokers

Abstract: The objective is to determine the relationship between brand-specific advertising and promotions in convenience stores for Marlboro and Camel cigarettes and choice of usual brand among school students. A cross-sectional survey was designed that merged records of store tobacco advertising and promotions. The survey was administered to 3,890 U.S. high school smokers with a usual brand, matched to 196 convenience stores. Choice of Marlboro as a usual brand was associated with presence of a Marlboro gift with purchase (p .05) and negatively associated with a greater share of exterior advertising voice for Camel (p < .001). The results are consistent with the notion that Marlboro-specific advertising and promotions may influence choice of Marlboro as a usual brand to smoke among teens, but resultsfor Camel are mixed and inconclusive. Further research is required to confirm and extend these findings.

Disenfranchising the disabled: the inaccessibility of Internet-based health information.

Abstract: Individuals are increasingly turning to the Internet for health-related information. The acquisition of this information influences how people decide to treat an illness or condition, the types of questions doctors are asked, and how people take care of themselves. The power and importance of this information makes it essential that it be accessible to all individuals. This research explored the extent to which Internet-based health information is accessible to visually-impaired individuals who rely on automated screen readers (the most common way that visually-impaired individuals access the Internet). The home pages of 500 individual web sites representing 50 common illnesses and conditions were selected for evaluation. Findings indicate that accessibility is currently very low; only 19% of examined sites' home pages were accessible. Analyses of reasons why home pages were inaccessible indicate that accessibility could be improved if recommended design and coding changes are implemented.

Impact of emotional stability and attitude on consumption decisions under risk: the Coca-Cola crisis in Belgium.

Abstract: This article focuses on consumer reactions during and after the Coca-Cola crisis of June 1999 in Belgium. The research tests for associations between the personality trait "emotional stability," attitude toward the brand, and self-reported behavior. Cross-sectional data are collected from a sample of Coca-Cola drinkers between 19 and 22 years old. The data are analyzed through the specification and estimation of a structural equation model and ANOVA. A direct and positive effect of attitude toward the brand on the behavioral response is found. No direct effect of emotional stability on behavior is revealed. However, indirect effects of personality mediated by attitude are discovered. Further, emotional stability is found to correlate negatively with importance attached to information during the crisis. Fast and transparent communication with specific attention to lower emotional stability groups, as well as the inclusion of personality and attitude measurements in future health and food safety studies, are recommended.

The influence of organizational characteristics and campaign design elements on communication campaign quality: evidence from 91 Ugandan AIDS campaigns.

Abstract: This research proposes and tests a model of the relationship between organizational factors, campaign design elements, and campaign quality of communication campaigns. It is the first quantitative study to test these relationships across many organizations. The context for the study was AIDS education and outreach campaigns in Uganda, during a time of successful decrease in the spread of HIV infection. Ninety-one organizations were surveyed. Since only 14% of the organizations collected exposure or outcome data, the study focused on the factors affecting campaign quality. Quality was examined by measuring goal specificity, execution quality, and message quality. The results show that financial resources, professional training, participation of outreach workers in planning the campaign, and audience participation in planning and executing the campaign were key organizational variables affecting the quality of the campaigns. The important campaign design elements affecting campaign quality were conducting research, using multiple channels, targeting only a few groups, and pretesting messages. The results have import for campaign planners, managers of organizations conducting campaigns, and funders. In addition, it is vital that organizations collect exposure and outcome data in the future to provide feedback on each campaign.

Development of Targeted Message Concepts for Recent Asian Immigrants About Secondhand Smoke

Abstract: Residents of Boston's Chinatown and the Vietnamese community in Boston's Dorchester section are recent immigrants from China and Vietnam, countries whose smoking prevalence rates for men are among the highest in the world and whose rates for women are very low. We conducted exploratory focus groups in these communities to examine issues related to secondhand smoke and to generate message concepts for health education materials that would convince recent Asian immigrants to respond to the public health threat that secondhand smoke poses. The message concepts, which were tailored specifically for Chinese and Vietnamese immigrants, used themes that were consistent with the cultural values of each group as expressed in the focus groups, yet also reflected the fact that, in many ways, these immigrants are seeking to adapt to American norms. We suggest that it is possible to construct culturally appropriate health education materials for recent immigrant populations rather than rely on simple translations of English-language materials. An intervention study using these message concepts is needed.

Dietary supplement safety information in magazines popular among older readers.

Abstract: Dietary supplements are extensively used in the United States, especially by people age 50 and over. Surveys have shown that magazines and other news media are an important source of information about nutrition and dietary supplements for the American public. It is uncertain, however, whether magazines provide their readers with adequate information about the safety aspects of supplement use. This report presents an analysis of supplement safety information in articles published during 1994-1998 in 10 major magazines popular among older readers. This time period was chosen to allow the impact of the 1994 Dietary Supplement Health and Education Act (DSHEA) to be assessed. The evaluation included 254 magazine articles. More than two-thirds of the articles did not include comprehensive information about the safety aspects of the dietary supplements that were discussed. Information about safety issues such as maximum safe doses and drug-supplement interactions was often lacking even in otherwise informative and well-researched articles. A total of 2,983 advertisements for more than 130 different types of supplements were published in the magazines surveyed. The number of advertisements per year increased between 1995 and 1998. Supplements of particular interest to older adults (such as antioxidants, calcium, garlic, ginkgo biloba, joint health products, liquid oral supplements, and multivitamins) were among the most frequently advertised products. Although magazines popular among older readers contain extensive information about dietary supplements, these publications cannot be relied upon to provide readers with all of the information that they need in order to use supplements safely.

Antismoking advertising: figuring out what works.

Abstract: (2002). Antismoking Advertising: Figuring Out What Works. Journal of Health Communication: Vol. 7, No. 2, pp. 157-162.

Accounts from the field: a public relations perspective on global AIDS/HIV.

Abstract: This study is a theoretical as well as empirical exploration of the power and cultural differentials that mark and construct various intersecting discourses, specifically media discourse, on global AIDS/HIV. It applies the language and concepts of public relations to understand how the press coverage of the pandemic is associated with the variables that impact the newsmaking process as well as the public and policy implications of macro news frames generated over time. Theoretical work in the areas of agenda setting and news framing also instruct the conceptual framework of this analysis. Narrative analysis is used as a methodology to qualitatively analyze three pools of accounts-from people either living with AIDS/HIV, involved in AIDS/HIV work, or discursively engaged in the media construction of the pandemic; from transnational wire service journalists who cover the issue at global and regional levels; and policy shapers and communicators who are active at the global level. These three communities of respondents represent important stakeholders in the AIDS/HIV issue. The findings are analyzed from a public relations standpoint. Perhaps the most important finding of this study is that the public relations approaches used to address AIDS/HIV related issues need to be grounded in context-specific research and communicative practices that bring out the lived realities of AIDS/HIV at grassroots levels. The findings also posit that those situated at critical junctions between various stakeholders need to cultivate a finely balanced understanding of the etic and emic intersections and subjectivities of global/local AIDS/HIV.

The plural of anecdote is not evidence.

Abstract: The 21st Century communication age has created unprecedented opportunit y for instantaneous information transfer. Globalization translated observation and opinion into the data that forges the foundation of so-called knowledge. With such speed and freedom of expression, un®ltered information abounds. The consequences are great in a new world where terror and disease know no boundaries safety and health remain the ubiquitous ideal. While many of us herald new technologies as liberators providing access to information, we may be professing unfettered opportunitie s for ignorance. New informationÐso-called ``news’’Ðreaches people differently in multiple contexts. This is particularly important to consider as scienti®c discovery, medical breakthroughs , and political events all require decisions that affect our lives. How we react to biotechnology and cloning, complications of medical interventions , and violent acts of hatred is shaped with this. This new information often lacks moral guidance. For example, the increase in online news commentary authored by anyone has evolved to what many term a blog. This term, short for weblog, presents personalized news ®lters that often challenges the knowledge and wisdom foundation that supports Western thought . Thomas Friedman summed it up well in a recent editorial in the New York Times: ``At its best, the internet can educated more people faster than any other media tool we ever had. At its worst, it can make people dumber faster than any media tool we ever had.’’ Furthermore, Friedman warns `` . . ..the uneducated believe information from it even worse. They don’t realize the internet at its ugliest is an open sewer; an electronic conduit for untreated un®ltered information.’’ Say, for example, a consumer wanted vaccine information and went to the most popular search engineÐgoogle.comÐand typed in vaccine info. Voila, the National Vaccine Information Center (NVIC) would appear as well as lawyer’s litigation services. With one click the user could be in what looks like a credible site. The NVIC is an organization dedicated to limiting the use of vaccines as it was started by Dissatis®ed Parents Together (DPT). There are countless other examples with the scienti®c lexicon and common phrases throughou t the world. This is particularly important for health communication. Clearly, individual observation on medical issues repeated over cyberspace challenges the peer-reviewed, conventional wisdom, and status quo. Nonetheless, the new ``paradigms’’ of Shared Decision Making (SDM) and Evidence Based Medicine (EBM) continue to percolate in

High school journalists' perspectives on tobacco.

Abstract: How issues are covered in the media is an important factor in influencing public opinion, policy, and individual behavior. During the 1990s, the tobacco control movement developed a youth focus, prompted by research showing that most adult smokers begin tobacco use as teens. However, concern has been raised that this youth focus has derailed the overall goal of achieving a smoke-free society. Numerous studies have analyzed tobacco coverage and documented the impacts of media messages on youth. To learn how tobacco is covered in a medium primarily produced by and for youth, we conducted an analysis of tobacco coverage in high school newspapers. High school newspapers, like other media, communicate social messages through both content selection and framing. We surveyed a national sample of high school journalists and conducted content and frames analyses of tobacco articles (n = 257) from their publications. The most commonly used frame was "kids" (46%), followed by "killer" (31 %), "nonsmokers' rights" (10...

New insights into how mass media works for and against tobacco.

Abstract: The last issue (Issue 7[2]) of the Journal of Health Communication focused on studies from two perspectives: the in ̄uence of tobacco advertising and promotions , and the counter-in ̄uence of anti-tobacco messages. The variety of message-delivery channels and audience effects addressed in the featured articles reminded researchers and practitioners of the need for multifaceted tobacco control programs that combine educational, clinical, regulatory, economic, and comprehensive approaches as outlined in Reducing Tobacco Use: A Report of the Surgeon General (Department of Health and Human Services, 2000). As de®ned in Centers for Disease Control and Prevention’s (CDC’s) Best Practices for Comprehensive Tobacco Control Programs (1999), counter-marketing consists of media-based activities to counter the in ̄uences of tobacco advertising and to increase health messages and in ̄uences throughou t a country, region, state, or community. Tobacco control programs within the United States and around the world increasingly include counter-marketing as part of their comprehensive efforts to reduce tobacco use. Evaluations of these programs indicate that counter-marketing, as a component of a comprehensive tobacco control program, is an effective strategy for reducing overall consumption, increasing the number of people who stop smoking, reducing the number of young people who start smoking, and reducing nonsmokers’ exposure to secondhand smoke (Hopkins et al., 2001). A major element of Best Practices is the need for programs and policies (including counter-marketing campaigns) that segment and target populations experiencing tobaccorelated health disparities. Chen et al. (2002) analyzed how receptive ethnic minority California young people aged 12 to 17 were to tobacco advertising and promotions . The authors found that receptivity to advertising messages correlated with higher smoking rates among young people from diverse ethnic backgrounds. For these young people, cigarette brand identi®cation and promotiona l items emerged as the variables of greatest importance. The article points to critical issues in the design and targeting of countermarketing programs that require further investigation: understanding the protective factors that make some young people less vulnerable to tobacco advertising and ®nding ways to counter the affects of tobacco advertising among susceptible young people.

Public health at risk: media and political malpractice.

Abstract: (2002). Public Health at Risk: Media and Political Malpractice. Journal of Health Communication: Vol. 7, No. 2, pp. 83-85.

An examination of adolescents who were and were not exposed to "Teens Stopping AIDS": reaching the hard-to-reach.

Abstract: Teens Stopping AIDS (TSA) was an HIV prevention project in Sacramento California that involved coalitions of volunteers in designing and launching a social marketing intervention. Mounted in 15 zip codes where teen sexually transmitted disease (STD) and pregnancy rates were high TSA delivered HIV prevention messages for one year through various communication channels (e.g. radio spots posters skills-building workshops). Sixty-seven percent of 521 sexually active adolescents surveyed in a random sample phone interview reported exposure to TSA. To inform future refinements in the intervention logistic regression was used to identify factors associated with exposure to the program. Eighteen-year-olds were less likely than their younger counter-parts to report exposure to TSA (OR [odds ratio]=.54 p<.05). Adolescents living in zip codes where a concentrated effort had been made to hold workshops display posters and organize peer outreach were more likely than adolescents living outside of these zip codes to report any program exposure (OR=2.57 p<.01). Adolescents traditionally viewed as ‘‘hard to reach’’ (i.e. males minorities and those with a history of high-risk behavior) were no less likely than other adolescents to report exposure to TSA. Characterizing the members of the unexposed segment of the target audience made it possible to offer practical suggestions for expanding the reach of the program. (author’s)

Presence of pro-tobacco messages on the Web.

Abstract: Ignored in the finalized Master Settlement Agreement (National Association of Attorneys General, 1998), the unmonitored, unregulated World Wide Web (Web) can operate as a major vehicle for delivering pro-tobacco messages, images, and products to millions of young consumers. A content analysis of 318 randomly sampled pro-tobacco Web sites revealed that tobacco has a pervasive presence on the Web, especially on e-commerce sites and sites featuring hobbies, recreation, and \"fetishes.\" Products can be ordered online on nearly 50% of the sites, but only 23% of the sites included underage verification. Further, only 11% of these sites contain health warnings. Instead, pro-tobacco sites frequently associate smoking with \"glamorous\" and \"alternative\" lifestyles, and with images of young males and young (thin, attractive) females. Finally, many of the Web sites offered interactive site features that are potentially appealing to young Web users. Recommendations for future research and counterstrategies are discussed.

Telehealth--promise or peril?

Abstract: In the midst of the Internet boom, the U.S. Science Panel on Interactive Communication and Health (Eng, 1999) presented a compelling document to address the extensive potential that new technologies might offer for advancing health. The Panel offered a new term, Interactive Health Communication (IHC) to highlight the promise. IHC was de®ned as: interaction of an individualÐconsumer, patient, caregiver or professionalÐwith or through an electronic or communication technology device to access or transmit health information, or to receive=provide guidance and support on a health-related issue. Broader terms such as telehealth and telemedicine are often used. Today, telehealth encompasses the full spectrum of applications using digital technology and telecommunications systems for health, including health professions education, continuing education, consumer health education, community health information networks, public and school health, research, administration, assessment, teleconferencing, and applied health informatics (e.g., computer modeling, database development, storage=retrieval=mining, electronic record development, consultation, third party billing, etc.). While these terms are often interchanged with similar intent, the ®eld has been moving in a variety of ways. This issue of the Journal offers a variety of articles with original research and ideas that explore how the ®eld has advanced. This new communication technology and Internet boom has brought us closer to what McLuhan envisioned as a global village despite the diversity of consumers. In the United States, women have become the leading users of the Internet and the `̀ wired and retired’’ continue to be a growing segment of society apt to use the Internet to access health information resources. Of course there are pitfalls, as those who could bene®t from IHC often remain marginalized. Regardless, what has become clear is that as the users grow, they require credible sources providing tailored communication. Merely placing a library of data and information and increasing `̀ access’’ does not de facto improve knowledge, understanding, or health. Current wisdom continues to suggest what is needed is information tailored to the way the individua l comprehends, thinks, and behaves. Essentially, we need to match health consumer demands with applications that address his or her individual needs. The three areas of telehealth applications can be summed up well with our public health jargon: primary, secondary, and tertiary prevention. Translated for the public: staying healthy, getting better, and living with disease. It has been clear for some time that disease prevention and health promotion are the principal ways to insure public health. Yet, most consumer demand in IHC is similar to traditional health care delivery; it