Team 6 Health Literacy Blog

In class we have been talking a lot about health literacy, and what it means to be literate. We have been adopted the U.S. Departments definition of health literacy for our use, defining health literacy as “the ability to obtain, process, and understand basic health information and services to make appropriate health decisions—is essential to promote healthy people and communities.” In order to have individual level health care it is important that the individual knows what is going no with their own body, can articulate that, and then work with health care advisers to make decisions about their health.

We have looked at a few studies that demonstrate the importance of educating and increasing health literacy. Hindin et al. showed how increasing knowledge in parents about what their children are learning about health from television can have positive health impacts. Horodynski et al. showed how the perception that care-givers have about their own behavior and their toddlers isn’t usually accurate – but with training they can have a more realistic perception. Taken together I think that these articles outline the importance of health literacy. So often people fall into the Gestalt default and become influenced by outside forces without any real consideration of themselves. If we design programs that make them become more conscious of their perceptions and behaviors associated with health than we will be moving them through the stages of change, at least to contemplation and maybe actual behavior change.

The final article for the week about health literacy and patient physician communication plays in perfectly with our previous discussions about audience segmentation as well as channels of communication. This meta-analysis found that differences existed in demographics. Age was one example of a difference they found. This difference was also found by the Department of Health and Human Services. These results call for a shift in the way that doctors think of communicating with their patients. The job of a doctor isn’t necessarily to get someone to understand their disorder/disease, it is to make them better. I think the prevailing pragmatic approach to this is to  speak to different patients differently, depending on how health literate they are. Using demographic, psychosocial, and psychographic information a better method of communicating to the individual can arise. Based on these audience segmentation strategies a channel of communication can come out where doctors can be sure to deliver their message effectively. This can include physician-patient conversations and verifying that they understand, but also specified pamphlets or instruction lists.

I think the goal of a health care professional is to increase health and the best way to do that is to design messages and communication encounters that best facilitate health improvement. In a time of such economic hardship, it is important that we treat patients and prevent disorders the most efficient way possible. It is too costly to have to send someone to the hospital a second time because they didn’t understand how to take their medication when they got home. I think that there are real economic consequences that result from the scientific push away from health communication in a way that most benefits the patient.

http://www.kaiserhealthnews.org/Daily-Reports/2012/March/22/Weekend-Reading.aspx

http://www.health.gov/communication/literacy/issuebrief/

Group 6 Post

Dr. Hosig’s lecture on her diabetes research really opened our eyes to the prevalence and dangers to diabetes. While many programs and research attempt to treat the symptoms of diabetes through behavioral changes, such as eating healthy and exercising, another type of diabetes treatment has shown promising results.

With a growing number of diabetes patients in the U.S., new studies have taken a non-traditional approach to treating diabetes. Two studies have shown that stomach surgery has the potential to reverse Type 2 diabetes for those with severe symptoms. The first study, conducted in Cleveland Clinic, showed that 40 percent of patients who had received the surgery were able to regulate their blood sugar, while a second study conducted in Italy, showed even better results, up to 75 percent full remission from diabetes. The surgery helps reduce caloric intake, helps patients drop weight, and produce hormonal changes that help patients control their blood sugar.

“With these operations, we could take people with diabetes who are just barely obese… and put diabetes in full remission,” said surgeon Thomas Magnuson of Johns Hopkins University.

The results are very promising, but they come with several caveats. First, the American Diabetes Association and the National Institutes of Health did not list surgery as an option in their treatment guidelines until 2009, so this treatment is still fairly new and might not be as popular as other methods. Second, the procedure alone costs $20,000 to $25,000, which may hinder those without insurance from getting the operation. Third, the surgery is not without side effect. Few patients in the two studies suffered from anemia and osteoporosis.

Despite all the success, many readers are very skeptical about the new procedure. Majority of the comments claim that “simple diet and exercise” will suffice and surgery is not necessary. Others claim that getting surgery is too drastic and that regulating your diet is just as effective.

“Some people will say it’s an extreme solution,” said Cleveland Clinic cardiologist Steven Niessen, “but it’s an extreme problem.”

Other readers criticize that “simple diet and exercise” is not as simple as it sounds and that sometimes, drastic measures have to be taken for those with extreme type 2 diabetes.

The risks and problems with surgery are evident, but do they outweigh the results? Is it worth getting surgery done for something that may be manageable through diet and exercise?

Check out the article here and share your thoughts!
http://www.washingtonpost.com/national/health-science/stomach-surgery-more-effective-than-medicine-for-diabetes-studies-find/2012/03/26/gIQAdlvWcS_story.html?Post+generic=%3Ftid%3Dsm_twitter_washingtonpost

When Moms Cause More Harm Than Good — Childhood Obesity (Group 4)

Recently there have been numerous articles pertaining to childhood obesity and the huge crisis younger generations are experiencing because of unhealthy eating habits and lifestyles. One article in particular that caught my attention was featured on nearly every prominent news network.

The article is about a controversial segment found in the April issue of Vogue magazine, written by Dara-Lynn Weiss, about a strictly enforced diet she required her 7-year-old daughter to endure. Weiss took her daughter, Bea, to a pediatrician specializing in childhood obesity and learned that her daughter was at risk for being clinically obese, and consequently in danger of experiencing high blood pressure, cholesterol and diabetes.  The specialist suggested a “child-friendly” dieting plan known as “Red Light, Green Light”, which incorporated “red lights” for bad foods and “green lights” for good foods to help Bea understand healthy eating.

However, Weiss took this idea of dieting for her 7-year-old to the extreme!  She admits that she has personally struggled with healthy living habits. Weiss said, “growing up in an affluent, achievement-driven suburb, I had suffered through my own issues with food, eating and weight.” At one point in her life, Weiss even attempted to get a doctor to prescribe her appetite suppressant fen-phen.  Her own struggle with body image and healthy habits affected the way she tried to teach her daughter what was right.

Weiss admits to being VERY inconsistent in how she fed Bea – sometimes a snack consisted of pizza, a chicken gyro, or coffee cake, and other times she would require Bea to choose from fat-free soup to a hard-boiled egg.  Aside from the fluctuation in food choices, Weiss created a workout regimen for Bea that was more geared for an adult. When a parent is trying to incorporate exercise into a child’s lifestyle they should do things that are enjoyable, play in the park, playground, sports, or swimming and explain the importance of exercise. Weiss even wrote in her article that she once deprived Bea of dinner as a form of punishment for her eating habits earlier in the day.

Various bloggers and experts were interviewed and made these remarks—“Weiss comes across as obsessive”, “I’m pretty sure Weiss just handed her daughter the road map to all her future eating disorders”, and “It’s no surprise that this child has weight issues, since her mother has not conquered her own issues on that regard.”

Later in the interview Weiss admits that she “clung to the clinical obese term because it carried a scary, diagnostic tone.”  Although Bea lost 16 pounds, grew 2 inches and is in better physical shape for someone of her age, she is unhappy and undoubtedly scarred from this ordeal her mother put her through. Her emotional state is in a far worse condition. I think this article is a perfect example of how childhood obesity is handled poorly particularly by parents. There are so many positive routes to take when fighting this epidemic. Because of the way this mother chose to approach her daughter’s weight, she has created emotional scars that will likely influence this young girl the rest of her life.

For More Information Check Out These Links:

http://www.foxnews.com/health/2012/03/26/mothers-strict-diet-for-7-year-old-raises-controversy-criticism/

http://www.cbsnews.com/8301-504763_162-57404670-10391704/should-7-year-olds-be-put-on-strict-diets-vogue-article-sparks-debate/

“Why Do Sports Stars Collapse in Action?” via CNN Health (group 3)

This past weekend I lost a friend to a heart attack while playing pick-up football.  He was 22 and in excellent physical condition with no prior history of health problems.  The news is shocking but at the same time it has recently been brought to light that even top athletes are collapsing from undiagnosed heart problems while in their prime.

Athletes are generally required physical examinations before playing sports, but in an article by Gary Morley on CNN, he explains that many heart conditions can go unnoticed. Hypertrophic cardio myopathy is one of those conditions and occurs when the muscles of the heart thicken and stop blood flow.

“‘With EKG screening, sometimes this isn’t caught,’ [Dr. Chandan ] Devireddy says. With the hypertrophic cardio myopathy we’re discussing, about 70% of the time the first incidence of that being diagnosed is with a sudden cardiac death episode.'”

How mindblowing, chilling, and completely baffling is that?  Not only does it contradict everything we have every known about heart healthy activities and physical exercise, but it almost seems as though your heart is completely controlled by chance.

Some of our Tech athletes just experienced the NFL Combine and it is interesting to note they are required to spend a whole day in the hospital getting every part of their body x-rayed and tested. However, this measure varies by sport and by country.  This particular article addresses an English Premier League soccer player’s sudden collapse.

Fabrice Muamba, 23, came to England by way of the Democratic Republic of Congo.  Muamba collapsed on the field during a game and is currently in intensive care with a grim outlook.  His condition has not been diagnosed yet but it seems there is an underlying condition that has gone undetected.

Dr. Hilary Jones, a medical expert from England said that hypertrophic cardio myopathy is marginally more common in black athletes than in whites.  Italy has implemented a screening program for all young pro-athletes that was effective for detecting several cases of abnormalities.  This article does not discuss much research done on either of those points and raises quite a few questions.

Should athletes get extensive screening like EKG’s and if so how often?  How often should your average person get their heart checked since this can occur to anyone? How can we communicate the idea that though you may be perfectly healthy, this can happen at any time without warning?

In case you missed the hyperlink within the text, please click here.

-HBS 

College Alcohol Consumption: Group 2

It’s no surprise to us as college students that alcohol is a huge part of a large university. However, an article on Health.com reveals a darker side of the innocent Friday night part with friends: a visit to the emergency room.

The study was conducted on various universities throughout the nation and concluded that on a university with about 40,000 students, the spending on emergency care for alcohol related incidents ranges from $469,000 to $546,000. The incidents mentioned in the article are head-related injuries from black-outs, broken bones, etc. During the two years of the study 30% of males and 27% of females had to visit the emergency room for injuries related to alcohol consumption. We all know that people don’t just get broken bones, but there are even fatalities from drinking too much alcohol.

Binge drinking in college results in serious costs to the health care systems for and around universities, so what does this mean?

The study found that about 44% of college students binge drink. Therefore, that part of the population would be considered the “at risk” population when we’re talking about the implications of the study for what we need to communicate in order to save college students form injury and improve the overall health care systems that serve universities.

“Given limited campus resources, the study results support targeting efforts at preventing alcohol-related injury [among] students with a history of blackouts,” the researchers said. “In our cost estimate, close to a half-million dollars could be saved in emergency-department utilization costs on a large university campus each year if interventions targeting blackout sufferers were successful.” – direct quote from the study.

The study concludes by its implications that directly relate to what we study. I think this is a particularly interesting study because it’s us. These are college students. Knowing who we are, knowing our friends – what does it mean to target and cater to the audience in order to change these behaviors? Will education simply change something? Will incentives change behavior? Does it require a social movement?

I am curious to get the input of the class on what it would mean to develop a campaign for us. I don’t think it would be the easiest thing in the world… therefore: how can it be done? Can it be done?

Read the full article: http://news.health.com/2012/03/19/excessive-drinking-costs-u-s-colleges-millions-annually/#more-55080

Group 1 – Graphic ads campaign to combat smoking

Fear advertising or shock advertising has been around for years.  For some products, such as beauty products, it has proven to be effective.  Women have fears of aging or having dry skin, so they buy the products that abolish those fears.  Other fear based campaigns, such as those that advocated against illicit drugs in the late 1980’s and early 1990’s, surprisingly, weren’t as effective.  The ads showed a picture of a brain, then another image of “what your brain looks like on drugs,” and unfortunately, the use of illicit drugs had a negligible decrease.  The question of 2012, is will the fear tactics be effective in convincing current smokers to quit, and preventing teens from picking up the habit at all?

 

According to an article on CNN, titled “CDC unveils graphic ads to combat smoking,” the federal health officials are unveiling a $54 million national media campaign to get smokers to quit and prevent anyone else, especially children, from starting.  The campaign is called “Tips From Former Smokers,” and let me tell you, it was difficult to watch.  The campaign is intended to educate Americans about the dangers of smoking through the hardships that other former smokers have encountered.  The ads include graphic pictures and stories about ex-smokers who have suffered severe health consequences due to tobacco use.

 

Personally?  I think these advertisements will be effective.  As we learned in class the other day, advertisements today need to be made at 5^th grade reading levels to reach the majority (including the low literacy portions) of the population.  But honestly, how much medical information an you really convey at the 5^th grade level.  This campaign took another route.  These advertisements and the campaign as a whole focus on graphics rather than words, and after seeing some of the ads, the message would be clear to anyone: smoking kills.  As we have all heard a million times in our lives, pictures speak a thousand words, and to be honest, some of these pictures say much more than that.  There are harsh images of leg amputations, lung removals, surgically created neck holes, and more.  There is no doubt in my mind that the messages will be clear to all audiences.  While comprehension proficiency is a problem in many parts of the United States, this nationwide campaign will speak loud and clear to all people.

 

The issue?  Will people ignore these advertisements because they are too difficult to view?  We have all seen the Sarah McLachlan Animal Cruelty commercial that just wrenches at our hearts.  And to be honest, I turn the channel whenever it comes on.  I have even been one to advocate that the commercial is unethical, and that it attacks our emotions too heavily.  However, the reason we all hate this commercial so much, is not just because of the images alone, but because we see something so terrible, yet many of us can’t afford to help the cause.  But quitting smoking has never been easier.  There are patches, gums, exercises, reinforcement groups, etc., that are cheap remedies to quitting the addiction.  So when people say these advertisements make them turn their head, well I think that’s just smokers not wanting to face the truth.

 

So, back to the question.  Will this campaign be effective?  Only time will tell.  As this point, the health industry is reaching for desperate measures to reduce smoking health consequences and fatalities.  It seems as if the tobacco industry is always one step ahead.  Just as the CDC is about to run it’s first paid, comprehensive national anti-tobacco advertising effort, statistics came out that revealed “the tobacco industry spends more than $27 million a day on marketing to kids and others — about $10 billion a year. In two days, the industry spends about what the government has budgeted for the entire 12-week campaign.”  The tobacco industry depends on addicting people at young ages, after all, that is their future clientele.  And it works.  The American Cancer Society revealed that nine out of 10 smokers started before they turned 18.

 

The hopes is that this campaign, which highlights very realistic fate about what awaits current smokers if they continue their tobacco addiction, will effect people like never before.

 

I have been a non-smoker for 21 and ½ years.  And having been raised by two parents who have smoked my entire life, friends that smoke regularly, and peers who are similarly addicted, I can honestly say it is advertisements like these that have kept me smoke-free.  I think the health industry is taking a great risk with this campaign.  Graphic pictures, while gruesome and difficult to look at, saves lives.  With 443,000 annual fatalities and more than 8 million currently living with smoking-related conditions, this campaign is long overdue.  Why do so many people smoke when they know it can kill them?  My thoughts…the “that won’t happen to me” mentality it too prevalent amongst smokers.  I think that this campaign, which comes from smokers themselves, will convince people that yes, it can happen to you, and frankly it probably will.

 

What are your thoughts?  Are fear-based campaigns effective?  Do you think it’s unethical to show people such gruesome images?  Will this campaign reduce smoking amongst teens?

 

For the complete article and examples of the advertisements, click here:

http://www.cnn.com/2012/03/15/health/feds-tobacco-ads/index.html

Group 7 Blog Post

Today, CNN posted an article written by Dr. Otis Webb Brawley, the chief medical officer of the American Cancer Society and a practicing oncologist. Dr. Brawley is, without a doubt, a prestigious professional, which is why I was confused and shocked when I read his article regarding women and the newest requirements for annual Pap smear screening. The article, No more annual Pap smear: New cervical cancer screening guidelines, discusses the guidelines requiring less Pap smear screens for women and other regulations.

The article states that in the 1930s, cervical cancer was the deadliest women’s cancer in the United States. Over time, there has been a significant decrease in the death rate due to cervical cancer. We learned from our guest speaker Professor Shinault that this statistic is true; cervical cancer has become less of a threat in the face of other women-related cancers. Both the advancement in technology and the introduction of the HPV vaccine (Gardasil and Cervarix) have helped to greatly reduce the number of long-term cervix cancer patients. These numbers are so minimal, in fact, that a few organizations have combined to publish a new set of screening recommendations for women. The U.S. Preventive Services Task Force conducted research and reviewed scientific literature and came to a few conclusions.

(For the guys who aren’t sure about this topic, Pap smears are samples taken and tested for any abnormalities in the girly region.)

First, women under the age of 21 should no longer be given Pap smears. ..What? Doesn’t that completely defy what doctors and society have been telling us since middle school? For any young women reading this article, you’re most likely around the age of 21 and you’ve most likely had your HPV shots or at least heard about them. I had always been under the assumption that it was the thing to do in high school. I don’t mean to sound like I’m confusing Pap smears with HPV vaccinations, but to clarify, I had always thought that those were both crucial parts of going to the doctor and preventing/detecting anything unusual. HPV shots are really only required for sexually active girls, but I think that most girls (in today’s society) under the age of 21 have had some kind of sexual contact. Getting a Pap smear always seems to be a dreaded occasion, but it’s essential to being aware of your body’s health.

In the beginning, the article never really specifically states it’s reasons for this change in policy. It does say that “these guidelines will lead to less confusion for health care providers and the public” and that “this will ensure that women receive the benefits of testing while minimizing the risks.” I feel that this article, while it’s intentions may be good, could have been a lot more specific as to why and it’s reasoning behind these drastic reductions. Yet as you read on, it goes on to say that treatments for HPV can lead to cervical incompetence and future miscarriages. It also states that HPV can take over 10 years to progress to anything dangerous. (Note the “can.”)

Another guideline says that women aged 21 to 29 should only get Pap tests every three years. Women age 30 and over should also get them every three years, yet with different specifications. There are certain guidelines involving the combined Pap results and HPV test results depending on their outcomes and how to go about follow-up appointments.

Basically, my bottom line thought about this article is simple: why print this article and leave out the specifications of something that I would think is rather prevalent and alarming? Is it bad that I’ve been getting Pap smears and HPV vaccines before I was 21 and more often than every three years? Someone who shares my thoughts and glances at this article will obviously ensue in a slight panic. It disappoints me that I haven’t been more exposed to the possible negative impacts of these screenings and shots. Another kicker to this article was about HPV infections: “most infections that are not treated subside within nine months without residual effects.” Does that mean that it’s suddenly alright to let an HPV infection happen and go untreated?

If you’re going to put out information suggesting a mass public movement, in this case girls getting the HPV vaccine, then please fully educate us and our parents on the negatives as well as the positives. If you’re not going to educate us during the fact, then make sure there is adequate information out there before publishing things such as this article. After having this thought, I actually researched the threat of danger regarding frequent Pap smears, and the information is out there, I just feel that it’s never been conveyed to me through my gynecologists, public school system education, or even social media. This concerns me regarding the health communication aspect of the situation. There was practically a mass push for teenage girls to get the vaccine; why wasn’t there more information? Is it because they just didn’t know then? Was my generation the group of test guinea pigs needed to come to these findings? It scares me to think that epidemics such as this are pushed upon impressionable young girls without full knowledge or sincere notice of warnings and possible outcomes.

So in that case, there needs to be a mass push of this newfound knowledge. With this article, the U.S. Preventive Services Task Force is making a statement about the need for less Pap smears and careful HPV treatment. The article could have used more information or maybe a link or suggestion of where to find more information about its findings. However they decide to do it, I feel that other young women like myself would benefit from this information when taking their future physical health into consideration.

If you’d like to read this article for yourself, it can be found here:

http://www.cnn.com/2012/03/14/health/brawley-cervical-cancer-screenings/index.html?hpt=he_c2

Dangers of Soda Group 8

CNN posted an article about a new study that has revealed the dangers of sodas and other sugary drinks. The study was published in the American Heart Association Journal. According to the study men who drink just one 12-ounce soda per day his risk for heart attack increases by 20 percent compared to men who do not. Sugary-beverage consumption “appears to be an independent risk factor for heart disease,” says lead author Frank Hu, M.D., a professor of nutrition and epidemiology at the Harvard School of Public Health, in Boston.

One of the strangest things about the study is even if someone drinks a sugary drink without gaining weight because of it he is still just as at risk for heart attacks. Most people associate weight gain with increased heart attack, but sugary drinks affect triglycerides and HDL which leads to increased heart attack risk without being obese.

Sugary drinks have also been linked to type-2 diabetes in adults because it causes inflammation, which is a risk factor in diabetes.

The study was done by taking blood from a sample of men and the blood results confirmed the hypothesis. The main limitation of the study was one method was a questionnaire and relying on memory is not a good way to conduct a study.
Since this and other similar studies have shown the same results a campaign can be developed that targets adult males. Sodas can be a big part of some male’s diets and trying to convince them to not drink them can be a difficult task. Fear tactics can be used to persuade males of the danger soda has on the body. Pamphlets that lay out the effects on the body can be developed to inform males. Once attention is grabbed then the campaign needs to demonstrate how easy it is to change lifestyle habits of drinking sodas. If the audience believes there are little to no barriers then his self-efficacy will increase, which results in a greater likelihood of behavior change. Messages such as, “Replacing one soda per day with a juice will decrease the risk of heart attack,” or “Replacing soda with a diet soda will decrease the risk of heart attack,” can be developed.
This is one step in the communication campaign process. How would you choose your target audience? How would you test your message? What evaluation process methods would you use? These are all things that need to be considered before developing a health related campaign.

For more information on the study click on the link below

A soda per day may raise heart-attack risk