The Contributions of Health Communication to Eliminating Health Disparities

University of Pittsburgh, Pittsburgh, Pennsylvania, United States
American Journal of Public Health (Impact Factor: 4.55). 01/2005; 94(12):2053-5. DOI: 10.2105/AJPH.94.12.2053
Source: PubMed
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Available from: Sandra Crouse Quinn, Apr 03, 2014
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    • "Adhering to feminist research methodology (Hesse-Biber & Leavy, 2007; Jagger, 2007), we used focus groups to capture the how and why of individuals' lives as either homeless mothers or caseworkers. Focus groups are arguably the best way to give voice to disenfranchised individuals and populations, provide important context for designing programs to meet community-identified needs, and build trust between individuals , communities, and the services intended to support them (Freimuth & Quinn, 2004; Ruff, Alexander, & McKie, 2005; Sullivan-Bolyai, Bova, & Harper, 2005). Thus, the use of focus groups in our study created an avenue to collect and analyze data that could be shared with the partnership to develop interventions to reduce health and social disparities among homeless families (Christopher, Watts, McCormick, & Young, 2008; Fowles, 2007; Rashid et al., 2009). "
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    ABSTRACT: Homelessness threatens the health and well-being of thousands of families in the United States, yet little is known about their specific needs and how current services address them. To fill this knowledge gap, we explored the experiences of homelessness families in Detroit, Michigan. We targeted homeless mothers and their caseworkers for study to see if the perceptions of needs and services were in alignment. Using focus groups and content analysis, we identified four overarching themes that illustrate homeless mothers' experience with homelessness. We then analyzed data from caseworkers to look specifically for similarities and differences in their perceptions. Key findings included reports of family histories of violence, poverty, social isolation, and a lack of informal support as contributing to homelessness. The differing perspectives of mothers and their caseworkers regarding how best to move forward highlight how current programs and services may not be meeting the needs of this growing and vulnerable cohort.
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    • "Participants emphasized the importance of strategic use of the news media and the benefit of holding regular meetings to keep all stakeholders involved. These 2 suggestions are echoed in the literature, which cites the benefits of media advocacy and stakeholder engagement (15,16). As public health practitioners and advocates seek to apply lessons learned from Topeka, many tools are available to aid them in determining best evidence, assessing community needs, and planning and evaluating programs (17). "
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    ABSTRACT: Regular physical activity can help prevent chronic diseases, yet only half of US adults meet national physical activity guidelines. One barrier to physical activity is a lack of safe places to be active, such as bike paths and sidewalks. Complete Streets, streets designed to enable safe access for all users, can help provide safe places for activity. This community case study presents results from interviews with residents and policymakers of Topeka, Kansas, who played an integral role in the passage of a Complete Streets resolution in 2009. It describes community engagement processes used to include stakeholders, assess existing roads and sidewalks, and communicate with the public and decision-makers. Key informant interviews were conducted with city council members and members of Heartland Healthy Neighborhoods in Topeka to learn how they introduced a Complete Streets resolution and the steps they took to ensure its successful passage in the City Council. Interviews were recorded, transcribed, and analyzed by using focused-coding qualitative analysis. Results included lessons learned from the process of passing the Complete Streets resolution and advice from participants for other communities interested in creating Complete Streets in their communities. Lessons learned can apply to other communities pursuing Complete Streets. Examples include clearly defining Complete Streets; educating the public, advocates, and decision-makers about Complete Streets and how this program enhances a community; building a strong and diverse network of supporters; and using stories and examples from other communities with Complete Streets to build a convincing case.
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    • "Although health communication interventions are sometimes able to reach broad audiences, they are generally expected to have only small effects on behavior (Freimuth & Quinn, 2004). The limitations of health communications may be especially relevant for at-risk populations experiencing health disparities and when behaviors are dependent, at least in part, on environmental factors outside the immediate control of the individual (e.g., access to medical care, cost). "
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    ABSTRACT: Examine the longitudinal effects of personal narratives about mammography and breast cancer compared with a traditional informational approach. African American women (n = 489) ages 40 and older were recruited from low-income neighborhoods in St. Louis, Missouri, and randomized to watch a narrative video comprised of stories from African American breast cancer survivors or a content-equivalent informational video. Effects were measured immediately postexposure (T2) and at 3- (T3) and 6-month (T4) follow-up. T2 measures of initial reaction included positive and negative affect, trust, identification, and engagement. T3 message-processing variables included arguing against the messages (counterarguing) and talking to family members about the information (cognitive rehearsal). T4 behavioral correlates included perceived breast cancer risk, cancer fear, cancer fatalism, perceived barriers to mammography, and recall of core messages. Structural equation modeling examined interrelations among constructs. Women who watched the narrative video (n = 244) compared to the informational video (n = 245) experienced more positive and negative affect, identified more with the message source, and were more engaged with the video. Narratives, negative affect, identification, and engagement influenced counterarguing, which, in turn, influenced perceived barriers and cancer fatalism. More engaged women talked with family members more, which increased message recall. Narratives also increased risk perceptions and fear via increased negative affect. Narratives produced stronger cognitive and affective responses immediately, which, in turn, influenced message processing and behavioral correlates. Narratives reduced counterarguing and increased cognitive rehearsal, which may increase acceptance and motivation to act on health information in populations most adversely affected by cancer disparities.
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