Comm 321 Exam 3

What does framing refer to in the context of the media?

framing is related to the agenda-setting theory; framing of news stories involves the selection and emphasis of certain aspects of the issue while excluding other aspects the reporting of the news is influenced by a variety of social, cultural, and economic factors

How do conversations about illness and identity affect patients and their families?

-Couples caring for an older adult have significantly less personal time, depleting their satisfaction -ill loved ones struggle to find a new identity as a patient -Caregivers often hesitate discussing their own distress with others -Pain management becomes an important issue -many family caregivers are reluctant to communicate problems they encounter during caregiving process -providing emotional support is one of the most time consuming and challenging aspects of caregiving -patient distress is positively correlated with caregiver depression or burden

Be able to identify how health literacy was integrated into the new Affordable Care Act

-Health literacy, cultural, and educational background should be taken into consideration -Review information on labels and print advertising on risks of prescription drugs 1.includes definition of health literacy and integrates health literacy into law of the land 2.notes relevance to dissemination of research prescription medication labeling 3.education of healthcare providers, workplace wellness and shared decision making 4.institution of medicine and federal legislation later 5.adopted this definition and have it for advancing a health literate america 6.health literacy has grown from an under-recognized silent epidemic to an issue of health policy and reform understanding the nature of health literacy and its relevance to health outcomes has been under research to improve it.

What are some consequences of health information?

-Inconsistent messages create confusion and mistrust

What are the two common outcomes associated with health literacy?

-empowerment -overwhelmed -determined by patients health literacy

Why is there a low number of people entering into hospice?

-hospice eligibility requirements for medicare patients require physicians to certify potential hospice patients have less than six months to live -providers are reluctant because healthcare insurance options do not provide many financial incentives -most insurance plans do not adequately cover services for end of life care

How does the media depict violence and what are the effects associated with these portrayals?

-violence is the norm in television and movies -Children will witness 8000 murders and 100,000 other types of violent acts before elementary school cognitive and emotional maturity, intelligence, gender and viewing habits mediate the effects of violent content on aggressive behavior violent video games are believed to have a negative effects also

What are the major goals of health campaigns and how do these goals affect desired outcome?

Awareness/Behavioral Change: Goal of campaigns is to change, attitudes, beliefs, or behaviors about risky health behaviors Ex: anti-smoking, safe sex Public Policy/ Advocacy: Goal of campaigns is to highlight structural inequities in healthcare access Ex: political campaigns for healthcare reform The goal of the the health campaign will determine the target audience also

What is the extended parallel process model?

Based on fear, anxiety and worry EPPM examines fear appeals as a motivation for health behavior change. Individuals exposed to a fear message engage in two sets of parallel cognitive processing: Cons: can cause negative outcomes Fear control: Involves an assessment to how to cope with the emotional reaction to a threat Danger control: refers to the appraisal of a threat and how it should be dealt with Ex: women with hole in throat for nicotine addiction, truth advertisement with deformed beings Fear appeals are defined as persuasive messages that attempt to frighten an audience into implementing a recommended response and are used frequently by politicians, advisers, etc. Fear appeals need to be used with some degree of caution Too much fear can lead to such intense emotional reactions that people become too preoccupied with their fear to think rationally about steps they can take to avoid the threat

What are the major goals of formative campaign evaluation and the role of pilot testing during this process?

Formative campaign evaluations are conducted to minimize possible campaign shortcomings prior to launch; focus groups and interviews are conducted 1.) Objectives of the Formative campaign include: -Understanding the target audiences barrier to action. -Learning the appropriate language to develop messages -Developing a conceptual model. 2.) Pilot testing -using a sample of the target population, campaign designers can gauge what aspects of the campaign work and do not work with a group of people who are similar to the larger population -when obtaining feedback about the campaign from the pilot sample, campaign designers should measure the degree to which the campaign messages let to cognitive and/or behavioral changes in the group and potential problems with the campaign

How is the internet and mobile content affecting the creation of personalized health information?

Health campaign messages can now be tailored on a personal level due to the use of computer algorithms to place people in certain subgroups; -this can increase the complexity and cost of the campaign however Online and mobile communication devices have enabled personalized health.

What four factors factors contribute to health literacy?

Cultural knowledge Oral literacy (listening and speaking ability) Print literacy (reading ability) Numeracy (mathematical ability)

Explain the advantages and disadvantages of email, electronic medical records, and telemedicine

Email has allowed doctors to consult with one another and their patients rather easily Advantages: allows efficient, cost-effective communication over geographic distance Disadvantages: can be impersonal, lacks nonverbal cues and immediate feedback Electronic medical records are replacing paper-based records in many clinics Advantages: can eliminate redundancies, records easily shared among in-network providers, reduces medical errors Disadvantages: difficult to export information to different platforms, reduces face-to-face patient-provider interaction Telemedicine is the "use of communication technologies to facilitate the delivery of healthcare at a distance for the direct benefit of patients" (p. 167) Advantages: helps doctors stay in touch with patients, delivery of services to geographically isolated patients Disadvantages: patients might be excluded from conversations

Define evaluation in the context of health campaigns and explain the difference between outcome and process evaluations

Evaluations: Systematic application of research procedures to assess the conceptualization, design, implementation, and utility of intervention programs. Process evaluations: Assessment on why a campaign was or wasn't successful. Outcome evaluation: Was the campaign successful in changing the behaviors of its audience.

Hospice care vs. palliative

Hospice Hospice programs far outnumber palliative care programs. Generally, once enrolled through a referral from the primary care physician, a patient's hospice care program, which is overseen by a team of hospice professionals, is administered in the home. Hospice often relies upon the family caregiver, as well as a visiting hospice nurse. While hospice can provide round-the-clock care in a nursing home, a specially equipped hospice facility, or, on occasion, in a hospital, this is not the norm. Palliative Care Palliative care teams are made up of doctors, nurses, and other professional medical caregivers, often at the facility where a patient will first receive treatment. These individuals will administer or oversee most of the ongoing comfort-care patients receive. While palliative care can be administered in the home, it is most common to receive palliative care in an institution such as a hospital, extended care facility, or nursing home that is associated with a palliative care team.

Identify factors related to persuasive message construction (spokesperson,logical/emotional appeals, two-sided messages, inoculation, and prospect theory

Many elements of a message must be taken into consideration when selecting an approach: -Credibility of the presenter/spokesperson Logical appeals: persuading through facts and evidence -Emotional appeals: persuasion evoking emotions -Two-sided messages: tells you both sides of the issue. Ex: E-cigarettes pros: no tobacco, cons: effects of aerosol Benefits: credibility because unbiased, built-in counter argument, weigh against issue but other evidence to support giving the consumer the freedom of choice -Inoculation messages: Presenting audience with weak arguments that are contrary to the goals of the campaign along with information that refutes the arguments ex: People don't like to wear condoms but..... -Prospect Theory (gain v. loss frame): loss frame most useful when someone engages in detection behavior; "lives saved, lives lost" gain: have nothing to lose from it. Ex wearing your seatbelt, putting on sunscreen

How does the media portray unrealistic depictions of health related issues?

Many medical shows feature unrealistic portrayals of health and illness Media also promote unhealthy behaviors: Eating disorders Body image fixation / desire for cosmetic surgery Alcohol consumption Tobacco use Sexual behavior

Talking about death is difficult. What are some common methods used by family members to talk about death?

Many people use metaphors for death Euphemisms mask the seriousness of death ex. he passed away; or kicked the bucket Also help people deal with issues of death and dying

What do mediated depictions of alcohol use, tobacco use, and sexual practices have in common?

Media generally emphasizes all of the positive aspects while ignoring the potential consequences

Identity factors related to audience attention

Messages should: -Be salient (noticeable) -Include cues to action -Contain vivid colors and images -Be repeated

Define the "sandwich generation"

Middle-aged adults supporting both their children and parents

Conversations about death: positivists and negativists and why doctors avoid conversations about death

Positivists-individuals that feel that they have largely achieved the goals they have set for themselves in life and who reflect positivity upon their present life. Negativists-people who reflect negatively upon their lives, especially those individuals who did not have the opportunity to fulfill dreams or who have regrets about their behaviors and these people may look on death with despair Why doctors avoid conversations about death: -physicians tend to be optimistic when talking to patients about life threatening illnesses - many doctors feel that they will be perceived as "giving up" on the patient if they talk about dying and that this will eliminate the patient's sense of hope and lead to depression. Studies found that doctors and patients who avoid discussing life threatening conditions as long as possible and as minimally as possible, often lead to rushed decision making about treatment decisions.

Define polypharmacy

Problems that arise from the prescription of excessive number of medications and the interactions between them

What are the principles of message tailoring?

Recent health communication campaigns have relied on the process of message tailoring to enhance their effectiveness Crafting messages that are very specific to a target audience: 1.) Segmentation: dividing the target audience according to important criteria. Ex: Man frying egg, promoting anti-drugs 2.) Targeting: selecting the appropriate channel to deliver the message Ex: 1987 commercial of father and son, anti drug 3.) Tailoring: matching the message to the audience . Ex: Rachel Leigh Cook smashes everything with a cast iron emphasizing the effects of heroin, anti-drug. Targeting teenages, people who knows people who use heroin Tailored messages are more relevant

What is a caregiver and what do they do?

anybody who provides unpaid help or arranges for help of a relative or friend because they have an illness or disability -martial partner -family members -adult children and women most common For many caregivers, the roles that they play are primarily related to support or coordination -Providing tangible or emotional assistance -Acting as a liaison between patient and provider -Handling social or financial affairs -Monitoring symptoms and reporting to providers

What are advanced care directives and what role does communication play in these statements

are legal documents that instruct family members and other loved ones about the wishes of an individual after he or she dies. They give individuals much more control over how they will be treated by healthcare professionals if they should lose their ability to communicate with others. allows people the reassurance that they will be treated in ways that are consistent with their values in situations where others are making decisions about their life and death (whether to be kept on life support no matter what or to let die when ready). these topics are not easy to discuss but individuals may need to express their wishes to family members over what should be done if they should face a terminal illness or impending death

Know what uses and gratifications theory is and what UGT argues in terms of the reasons people consume media

argues that people consume media to fulfill one or more psychological or information-seeking needs

grief

can be defined as the normal process of reacting both internally and externally to the perception of loss. Individuals often experience and express grief in different ways, and the way in which a person will grieve depends on the personality of the grieving individual and his or her relationship with the person who died

How supportive relationships can help caregivers and the importance of competent communication in these relationships

caregivers may experience added stress when they do not have the opportunity to express their concerns and this can lead to depression, burnout, anxiety, social withdrawal, and reduced quality of life

Death is a life transition that is ____ and ____

complicated and painful

What is Alzheimer's disease?

degenerative and fatal disease that affects nearly 4.5 million Americans; specific pattern of neurological degeneration with symptoms of dementia; abnormal clumps and tangled bundles of fibers; symptoms include: short-term memory problems, confusion, and communication impairments

What five theoretical approaches are very useful in the formation and evaluation of health campaigns?

Social cognitive theory Theory of reasoned action Health belief model Extended parallel process model Stages of change model (transtheoretical model)

How do most healthcare transactions proceed and how does a consumer mentality affect this process?

Subjective: patient Objective: physician Assessment: physician Plans: physician (maybe patient)

What is the Health Belief Model? How do threats affects behavior?

Two parts: 1. threat cue... 2. cue to action (here is what you can do) The health belief model focuses on an individuals' perceived threat of illness and their behavioral response to the threat When confronted with information about a disease or illness people generally: 1. asses their perceived susceptibility 2. gauge the severity of the threat were it to affect them 3. asses threats to their health vis-a-vis the costs and benefits of changing their behaviors and make appraisals of their environment and resources when making decisions about how to avoid or manage a threat cues to action is also an important contributor

Identify advantages and disadvantages associated with online support groups (including the definition of unbounded networks)

Unbound networks: Internet Communities; not hampered by temporal and geographic locations Advantages -Provide alternative when Face to Face (FTF) is not possible or too difficult -Access to much larger group of people for help Disadvantages: -Lack of immediacy when communicating with others -Difficulty of expressing and interpreting emotions due to reduced nonverbal cues -Inability to touch others -Unwanted messages from unsolicited parties (spam) -Increased opportunities for individuals to misrepresent themselves to the group

What is audience analysis and what are the different sources of data that can be used for this?

Understanding, current values, attitudes, and behaviors of salient audience members Existing data sources: public records (hospital records, police reports, etc.) can help identify target audiences Surveys: can be a good source of new data, particularly when using a representative probability sample. Interviews and focus groups: provide in-depth responses and discussion of health behaviors and attitudes

Discuss MyCareTeam as an example of telemedicine

Very effective website where people with diabetes can keep track of their levels and share them with their doctor. Also helps rural areas

Know what social information processing theory argues about computer-mediated communication, how this factors into the discussion of online support groups, and the meaning of the phrase "hyperpersonal communication"

Walther's social information processing theory has been utilized to explain the ways that people interact online -Communicators utilize the properties of the internet to create and manage a favorable impression online -Receivers of messages play into this through idealizing characteristics of the message sender -Online users report more positive perceptions of partners and are more certain of their perceptions (compared to FtF) -more time to edit their communication making the interactions more controllable and less stressful -This process leads to hyper personal communication -more intimate and socially desirable exchange than F2F

Why do many family members become caregivers?

people cannot afford professional caregivers

What are the three dimensions for evaluating health information

quantity and quality, value, accessibility +Quality &Quantity: -Thinking of patients as "healthcare consumers" -Questions of responsibility -patients->responsibility is on doctor -consumer->"I am responsible" Questions of knowledge and expertise -patients->doctor is expert -consumer->claim some of expertise Questions of expectations Patient-provider encounters tend to follow a script: Subjective: patient Objective: physician Assessment: physician Plans: physician (maybe patient) Support groups give patients the opportunity to voice their concerns -Patients share subjective experience with one another Another context to consider the quantity and quality of information is informed consent +Values -Health communication is not value-neutral -Guided by assessments of right/wrong, good/bad,etc -The concept "quality of life" is affected primarily by views -Values are reflected in public health campaigns Accessibility -In most patient-provider interactions, access to health information is controlled by the provider -HCPs (health care providers) sometimes withhold information -Paternalism: attempt to "help" patient -Information control -Knowledge gap -Health care providers are not the only source of information -Friends and family -The media -Entertainment education- after school specials -not-for-profit organizations- Susan Coleman Foundation- breast cancer -Internet sources

Define reach and specification as they relate to message dissemination

reach: percentage of people being exposed to the campaign message -research has found that campaigns with greater reach were more influential in changing target audience behavior than campaigns with limited reach specification: the ability of a channel to influence certain subgroups of a population

Define cultivation theory and what it argues in terms of how media influences occur

reality portrayed in the mass media influence our perception of reality in the real world over an extended period of time. Long-term repeated exposure to mass media messages shapes our understanding of the world in ways that are consistent with how reality is portrayed in the media. Mainstreaming: people who consume a great deal of media have attitudes consistent with those depicted in the media First-order effects: information gained from media consumption-->good Second-order effects: attitudes gained from media consumption Cultivation theory: reality portrayed in the mass media influence our perception of reality in the real world over an extended period of time. Long-term repeated exposure to mass media messages shapes our understanding of the world in ways that are consistent with how reality is portrayed in the media

bereavement

refers to the period of time in which an individual experiences grief and mourns the death of a loved one. Members of a bereaved person's social network do not always understand grief or do not know how to communicate appropriately with someone who has experienced the death of a loved one

Quality of life: differences in how people define it and what it "means"

some people look at quality of life as more important than health Recent immigrants to the US often adopt very unhealthy practices in order to fit in

define health literacy

the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions

Sexual education as an example of "health literacy:" how young men and women are taught about sex, what they are taught about sex (STD and pregnancy avoidance), how families and media influence attitudes.

"appropriate" sexual education is highly contested in the United States. 1.) Role of educators: Treatment of males and females, how we view how many partners each gender has. heteronormativity 2.) Role of the Media Particularly significant in influencing perceptions about sex Media only shows positive effects of sexual behavior and rarely addresses the potential consequences (STD's, pregnancy, etc.) 3.) Families are an important source of information for adolescents. Families set expectations for Children. Children learn from watching their parents. 4.) Teenage pregnancy is one issue that both parents and educators focus on Teen pregnancies are decreasing. 5.) Overall, 37 States require abstinence as part of Sexual Education. -26 require abstinence be stressed -11 require abstinence be presented as one method of contraception Only 18 states (and D.C.) require that information on contraception be provided. Only 21 states (& D.C.) legally require Sex Education as a part of school curriculum. Only two states (CA & LA) require that sexual education be free from religion. More states require that sex is taught as part of marriage (18) than discuss the negative outcomes associated with teen sex (13) 12 states require that information about sexual orientation be presented -9 states talk about sexual health for all sexualities -3 states require that homosexuality is discussed negatively

Healthcare corporations and providers are increasingly utilizing social media to:

-Listen to patients by seeding conversations -Engage with patients and patient communities -Educate (through mix of user- and physician-generated content) -Enable people to take a leading role in healthcare decisions

How have technologies changed the patient-provider dynamic

-More health information is accessible to the general public now than at any point in history -Most people rely on General search engines (e.g., Google, Bing) Wikipedia and other "crowd-sourced" information sites -physicians are reluctant to transcend traditional provider-patient relational boundaries because of such issues as patient privacy, the reduced ability to provide psychosocial dimensions of healthcare increased vulnerability to medical malpractice litigation -responding to multiple emails would drastically increase physician workload -emails increase patient satisfaction, feelings of safety, and quality of care -majority of patients prefer online communication as opposed to face to face -Patients ask about info they read online -tend to overdiagnose -can aid in diagnoses as well but not as often

How has technology facilitated and changed continuing education for providers?

-Most providers are required by state to continuing ed courses to maintain license -Many web based continuing education courses -Cheap -A variety of web-based continuing education courses have appeared, and many allow providers to complete the course at their own pace, some even allowing providers to download a certificate of completion at the end of the course -Web-based continuing education courses support the use of the multimedia, and they are relatively inexpensive to design, implement, and maintain **The variety and quality of Internet-based continuing education courses vary and this needs to be assessed in future research along with the other cost-cutting benefits these courses offer to the healthcare system**

How do some patients deal with illness and what are the stages of grief?

-Some patients report experiencing "social death" -Patients and their families might avoid discussing illness -Patients frequently experience "stages of grief" -Denial -Anger -Bargaining -Depression -Acceptance **Note** everyone grieves a certain way and these stages of grief are not scientifically supported; not every stage is always reached and there is not a definite order to these stages

How should health communication scholars focus on health literacy recommendations?

1. Recognize health literacy is foundational to reforming health and healthcare in America 2. Develop and advance metrics for communicating progress for improved health literacy 3. Integrate lessons of growing body of evidence from field of health literacy into coordinated national responses to improved patient safety, preparedness and response.

What are the five steps of conducting a campaign?

1. audience analysis: understanding current values, attitudes, and behaviors of salient audience members -data, surveys, interviews/focus groups 2. segmentation: dividing the audience based on their relevant characteristics -sex, age, race, etc 3. crafting a persuasive message salient, cues to action, colorful, etc. appeal to logos, pathos, ethos 4. Deciding channel -targeting: deciding best channel; tailor the message

What are the health related needs fulfilled by the media

1.Information Seeking 2. Entertainment/diversion or tension release 3. Social needs: personal integrative function 4. Convenience -Helps fulfill our desire to reduce uncertainty about health issues by gathering information that will help us to make better choices about how we should respond to daily events ex. People may pay attention to health stories in the news; may go to internet sources such as webmd; may read magazines such as Men's Health

What are the three main issues associated with health information as it is presented on the internet

1.Issues of understanding: just because someone can locate information does not mean they will understand it or apply it correctly 2. Issues of credibility: many websites allow anonymous posting/crowd sourcing of data 3. Issues of accessibility: many people do not have access to computer information. Health literacy also affects some people's ability to understand.

Define message tailoring and explain the three components of message tailoring

Any combination of information and behavior change strategies intended to reach one specific person, based on characteristics that are unique to that person, related to the outcome of interest, and derived from an individual assessment. 1. Segmentation: dividing the target audience according to important criteria 2. Targeting: selecting the appropriate channel to deliver the message 3. Tailoring: matching the message to the audience Tailored messages are more relevant Tailored messages gain more attention Tailored messages eliminate unnecessary information

How are demographic trends affecting the role of senior care in the US?

Average lifespan increasing People over the age of 65 makes up a large proportion of consumers of the US healthcare system. Many of these individuals are on fixed incomes that may make it difficult to meet ally of their health care needs. Some older individuals are negatively stereotyped by healthcare providers can often lead to depression and other negative psychological health outcomes for older people. Older adults are diagnosed with cancer more than any other segment of the population, have higher incident rates and arthritis and hypertension. Those 85 and older have higher incidents of memory impairment than younger age cohorts.

What are the three main barriers to hospice care and what is "drive by" care?

3 barriers to hospice care: 1.Lack of continuity of care between hospice team members 2.The inability of hospice staff to meet the emotional and spiritual needs of patients 3.Lack of adequate training among healthcare professionals in taking care of those who are dying. "Drive by care"- is when hospice team members often move from one patient to the next, rushing to complete visits, documentation, and follow-up only to learn of the death of the patient the next morning, before "care" could be provided.

What is the Transtheoretical Model

AKA the Change model: describes the five stages of behavioral change 1.) Precontemplation: Unaware of health issue and subsequently do not think about making a behavior change "did you ever think about quitting smoking?" not even thinking about it 2.) Contemplation:People are aware of a health issue but may still be weighing the pros and cons of adopting some type of behavioral change Thinking about it needs to be changed 3.) Preparation and Determination: Individuals actively begin planning to change their behavior 4.) Action: Behavior action actually occurs Ex: Using condoms while having sex 5.) Maintenance/Relapse: Refers to whether people stick to their behavior change or relapse into one of the previous stages individuals in different stages exhibit distinct behavioral characteristics -researchers can effectively analyze and segment a target audience according to their different stages of change

Adolescent "risky" behaviors: the prevalence of adolescents who experiment with drugs, alcohol, and sexual behavior (you do not need to know exact numbers here, just general trends)

Adolescents experiment w/risky behaviors, increase steadily w/age. Adolescents frequently experiment w/risky behaviors 37% of adolescence experiment w/drugs before the age of 18 -The average of the "first use" is 13 years of age -Most popular drug is weed (3%). The percentage of adolescents abusing alcohol increases steadily with age. .5% among 12 year olds. 17.2% among 19 year olds

What is the overall process of hospice care? How is it initiated? Where does most care take place? How does care proceed after admission?

Hospice refers to programs that provide support and care for people in the last phases of an incurable disease, with a focus on maintaining the quality of their remaining life by providing services that both aid physical comfort and address psychological and spiritual needs. How is hospice care initiated? When a candidate for a hospice program is identified, hospice staff members generally hold an initial meeting with the patient's primary physician(s) and a hospice physician to discuss the patient's history, physical symptoms, and life expectancy. Hospice staff members meet with both patient and their family to discuss the hospice philosophy, available services, and expectations. Staff and patients discuss pain and comfort levels, support systems, financial and insurance resources, medications, and equipment needs. A plan of care is developed for the patient and is regularly reviewed and revised according to the patient's condition. Following the death of a hospice patient, bereavement services and counseling are typically available to loved ones for a year. Where does hospice care take place? Hospice care takes place in the patient's home, although more and more in patient hospice facilities are becoming available. In-patient hospice facilities are helpful for patients who do not have family members or other loved ones to care for them. A family member is typically the primary caregiver and makes decisions for the terminally ill individual. physicians or nurses are responsible for making decisions about increases or decreases in pain medication hospice staff provide 24/7 support -provide family caregivers with training in pain and symptom management

Explain the importance of verbal and nonverbal issues in the caregiver/patient situation, esp. the role of nonverbal communication in caregivers' approach to pain management.

If patients cannot communicate the amount of pain they are experiencing due to their illness, caregivers run the risk of under-medicating or over-medicating their loved ones, which can lead to problems such as the accumulation of toxins associated with pain medications, renal dysfunction, decreased cognitive functioning, and organ failure. Under-medication can lead to inadequate pain control and unnecessary suffering for the patient. Caregiver must rely on nonverbal signs of pain, such as facial expressions and body movements. Nonverbal and behavioral cues indicating pain are often used by caregivers as a sign of whether to increase pain medications.

Compare/contrast interviews and focus groups: know how each is conducted and the relative strengths of each approach

Interviews and focus groups are good methods for gaining a thorough understanding of target audiences' perceptions of a health issue and their health-related needs. -Interviews involve talking to individual audience members. -Focus groups are group interviews with about 8-10 people -Strengths of focus groups over interviews is that one person's responses can influence other participants response by remembering similar experiences with a health issue and can change the richness of the data by providing multiple viewpoints on the subject Cons to focus groups -some individuals may be apprehensive to talk in a group -some individuals in a group tend to dominate the discussion

Give statistics that identify the scope of the health literacy problem in the US

Nearly half our adult population lacks the literacy skills to understand and use health info More than 1 in 3 americans cannot understand/remember their doctors instructions regarding medications 85% of Americans cannot understand their contribution to their health insurance costs 1 in 10 Americans are considered health literate

What are some arguments scholars make in regard to media portrayal of disordered eating

Obesity is influenced by the media -children see nearly 5500 messages/year that promote unhealthy eating -TV stars serve as poor role models for healthy eating -many are portrayed drinking and eating but are extremely thin Eating disorders -media portrays the thin ideal for women -less than 5% suffer eating disorders there has been an increase among women over the past few decades -media distorts perceptions of ideal bodyweight via models and TV

What is representative probably sampling?

Obtaining a sample for a survey involving randomly selected participants for a sample from a sample frame - a list of population members

What is the agenda setting theory? How does the media achieve this through gatekeeping, underreporting, and over reporting?

One of the primary ways that media affect the general public is through agenda setting -agenda setting refers to how the daily selection and display of news stories by the media influences audience perceptions about the importance of news topics and issues News reporters serve a gatekeeping role is society by deciding which stories are newsworthy and reporting on them -this helps shape public perception -gatekeeping often linked with political views News media privilege sensational stories, causing many people to misunderstand the risks and severity of certain behaviors or diseases under or overrepporting of a health problem or issue can ultimately affect the public's understanding of the issue and their behaviors towards it

Where was hospice care developed and what is the goal of hospice care?

Originated in England by Dame Cicely Saunders who was a nurse interdisciplinary team should manage with primary goal being pain and symptom management for patient and death education and bereavement counseling should be given to family members Goal of hospice care is to provide a dignified, comfortable death for the terminally ill and to care for the patient and family together -are being given increasing recognition in mainstream medical care

Know the concept of paternalism and how physicians sometimes strategically withhold information (leading to a "knowledge gap")

Paternalism: Is the attempt to help the patient. Paternalistic view: The policy or practice on the part of people in positions of authority of restricting the freedom and responsibilities of those subordinate to them in the subordinates' supposed best interest. Patients feel as if their role is to obey and cooperate and provider should take dominant role (p.27) Physician's sometimes strategically withhold information to attempt to help the patient but leads to a knowledge gap (By not giving other treatment options for the patient to decide for themselves?) This could be due to, for example, a patient performing research and wanting one form of treatment that the provider does not agree with so the provider says only what makes his form of treatment sound best. In other words, guiding the patient to do one thing when there are multiple options Knowledge Gap: patients aren't as informed, do not have all the information to make an informed decision; gap between healthcare providers and patients

What is palliative care, the goals of palliative care, and the (financial) barriers to palliative care?

Palliative care: an approach to medicine that emphasizes reducing pain and suffering among terminally ill patients as opposed to prolonging life at the expense of sickness, pain, embarrassment, and time away from loved ones (curative care); palliative care accepts death as a normal process **REQUIRES INTERDISCIPLINARY TEAM** Goal of palliative care: pain and symptom relief, attention to psychological and spiritual aspects of dying, and involving a patient's family and other support network members in the process of dying. Financial barriers of palliative care: Palliative care in the US has been limited by insurance reimbursement requirements as well as by a shortage of well trained healthcare providers who are knowledgeable about end of life issues. For example: managed care organizations can save money by delaying referrals to hospice and palliative care programs- in some cases anywhere from $1700 to $4900 per admission, which is one of the major reasons why people are referred to hospice and palliative care programs late in the cycle of terminal illness.

Be prepared to describe the financial and health-related impacts of poor health literacy

Patients who have a low health literacy may not understand the medication they are taking. -Ex: adult male not taking heart medication for hypertension because not feeling hyper -Woman takes double pills in morning to make up for not taking one at night

Define audience segmentation and identify salient criteria associated with the process (including the sensation-seeking example used in the book)

Segmentation: dividing the audience based on their relevant characteristics Examples of characteristics include age, sex, gender, personality, etc. -specific messages tailored to unique characteristics of subgroups of the target population tend to be more effective -segmenting audience based on sensation seeking -sensation seekers are individuals who like to take risks -high sensation seekers like messages that are fast paced and exciting

Effects of media consumption on desire for cosmetic surgery

Shows such as Nip/Tuck, The Swan, and Extreme makeover reflect our culture's obsession with cosmetic surgery these shows promote the idea that women need to have cosmetic surgery in order to achieve a high sense of self esteem and happiness shows downplay the risk of these surgeries

Define incidence, prevalence, and causality. Also know the dimensions of causality (necessary v. sufficient conditions, probabilistic causes)

Terminology frequently used in health reports contributes to confusion Prevalence: the proportion of people in a population who already have a given attribute or condition ex:The number of children who already have an ASD: 1 in 88 Incidence: the number of new events in a given population within a fixed timeframe (usually per year) Causality: a cause is something that produces a specific outcome Causality can be defined along two dimensions Necessary vs. sufficient causes If A is necessary for B (necessary cause) that means you will never have B if you don't have A. In other words, of one thing is a necessary cause of another, then that means that the outcome can never happen without the cause. However, sometimes the cause occurs without the outcome. If A is sufficient for B (sufficient cause), that means that if you have A, you will ALWAYS have B. In other words, if something is a sufficient cause, then every time it happens the outcome will follow. The outcome always follows the cause. However, the outcome may occur without the cause. Probabilistic (statistical) causes (statistical) causes - odds that we get a certain health problem EX: Smoking 3 packs a day increases your chances of getting cancer by 30%. Yet, we still know people who smoked all their lives and lived to be old. * Most health information is "probabilistic".

Explain the Diagram included in Parker and Rattan's report

The 2004 IOM report set forth a model which describes how individual health literacy skills are influenced by culture and society, the educational system, and the health system Reading and numeracy are fundamental components of literacy, -health literacy includes a broad range of cognitive and social processes that are involved in the act of comprehending and responding to both oral and print communication An individual's ability to read, understand, and act on health information is ultimately determined by the clarity and complexity of the required text. The IOM health literacy report acknowledged that the epidemic of poor health literacy actually reflects a problem in the way health information is communicated to people when trying to determine what they must do to take care of their health.

Post mortem decisions

There are 96,000 Americans waiting for organ donations, unfortunately many of these people will not receive a life saving organ because of public resistance to donating organs and tissue after death and because family members are reluctant to donate organs from their deceased loved ones There are different age limits on the donation of some organs and tissue, and a person's age and medical history are taken into consideration when an organ donation is made. There are a variety of reasons why people are reluctant to donate organs and tissue after death, including lack of knowledge about donation, religious and spiritual beliefs, concerns about body mutilation and the deservingness of potential recipients or organs and tissue, such as criminals.

Informed consent: what it is, why it is important, what it has become, and the challenges associated with the process of informing patients v. minimizing responsibility

What it is: Doctors will give you information about a particular treatment, test, or research study in order for you to decide whether or not you wish to undergo a treatment or test. This process of understanding the risks and benefits of treatment is known as informed consent. It lists the possible side effects and the process of the treatment, test or research. (Textbook: Patients in the US have the legal right to be fully informed about their health condition, and many Americans perceive this law as ethical and would insist on having full knowledge of their health situation, especially if they were at risk of dying from cancer or high blood pressure.) It is important because Patients should have full knowledge of what they are participating in or agreeing to do Become: Informed consent is now about protecting the providers from being sued. You are really just saying that you will hold yourself responsible for anything bad that happens. Informed consent seldom speaks about the alternatives or what might happen if treatment does not occur. Providers in the US often pressure family members to make decisions about treatment options relatively quickly Challenges: Some patients prefer to be informed if they have cancer and some prefer indirect communication which allows family members to be more hopeful about a loved one's recovery. Medical interpreters are required to interpret information for providers and patients without omitting or changing anything. This can make it difficult to convey information to patients in a culturally sensitive way, especially if the physician conveying information to the medical interpreter has little understanding of the health beliefs of the patient.

What are the two main challenges associated with caregiving communication?

Willingness to communicate concerns -Do not want to burden them with the added stress of thinking about concerns -Do not want to overstep interpersonal boundaries or add stress to the lives of others Communication of emotional support -researchers have found that the provision of emotional support is one of the most time consuming and challenging aspects of caregiving

How does caregivers' willingness (or reluctance) to communicate with others affects their role and health?

a caregiver's communication with their social network and providers can have a positive impact on their stress levels particularly when they are able to use their communication skills to obtain assistance an emotional support humor seems to be an effective way of coping with stress Many family caregivers are reluctant to communicate problems they encounter during the caregiving process to the people they are caring for or to others within their social network because they do not want to burden them with the added stress of thinking about these concerns. Family member caregivers often avoid communicating about their problems with others because they do not want to overstep interpersonal boundaries or add stress to the lives of others by raising concerns about caregiving. Caregivers may experience added stress when they do not have the opportunity to express their concerns, and this can lead to depression, burnout, anxiety, social withdrawal, and reduced quality of life. Competent Communication the ability to construct and use appropriate and effective messages to meet goals and needs and to successfully create and maintain satisfying relationships. Both older adults with cancer and their caregivers with higher communication competence had lower perceived stress levels and higher satisfaction with their support networks than individuals with lower communication competence

What is presbycusis?

age related hearing loss, problems increasing after age 45

cues to action

important in triggering an individual's motivation to make assessments of his or her available resources when action on campaign messages -internal cues to action: emerge from within the individual; ex. someone starts an exercise program b/c they feel bloated or unenergetic -external: pressure from peer out members; ex. peer or celebrity testimonials about the positive effects of exercising campaign designers need to incorporate cues to action within campaign message to effectively motivate their target audience

What kind of approach to information do most people in the US take

more is better

Caregivers for the ill: What are the recent demographic trends?

most primary caregivers are family members ill equipped to deal with the physical and emotional stress of caregiving Caregiving is correlated with negative caregiver health with 17% of US caregivers reporting fair or poor health, compared with 13% of the general adult population As the length of the human life span increases individuals are living longer, and with advances in medicine it is now possible for people with a variety of long-term illnesses to live with their condition for many years. Only about 5% of older Americans currently experience institutional long term care, but this number is projected to grow in the next several decades with the aging of the baby boomer age cohort.

What is the social cognitive theory? What are the two overarching expectations associated with SCT? What is the meaning of self-efficacy? How does attitudes, values and environmental influences affect behavior?

think self efficacy or "you can do it" SCT: health related behaviors are ultimately the result of a combination of an individuals thought processes and influences from his or her social network and life situation A person's beliefs have considerable influence over his or her behavior SCT posits that behaviors are guided by 2 expectations i)the expectation that an action will lead to a particular outcome -ex. someone who does not believe exercise will reduce the risk of heart disease is unlikely to listen to a health campaign that says to exercise ii) the expectation a person has about his or her ability to perform this action -ex. if someone does not believe they are likely to get in shape the most likely will not get in shape; has a lot to do with self efficacy self efficacy:the belief by an individual to in their ability to exert personal control over a situation

What is the Theory of Reasoned Action? What are the two processes that predict behavioral intentions? Identify additional factors related to behavioral intentions.

think social norms; "someone you look up to does it so you should too" TORA states that the primary predictor of a behavior is an intention to engage in that behavior TORA posits that behavioral intentions can be predicted by two parallel cognitive processes i) a person's attitude toward the behavior under consideration i.e. evaluation of the behavior as positive negative or neutral ii) his or her appraisal of relevant social norms i.e. approval of friends and family members to the behavior in question; "will the approve?"

What is the sleeper effect?

when a behavioral change due to being exposed to a campaign message occurs slowly -this makes it difficult to asses when to evaluate the campaign

anticipatory grief

when a person is dying from a long-term illness, his or her loved ones often experience anticipatory grief; may have the same symptoms as those experienced after death has occurred

What do some physicians in other countries do when they know a patient is dying?

withhold information to the family