New Technologies in Health Communication CH 13

Can facilitate communication to those who are not comfortable, but can make patients feel more pompous and arrogant towards providers - May feel that these drugs will cure all their problems and that they are affordable

How are patient attitudes affected toward prescription drugs and communication behaviors with providers because of Direct to Consumer Ads?

Should be utilized because translational research is slow - opportunity is that information can be shared and exchanged quickly and widely using Web 2.0

What is a potential opportunity for dissemination and implementation? Why should this be utilized?

Can design education materials and interventions for low literature patients

What is a potential opportunity in regards to technology that can address health literacy?

HIT can facilitate evidence based races regardless of patient demographics - overcomes aversive racism and bias Minority patients can be assisted through information tailoring and self management tools

What is a potential opportunity that would address health disparities? What would this overcome? How else can minority patients be assisted?

We can determine our relative success or failure by comparing ourselves to others interpersonally or through media

What is the social comparison theory?

Relying on digital info makes people rely on the biomedical model - can human interactions really be replaced (need a human touch) - is it a focus on quality vs quantity?

What needs to be considered about patient provider interaction with the rise of Technology?

80% (common) - seek info on disease/condition, treatments, doctor, hospital, and insurance - you've adult female, white, higher income, higher education

What percentage of people seek information? What types of information do they seek? Who is more likely to seek info?

11%

What percentage of users who download an app to help them track or manage their health?

225,000 patients in Hawaii (Chen et al., 2009) KPHealthConnect Studied pre and post implementation rates Studies office visits, telephone visits, and emails (became substitutes)

What study was conducted to examine if electronic health records burden healthcare resources?

Studied increased info seeking because of DTCAs - there was dissatisfaction with provider who denies request - provides evidence for agenda setting, priming, and framing

What was Lee's 2010 study? What does it provide evidence for?

Office visits declined, e-mail and phone calls increased, and efficiency improved

What were the results of the Hawaii study by Chen et al, 2009 with the EHRs

The FDA - Ads have to give description of symptoms and risk associated

Who oversees Direct to Consumer Ads? Give an example

- we learn from the media - we form attitudes about diseases and behaviors based on media - we develop beliefs and what causes disease and how to cure them

Why do we care about media effects in health?

Anonymity, convenient, everything is available, provided better understanding, reassurance, Second options, avoid barriers

Why do we seek info online?

- to see or get a copy of your medical record - to request to have any mistakes corrected - to get a notice about how your health info is used and shared - to say how and when you want to be contacted by your provider - to file a complaint if you think any of these rights have been violated

With the HIPAA Privacy Rule, you have the right to...

Use of professional marketing tools caused opt in rate to range from 88-92% - means that patients need to be encouraged, informed, and reassured for using technology

(Tripathi et al. 2009) discovered what increased opt in rate in the 30 healthcare organizations for HIE and EHR? What was the exact percentages? What does this mean?

18% to 57%

From 2001 to 2011, physicians' use of EMR/EHR systems increased from...

Social media - creating and consuming information (people contribute to the media)

Give an example of interactive media

Fit bits and apple watches, nutrition and fitness apps, online communities, sleep apps

Give examples on how technology helps manage our personal health?

Improve patient safety, provide more coordinated care, give better adherence to evidence based medicine by provider

How are electronic records helpful?

Personal health record - private, secure software apps - patients can store, organize, and share health info (have more control)

What is PHR? Describe it

Studied opt in to data being uploaded Rather than asking patients to upload, they demanded that they should - emphasizes that the new system would solve problems (inconvenience and cost), and the benefits of it (convenience, safety, ease, control) - addressed safeguards for security - providers encouraged patients to join

As there were more concerns with technology, a collaboration of 30 healthcare organizations assessed implementation of HIE and EHR. Describe the study

Compared MHM users and non users (selection bias is present) Office visits, calls, clinics and ER visits, and hospitalization MHM users showed increases

Describe how Palen et al. 2012 conducted a study on 88,600 patients in Colorado with MyHealthManager?

N=430 - 76% white, 75% female - prediction: more TV will lead to more loneliness, hopelessness, and shyness - what happened? Prediction was correct Cross sectional data (collected at one time)

Describe the study conducted that examined the cultivation theory. What type of data was collected?

Patient

EHRs follow the...

Friends episode - condoms are 97% effective

Example of social cognitive theory in real life?

Step 1: mass media influence people to think about a certain topic (DTCA from media - agenda setting) Step 2: seek our more info from others who them deem opinion leaders (taking w more healthcare providers)

Explain DTCA and the two step flow model

Examines ways in which issues are presented in the media and how they influence our understanding - influences HOW we thinks about issues

Explain Framing as a theory of media effects. What does it influence?

No name, just brand - broader seeking ad/(obtain more info from provider) - regulates by FTC, not FDA

Explain help seeking ads. What is the unique rule to these ads

The most common ad - have to accurately describe the pros and cons of medication

Explain product claim ads

Stories told by media, especially TV, shape the way we view the world - portrayals of health and psychosocial health

Explain the cultivation theory. What does it portray!

Talk about name of medication but not the use of the prod and cons associated

Explain the reminder ads

Focus on how we learn by observing others - our values, thinking, behaviors are influenced - modeling via media especially when we identify with characters - people learn but are not exposed to realistic consequences

Explain the social cognitive theory (Bandura)?

Ways media makes certain issues more prominent by covering them more often that others - tells us WHAT issues to think about, not HOW to think about the,

Explain the theory of agenda setting? What does it tell?

Embedding health related information into popular media narratives with the goal of changing knowledge, attitudes and behaviors - health professionals work with writers and producers to create storylines - require both accurate and entertaining context

Explain the theory of entertainment education

Attainable - people become motivated Unattainable - May avoid positive changes

Explain upward social comparison and what can happen if goals are attainable or unattainable

No (only in US and New Zealand) - only we have pharmaceutical company ads rear reach mass audiences

Is DTCA an international practice?

Health care

People who are more engaged in their health actually get better...

Extended care evisits, home TeleHealth, virtual visits, medication adherence, clinical support, transmit files from home

Provide examples of how emerging technologies offer new ways for you and your doctor to monitor and manage chronic illness?

Tell viewers where they can learn more info

The FDA mandates that DTCA TV ads must..l

Have fine print describing potential drug risks

The FDA mandates that DTCA print ads must...

Your own health information, regardless of paper or electronic form

The HIPAA Privacy Rule gives your rights over...

Providers set up physical, administrative, and technical safeguards to protect your information (ex. Passwords and PINs)

The HIPAA Security Rule requires...

Scripts from physician AND pharmacists, nurses, and other physicians - more likely to get drug from PCP after citing other providers as sources (indicates that if patient did not get script, they asked to switch providers)

Those exposed to DTCAs sought into about... (they were also more likely to...what did it indicate?)

- make doctor visits faster - seamlessly coordinate your care among all your doctors - allow you to be in full control of medical data

Today, many doctors are using electronic health records. Patients' health info/data on electronic records help...

Interactive and non interactive

What are "two types" of mass media?

Social networking sites, social networking for patients or physicians, blogs (patient or provider)

What are common ways with which people share information?

Provide quantitative info about effectiveness, include cost of drug to keep expectations more reasonable

What are some reforms to polities for DTCAs?

Agenda Setting, Framing, Cultivation Theory, Social Cognitive Theory, and Social Comparison Theory

What are the Theories of Media Effects (list them)

- information accessibility - information relevance - information credibility - information sharing

What are the challenges of information seeking in Health 2.0?

Ads boost corporate profit - unethical practices (misleading ads) - gives patients false hope - dissatisfaction with healthcare providers who do not prescribe requested med

What are the cons to Direct to Consumer Ads?

- no content analysis - how is health portrayed? - temporal order - establishing a baseline (have to know the subjects attitudes/psychosocial health before study) - how do we measure exposure - could be a problem when recalling memory - multitasking could take place

What are the limitations of research on cultivation theory?

People with stigmatized illnesses feel less embarrassed when discussing treatments - offers insight on how to seek help

What are the pros to Direct to Consumer Ads?

Product claim ads, reminder ads, help seeking ads

What are the three types of DTCAs?

Check that info is correct and complete Keep track of important health info Have medical history available See your medicine and dosages

What can you do with your electronic health record?

Promote prescription medications to lay audiences through print and electronic media - began in 1981 - now $5 billion a year

What do Direct to Consumer Ads promote? When did they begin? How much do they make now?

Efficient, effective, and safe healthcare

What do EHRs promote?

EHR - electronic health record - digital version of medical record - shared by doctors, labs, pharmacies, hospitals, and insurance companies

What does EHR stand for? Explain

Health Information Technology

What does HIT stand for?

- if we are invested in the show, if we identify with the characters, and when we lose our sense of self in context

What facilitates learning from entertainment education?

Human agency, human capabilities, vicarious learning, and self efficacy

What four concepts does the social cognitive theory reveal?

EHR specialists can ID at risk patients, and technology can reach out with tailored messages (ability far outpaces responsibility) - example: pregnant 16 year old and tailored target messages

What future considerations need to be made with the concept of "ability vs responsbility"?

HIE- health information exchange - allows electronic patient healthcare information to be shared within and across healthcare organizations

What is HIE? What does it allow?

Applications, services, and tools available via Web 2.0 technology that allow people to seek, shares and manage health info online

What is Health 2.0?

HL in context of electronic services; use to solve or manage problems

eHealrh literacy is...