OTM: Dollars for Doctors

I love NPR On The Media (OTM), and this past week included a particularly interesting (given my interests in health communication) story. Dollars for Doctors is a conversation summarized by OTM as:

As part of the Obama administration’s healthcare reform, patients will, for the first time, be able to see what money pharmaceutical companies are paying to physicians and how – every notepad, free trial and conference junket. Reporters Charles Ornstein and Tracy Weber have, over the last 18 months, have been engaged in a kind of dry run, following a money trail that 13 pharma companies were legally required to disclose.

There were a few parts of this segment that I thought could lead to interesting research projects...

The first was pretty obvious, which is how news consumers (aka: patients) would actually read, make sense of, and (potentially) act on information provided by journalists. Databases provided by news organizations can be amazing resources, but even the best-designed systems can be pretty complicated. How readers use the raw data (however that might be provided), as well as whatever stories the journalists produce using that data, would be pretty interesting. I'd have to imagine readers' health literacy would play a role there, of course. It takes a pretty media- and health-savvy consumer to really dig into this and fully understand the implications, I suspect.

The other thing that I thought was surprising was the healthcare providers that can write prescriptions but AREN'T covered by these kinds of agreements meant to provide extra sunshine on how pharma companies pay physicians to give speeches and such. They noted in the stories that other healthcare providers with prescriptive authority (e.g., nurse practitioners) aren't included. If pharma companies believe these kinds of payments do influence prescription decisions, will the funding shift to these non-covered healthcare providers? The view of nurse practitioners is pretty limited in academic literature on DTC prescription drug advertising (compared to physicians or patients), and this just got me thinking about how other healthcare providers merit more attention given these kinds of stories.

Phase 2

Well, I'm back after the holiday break. More significantly, I'm back after receiving the positive news that I got tenure at UT. This, of course, made for a particularly outstanding holiday break.

It's an interesting, and exciting, moment in my research agenda. I've had a few projects in the back of my mind for years now - related to health literacy measurement, for example - that I just shelved due to a need for projects that didn't have the potential to become black holes on time, energy, resources, etc. Now, though, I'd like to think I have a little more flexibility in the kinds of research questions I can ask and work to answer.

I'll get back to regular posting now that the semester is just a week away, and I'll discuss some of these potential new projects as I figure out what I'm going to pursue next.

Exchanging Health for Commercialization: The News Media's Mediation of the Baby Carrots Campaign

Another article just came out in press that I wanted to point interested readers to... This article, "Exchanging Health for Commercialization: The News Media's Mediation of the Baby Carrots Campaign," was a fun one to work on. It looked at how the mass media (journalists, really) covered a novel advertising campaign designed to increase consumption of baby carrots.

The abstract is:

The public receives a great deal of its public health information from the media, which has the ability to deliver such information and to affect public perceptions about issues. The study presented here examines the media’s mediating role in a recent marketing campaign with possible health implications. The baby carrots campaign targeted children and teenagers, advertising baby carrots as junk food. The campaign received much attention from media sources, and coverage of the campaign moved across a range of media from traditional outlets to digital news sources, mostly without putting a critical eye to the campaign or how relevant health issues were addressed. A census study of print and online media content over a four-month period beginning just before the campaign’s launch revealed the media relied heavily on campaign sources to frame the advertisements as positive and effective in generating buzz. Media coverage of the campaign offered little commentary from independent sources, such as message-design or public health experts, and limited input from the general public, thus presenting an imbalanced perspective. Blogs were more critical, framing the campaign as negative and non-effective. However, this study revealed that neither the media nor blogs raised relevant health issues such as the potential health benefits of eating more carrots. While the campaign’s marketers may have succeeded in promoting baby carrots ephemerally through the media, journalists and other media sources may have missed an opportunity to promote a more lasting public health discussion.

One of the first news stories about this campaign actually led to a great in-class exercise, where I asked grad students to increase consumption of baby carrots. I had eight teams that semester, and I don't think a single one picked the strategy in this campaign. It was a great exercise, though, I've used it once or twice since then - it gives students a chance to get very creative and think about non-obvious ways to increase sales of baby carrots.
You can get the full article in PDF form here.

The full reference is:

Holton, A., Love, B., & Mackert, M. (2011) Exchanging Health for Commercialization: The News Media's Mediation of the Baby Carrots Campaign. Cases in Public Health Communication & Marketing, 5, 2-25.

Memory Performance, Health Literacy, and Instrumental Activities of Daily Living of Community Residing Older Adults

I'm busy traveling (and relaxing) over the holiday break, including celebrating the good news that I got tenure. (Hooray!) But I just realized a new article I co-authored in Nursing Research is out. The article is available on the Nursing Research website here.

The abstract is:

Background: Health literacy is associated with cognitive function across multiple domains inolder adults, and these older adults may face special memory and cognitive challenges that can limit their health literacy and, in turn, their ability to live independently.

Objectives: The aim of this study was to evaluate if an association existed among health literacy, memory performance, and performance-based functional ability in community-residing older adults.

Methods: Forty-five adults participated in this study. Designed to reflect everyday memory, the Rivermead Behavioral Memory Test (RBMT) bridges laboratory-based measures of memory and assessments obtained by self-report and observation. The RBMT classifies individuals into four categories of memory performance: normal, poor, mildly impaired, and severely impaired. The participants were recruited in the two categories of normal (=22) or impaired (=16) category on the RBMT. The sample consisted of 14 who were in the impaired category and 31 in the normal group. Their average age was 77.11 years, and their average number of years of education was 15.33 years. Health literacy scores measured with the Rapid Estimate of Adult Literacy in Medicine.

Results: Health literacy scores were high (M = 65.09, SD = 2.80). Thirty-four participants or 76% of the sample scored a 66 out of a possible score of 80. Pearson correlations were calculated for the study variables. Health literacy scores with education and cognition (.30), memory performance groups (normal vs. poor; .25), and performance-based instrumental activities (.50) were associated significantly.

Discussion: The development of a broader assortment of health literacy instruments would improve the ability of researchers to both compare studies and build on the knowledge and results of others.

This was a great project, I was excited to be involved with it. The full reference is:

McDougall, G., Mackert, M., & Becker, H. (2012) Memory Performance, Health Literacy, and Performance-Based Instrumental Activities of Daily Living of Community Residing Older Adults. Nursing Research, (61) 1, 70-75.

Google Scholar Citations

I was playing around with this for a few minutes today, so I wanted to share Google Scholar Citations for anyone that hasn't checked it out yet. If you work through the sign-up process, Google Scholar will figure out which articles you have authored and then track which are being cited, in which journals, etc. It's a very cool tool, and I'm looking forward to messing around with it a bit more when I don't have too many end-of-semester loose ends to tie up.

Advertising Educational Foundation: Visiting Professor Program

I just received an e-mail this morning about the AEF's Visiting Professor Program, which is a chance to spend a couple weeks visiting an advertising agency. I did this a few summers ago, spending two weeks (mostly) at Ogilvy Healthworld in NYC. It was a GREAT experience which helped me with my research and my teaching.

For anyone out there interested in learning more about advertising agencies, I'd highly recommend checking out more information about the program: http://www.aef.com/on_campus/professor/vpp/3001

Health Literacy, Self-Efficacy, and Patients' Assessment of Medical Disclosure and Consent Documentation

I'm excited that a new article I co-authored is now out online at Health Communication. It relates to a project I'm involved in that was looking to improve medical disclosure and consent forms used in Texas. This particular paper looks at the relationship between health literacy, self-efficacy, and patients' understanding of these complicated documents. (I presented another perspective on this project at NCA as part of the top paper panel in the applied division.)

One of the things I've really enjoyed about this project is the chance to work with colleagues in the UT Communication Studies department. Some of my most enjoyable research projects involve collaborators from other departments, and this was no exception - everyone brings different perspectives to the project and you can end up somewhere quite interesting and productive.

The abstract is:

Informed consent documents are designed to convey the risks of medical procedures to patients, yet they are often difficult to understand; this is especially true for individuals with limited health literacy. An important opportunity for advancing knowledge about health literacy and informed consent involves examining the theoretical pathways that help to explain how health literacy relates to information processing when patients read consent forms. In this study, we proposed and tested a model that positioned self-efficacy as a mediator of the association between health literacy and patients' comprehension and assessment of informed consent documentation. Findings from structured interviews with patients (n=254) indicated that lower health literacy predicted lower self-efficacy, which predicted feeling less well informed and less prepared, being more confused about the procedure and its hazards, and wanting more information about risks. Incorporating awareness of self-efficacy into disclosure documents and consent conversations may be a useful means of prompting patients to ask questions that can help them make informed decisions about care.

You can get the article through Health Communication here, and the citation is:

Donovan-Kicken, E., Mackert, M., Guinn, T., Tollison, A., Breckinridge, B., & Pont, S. (2011) Health Literacy, Self-Efficacy, and Patients’ Assessment of Medical Disclosure and Consent Documentation. Health Communication. (online access first) doi: 10.1080/10410236.2011.618434

Implications - Real vs. What We Might Wish

It's been a busy week after NCA, lots of grading and such before the semester ends... At this point there is one particular moment that really jumps out at me from NCA. I tried to go back and figure out which panel/paper this was, but I haven't been able to pin down the exact paper. So what I'm about to write is based on a few brief notes and my recollection of that presentation.

(Warning: All numbers and study details are extremely approximate.)

I was at a panel for the health communication division. One of the papers was about how a plot about organ donation embedded in a TV show might influence positive interpersonal communication about organ donation and eventual intentions to sign up and be an organ donor. The idea of embedding educational content or plot lines in TV shows is something that has been done before, of course, but the paper included a look at perceived realism and perceived entertainment value of the show as independent variables. Figuring out what is more important (realism vs. entertainment) is interesting for research purposes but also potentially practically meaningful if TV shows actually want to have a positive impact on public health.

As the presenter worked through the paper, which was a regression analysis (IIRC), the entertainment value was approximately five times more meaningful in predicting interpersonal communication and intentions than realism.

In discussing the results, the presenter made the point that this means TV shows (hopefully working with medical professionals and social scientists) should focus on entertainment AND realism to influence behaviors in a positive way.

There are a lot of questions and thoughts I might have about this research... The most immediate at that point would probably be: Are perceived realism and entertainment value opposite ends of the same spectrum for most viewers? I'd have to imagine that for many people as realism goes up the entertainment value is apt to go down. I don't believe the actual presentation included this information (though the paper version might), as well as how other things might influence viewers' perceptions of both realism and entertainment value (health literacy, working as a health professional, etc.).

Anyway, assuming that's the case, the recommendation shouldn't (can't, really) be to focus on entertainment AND realism. It would seem that the focus should be on entertainment (which is five times as powerful) and only enough realism to pass whatever the minimum threshold would be for most people.

All I could think about when listening to that discussion, and something I've certainly thought when reading research articles, is sometimes academics think about implications the way they WANT the world to work (people should be able to appreciate increased realism and be more entertained) than what I suspect might be the reality (those two things aren't necessarily related for most TV viewers).

That potential issue in the discussion aside, it was an interesting project that got me thinking about some things I might want to look at regarding issue placement in TV shows.

As always, I really enjoyed NCA. There were a lot of interesting panels and presentations, and it's always exciting to hear about some of the excellent work going on in the health communication division.

ICA/NCA Health Communication Divisions Thesis and Dissertation of the Year Awards Solicitation

Helping spread the word...

(A few random thoughts on NCA to come in the next day or two.)

*********************

ICA/NCA Health Communication Divisions
Amanda L. Kundrat Health Communication Thesis of the Year Award
Health Communication Dissertation of the Year Award
2012 CALL FOR NOMINATIONS

ICA and NCA are pleased to release a call for outstanding masters theses and doctoral dissertations in the area of health communication. A cash award is given in the amount of $500 each for the top dissertation and top thesis.

To be considered for the 2012 awards, theses and dissertations must have been completed (defended) between 1 September 2010 and 31 December 2011. If the completion date was in the last four months of 2010, the thesis or dissertation cannot have been submitted for last year’s (2011) competition. Individuals may nominate themselves, but advisors must be notified of the nomination. Thesis and dissertation nominations will be evaluated by a panel of officers and members of the ICA and NCA Health Communication Divisions, with the ICA Chair serving as the award coordinator.

**Please read the following instructions for submitting a nomination packet carefully and in their entirety, because they have changed substantially since the 2010 competition.**

The nomination packet should include (a) a cover letter with the name, postal address, telephone number and email address of the nominee and his or her advisor(s) and completion date of the thesis or dissertation, and (b) a summary (excluding title page and references) of the thesis or dissertation not exceeding 5 pages (Times New Roman 12” font, double-spaced, one-inch margins on all sides, and in English; not counting title page and references). The 5-page summary should describe clearly and concisely the study’s rationale, theoretical framework, research questions, methods, results, and conclusions. Care should be taken to mask the identity of the author within the text of the summary. The summary should include a title page that contains only the title of the thesis or dissertation. Complete theses or dissertations or chapters of same will not be accepted for review. Reviewers will be instructed not to read beyond the first 5 pages of text. PLEASE SUBMIT PACKET AS A MS WORD DOCUMENT—NOT AS A PDF.

On or before March 1, a slate of up to 3 finalists for each award will be selected by the evaluation committee. Finalists will be invited to submit an extended integrated summary of the thesis or dissertation not exceeding 30 pages (double-spaced, one-inch margins on all sides, and in English). These summaries will be reviewed by the committee and the award winners will be selected from among the finalists.

Send an electronic copy of the nomination packet including cover letter and 5-page summary to:
Monique Mitchell Turner
Chair, ICA Health Communication Division
Email: mmturner@gwu.edu

The deadline for receipt of the nomination packets is January 27, 2012. Nomination packets received after that date will not be reviewed.

NCA Presentations

I'm definitely looking forward to NCA this week, it's always interesting to hear about new research and present things I've been involved with. This year at NCA I'm a co-author on two papers being presented:

Health Literacy, Self-Efficacy, and Patients’ Assessment of Medical Disclosure and Consent Documentation
Thursday @ 3:30-4:45pm in the Sheraton New Orleans, Poydras - Third Floor

Sources and Predictors of Patient Uncertainty When Reviewing Medical Disclosure and Consent Documentation
Saturday @ 12:30-1:45pm in the Sheraton New Orleans, Napoleon D3 - Third Floor

I'll be doing the Saturday presentation, which is the top paper session in the applied communication division. For anyone that might be heading to NCA and looking to talk about health literacy and health communication, drop me a line!