Tuesday, August 21, 2007

Too Many Choices in Healthcare?

I recently finished reading The Paradox of Choice: Why More is Less, by Barry Schwartz. The main point of the book is that people don’t necessarily like making decisions, and the ever-increasing array of options for so many of the choices in our lives has the potential to make everyone miserable.

He cites several studies of decision making in healthcare as he progresses through the book. One example included a study that presented doctors with the case history of a man with osteoarthritis. Doctors were given the choice to prescribe a new medication or refer to a specialist – 75% of the doctors prescribed the medication. In a simple twist, another group of doctors were given the same case history and two potential new medications. Now only 50% of the doctors prescribed a medication; the other half were willing to avoid making the decision and simply refer to a specialist.

Other examples relate to cancer patients. When people are asked by researchers if they would like to choose the method of cancer treatment they would receive if they (hypothetically) developed cancer, the vast majority say they would. Actual cancer patients, however, want no such thing – they don’t want the responsibility of making that sort of decision.

While the book wasn’t written to apply to health communication research, the implications are (at least to me) interesting. The Paradox of Choice is a pretty quick and easy read, and it is the kind of book that has the potential to get you thinking about the topics you’re personally interested in from a different point of view.

Monday, August 20, 2007

Health-Related Documentaries

I’m a big fan of Scientific American, and the latest issue (titled “Feast and Famine: The Global Paradox of Obesity and Malnutrition”) was right up my alley. One of the articles in the issue (Sowing a Gene Revolution) talked about the potential for genetically modified (GM) foods to improve agricultural production and profits around the world. It’s an interesting article on its own, but it also reminded me of two documentaries that I’ve enjoyed and used over the past couple of years.

The Future of Food: This documentary is all about GM foods, particularly Monsanto and some of its legal battles with farmers. Probably my favorite moment is two commercials around a ballot initiative to make sure GM foods were marked on food labels; one is from the mom who organized the initiative, the other is from the industry opposing the initiative – which happened to hire a woman for the commercial that looked a lot like the mom in the other ad… If nothing else, it’s a fun piece of the video to show in an advertising class.

Sweet Misery: A Poisoned World: This movie is about aspartame and a lot of the issues surrounding its approval and ongoing questions about related health risks. It’s a little rougher around the edges than The Future of Food, but still definitely worth watching.

A little creative work with Google or YouTube can typically lead to at least chunks of these movies that you can watch and see if you want to get the entire movie to have on-hand for research or teaching purposes. They both come with certain biases, which isn’t necessarily surprising… But I think both of these movies are quite good, so I wanted to mention them here for those who haven’t seen them yet.

Thursday, August 16, 2007

Alcohol-Related Public Policy Funding

Looking through my NIH e-mail from last week, I saw there were several options available to seek funding for Research on Alcohol-Related Public Policies such as Those Detailed in the Alcohol Policy Information System (R01, Ro3, R21).

Related or not, it got me thinking about findings I first heard on a NIH podcast a week or two ago about researchers discovering five types of alcohol dependence. The work, funded by the National Institute on Alcohol Abuse and Alcoholism, outlined the following types of alcohol dependence:
  1. Young adult
  2. Young antisocial
  3. Functional
  4. Intermediate familial
  5. Chronic severe
The podcast discussing the research findings was extremely interesting, to hear the breakdown of the different types of dependence and the general profile of the people in each. For those with an interest in alcohol abuse and alcoholism, the full study was theoretically published online in Drug and Alcohol Dependence. (I can't find the link, otherwise I'd do more than just post a link to the journal.)

Monday, August 13, 2007

Making Health Communication Programs Work

I'm guessing that a lot of people involved in health communication might already know about this book, but I thought that it couldn't hurt to add a bit of info about it here...

Making Health Communication Programs Work is a handbook from the National Cancer Institute (NCI) that grew out of the work there developing, implementing, and evaluating health communication programs. Also know as "the pink book," it's a great resource for anyone with an interest in health communication to get another perspective on how campaigns can be built and evaluated. It can also serve as a nice textbook for a class on health communication campaigns.

An extra bonus is the fact that the entire text of the pink book is available for free as a PDF (here).

The book covers everything from planning and strategy development, to pretesting materials, to implementing the campaign, to evaluation. It's a great overview of the health communication campaign process from start to finish, definitely a useful resource for teachers and students with interests in this area.

Friday, August 10, 2007

The Efficacy (?) of Abstinence-Only Programs

Today I did a quick search of the Scientific American website to follow up on one of their 60-Second Science podcasts. It didn't take long to find the article discussing a study that reported abstinence-only programs do not reduce HIV risk. It was this segment in the middle that really caught my attention:

Compared with no program, safer sex programs, and various other control programs, the abstinence-only programs did not seem to reduce HIV risk. Specifically, abstinence-only programs did not influence the rate of unprotected vaginal sex, the number of sexual partners, condom use, or initiation of sexual activity.

In one trial, there was evidence that abstinence-only programs may have had an adverse effect. Compared with a comparison group of young people who did not participate in an HIV prevention program, abstinence-only programs were associated with a rise in sexually transmitted infections and pregnancy.
The podcast ended with a rather pessimistic view about the likelihood that such findings would influence the amount of money being spent by the U.S. government on abstinence-only programs. (Off the top of my head I think it was something in the $100 million range.)

It would be an interesting exercise to test the knowledge students from such programs have of condom use, sexually transmitted infections, etc. and compare that to students who have been through other programs. I'm curious if the differences between those students could be due to a knowledge deficit in the abstinence-only groups or something more related to their attitudes... Questions to be answered, certainly.

Tuesday, August 7, 2007

60-Second Science

This afternoon I was listening to a Scientific American 60-Second Science podcast and it discussed a study that found pre-schoolers demonstrate major brand preferences. One of the things they discussed was testing children by providing "normal" carrots vs. carrots that looked like they came from McDonald's. (McDonald's, of course, doesn't offer carrots on the menu.) The kids preferred the McDonald's carrots by more than two to one.

(The podcast didn't mention the authors of the study, but I'm guessing from the title that it was Exposure to Food Advertising on Television Among US Children from Archives of Pediatric &Adolescent Medicine.)

In any case, it's an interesting demonstration of the power that brands can have with children. It also makes me wonder what McDonald's could really do to promote healthy eating in children if it made good business sense to do so... I have to wonder (hope?) that promoting healthy eating among children might become something akin to the potential advantage businesses are looking for as they find ways to be eco-friendly and market themselves as such.