Talking About Health; Why Health Communication Matters

How are church dinners changing eating habits in the Mississipi Delta?

August 30, 2011

Access is everything. Access to health care. Access to education. Access to employment. Access to role models who walk the walk and talk the talk.

One of the followers on this blog brought the New York Times article, ‘Preaching a healthy diet in the deep-fried delta’, to my attention. You can find the article at http://www.nytimes.com/2011/08/22/us/22delta.html?pagewanted=all.

Why in the face of so many messages about diabetes, obesity, and heart disease would anyone continue to eat fried foods? Because it tastes good. And because we socialize and have fellowship with family and friends over meals that feature these foods. But Reverend Michael Minor and other church leaders have been working to change all that.

‘No fry zones’ and fruit platters, fresh water and no soda… these are the new ‘normal’.

I’m No Martha Stewart… So Why Do I Like to Garden So Much…?

5 minutes of gardening improves mood… that’s something worth talking about.

August 6, 2011

I grew up in the Korean War era as the daughter of an enlisted Air Force father, with both my parents’ families living in Michigan. And both had gardens. [here’s a site with some great garden blogs… http://www.invesp.com/blog-rank/Gardening ]

My father’s parents lived in town and when you stepped outside the back door and turned left, you came to Grandpa’s garden… Row upon row of carefully tended fresh produce…including tomatoes that Grandpa picked and offered with a sprinkle of salt and a smile… We would both bite into our red ball and let the juice run off our chins…grinning at one another. Then he would pick tiny little cucumbers and we would repeat the same ritual… salt, bite, less juice…big grin.

My mother’s parents lived on a farm. The barn. The hay wagon. The cows that got milked…

Flowers and flower bushes growing along the house, along the field, and in clumps dotting the mowed lawn. All things that fed into my ideas about gardens.

So it is the time of year when I am picking cucumbers from my own garden. I have harvested some tomatoes with more to come. And I have been enjoying flowers all summer long…

And I am catching up on some reading.

Prevention magazine in June 2011 had a headline: ‘JUST 5 MINUTES of gardening improves both self-esteem and mood [p. 19]. I read further and learned that an article published in “Environmental Science & Technology” reported these results. I wanted to know more… this turned out to be harder than I expected.

I went to the journal site…punched in gardening effects on mood, since Prevention magazine did not name researchers or an exact issue in which the research appeared. This kind of source-layering has been discussed here before… I was surprised and a little annoyed that I couldn’t find the study being reported so I could consider the evidence leading to the magazine’s conclusion. I read it in Prevention magazine which might be good promotion for them… or not — depending on whether a reader is willing to just take the magazine’s word about what the research concludes and how such conclusions were reached. It did get my attention but led to me asking: based on what?

After some time and leaving the journal site to just search Google more broadly, I found another article reporting about the research: http://pubs.acs.org/doi/pdf/10.1021/es101129n. It appeared May 15, 2010 in the journal on p. 3649 and was written by Robin Meha. She summarizes the research that Jules Pretty and Jo Barton did leading to the conclusion that just five minutes… FIVE MINUTES of gardening improves mood… http://www.ncbi.nlm.nih.gov/pubmed/20337470 .

And that is why I like to garden so much….

Grammie, were you that girl who played ‘boy’ games with the boys?

August 2, 2011

Yes, Grace… I was. We were painting the swingset and ‘chit-chatting’ as my granddaughter likes to call it. Being a baby-boomer has its perks as I have this long view of such matters as ‘what girls and boys do’ and some opinions about how it affects our health…all the way from bone density based on early childhood through developmental years of activity versus inactivity to body image and weight. Or so I thought.

Why is it that the same divisions that seemed like we worked through in the past still remain? The boys always played together at recess…something fun like kickball or chase or even just ‘let’s go expore the other side of the playground.’ The girls always played together at recess…something like ‘let’s catch up on who’s wearing what’ [like we couldn’t all see that and who cares…] and ‘let’s play house’…

Much to my surprise, Grace told me as we were painting all about how she is the girl who crosses over to play with the boys. I knew she played sports at recess because shopping for clothes for Grace means buying something pretty and pink but something–like she is wearing to drive the tractor with Granddad–that she can hang upside down in on any number of jungle gym type toys… skorts–those marvelous crossovers between shorts and skirts are the perfect ticket and have only gotten much cuter over the years. She told me that her best friend is a boy. She was the only girl invited to his birthday party. She told me how there is one boy who sometimes plays with the girls…when they need a ‘daddy’ for their household.

Interesting, I told her. I was the one rolling down hills, climbing trees, and well–being a ‘tomboy’ when I was growing up, too. “A tomboy? What’s that,” Grace asked me.

Well, at least that has changed…

How do we communicate about responsibility and health?

July 18, 2011

I have been basking in the summer heat… catching up on some research and and reflection, and most importantly–my family. July is the month that my granddaughter, Grace, visits… and we have been reading the American Girl book that introduces Kaya…an American Indian. And that is what made me think of today’s topic.

Chapter 2 of the book introducing Kaya, the title is ‘Switchings’, Kaya and all of the youngsters old enough to share in the responsibility for Kaya’s mistake [leaving her twin brothers when she was responsible for watching them] gets a ‘switching’ — that is, she must lay face down on the ground along with all of her peers and pull her clothing up on her legs to her knees. Then the ‘Whipwoman’–elected by the tribe to administer switchings to the youth–takes twigs from a tree and gives the children lashes. The message is that what one of them does affects all of them… So, the bad behavior of one gets all of them into trouble….

Grace is 7 years old… I asked her what she thought about everyone getting a switching because Kaya had done something wrong. She said that it was fair because Kaya went off with two boys to ride horses when she should’ve been watching her brothers. So, she said, those boys should be punished, too. What about the others, I asked What about some of the kids who were punished who were nowhere near the other three kids? It seems fair…what we do does affect everyone, and everyone should support us in doing the right thing…

Interesting. I considered that I might use this book in my health communication classes this year to capture the many meanings of responsibility and health. Personal responsibility, as illustrated here, has more meaning than just what and how our behaviors affect our own health… It affects others, including the nation’s health care costs. But it is impossible to be responsible when all around us are people and ways temptinig us to forget about what we know we should do. And when there seems to be no support on the other end–no one and no ways to achieve the right things… ‘Switchings’…it is a good metaphor for what we are doing to ourselves as a nation when it comes to health and health care…

The picture that is worth a thousand words–what’s on your plate?

June 20, 2011

We just returned from our annual river sojourn. It is like a family reunion.

For five years, we have been kayaking with the same group of folks plus some newcomers each year, growing the family to more than one hundred paddlers on the water together this year, plus nearly a dozen expert guides to shepherd us along the 60 miles of riverway.

There really is nothing like the stretch of river that runs between Bedford and Saxton, Pennsylvania. This is called the Raystown branch of the Juniata River.

As you enter the Cypher area, you begin to feel the isolation… with literally no sounds of trains, highways, nothing but the beauty of rock cliffs on either side of you as you paddle along.

The outfitters were super in letting us stretch out between each other… In fact, the first paddlers in each night were an hour ahead of the last paddlers… One outfitter always assumed the ‘first’ position as the lead boat. Another outfitter always assumed the last position as a sweep boat…assuring that we were all in between them.

The rest spread out among us, assuring that there was assistance should it be needed. Because it isn’t all downhill moving water with gentle winds. There are some rapids along the way as well… just to keep it interesting…

As part of the sojourn, meals are provided. Breakfast, lunch, and dinner were served on plates that made me chuckle as I thought about Michelle Obama’s ‘food pyramid’ plate. You may have seen that she advised that we start talking about and using pictures of a dinner plate to emphasize what healthy eating looks like. http://www.choosemyplate.gov/

For Michelle Obama’s plate, half the plate is devoted to fruits and vegetables, the other half to grains and protein. ….hmm, on the sojourn, a typical breakfast was 4 sausage links, a spoon of scrambled eggs, coffee, some fresh fruit, and a biscuit or other bread…. more than half was protein, one-fourth fruit if you really dipped into it, and if you took the bread–that finished the plate. Lunch was a sandwich, potato chips, and a cookie…sometimes, some fresh fruit. No–the sandwich did not have fresh vegetables on it. Dinner? Meat or casserole with meat, scalloped potatoes or pasta side dish, a roll and butter, cake or pie or ice cream…. So, my plate this week? 2/3 vegetables… just to balance it out a bit. 😉

What innovations would make my life simpler and thus improve my health ?

June 9, 2011

As I noted in the last blog post, sometimes it is the simplest thing that could make the world a better place. I talked about a ‘nose contact’ and I promised to keep track of innovations that seemed like they would help me. I asked you to do the same… Here is what I discovered this past week…

On the larger playing field, I discovered that I rely on the internet to answer a thousand little everyday questions. For example, it is the time of year when I am attempting to do a bit of patio gardening. And I moved my three-year-old geranium plant from the indoors to the outdoors… I saw my husband’s grandmother move her geraniums from a Missouri porch into her kitchen each year…and back outside each spring. I wouldn’t otherwise have thought about trying to do this.

But this year, the plant isn’t producing any blossoms…well, very few. So I wanted to go online and see why. Only I couldn’t. The internet has been down more than it has been up at my house over the past week. Which is annoying since I depend on it for work and for information in a thousand other ways. Finally, we had to give in and have the cable company come over and check it out yesterday. Well, the signal is weak because the wire in the ground from the cable box has eroded. So–innovation number 1–why can’t someone make cable wire that doesn’t erode over a decade’s time?

And then there are my birds. I call them my birds because I feed them and have bird baths for them. I open my windows to hear them sing. I keep some bird houses in the backyard for them… two for blue birds and one for the martins. My mother’s mother had bird houses that are my earliest memory of the calm that comes from just watching and listening to these winged creatures.

At any rate, anyone who has fed birds from feeders on their deck knows that their seeds are a constant carpet anywhere nearby. As I was cleaning the deck for the season, I was shocked to see the literally pounds of hulls and well, bird poop that needed to be cleaned up as well.

Suddenly, having their feeders didn’t seem so wonderful. I looked online…of course… to see what others have offered in the way of solutions. Feed them only sunflower seeds without the shells… but realize this does nothing about the well, other end of the story.

I did quite an extensive search. Everyone just says move the feeders off the deck… Really? Can’t someone come up with a bird feeder where the birds fly into it, eat, are encased in a clear globe with entry and exit ports but the bottom half can catch the seed discards? Yes, that would be a solution to a dilemma that it seems I am not the only one facing… There are tons of online discussions about it.

And that would make my life simpler and thus improve my health…

…cell phones and cancer…why now?

June 2, 2011

We have been hearing about the World Health organization’s conclusion that cell phones pose a health risk that is similar to lead exposure [http://www.latimes.com/health/la-he-who-cell-phones-20110601-1,0,3926296.story]. A summary of the report will appear in a medical journal in July. But advance news stories indicate that as with lead exposure, more exposure increases risk. Cell phone use rarely–less risk. Cell phone use for hours at a time and/or every day–greater risk.

Why has this report come out now? Last year, the U.S. National Cancer Institute reviewed research relating to cell phone use and cancer and posted a summary of their conclusions at http://www.cancer.gov/cancertopics/factsheet/Risk/cellphones. It is tricky to read through the findings. They sometimes suggest that the issue has been directly studied. The ‘gold standard’ for clinical trials is based on randomly assigning individuals to a condition in which the thing to be studied is ‘given’ to those participants and another condition for which the randomly assigned individuals do not have exposure to the thing being studied. Thus, when the NCI reports about studies that have compared individuals who subscribe to cell phone service with those who do not, it begins to sound like a randomized trial. I subscribe to a cell phone service and seldom use my cell phone. My daughter has a cell phone service, it is the only phone she has [no land line], and she uses the phone–talks on it–a lot. So if we were both included in the study mentioned by NCI based on being subscribers, the results might not be an accurate reflection of a relationship between cancer and cell phone use. Subscribers who seldom use their cell phones, if included in the denominator of an equation designed to inform about risk, may artificially reduce the overall risk.

For example, if there are 2 cases of cancer in people in the population that is not subscribed to cell phone service–let’s say that is 100 people–and there are 2 cases of cancer in people in the population that is subscribed to cell phone service–let’s say that is 200 people–it suddenly appears that there are fewer cases in the latter…. But what if only 50 subscribers use the cell phone everyday….not even counting how long everyday–just everyday. 2 cases among 50 people is twice the risk of the poulation of nonsubscribers… Is that accurate?

So that has been the challenge for some years now. No one is going to conduct a randomized trial of cell phone use in which they randomly assign some people to be users and some to be nonusers, and then have some users use briefly everyday, and some users use for two hours, and some more…and track cancer incidence across yearssssss of the lives of the participants. So we have to rely on the research that makes comparisons such as the one described above. The WHO’s group of scientists apparently reached the conclusion that the nearly four dozen published studies reviewed with the thousands of particpants is sufficient evidence to classify cell phones as a possible risk for cancer. In view of how cell phones work, it seems a safe bet. And the ways to reduce risk by using the cell phone with a device that keeps the phone away from my brain is an easy and effective way to reduce that risk…

What does communication have to do with inequities in medical research participation?

May 4, 2011

“The cutting edge of technology is the bleeding edge of technology…”

There are inequities in who participates in medical research. Medical research thus contributes to disparities in who benefits from the research. Efforts to communicate to recruit participants to medical research are far-reaching–going beyond who participates to who fits the profile of a patient likely to benefit from research–based on who participated in the research.

We who participate in medical research are pioneers in the medical frontier. Whether we realize we are pioneers or what that means to any one of us varies. Our participation or lack thereof, creates disparities both in terms of who is participating in medical research and then in terms of who has access to the therapies linked to medical research. These are related and it’s hard to say where one starts and the other begins…

If research is being conducted with educated, well-nourished participants, it will be difficult to say that what is learned can be adopted by or applied to less educated, poorly nourished participants. And this example can be extended to a host of other situations where the research is conducted with one group and the findings are not used to benefit other groups because there is genuine concern that they may not apply to them.

How should we talk with children about a parent’s cancer diagnosis?

April 15, 2011 GUEST BLOG POST by Alan Mars

I have been reviewing research about talking to children about a parent’s cancer diagnosis. One such article [see citation below] relates to parents communicating with their children about the mother’s diagnosis of breast cancer. It focuses on how important it is to engage and include the fathers when communicating about the diagnosis of breast cancer to the mother’s children.

In this article, based on the research done by the authors, the reader learns that an open family communication style is important when a family is coping with the emotional distress that accompanies the genetic testing process. In other words ,all members of a family (children as well as parents, even grandparents) need to be able to feel that he/she can voice the emotions he/she is feeling because of the diagnosis of breast cancer in the mother, not just keep it bottled inside.

The authors also believe that a strong relationship between the mother and the father can help the open communication to continue. This is stated because in many cases of the study, when the father was not present on a consistent basis, it was shown that communication was lacking between the mother and the children, and this hindered the coping/recovering process of the family.

Basically, fathers are more important with the communication process of a family than they may realize… especially when that family involves a mother diagnosed with breast cancer! Let me know what you think about this research!

Demarco, Tiffani A., Beh N. Peshkin, Heiddis B. Valdimasdottir, Andrea F. Patenaude, Katherine A. Schneider and Kenneth p. Tercyak (2008). Role of Parenting Relationship Quality in Communicating about Maternal BRCA1/2 Genetic Test Results with Children. National Society of Genetic Counselors, volume 17, 283-287.

What role can coaches play in preventing concussions among athletes?

April 14, 2011 GUEST BLOG POST by Mike Emmerling

The Centers for Disease Control and Prevention, CDC, along with the support of partners and experts in the field of concussions, developed a “Tool Kit” for high school coaches giving them knowledge, attitudes, and practices related to the prevention and management of concussions. The Centers for Disease Control and Prevention did a study on their “Tool Kit” in 2005-2006 using their website for coaches whose schools owned and used the “Tool Kit” as their participants.

This study was a mixed method evaluation first by a mail survey which collected quantitative information on coaches’ use of the “Tool Kit.” Second, six focus groups were conducted with a sample of coaches who responded to the survey to gain further insight into the quantitative findings. A semi-structured moderator’s guide with open-ended questions was used to lead the particular focus groups discussion(s). The participants were made aware that the focus group discussion(s) would be audio recorded and no participants objected. Finally participants were self-selected and represented diverse geographical locations on a variety of various sports.

Of the 333 eligible coaches who responded to the survey, most were male and coached at a public high school. Most of these coaches had over ten or more years’ experience. The majority of the coaches lived in suburban or rural areas with less than 1,000 students in their school. The variety of sports that these coaches coached included football (41%), boys’ basketball (13%), and girls’ soccer (11%). Concussions were highly relevant topic because 63% of coaches reported being aware of sports-related concussions among their athletes during the 2005-2006 playing season.

The end results of this study showed that the “Tool Kit” led to positive changes in high school coaches ‘knowledge, attitude(s), and behavior(s)/skills toward concussion prevention and management. Despite the fact that most of the coaches who responded had 10 or more years of coaching experience, the coaches made changes in the ways they prevent and manage concussions. Findings from this survey also suggest that many coaches face barriers to preventing and addressing concussions because there is no specific concussion policy in high school sports. This study in the end shows that coaches have a strong role and responsibility when dealing with the safety of their athletes and concussions. Coaches feel obligated to educate themselves about concussions to ensure the correct use of safety equipment and implement training techniques that minimize the potential concussion risk by allowing more people who are experts in concussions to become more involved in the sports program.

Sarmiento, K., Mitchko, J., Klein, C. and Wong, S. (2010), Evaluation of the Centers for Disease Control and Prevention’s Concussion Initiative for High School Coaches: “Heads Up: Concussion in High School Sports”. Journal of School Health, 80: 112–118.