Talking About Health; Why Health Communication Matters

How fear appeals affect our motivation to practice healthy habits?

A winter walk

February 7, 2010

Fear is something most of us would rather not experience. Especially when it comes to our health. Yet, so much communication about health aims to make us fearful. Why is that?

Over time, research has shown that fear can be motivating. Because we don’t want to be fearful when it comes to our health, we may take action. That is, if we know how and believe the action will actually benefit our health.

The problem with too many fear appeals aimed at our health is that they do not fulfill the task of telling us what action to take, why the action will be effective, and how we can develop the skills or gain the resources to take the action.

Take the example of skin cancer. Most of us know that too much exposure to the sun can cause this deadly disease. We also know that some sun or UV exposure helps our body make vitamin D. So how much sun is too much sun? What if we like to stay healthy by being outdoors in the sun? What if our job requires us to be in the sun? An effective fear appeal communicates about these issues and doesn’t just make us fearful about being in the sun.

So if communication about health makes you feel fearful, look for the response recommended to reduce the threat. If the message doesn’t contain that information, it’s not a very good message. But at least you will know that what to look for to control the danger posed in the message and your fear as well. A response to the threat and ways you can carry it out.

Until next time, talk about health with the ones you love. It really might be a matter of…life and death.

Who is the source of that information about health on the internet?

119_1916 January 19, 2010

Surveys show that most of us go to the internet to search for health information and we do it fairly often. I was reminded of that as I had one of my infrequent flair-ups of pseudogout. It has been years since I’ve had the pain and swelling in my knees and this time it affected my fingers, my wrists, and even my back. And it didn’t go away after a few days. So I went online. And I found lots of information.

How we search for health information on the internet and what we do with the information once we have it is likely to predict whether the information is going to help or harm us. We can conclude that we are not at risk based on the information and be wrong. We can conclude that we are at risk based on the information and also be wrong. So a good place to start thinking about health information found on the internet is to consider the source of the information.

First, consider the motivation of the source. In the broadest sense, .com sites are commercial, while .org sites identify organizations, and .gov sites come from the government. We usually start with a search engine such as Google to seek answers to our questions. When I did, Google health came up as the first link to information. With so many people searching for health information, I guess it isn’t too surprising that the owners of a search engine like Google might want to get in on the act…

Second, consider the expertise associated with a site. Just ‘who’ is the author of the content you are reading and applying to your health? Is it a doctor or a nurse or a physical therapist? Is the doctor speaking on behalf of research or based on experience as a doctor? Is the information just presented, so the source is just the internet with no way of knowing if there is medical research to support the claims, particular researchers presenting the claims, or doctors supporting the research conclusions. I followed the Google health link and I searched for information about the expertise. I found some information at the bottom of a loooooooong page of information. But I couldn’t trace it back to any research. So I couldn’t find out much about where all the conclusions were coming from. Health communication researchers find this to be the case time and again. Not just on the internet. In newspapers, magazines, and broadcast news reports, the expert source on which information is being based is too seldom mentioned.

Third, what part of the information is the author of the content emphasizing, and what part is not being discussed? Is the author providing information for an organization that wants them to present a particular point of view? So, they might be describing the benefits of getting care at the organization whose site they represent but not tell you that it cost more than your insurance is likely to pay. Or, they might be telling the benefits related to one type of treatment for the drug company who has paid for the site you are reading, and they likely believe in those benefits, but there may be no discussion of the risks for the treatment. So, consider not only what content is included in the information but what content might be missing as well.

Doing so should help to make the information we find useful and help us to frame additional searches for more information to fill in the missing content…

What about public health care reform?

117_1784 January 10, 2010

I never hear anyone talk about public health when they talk about ‘health care reform.’ This bothers me because we have a univeral system of public health in the U.S. and we spend quite a lot of resources on it. The services linked to our public health care system range from checking the quality of restaurants and ‘grading’ them to providing newborn screenings. We spend quite a lot of time deciding what services to provide in each state. Besides registering births and deaths, and newborn screenings, many states have prenatal care programs, other women’s health programs, and a wide range of programs from smoking cessation to drug prevention to cancer screenings.

We don’t talk much about public health. But what might a connected system of health care built on the system of clinics and services for public health look like? How would doctors and health care staff feel about building on their infrastructure? Some states have regional health care directors? How would they regard an effort to connect the services they oversee to a broader range of services for the public to consider as a choice for care?

Anyone?

HPV, HIV, HBV…and more

January 8, 2010

I am working on a project designed to understand how college students think about HPV. I have learned that the human papillomavirus — HPV — is confused with HIV by some male college students in this project and that some females confuse it with HBV — the hepatitis B virus…

The media has covered the HPV vaccine and, of course, we have all those direct-to-consumer ads appealing to the ‘I want to be one less’ angle. What isn’t clear in many of these stories and ads is that HPV is transmitted by skin-to-skin contact. That is why genital HPV cannot be guaranteed to be protected by use of a condom during sexual intercourse.

The HPV vaccine is, of course, not designed to prevent HIV. A female who has completed the series of HPV shots likely has about five years of protection from HPV. She is not protected from the human immunodeficiency virus — HIV. Males who mistake the two conditions, HPV and HIV, may wrongly believe that the HPV vaccine protects her and him from HIV and thus feel less inclined to use a condom to prevent HIV. That is a serious mistake.

The incidence of head and neck cancers over the past decade has been found to be related to oral HPV. College males who report engaging in open-mouthed kissing have been found to be more likely to test positive for oral HPV. But this is not the only path for transmitting oral HPV. As with genital HPV, the skin-to-skin contact provides a transmission route.

There is a vaccine for HBV. HBV affects the liver and is transmitted in ways that are similar to HIV, including blood and bodily fluids. It really can be a matter of life and death if we fail to keep straight the differences between these three and our actions to prevent them.

New Year’s resolutions…

The beauty of winter January 4, 2010

Everyone is talking about them. Diet. Exercise. Smoking. Alcohol. Getting cleansed. Staying cleansed. If only we could figure out how to bottle all those good intentions and keep them next to too much work and too little time.

Where is ‘play’ on the list? That is what I love most about being with my grandchildren. They remind me that jumping rope and playing catch and swinging and wrestling shouldn’t be such work. They should be fun. And reading the comics in the daily paper…that’s fun, too. When was the last time your doctor asked you, “Are you having enough fun?”

What’s new for HPV in 2010?

imgp0009 January 2, 2010

Near the end of 2009, the U.S. FDA approved the use of an HPV prevention vaccine for boys. It will be interesting to see how this will be sold in the marketplace. After taking such care to sell a vaccine as a strategy to reduce the incidence of cervical cancer with the slogan, “I want to be one less,” and assuming that even among a public with moderate to low levels of health and science literacy — most know that males do not have a cervix, what will the pitch be to convince parents to vaccinate their sons? It seems unlikely that any ad will focus on selling a vaccine to parents that implies that their sons could be the vectors of disease for girls, as that would turn attention toward sex which the advertisers so carefully avoided in focusing on cervical cancer.

Whatever the pitch, part of our conversation should focus on the vaccine’s efficacy. Clinical studies vary in estimating how many years of protection a vaccine affords, but it seems to be around three years. Some say it may be five years. In either case, there is no revaccination policy at present. As consumers, parents, patients…we need to advocate for a policy.

We need to ask ourselves if and when it is the right time to be vaccinated. We need to understand what HPV is and how it is transmitted. Since the virus is spread in skin to skin contact, a condom may not be enough protection from getting the virus if we come in contact with it during sex. We should talk about that fact with our daughters who may be trying to decide if the use of a condom is the best way to protect themselves from sexually transmitted infections and diseases. And we need to talk with our sons about the fact as well, and remind them that the HPV prevention vaccine does not protect from HIV.

We need to realize that for women, being vaccinated does not mean we do not need to have cervical cancer screenings. Will the advertisers include that in their future messages?