Week 9-Health and Wellbeing

Question 1

What is the history of Health Campaigns?

Answer 1

■ Rogers and Storey (1987) state a campaign “intends to generate specific outcomes or effects (2) in a relatively large number of individuals, (3) usually within a specified period of time, and (4) through
an organized set of communication activities e.g., repeated advertisements’’ (p. 821).

■ Substantial history of health campaigns

■ Early campaigns e.g., 1700’s Reverend Cotton Mather using pamphlets to promote inoculation against smallpox

Rogers and Storey (1987) stages of media health campaigns:
■ 1940s and 1950s many large-scale campaign efforts failed (plan was to repeatedly inform which will eventually change their behaviour)
■ 1960s and 1970s greater campaign success, more understanding of effective campaign design (e.g., we know fear-mongering can make people switch off)
■ 1980s and 1990s more information about campaign success and limitations

Question 2

What is The Heart Truth and Red Dress Health Campaign? (Successful Campaign)

Answer 2

■ Branding has become more important in health campaigns (e.g., ribbons)

■ Branding increases visibility, raises awareness, and provides a reminder

■ Need to raise awareness of heart disease in women

Formative research to investigate women’s perceptions and barriers to heart disease (and thus to determine if the campaign was needed):
■ 1. Women perceived heart disease as a ‘man’s disease’
■ 2. Women lacked awareness and knowledge of heart disease risk factors
■ 3. Women lacked motivation to change behaviour modification

■ Developed the Red Dress Symbol with the text ‘‘Heart Disease Doesn’t Care What You Wear – It’s the #1 Killer of Women’’

In initial pilot tests participants reported it (Anderson et al., 2013):
1. Would catch my attention
2. Is appealing
3. Makes me stop and think about my own risk for heart disease,
4. Motivates me to want to do more to lower my risk of heart disease
5. Has a message that is ‘‘just right,’’ not too strong or too weak

Question 3

What did Anderson, Silliman, and Schneider (2013) find about views on the The Heart Truth and Red Dress Campaign?

Answer 3

■ Women (N = 475) completed a survey

■ Greater proportion of participants familiar with the Red Dress symbol identified heart disease as the greatest health problem facing women and the leading cause of death of women

■ They were also more likely to identify causes of heart disease and behaviour that could minimise risk

Question 4

What are Anti-Drug Campaigns? (Unsuccessful Campaign)

Answer 4

■ Anti-drug campaigns such as the ‘Just Say No’ Regan era campaigns provided little evidence for their efficacy

■ Campaigns have often used fear and moralistic principles to deter drug use i.e., it’s bad without explaining the health consequences or uses extreme consequences

-Didn’t really research in advance why people have drugs and barriers to stopping this

■ Campaigns have backfired e.g., ‘heroin chic

Question 5

Anti-Drug Campaigns: Meth

Answer 5

■ In the 2000’s, the anti-methamphetamine media campaigns, ‘Faces of Meth’ (FOM) and ‘The Meth Project’ (TMP) used images to produce fear, shock, and disgust and deter drug use (wasn’t designed by a health or media psychologist but a software specialist: CHECK THIS)

■ FOM – paired mug shots
■ TMP – consequences of use

■ Have encouraged a specific image of methamphetamine users in the general public

■ The campaigns have been praised by police and politicians

■ FOM and TMP - shock, fear, and disgust are used and targeted at those who do not yet use meth

■ They may demonise and stigmatise users, shaping general perceptions rather than actively reflecting the situation

Question 6

What did Marsh et al. (2017) find about the impact of Anti-Drug Campaigns: Meth

Answer 6

■ Investigated how current and former methamphetamine users and manufacturers perceived the two
campaigns in how effective and accurate they were (each had been a chronic user and manufactured).

■ None said the campaigns had impacted on their decision to use or continue to use or stop using (so they didn’t question their use).

■ Several said the depictions were humorous and entertaining.

■ People reported that they did not identify with the unclean user with dramatic
physical changes (didn’t feel they were credible).

■ They also reported that their own addictions were too powerful to be overcome by the adverts (so telling people to stop isn’t enough but rather campaigns should look at the risk factors associated with substance use)

Question 7

What did Boles et al. (2014) find about Campaign Effectiveness and Behaviour
Change?

Answer 7

■ Assessed the effectiveness of the ‘It Starts Here’ campaign which featured paid and unpaid media on the web, television, billboards, and transit (so was widely spread).

■ Targeted at mothers under the age of 45.

■ Nearly 70% of people were aware of at least one campaign element.

■ Nearly 80% of people who were aware of the media campaign intended to reduce the amount of soda or sugary drinks they provided to children (so effective as it’s changing people’s knowledge and intentions)

■ HOWEVER, there was no change in self-reported consumption (always important when investigating campaign effectiveness to investigate behavioural change).

Question 8

What did Richardson et al. (2014) find about the effectiveness of tone in health campaigns?

Answer 8

■ Categorised UK government-funded televised tobacco control campaigns from April 2005 – April 2010 as either positive (happiness, satisfaction, hope) or negative (fear, guilt, disgust) and looked at its effect.

■ Positive messages were most effective at increasing quitline calls, whereas those with negative emotive content also impacted on call rates – but only at higher levels of exposure (there’s a cost-implication of how much you can get this advert out to people)

-You want the message to be strong enough that it is taken seriously, but not to the point it is fear mongering

Question 9

What did Snyder and Hamilton (2002) find when conducting an evaluation and meta-analysis on health campaign effectivness?

Answer 9

■ Meta-analysis of 48 health campaigns that were conducted in the United States

■ Overall, mean effect size of r = .09 (average campaign changed the behaviour of about 8% of the population in the expected, positive direction)

■ Success varied e.g., seatbelt, oral health, and alcohol campaigns the most successful (i.e., change which is usually easy to change behaviourally)

■ Campaigns focused on adoption of new behaviour more successful than prevention or cessation (e.g., walk for 15 minutes after tea rather than to stop smoking after tea)

■ Campaigns with greater reach or exposure more successful (doesn’t mean it will necessarily be successful but rather acts as a reminder)

Question 10

What did Derzon and Lipsey (2002) find when conducting an evaluation and meta-analysis on health campaigns?

Answer 10

■ Derzon and Lipsey (2002) conducted a meta-analysis of 72 campaigns designed to prevent or reduce youth substance use

■ Campaigns using radio, video, and television were more effective than those utilizing print media (adolescents don’t typically read newspapers nowadays)

■ Campaigns focused on alcohol use were more successful than campaigns focused on illicit drugs or tobacco

■ Campaigns targeted at youth had little success, those directed toward parents and retailers had more success (as they typically regulate and monitor their child’s behaviour e.g., punishment for drinking underaged).

Question 11

What are the Principles of Effective Campaign Design? (Noar, 2006)

Answer 11

Success is more likely when campaign designers…
■ Conduct formative research with the target audience to clearly understand the behaviour and the problem area (i.e., initial research in advance - e.g., why do people adopt these behaviours? is it habitual?)

■ Use Health theory as a conceptual foundation to the campaign; theory will suggest important determinants around which to develop messages

■ Segment audience into meaningful subgroups based on important characteristics such as demographic
variables, risk, personality etc., (i.e., target particular groups)

■ Use a message design approach that is targeted to and likely to be effective with the audience segment (i.e., target)

■ Place messages in channels widely viewed by the target audience; strategically position campaign messages within the selected channels (e.g., younger audience = social media campaign)

■ Conduct process evaluation including monitoring and collecting of data on implementation of campaign activities (i.e., how well it is implemented)

■ Use a sensitive outcome evaluation design that reduces threats to internal validity and permits firm causal conclusions about the campaign’s influence on attitudes and behaviours to be made (and to determine whether the campaign wants to change attitudes or behaviour)

Question 12

Campaign Quality and Effective Communication: World Health Organisation: What are the 6 Principles for Effective Communication?

Answer 12

1. Accessible to decisions-makers
2. Actionable by decisions-makers
3. Credible and trusted as perceived by decisions-makers
4. Relevant to decisions-makers
5. Timely to enable decision-making
6. Understandable to decision-makers

Question 13

True or False: Health campaign information is easily accessible

Answer 13

True!

Question 14

What did Sharma et al. (2017) find about Awareness, Scares, and Misinformation?

Answer 14

■ Searched Facebook for one week using the terms Zika and virus.
■ Posts were classified as either relevant information / news or misleading information based on the quality of scientific information, emphasis on prevention, and citation of credible sources.

■ Misleading posts were far more popular than posts dispersing accurate, relevant public health information about the disease.

■ The most useful post was a World Health Organization press release, which had viewership of 43,000 views with 964 shares.

■ The most popular misleading post was a video called ’10 reasons why Zika virus fear is a fraudulent medical hoax’. It had more than 530,000 views, 19,600 combined shares and 600 supportive comments.

Question 15

What is Awareness, Scares, and Misinformation?

Answer 15

■ In February 2013 a retired professor of medicine published a book arguing that cholesterol is not linked to cardiovascular disease and denying the benefits of statins for cardiovascular prevention.

■ The book received extensive media coverage and public discussion.

■ Rates of statin discontinuation (both overall and in each cardiovascular risk group) were greater in 2013 after the media event than in previous years (Bezin et al., 2017) therefore the impact of this is very harmful

Question 16

What’s the impact of Media on beliefs on vaccinations and autism

Answer 16

Recommended by lecturer not much said

Question 17

What are the benefits of Health Apps and Smart Devices?

Answer 17

■ Wearable devices and smartphones provide opportunities for activity / health tracking and health promotion

■ They can increase the scalability, reach, and impact of existing health interventions (not always accessible to have a GP advising on healthcare so allows more up-to-date feedback)

■ Features include personal goal setting, rewards, the ability to compete or connect with others, tracking performance overtime, making activity more novel or fun

Question 18

What did Naslund et al. (2016) find about Health Apps and Smart Devices?

Answer 18

■ Gave those enrolled on a 6 month intervention delivered through a community mental health center
fitbit wearable tracking devices and smartphones for use during the program.

■ Each participant had a serious mental illness (e.g., depressive disorder) and obesity.

■ They wore the fitbits for 84.7% on average of the days enrolled on the program.

■ They were satisfied with the intervention and reported that it helped them to monitor their activity and reaching daily goals.

■ ”It would send a message to my phone that says ‘you’re only 650 steps away from your goal!’ then I would go oh yeah, I could do that easy…So it did encourage me to meet and often exceed my step goal”.

Question 19

What did Krebs and Duncan (2015) find about health app usage?

Answer 19

■ Cross-sectional survey of 1604 mobile phone users throughout the United States

■ 58.23% of mobile phone users had downloaded a health-related mobile app (shows it is relatively common place in areas such as the US)

■ Those using health apps tended to be younger, have higher incomes, be more educated, be Latino/Hispanic, and have a body mass index (BMI) in the obese range

■ For those using apps, trust in their accuracy and data safety was quite high, and most felt that the apps had improved their health

■ Fitness and nutrition were the most common categories of app

■ Reasons for not using apps were lack of interest, cost, and concern about apps collecting their data

■ Also - the extent to which people take care of their own health (health consciousness) predicts usage of health apps (Cho et al., 2014)

Question 20

What’s the reliability of Health Apps?

Answer 20

■ Monitoring apps may not be regulated

■ Instant Blood Pressure app estimates blood pressure

■ Between its release on June 5, 2014, and removal on July 30, 2015 (421days), the app spent 156 days as one of the top 50 best-selling iPhone apps

-If they were reliable, it would give us reassurance and mean individuals would be less likely to book a GP appointment for minor queries

Plante et al. (2016):
■ “The BP measurements from an mHealth app with more than 148000 units sold were highly inaccurate. The low sensitivity for hypertensive measurements means that approximately four-fifths (77.5%) of individuals with hypertensive BP levels will be falsely reassured that their BP is in the non-hypertensive range”

-Implications for this could be severe not only because people are spending money on this, but it could prevent people from going to GP appointments or taking medication due to false information being given.

Question 21

What did Kogan et al. (2017) Pokemon GO and Activity?

Answer 21

■ Pokemon GO is a location-based online game in which players find and capture Pokemon characters

■ It encourages people to venture into new places – particularly as some characters are only found in specific environments (e.g. near lakes)

■ Use related to exercise, social interaction, and weight loss (the average weight loss was 3lbs)

■ Researchers surveyed behaviour and perceptions of US Pokemon GO players

■ 43.2% reported spending more time with family/household members since they started playing PG (5.7% reported less time)

■ 52.3% reported increased time with their dog since playing (1.5% reported less time)

■ 62.9% reported they walked their dog more since playing

-Unfortunately, once the fad is over and people stop playing the game, the results dissapate (i.e., weight gain)

Question 22

What did Miah et al. (2017) find about Technology and Support for Rural
Communities?

Answer 22

■ Rural citizens in developing countries experience a “digital divide - limited access to experts and electronic health (e-health) information

■ In Bangladesh, there is one GP for every 1700 patients

■ 70% of total population live in rural areas, 75% of total qualified GPs are practicing in urban areas

■ Developed and evaluated the Bhalo-Achi app (I am Fine) to provide general healthcare decision support and medical information

■ This app included: Medical consultation, finding alternative (cheaper) medicine, reducing frequency of direct consultation, improving self-management

Question 23

What’s the link between Social Media Use and Health seeking advice?

Answer 23

■ 83% of internet users look for health information on the internet, and 72% specifically said that they use social media (Frimming et al., 2011)

■ When dealing with a specific health issue, 40% specifically used Facebook for support and confidence in educating and dealing with the issue (Oh et al. 2013)

■ However, the information on the internet may be misleading, incorrect, or inconsistent

■ People may use information from the internet to challenge advice or treatment from a health care provider (i.e., will have more confidence to advocate for themselves)

■ When people talk to their doctor about information they find online, the doctor disagrees one fifth of the time (Fox et al., 2013) (i.e., can cause conflict between the patient and doctor: some doctors may be open whereas others may feel as though their profession is challenged + patients may disengage from professional support if they have been denied).

Question 24

What did Campisi et al. (2017) find about the link between Social Media Use and Mental / Physical Health?

Answer 24

■ Students (89, 74 women) completed questionnaires, researchers tracked their incidence of upper respiratory infections for ten weeks

■ Students reporting that Facebook provoked stress / anxiety displayed more upper respiratory infections

■ Other health behaviour (such as sleep, social support, physical activity) did not explain the associations

■ But, Orben and Przybylski (2019) did a large scale study (N = 17,247), finding little evidence for relationship between adolescent screen time and wellbeing

Question 25

What’s the link between Virtual Reality and Social Anxiety (Dechant et al., 2017)?

Answer 25

■ Virtual reality can simulate real-world scenarios and activate anxiety

■ 19 lowest and 18 highest socially anxious participants selected from 119 original participants

■ Physiological reactions and eye movement were monitored during virtual reality interactions of social situations with researchers creating train platform and doctor waiting room scenarios

■ Can be used as a basis for intervention

Question 26

What’s the link between Virtual Reality and Autism? (Didehbani et al., 2016)

Answer 26

■ Virtual reality can provide children with Autism Spectrum Disorders with a forum to practice and rehearse social skills

■ Thirty children (26 male) between the aged 7-16 diagnosed with Autism Spectrum Disorders

■ Pre-testing questionnaire pack before starting the training program

■ 10 VR sessions, 2 per week, 1 h each with a peer

■ Each scenario addressed a specific objective e.g., meeting new people, dealing with a bully

■ Results revealed improvements on measures of emotion recognition, social attribution, and executive function of analogical reasoning (and was better at recognising emotions, people’s priorities and plans thus better equipped for social interactions in real life).

-Therefore these are the kinds of things that can be beneficial

Question 27

Why does the Heart Truth and Red Dress Campaign work?

Answer 27

■ Dress is not worn – crosses age and racial boundaries (allows it easier for all women to relate if there is no visual model who may differ in SES, race, weight etc.,).

■ Can be adapted for different purposes such as a range of events e.g., health screening events, workshops, lunches, fashion shows

■ Example, Red Dress Collection at Mercedes Benz Fashion Week in New York with red dresses contributed by the industry’s top fashion designers (which would get a lot of media attention)