Evaluating Health Evaluating Health InformationInformation

Health CommunicationHealth Communication

Impact of Health InfoImpact of Health Info

• Negative effect (fear, denial, etc.)Negative effect (fear, denial, etc.)• Positive effect (empowering, Positive effect (empowering,

knowledge, etc.)knowledge, etc.)

Health LiteracyHealth Literacy

• One’s ability to understand, process and have One’s ability to understand, process and have access to accurate health information is access to accurate health information is integral to: integral to: – decision-making, decision-making, – relations b/t providers and patients, relations b/t providers and patients, – patient rights, patient rights, – informed consent, etc.informed consent, etc.

• Degree to which individuals have capacity to Degree to which individuals have capacity to obtain, process and understand basic health obtain, process and understand basic health info and services determines ability to make info and services determines ability to make appropriate health decisions.appropriate health decisions.

Factors Affecting Health Factors Affecting Health InformationInformation

• Quantity and qualityQuantity and quality• AccessibilityAccessibility• Foundational valuesFoundational values

Quantity and QualityQuantity and Quality• Health educators try to figure what is the Health educators try to figure what is the

right amount of information, and the right right amount of information, and the right formats to give different audiencesformats to give different audiences

• Laypersons are often not recognized as Laypersons are often not recognized as legitimate sources of health information legitimate sources of health information (knowledge of symptoms, explanatory models, (knowledge of symptoms, explanatory models, etc.) – etc.) – – when providers discount patients’ health info as when providers discount patients’ health info as

subjective or irrelevant, the recommended health subjective or irrelevant, the recommended health behaviors are less likely to be followed. behaviors are less likely to be followed.

– ““Subjective-objective dichotomy” doesn’t make any Subjective-objective dichotomy” doesn’t make any sense since all data must be interpreted by sense since all data must be interpreted by someone – someone – • it is always subjective – and the layperson’s experiential it is always subjective – and the layperson’s experiential

evidence could also be seen as a kind of dataevidence could also be seen as a kind of data

Quantity and QualityQuantity and Quality

• Informed consent is seen as a catch-Informed consent is seen as a catch-all to relieve doctors from all to relieve doctors from discounting patients’ rights or failing discounting patients’ rights or failing to give full disclosure, but unless its to give full disclosure, but unless its done in an educational manner with done in an educational manner with full permission for the patient to full permission for the patient to withhold consent it is meaningless.withhold consent it is meaningless.

Questions of ValuesQuestions of Values

• No info is value-neutral (it all No info is value-neutral (it all reflects our foundational values, reflects our foundational values, definitions or principles of definitions or principles of right/wrong, etc.)right/wrong, etc.)

• (e.g. condom promotion depicts (e.g. condom promotion depicts clash between propriety and disease clash between propriety and disease prevention) (see. P. 276)prevention) (see. P. 276)

Questions of ValuesQuestions of Values

• Most messages have hidden agendas – Most messages have hidden agendas – – What goals are chosenWhat goals are chosen– What claims or arguments are madeWhat claims or arguments are made– How are health problems definedHow are health problems defined– What are the values of those proposing a health What are the values of those proposing a health

interventionintervention– What values underlie the evaluations conducted of What values underlie the evaluations conducted of

health campaignshealth campaigns– What are the social and political circumstances What are the social and political circumstances

that may favor some interventions over othersthat may favor some interventions over others– Who is likely to benefit ad who will be Who is likely to benefit ad who will be

disadvantaged as a result of choices made in disadvantaged as a result of choices made in health messages and interventionshealth messages and interventions

Questions of ValueQuestions of Value

• Example: U.S. vs. Canadian drug Example: U.S. vs. Canadian drug campaigns – campaigns – – abstinence vs. harm-reduction abstinence vs. harm-reduction

• (Just Say NO and DARE lack specific advice on how (Just Say NO and DARE lack specific advice on how to resist temptations for drug use or how to quit; to resist temptations for drug use or how to quit; lack of detail; mixed results) lack of detail; mixed results)

– Harm reduction campaigns recognize that Harm reduction campaigns recognize that people will use drugs and try to decrease people will use drugs and try to decrease negative consequences, by given specific negative consequences, by given specific instructions on which drugs are most harmful, instructions on which drugs are most harmful, and ways to reduce use or avoid disease, such and ways to reduce use or avoid disease, such as needle exchange; lots of positive evidence!as needle exchange; lots of positive evidence!

AccessibilityAccessibility

• Literacy levels in this country are low!Literacy levels in this country are low!• Paternalism – Paternalism –

– restricts information to patients; restricts information to patients; – lofty language; lofty language; – demeanor of control; demeanor of control; – less info given to disadvantaged groups who less info given to disadvantaged groups who

also feel less powerful to ask for it; class also feel less powerful to ask for it; class gap; gap;

– CDC Director Vicki Freimuth calls for CDC Director Vicki Freimuth calls for cultural and economic tailoring of health cultural and economic tailoring of health information.information.

AccessibilityAccessibility

• Increasing info – Increasing info – – all classes equally want more info than providers all classes equally want more info than providers

give; give; – mass media is useful; mass media is useful; – entertainment education has also been effective; entertainment education has also been effective; – telecommunication (hotlines) and Web (although telecommunication (hotlines) and Web (although

risks of assessing information are a problem); risks of assessing information are a problem); – health advertising is generally liked by consumershealth advertising is generally liked by consumers

• Locus of control – Locus of control – – those who feel in control of their health are more those who feel in control of their health are more

likely to seek info and act on it (internal vs. likely to seek info and act on it (internal vs. external)external)

AccessibilityAccessibility

• Extended Paralell Process Model Extended Paralell Process Model (Kim Witte) – (Kim Witte) – – People’s behaviors vary based on fear of People’s behaviors vary based on fear of

health threat; those who feel at risk and health threat; those who feel at risk and there is an effective response will be there is an effective response will be more likely to act, but if the threat more likely to act, but if the threat exceeds the belief in the proposed exceeds the belief in the proposed response then people may turn to denial response then people may turn to denial or fear.or fear.