Evaluating Health Information Health Communication

Impact of Health Info Negative effect (fear, denial, etc.)Negative effect (fear, denial, etc.) Positive effect (empowering, knowledge, etc.)Positive effect (empowering, knowledge, etc.)

Health Literacy One’s ability to understand, process and have access to accurate health information is integral to:One’s ability to understand, process and have access to accurate health information is integral to: –decision-making, –relations b/t providers and patients, –patient rights, –informed consent, etc. Degree to which individuals have capacity to obtain, process and understand basic health info and services determines ability to make appropriate health decisions.Degree to which individuals have capacity to obtain, process and understand basic health info and services determines ability to make appropriate health decisions.

Factors Affecting Health Information Quantity and qualityQuantity and quality AccessibilityAccessibility Foundational valuesFoundational values

Quantity and Quality Health educators try to figure what is the right amount of information, and the right formats to give different audiencesHealth educators try to figure what is the right amount of information, and the right formats to give different audiences Laypersons are often not recognized as legitimate sources of health information (knowledge of symptoms, explanatory models, etc.) –Laypersons are often not recognized as legitimate sources of health information (knowledge of symptoms, explanatory models, etc.) – –when providers discount patients’ health info as subjective or irrelevant, the recommended health behaviors are less likely to be followed. –“Subjective-objective dichotomy” doesn’t make any sense since all data must be interpreted by someone – it is always subjective – and the layperson’s experiential evidence could also be seen as a kind of datait is always subjective – and the layperson’s experiential evidence could also be seen as a kind of data

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

Questions of Values No info is value-neutral (it all reflects our foundational values, definitions or principles of right/wrong, etc.)No info is value-neutral (it all reflects our foundational values, definitions or principles of right/wrong, etc.) (e.g. condom promotion depicts clash between propriety and disease prevention) (see. P. 276)(e.g. condom promotion depicts clash between propriety and disease prevention) (see. P. 276)

Questions of Values Most messages have hidden agendas –Most messages have hidden agendas – –What goals are chosen –What claims or arguments are made –How are health problems defined –What are the values of those proposing a health intervention –What values underlie the evaluations conducted of health campaigns –What are the social and political circumstances that may favor some interventions over others –Who is likely to benefit ad who will be disadvantaged as a result of choices made in health messages and interventions

Questions of Value Example: U.S. vs. Canadian drug campaigns –Example: U.S. vs. Canadian drug campaigns – –abstinence vs. harm-reduction (Just Say NO and DARE lack specific advice on how to resist temptations for drug use or how to quit; lack of detail; mixed results)(Just Say NO and DARE lack specific advice on how to resist temptations for drug use or how to quit; lack of detail; mixed results) –Harm reduction campaigns recognize that people will use drugs and try to decrease negative consequences, by given specific instructions on which drugs are most harmful, and ways to reduce use or avoid disease, such as needle exchange; lots of positive evidence!

Accessibility Literacy levels in this country are low!Literacy levels in this country are low! Paternalism –Paternalism – –restricts information to patients; –lofty language; –demeanor of control; –less info given to disadvantaged groups who also feel less powerful to ask for it; class gap; –CDC Director Vicki Freimuth calls for cultural and economic tailoring of health information.

Accessibility Increasing info –Increasing info – –all classes equally want more info than providers give; –mass media is useful; –entertainment education has also been effective; –telecommunication (hotlines) and Web (although risks of assessing information are a problem); –health advertising is generally liked by consumers Locus of control –Locus of control – –those who feel in control of their health are more likely to seek info and act on it (internal vs. external)

Accessibility Extended Paralell Process Model (Kim Witte) –Extended Paralell Process Model (Kim Witte) – –People’s behaviors vary based on fear of health threat; those who feel at risk and there is an effective response will be more likely to act, but if the threat exceeds the belief in the proposed response then people may turn to denial or fear.