Health Literacy

We talked about Health Literacy in class this week. Most people seemed to enjoy the video, but I felt a little more ambivalent about it. A lot of the ways they discussed functionally illerate people reminded me of the article "Is there a hard to reach audience?" Excuses for not targeting hard to reach populations (like the functionally illiterate) in the proper way has included talk about how illiterate people have conceptual deficits. But the article said that this isn't true and that this idea and others like it labels people. It makes failing to target and effectively reach them their fault instead of placing the blame with public health professionals. Anyways, the video very briefly seemed to mention conceptual differences. It wasn't obvious, but I thought a bit of the negative attitude exposed in the hard to reach article was there. Truthfully, I also thought the psychologist who tests motorcycle focus groups was a bit of a sell-out. I could be biased though, especially given the product. I tend to think that driving cars is unhealthy, so motorcycling definitely doesn't fall in the health-promoting category for me.

I thought that the SMOG/FOG test was an interesting idea and a good tool. But what about words like "exercise", "physical activity", etc.? We use those words all of the time even though they have 3 syllables and would thus raise the reading level. I guess there's a balance. My group got it down to 6th grade reading level. Is that too low? Would people be offended? In the end, this lab can help us reach the low literacy group. But the situation seems more dire than that, so should we actually be focusing on more visual messages? It was good to get a reality check and to get out of the ivory tower. My job doesn't always allow me direct access to the community so it's easy to forget about readability. As students, we have to separate classwork from work in the community. We are expected to work from a higher level of literacy in classes, so it's easy to let that spill over into health communication pieces for the community.

Dilemmas

Dr. Engelberg started the class by asking all of us what we tell people when they ask for health advice. The answer he wanted from us was that most people don't want our advice; they really just want to be heard and perhaps validated. But I got stuck on what advice I feel qualified to give. The fact is that I don't feel too confident about giving advice. I think that grad school teaches us how to think but not what to think. Sometimes I wish I could have the latter though! Once I have my Masters, the pressure will be on from friends, families and strangers to give health advice. So it's a timely issue. Maybe that's one reason why I want to go into Nursing- so I can get a bit of the other side and be taught what to think. Is that so bad? I'm not sure yet.

As I said in my comments on the main blog, I am very nervous about the group project! But I do have a great group and a great organization to work with. So hopefully it will work out. The more I get to know the organization, the better I like it and the more pressure I feel to do right by it.

Hopefully these dilemmas will get worked out...

Drinking Gives You Breast Cancer!!!!!!!!!!

Well that's what the news says. One newscaster said that one drink per day can give you breast cancer... or was it associated with breast cancer? To some people there isn't much of a difference, and I even have trouble remembering the exact wording. But the message was clear. Put down that cocktail!

How do these studies get mentioned on the news? For one, the statistics in the study is that 1 drink per day will increase risk by 14%. The large increase in risk of 30% is reserved for women who drink more than 3 drinks a day.

My concerns: Cancer has so many factors I still don't understand how they isolate one factor and measure it over 20 years. As far as measurement goes, do you remember how many drinks you've had over the past year? The only way I would really remember is if I never or almost never drank or if I drank a good amount every day. So that really skews those results! I may not be a statistician or a particularly sharp research methodologist type, but the study definitely seems flawed. Maybe the news should stop acting like these studies are the end all be all. Or maybe I like cocktails.

Final straw: Kaiser Permanente funded it. Eww.

P.S.: Balanced reporting mandated that the newscaster had to mutter that obesity is supposed to increase risk of cancer by 50%. Hmm. 50% versus 30%. Number of obese people vs. number of people who drink more than 3 drinks a day. Why do they do these studies?!?!?!

Decide for yourself.
http://www.nbcsandiego.com/health/14216485/detail.html
http://www.eurekalert.org/pub_releases/2007-09/kpdo-kps092207.php

Soviet Propaganda poster from http://www.tululuka.net/alco/

Module 1

So this is the end of Module 1- good introduction. I've enjoyed the applied portion of the class, especially the information about presentations. As a general rule, I hate presenting. It's actually gotten worse with practice. My palms sweat and I have trouble understanding what I say- it all sounds like the intercomm voice on "Snoopy". I actually watch the audience for confused faces, but what I say seems to make sense to them! Presentations are a necessary evil in Health Promotion. Hopefully some day I can take the "evil" out of that and make further improvements to my career. Here's hoping!

Week 4

This week a quote from the professor really struck me- he said that when it comes to planning health campaigns, we should "set the reality of time and money aside" then "scale back". Something about this statement seemed unrealistic in and of itself.

Although I believe that this might be a good exercise, in the interest of brainstorming, I don't think that public health jobs really allow for that initial creativity. At my job, we are always extremely concerned with money. Maybe it has negatively impacted our productivity, but most public health work seems to be like that. Recent budget cuts have threatened a project that we have worked very hard on, and the scramble to find new funding may have left me a bit bitter on the subject. It always seems like outside concerns heavily impact the job. State budget cuts that failed to involve the people who actually do the work have shown that public health can be a bit thankless and precarious. Right now it seems like our project and a concommitant contract will be cut in ways that could defeat the actual purpose of each.

So while I appreciate the idea about not limiting ideas due to pesky things such as time and money, I find it hard to apply to work. Ok- that concludes my whining tirade. Perhaps this blogging is a great way to get out frustrations- so plus side! Welcome back optimism.

Week 3: Applying Theory to Campaign Development Activity

Wow-- what a title! Ok, so today's lesson definitely emphasizes that for better and for worse, sex, money and looks sell. So it's best to use that in health campaigns.

To drive this point home, we had to form groups and take over a topic and age group. My group, the "Paul Newman Fanclub", had to get out a nutritional message to an older adult population. It took an unexpectedly long amount of time for us to get this off the ground. We eventually settled on trying to get older independent living adults to go to a local Farmer's Market. The real point of the activity was to understand the differences between "low involvement" and "high involvement" people. I personally found this challenging at first-- low involvement people in this context aren't necessarily eating poorly, right? The key to it all really was that low involvement people are less interested in the campaign, therefore, we should have lower expectations for change in that group. For low involvement, our group just wanted to expose them to fruits and vegetables; but high involvement (they were probably already eating fruits and vegetables), the objective was to get them to increase the variety through some healthy recipes. My group had a lot of fun with this activity. I mean we had Paul Newman as a spokesperson! For low involvement, the reward was "Hot Farmer Paul Newman" and for high involvement, the inducement was "The Socially-Conscious Paul Newman". We didn't take it too seriously, but I think it was really effective in the end.

The question posed in class was: "Should we use sex, looks and money to promote health"? Well my group's campaign certainly did! Although I have a lot of issues with free choice and health promotion--- I would agree that in the end, we have to use any weapon we can. Unhealthy products use them all the time and we can't combat that effectively without working on that same, subconscious level. Health Promotion and Public Health wants to be above this, but we have to face that facts and research alone have not produced the positive outcomes.

Well that's my opinion-- what's yours?!?

Week 1: Thank You for Smoking

Hi all-
I'm a new blogger and not very good at this so bear with me....

Anyways about Week 1: I was thinking about "Thank you for Smoking". Good movie for Public Health people if any of you haven't seen it. At work, one of my collegues sent a link about how warnings on cigarette packs are now going to show graphic pictures of healthy/unhealthy lungs, etc (in the U.K.). This reminded me of a quote from the movie:

Senator Lothridge: Now as we discussed earlier, these warning labels are not for those who know, but rather for those who don't know. What about the children?
Nick Naylor: Gentleman. It's called education. It doesn't come off the side of a cigarette carton. It comes from our teachers, and more importantly, our parents. It is the job of every parent to warn their children of all the dangers of the world including cigarettes so that one day when they get older, they can choose for themselves.

This was in response to a similar campaign in the movie where people wanted to put a graphic skull and cross-bones on cigarette packs. What does everyone think about this? Given that anti-smoking in some places may have gone as far as it can go, how far much further can we infringe upon choice? Devil's advocate here. Definitely something to think about since Public Health seems to often dance on the line between freedom of choice and more compulsory ways of imposing health in the population.
Ok-- that's my thought for today!