Interactive Health Communication Technologies in the Public Health Sector: Positive Perceptions Still Outpace Actual Utilization

ABSTRACT

Effective population-based and patient-centered public health care is highly dependent on timely and reliable health-related information. The continuous growth and availability of health-related information brought about by the emergence of a new digital communications environment offers a range of opportunities that facilitate access to useful health information for the public health sector–for providers as well as patients. Such advancements, however, can only be realized if public health professionals are knowledgeable about existing sources of online health information, have the ability to successfully judge the reliability of online health information, and are able to acquire the information in a timely and efficient manner. This research follows on the heels of a survey of public health professionals in New York State that concluded that limited access and knowledge negatively impacted utilization of interactive health communication technologies. In this study, a survey was administered to providers at a large county health department located in central Michigan. Results indicate that perceptions regarding the advantages of online health information still far outweigh actual utilization. Barriers to actual utilization include lack of easy access to computers with high-speed connections, trusted and timely online information, training and staff development issues, and organizational policies concerning computer access and usage.     

The Affordance Utilization Model: Communication Technology Use as Relationships Develop

This essay proposes an affordance utilization model (AUM) that aims to understand the role of relationship development in communication technology use. The AUM draws from research regarding (1) social penetration theory and (2) the communication technology affordances of asynchronicity (i.e., a time lag between when a message is constructed and received) and reduced cues (i.e., the lack of visual and/or vocal cues). It proposes that these affordances are positively associated with communication competence and self-disclosure but that relationship development affects these associations. The AUM proposes that as relationships become more developed, communication technology affordances are less likely to be associated with communication competence and self-disclosure in relationships. The AUM also proposes that as relationships become more developed, relational partners will see affordances as less important and will use them less. Potential implications of the AUM for research on communication technologies in relationships are discussed.     

A Review of Multicomponent Interventions to Prevent and Control Tobacco Use Among College Students

Abstract

Objective: Multicomponent tobacco control programs have been implemented at the state and community levels and have led to a reduction in tobacco use. The purpose was to review the public health research literature on tobacco prevention and control programs on college campuses and derive evidence-based implications for comprehensive program implementation. Methods: MEDLINE, PsycINFO, ERIC, and PubMed databases were used to search the research literature concerning tobacco prevention and control programs conducted on college campuses published between 2000 and 2009. Results: No studies were found that implemented all 5 recommended components of a comprehensive program. Tobacco control programs containing policy and prevention education were used the most and promotion of tobacco-free environments and banning sales of tobacco products were used the least. Conclusion: The review suggests that despite the recommendation of comprehensive tobacco control programs to reduce tobacco use on college campuses, few institutions have implemented and evaluated programs consisting of multiple components.     

Perceptions and Use of a Web-Based Referral System in Child Welfare: Differences by Caseworker Tenure

In the child welfare system, technology may help caseworkers make service referrals efficiently. However, acceptance and use of new technology does not occur equally for all caseworkers. Influenced by the Technology Acceptance Model, we investigate differences in perceived ease of use and usefulness of a web-based referral system by caseworker tenure, and how these perceptions relate to use of the system. Results from 31 interviews with newer and more tenured caseworkers suggest important similarities and differences in how these groups perceive the technology, and suggest that differences in perception are related to differences in actual use.     

Researching Health Communication Technology Intervention Projects: The Challenge of Achieving Utilization Levels Sufficient for Evaluation

ABSTRACT

The deployment of interactive communication technologies to deliver health services and education has grown significantly over the past decade. Telemedicine, the use of telecommunication technologies for health care, is one specific application that has enjoyed significant public and private funding for research projects. However, telemedicine project evaluators have run into a serious barrier in their research efforts, namely, the deployment of telemedicine is often tremendously time-consuming and often yields utilization levels inadequate for research purposes. This article seeks to overview this problem through a case analysis of a multidimensional telemedicine project in Michigan that enjoyed both success and failure. The article concludes with a discussion of five universal challenges that must be addressed for project evaluators to achieve utilization levels to allow for reliable research conclusions.     

The potential of Web sites as a relationship building tool for charitable fundraising NPOs

The Internet and especially the new challenges within Web 2.0 provide organizations with the possibility of encouraging two-way communication and engaging publics in dialogue. Charitable fundraising nonprofit organizations (NPOs) can particularly benefit from the Web's relationship building potential. This study aims to explore the potential of Web sites as an online-communication tool of Swiss NPOs. Via content analysis, the Web sites of 134 Swiss charitable fundraising NPOs were examined in order to point out how those organizations are using the Web to create dialogic relationships with their most important stakeholder groups, which are potential donors and the media. Results indicate that the potential of the Internet for dialogic communication is not used efficiently by most NPOs. Nevertheless, NPOs seem to be acknowledging the importance of engaging publics in dialogue, as most of them replied to information requests from potential donors and the media.¹     

Responding to a Health Crisis on Facebook: The Effects of Response Timing and Message Appeal

This study examined the effects of timing and message appeal of a crisis response on organizational perceptions and behavioral intentions on social media. Using a health crisis scenario, a 3 (one hour vs. one day vs. one week after the crisis) × 2 (emotional vs. rational appeal) between-subjects experiment (N = 502) found that a crisis response posted one day after the crisis on Facebook elicited greater trust towards the hospital in crisis compared to a response posted in one week. The one-hour response and one-day response did not show differential effects on trust towards the hospital. The effect of timing was mediated by perceived credibility of the crisis response. In addition, the emotional appeal triggered greater trust, perception of reputation, and intention to “like” the post; whereas the rational appeal elicited greater intention to share and comment on the post. The study provides both theoretical and practical implications.     

Older Adults and Emerging Digital Service Delivery: A Mixed Methods Study on Information and Communications Technology Use,Skills, and Attitudes

Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability.     

The Internet: An Essential Tool for College Health Networking

Abstract

With the advent of the Internet, college health professionals have available to them a new setting in which to network. The Internet provides opportunities for immediate communication with a large and diverse community of colleagues. Through both the Student Health Service (SHS) Discussion Group and numerous health-related databases, the Internet serves as a powerful research tool for program development and improvement. Answers to queries about practice options, solutions for local problems, and support of innovative policies can be received almost instantaneously from college health professionals from across the United States and Canada. In this article, the authors summarize the history and current use of the SHS Discussion Group, provide a brief overview of Internet basics, and identify more advanced uses of the Internet by college health professionals.     

WEB PAGES, AUTHORS AND AUDIENCES: The meaning of a mouse click

One popular framework for analysing web pages has been to think of them as identity performances on the part of the author. This framework opens up possibilities for analysis of the ways in which identity performances are composed. The personal web pages to which this perspective is most immediately applicable, are, however, now only a small proportion of the overall amount of information available on the World Wide Web. It would be possible, by extension, to analyse institutional web pages as performances of the institutional identity. It is the contention of this paper that to do so is to miss out on some important aspects of web page design: namely that the production of a web page involves understandings not only of the audience for the page but also of the capacities of the technology. In addition, web page production has to become a socially meaningful act for the individual web page developer and the institution concerned. It is, therefore, argued that the analysis of web pages can usefully learn from media studies and the sociology of technology in this respect. An interview-based study of the developers of web pages for the service departments of a UK university is described. The ideas of audience which the authors use are far from homogeneous: they include an institutional offline audience for the page, a pre-existing imagined audience, developers themselves as audience, and the technology of the browser as a stand-in audience. The audience and the capacities of the technology are developed in context through the practices of designers.     

The Prevalence of Stalking Among College Students: The Disparity Between Researcher- and Self-identified Victimization

Abstract

Objective: Researchers examined the prevalence of self-identified and researcher-identified stalking victimization among college students. Participants and Methods: A representative sample of 1,573 (70.1% female; 29.9% male) student respondents completed an online stalking questionnaire. Results: Overall, 12% self-identified as having been stalked. Additionally, 42.5% (45.4% female; 35.7% male) of students reported experiencing at least 1 behavioral indicator of stalking victimization; however, only 24.7% of those self-identified as being stalked (25.6% female; 22.0% male). Conclusions: Stalking is a serious problem in the college community. A concern that needs to be addressed is the disparity between the number of those who met the behavioral criteria for stalking victimization, but who did not self-identify as a victim. The consequences of stalking victimization are highlighted. Recommendations for addressing this issue on campus are detailed in a plan that may help improve the retention, progression, and graduation rates for stalking victims.     

Health Information Seals of Approval: What do they Signify?

Much of the health information available to consumers on the Internet is incomplete, out of date and even inaccurate. Seals of approval or trustmarks have been suggested as a strategy to assist consumers in identifying high-quality information. Little is known, however, about how consumers interpret such seals. This study addresses this issue by examining assumptions about the quality criteria that are reflected by a seal of approval. This question is of particular importance because a wide variety of quality criteria have been suggested for online health information, including: core aspects of quality such as accuracy, currency and completeness; proxy indicators of quality such as the disclosure of commercial interests; and indicators that reflect the quality of the site or the interaction it affords, such as the availability of a search mechanism. The results of this study suggest that seals of approval are assumed to certify information quality primarily with respect to core quality indicators, aspects that subjects both consider to be important and feel relatively less able to evaluate for themselves (compared with their ability to rate proxy indicators of information or indicators of site or interaction quality). This assumption is largely inconsistent with practice: most seals of approval involve assessment of proxy indicators of information quality, rather than direct assessment of content. These results identify a problem that certification or accreditation bodies must address since, unless and until consumer expectations are congruent with evaluation practice, seals of approval will seem to promise more than they deliver.     

The Use of Humor to Cope with Secondary Traumatic Stress

Professionals in the area of sexual violence often use humor, both lighthearted and gallows humor, in an attempt to counteract the effects of the work on their well-being. There is little research, however, on whether the use of humor is effective in reducing symptoms of secondary traumatic stress. In the current study, more than 500 Internet Crimes Against Children task force personnel were surveyed about their level of secondary traumatic stress and the coping techniques utilized to mitigate work-related stressors. The use of gallows and light-hearted humor were independently related to secondary traumatic stress scores, even controlling for other coping strategies. The two types of humor were not related to secondary traumatic stress in the same direction, nor at the same magnitude.     

Aftermath of Tragic Events: The Development and Use of Community Support Meetings on a University Campus

Colleges and universities need to be prepared to address the psychological impact of tragedies on their campuses. In this article, the author describes the development and successful implementation of campus postvention services in the aftermath of college student deaths by suicide as well as by natural and accidental causes. The program has been well received and has gone a long way toward helping the campus community come together and heal after these types of tragedies. College officials adapted the program to address issues related to troubling national and international events as well local incidents, such as suicide attempts and students' loss of housing through fires. The author provides specific instructions so that readers can replicate the program on their own campuses, and additional materials are available upon request.     

Testing a New Measure of Sexual Health Knowledge and Its Connections to Students' Sex Education,Communication, Confidence,and Condom Use

ABSTRACT

This study investigates the nature of college students' sexual health knowledge, prior sex education coverage, and sexual communication and confidence. We created a new, comprehensive sexual health knowledge measure to assess 347 undergraduates' knowledge of reproductive health, contraception, condom use, sexually transmitted diseases (STDs), and HIV/AIDS. Overall, students demonstrated a fairly poor understanding of sexual health issues. Women were more knowledgeable than men, specifically on the topics of contraception and STDs. Prior exposure to sex education covering mainstream reproductive health issues or newer contraception methods was correlated with greater knowledge across all domains, particularly for men. Greater knowledge was also correlated with greater sexual assertiveness and confidence with condoms among women.     

Barriers and facilitators to evaluation of health policies and programs: Policymaker and researcher perspectives

Our research sought to identify the barriers and facilitators experienced by policymakers and evaluation researchers in the critical early stages of establishing an evaluation of a policy or program. We sought to determine the immediate barriers experienced at the point of initiating or commissioning evaluations and how these relate to broader system factors previously identified in the literature.We undertook 17 semi-structured interviews with a purposive sample of senior policymakers (n = 9) and senior evaluation researchers (n = 8) in Australia.Six themes were consistently raised by participants: political influence, funding, timeframes, a ‘culture of evaluation’, caution over anticipated results, and skills of policy agency staff. Participants also reflected on the dynamics of policy-researcher relationships including different motivations, physical and conceptual separation of the policy and researcher worlds, intellectual property concerns, and trust.We found that political and system factors act as macro level barriers to good evaluation practice that are manifested as time and funding constraints and contribute to organisational cultures that can come to fear evaluation. These factors then fed into meso and micro level factors. The dynamics of policy-researcher relationship provide a further challenge to evaluating government policies and programs.     

The Nature and Prevention of Harm in Technology-Mediated Self-Help Settings: Three Exemplars

SUMMARY

This paper argues that in addition to the substantial benefits they provide for members, on-line support groups create the potential for harm. Qualitative discourse analysis methods are used to examine messages exchanged in three distinct groups comprised of sexual abuse survivors, persons with disabilities, and parents. Examples of on-line practices with the potential to be harmful to individuals, dyadic relationships, and the larger group are identified. Several protective practices used by these groups that appear uniquely adapted for on-line support environments are also documented. Tentative guidelines are suggested for human services professionals interested in developing on-line support groups or referring clients to existing groups. The paper concludes with a discussion of the need for more research and a caution about the ethical responsibilities of researchers and practitioners who venture into this rapidly developing context of human service work.     

Factors Influencing Uptake and Use of a New Health Information App for Young People

Abstract

When young people need health information they are increasingly likely to use online sources and health apps (applications). Yet, these are not necessarily well-designed, reliable or appropriate, and research has primarily focused on adult use. Our study is the first to use qualitative mixed methods (focus groups and interviews) to apply the Technology Acceptance Model (TAM) to understand 26 young people’s uptake and use of a new, clinically-approved health app (application) for 16–25?year olds. We found that perceived usefulness, perceived ease-of-use, social influences and trust, all differently impacted children and young people health-app acceptance and effectiveness. Implications for future research and young-person health-app development are discussed.     

The Deployment of Information Technology in an International Rural Health Care Project

SUMMARY

This paper presents a case study of the utilization of Information Technology (IT) in a cataract surgery eye camp held outside a remote village in India. Detailed here are the organizational and technological context of the project, the steps taken in the development and deployment of a patient medical database, the data collection procedures employed during the eye camp, and the resultant information products of these endeavors. Discussed are the implications for the application of IT in the documentation and evaluation of time-limited health and social service delivery projects.