Evaluation of Continuing Education in Health Education: The Society for Public Health Education's 1983, 1984 and 1985 Mid-Year Scientific Symposia

The Society for Public Health Education's (SOPHE) first three mid-year scientific symposia were evaluated three months after each meeting with questionnaires mailed to all national SOPHE members who attended and a 10% sample of members who did not attend. 3% of SOPHE members attended the first meeting, rising to 7% and 12% in subsequent years. Persons spending their time in direct education and program plan ning/development and persons less active in health education professional organiza tions were under-represented at the meetings. About 90% of those who attended the meetings learned something that they had applied to their health education work. A third to a half had made contact with another health educator on health education business, and about one fifth had increased their participation in SOPHE affairs due to the meeting. Those who attended the mid-year meetings were significantly more likely to plan attendance at the next annual meeting than those who did not attend. Over half of those polled felt that SOPHE should continue to hold mid-year meetings; most of the rest were not sure. Strengths and weaknesses of the individual meetings are dis cussed, as well as suggestions for improvement, topics and forums for future meetings.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67185/2/10.1177_109019818801500201.pd

A content analysis of direct-to-consumer television prescription drug advertisements.

This article reports the results of a content analysis of 23 direct-to-consumer (DTC) product-specific television prescription drug advertisements broadcast during 2001. A majority of ads used both medical and lay terms to convey medical ideas. Most gave consumers somewhat more time to absorb facts about benefits than those about risks, which could have implications for the ''fair balance'' requirement. Complete references to additional product information were given only in text, casting doubt on whether these ads are making ''adequate provision'' for dissemination of detailed product information. Overall, our results call into question the potential of these ads to educate consumers. The volume of prescription drug advertising directed to consumers rather than physicians has grown tremendously over the past decade. Expenditures for DTC advertising According to U.S. Food and Drug Administration (FDA) regulations, prescription drug advertisements cannot be false or misleading and must have ''fair balance'' in the presentation of risks and benefits The FDA clarified the ''adequate provision'' requirement in a guidance issued in draft form in 1997 and finalized in 1999. The guidance suggested that DTC broadcast advertisements could meet the requirement by referring consumers to physicians and pharmacists and to more detailed product information available through a website, tollfree telephone number, and concurrently running DTC print advertisement (Talley, 1997; U.S. FDA, 1997FDA, , 1999. The 1999 guidance also stated that broadcast advertisements should present information relevant to indications and the major statement of important risks in ''consumer-friendly language'' (U.S. FDA, 1999). Direct-to-Consumer advertising has been the subject of intense debate in both the medical literature and the popular press, stemming in part from the tremendous growth in television advertising allowed by the 1997 FDA draft guidance. Proponents have argued that DTC advertising can increase treatment of underdiagnosed conditions, inform consumers about new treatments, enhance treatment compliance, and help consumers make better informed health care decisions Recent studies have addressed the impact of DTC advertising on consumers and the physician-patient relationship. Ninety-two percent of physicians in a 2002 FDA survey reported having had a discussion about an advertised drug initiated by a patient . In a FDA consumer survey conducted in the same year, 81% of respondents recalled having seen or heard a prescription drug advertisement in the preceding 3 months Other research has examined the content of DTC print advertisements. Roth (1996) examined dimensions such as target patient base, indication, and balance between 516 K. A. Kaphingst et al. Click here to access the Journal of Health Communication Online benefit and risk information. Consumer Reports (1996) evaluated the potential educational benefit and quality of 28 DTC print ads, assessing features such as use of medical jargon, placement of key information, print size, and comprehensiveness. Other content analyses of DTC print advertisements have been reported by colleagues (2000a, 2000b), Pinto The primary objective of the exploratory study presented here was to conduct a descriptive content analysis of a sample of product-specific DTC television advertisements. We gave particular attention to those features of the ads that might interfere with consumers' comprehension of critical information, keeping in mind what is known about the functional literacy skill levels of U.S. adults. Methods Sample We focused on product-specific advertisements appearing on the three major television networks (ABC, CBS, and NBC). Network stations are available to everyone with a television who lives within receiving range of a broadcast signal. The networks target a broad audience, while each cable channel usually targets a narrower demographic group. Advertisements broadcast on the major networks therefore can reach the largest cross section of the public. Our first step in assembling the study sample was to capture as many DTC advertisements as possible. Toward this end, we videotaped a 6-hour block of programming from one of the three major television network stations in Boston, Massachusetts, each day from February 1, 2001, to March 31, 2001. During the first 2 weeks of this period, we videotaped 6-hour blocks throughout the day. Examining this material, we determined that the broadcast hours between 10 AM and 4 PM were most likely to contain DTC advertisements. Thereafter, we videotaped this 6-hour block of time more frequently, but we continued to videotape other 6-hour time blocks as well so that any DTC advertisements broadcast only during other times of the day also might be captured. In the resulting 354 hours of programming, we identified 62 unique product-specific DTC advertisements for 33 prescription drugs for 22 indications. Advertisements were counted as product-specific DTC advertisements if they (1) advertised a prescription drug; (2) stated the name of the drug; and (3) gave at least one indication for the drug. We Content Analysis of Television Prescription Drug Ads 517 Click here to access the Journal of Health Communication Online counted product-specific DTC ads as unique if any content varied from another ad. We found only one advertised drug for each of 18 indications, two drugs each for asthma and osteoarthritis, three drugs for high cholesterol, and eight drugs for allergies. To select the final sample of ads, we used the following procedure. First, if there was more than one advertised drug for an indication, we randomly selected one of the drugs. Second, if there was more than one product-specific ad for a particular drug, we randomly selected one ad for analysis. There was one exception: for allergies, we included randomly selected ads for two prescription drugs in the sample, one for a nasal spray and one for a pill. Appendix A lists the prescription drugs and indications represented in the study sample of 23 ads. Coding Dimensions We used theory-derived coding dimensions that were directly relevant to FDA policy to code the advertisements in this study. We grouped the coding dimensions into three categories: (1) those related to the presentation of risk and benefit information in the ads; (2) those related to adequate provision for dissemination of detailed product information; and (3) those describing the educational content of the ads. We analyzed DTC television advertisements as communications designed to persuade consumers to seek further information about a prescription drug or to request a drug from their physicians. Our theoretical framework was McGuire's communication/ persuasion matrix We first outlined the coding dimensions based on input factors in McGuire's communication/persuasion matrix 518 K. A. Kaphingst et al. Click here to access the Journal of Health Communication Online Coding Procedure Two trained coders independently completed the protocol for each of the 23 ads in the study sample and discussed any discrepant codes to reach consensus. We conducted the analysis using SPSS 10.1 for Windows (Chicago, IL) based on the consensus codes. We calculated kappa values for the 102 categorical variables to assess intercoder agreement RESULTS The advertisements in the sample varied in length: 17 (74%) were 60 seconds, 3 (13%) were 45 seconds, and 3 (13%) were 30 seconds. Only 7 ads (30%) clearly identified the drug's manufacturer, 14 (61%) did not identify a manufacturer, and the remaining 2 ads (9%) included an unreadable manufacturer's name or logo. In this section, we present key results organized into three categories: (1) results related to the presentation of risk and benefit information in the ads; (2) results related to adequate provision for dissemination of detailed product information; and (3) results describing the educational content of the ads. Presentation of Risk and Benefit Information Fact Density We calculated the number of facts given about a drug's benefits and risks in the ads, including repetitions of a fact in the count. The ads provided a mean of six facts about drug benefits (range 2-12), conveyed in a mean time of 10 seconds (range 4-27 seconds). The mean number of benefit facts given per second was 0.54 (range 0.27-0.90). The ads presented a mean of 10 risk facts (range 2-19) in an average time of 14 seconds (range 3-23 seconds). The mean number of risk facts given per second was 0.78 (range 0.50-1.33). In 21 ads (91%), the number of benefit facts per second was less than the number of risk facts per second (mean ratio of benefit facts/second to risk facts/second ¼ 0.72; range 0.27-1.22). This ratio indicated that, on average, viewers had more time to absorb benefit facts than risk facts. Presentation of Risk Information We examined a number of different aspects of the presentation of risk information: (1) whether risk information was presented in one continuous segment; (2) whether risk information was set off by use of a different announcer or a change in speed, tone, or volume; (3) channel in which risk information was given; (4) type of side effect information provided; and (5) text messages and visual images shown during the risk information segments. Content Analysis of Television Prescription Drug Ads 519 Click here to access the Journal of Health Communication Online Nineteen of the ads (83%) presented the risk information in one continuous section, rather than interspersed throughout the ad, as shown in We also assessed the text messages and visual images shown during the presentation of risk information. Twenty-two ads (96%) gave text references to at least one source of product information (e.g., a DTC print ad). Nine ads (39%) included a text statement urging viewers to seek more information. Twenty-one ads (91%) showed positive or neutral visual images during the presentation of risk information; none showed negative images. Ad images were coded as positive or neutral if they were not clearly negative (e.g., characters shown being angry or sad)

Discrepancies between self-reported and observed physical function in the elderly: the influence of response shift and other factors

Goal: To explore the influence of social, psychological, and health factors on self-report of function. Subjects: A convenience sample of 289 community-dwelling elderly aged 65-97 years. Methods: We compared a measure of function based on observed performance, the Physical Capacity Evaluation (PCE) with a self-reported measure of functional limitations (HAQ), in a cross-sectional study. Stepwise multiple regression identified variables predicting self-reported disability, controlling for observed function. Results: Controlling for PCE, self-reports of greater disability (HAQ) were predicted by current joint pain or stiffness, use of prescription medications, urban dwelling, depression, female gender, lack of memory problems, arthritis and lack of exercise. A final model included recent decline in function, dissatisfaction with function, gender, joint pain or stiffness, and observed function, explaining 85% of the variance in self-reported disability. The hypothesis that aging is associated with declining expectations of functional ability was not supported. However, recent health problems affected participants' reporting of limitations, consistent with a recalibration-type response shift. Perceived decline in function over the past six months, a fall within the last month, illness in the last week and pain or stiffness on the day of the exam all raised self-reports of disability. As suggested by adaptation level theory, subjects with recent problems might have an inflated perception of limitations due to shifts in their internal standards. When administered first, the observed performance test improved correlations between observed and self-reported function, primarily among those who did not report a recent decline in function. This suggests that this group may have benefited more from salient information about their abilities provided by performing the PCE before self-report. Conclusion: Our data confirm the importance of social, psychological, and health influences in self-report of disability, and are consistent with the hypothesis that people may recalibrate their self assessments based on recent health problems.Function Physical assessment Disability Psychosocial Elderly