Looking Ahead: Addressing Ethical Challenges in Public Health Practice

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75478/1/j.1748-720X.2007.00188.x.pd

Communicating with providers about racial healthcare disparities: The role of providers’ prior beliefs on their receptivity to different narrative frames

Objective Evaluate narratives aimed at motivating providers with different pre-existing beliefs to address racial healthcare disparities. Methods Survey experiment with 280 providers. Providers were classified as high or low in attributing disparities to providers (HPA versus LPA) and were randomly assigned to a non-narrative control or 1 of 2 narratives: “Provider Success” (provider successfully resolved problem involving Black patient) and “Provider Bias” (Black patient experienced racial bias, which remained unresolved). Participants' reactions to narratives (including identification with narrative) and likelihood of participating in disparities-reduction activities were immediately assessed. Four weeks later, participation in those activities was assessed, including self-reported participation in a disparities-reduction training course (primary outcome). Results Participation in training was higher among providers randomized to the Provider Success narrative compared to Provider Bias or Control. LPA participants had higher identification with Provider Success than Provider Bias narratives, whereas among HPA participants, differences in identification between the narratives were not significant. Conclusions Provider Success narratives led to greater participation in training than Provider Bias narratives, although providers’ pre-existing beliefs influenced the narrative they identified with. Practice implications Provider Success narratives may be more effective at motivating providers to address disparities than Provider Bias narratives, though more research is needed

Consumer Perspectives on Access to Directâ toâ Consumer Genetic Testing: Role of Demographic Factors and the Testing Experience

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/137391/1/milq12262.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/137391/2/milq12262_am.pd

Analysis of the capacity of google trends to measure interest in conservation topics and the role of online news

With the continuous growth of internet usage, Google Trends has emerged as a source of information to investigate how social trends evolve over time. Knowing how the level of interest in conservation topics--approximated using Google search volume--varies over time can help support targeted conservation science communication. However, the evolution of search volume over time and the mechanisms that drive peaks in searches are poorly understood. We conducted time series analyses on Google search data from 2004 to 2013 to investigate: (i) whether interests in selected conservation topics have declined and (ii) the effect of news reporting and academic publishing on search volume. Although trends were sensitive to the term used as benchmark, we did not find that public interest towards conservation topics such as climate change, ecosystem services, deforestation, orangutan, invasive species and habitat loss was declining. We found, however, a robust downward trend for endangered species and an upward trend for ecosystem services. The quantity of news articles was related to patterns in Google search volume, whereas the number of research articles was not a good predictor but lagged behind Google search volume, indicating the role of news in the transfer of conservation science to the public

Diet and exercise changes following direct-to-consumer personal genomic testing

Background: The impacts of direct-to-consumer personal genomic testing (PGT) on health behaviors such as diet and exercise are poorly understood. Our investigation aimed to evaluate diet and exercise changes following PGT and to determine if changes were associated with genetic test results obtained from PGT. Methods: Customers of 23andMe and Pathway Genomics completed a web-based survey prior to receiving PGT results (baseline) and 6 months post-results. Fruit and vegetable intake (servings/day), and light, vigorous and strength exercise frequency (days/week) were assessed. Changes in diet and exercise were examined using paired t-tests and linear regressions. Additional analyses examined whether outcomes differed by baseline self-reported health (SRH) or content of PGT results. Results: Longitudinal data were available for 1,002 participants. Significant increases were observed for vegetable intake (mean Δ = 0.11 (95% CI = 0.05, 0.17), p = 0.0003) and strength exercise (Δ = 0.14 (0.03, 0.25), p = 0.0153). When stratified by SRH, significant increases were observed for all outcomes among lower SRH participants: fruit intake, Δ = 0.11 (0.02, 0.21), p = 0.0148; vegetable intake, Δ = 0.16 (0.07, 0.25), p = 0.0005; light exercise, Δ = 0.25 (0.03, 0.47), p = 0.0263; vigorous exercise, Δ = 0.23 (0.06, 0.41), p = 0.0097; strength exercise, Δ = 0.19 (0.01, 0.37), p = 0.0369. A significant change among higher SRH participants was only observed for light exercise, and in the opposite direction: Δ = -0.2468 (-0.06, -0.44), p = 0.0111. Genetic results were not consistently associated with any diet or exercise changes. Conclusions: The experience of PGT was associated with modest, mostly positive changes in diet and exercise. Associations were independent of genetic results from PGT

Communicating population health: print news media coverage of type 2 diabetes.

The public learns much about health and health policy from the news media. The news media can shape the public's opinions about issues by emphasizing certain features in their coverage, such as the causes of a problem, who is responsible for addressing it, and what groups are affected. This study examines media framing of the problem of type 2 diabetes, focusing on the extent to which the news media discuss diabetes using features that characterize a population health orientation (mentioning social determinants, upstream interventions, or disparities). We collected data from 698 print news articles appearing in 19 U.S. newspapers between 2005 and 2006. Results demonstrate that the predominant explanation for type 2 diabetes was behavioral factors and obesity. The predominant strategy to address diabetes was individualized behavior changes and medical care. A minority of articles described the social determinants of diabetes, upstream policy solutions, and disparities in diabetes; such articles appeared in a select subset of news outlets. These findings suggest the potential for great variability in public awareness of disparities in diabetes or its social determinants, with implications for the public's likelihood of supporting policies that may improve population health.http://www.sciencedirect.com/science/article/pii/S027795360900467

Communicating population health: Print news media coverage of type 2 diabetes

The public learns much about health and health policy from the news media. The news media can shape the public's opinions about issues by emphasizing certain features in their coverage, such as the causes of a problem, who is responsible for addressing it, and what groups are affected. This study examines media framing of the problem of type 2 diabetes, focusing on the extent to which the news media discuss diabetes using features that characterize a population health orientation (mentioning social determinants, upstream interventions, or disparities). We collected data from 698 print news articles appearing in 19 U.S. newspapers between 2005 and 2006. Results demonstrate that the predominant explanation for type 2 diabetes was behavioral factors and obesity. The predominant strategy to address diabetes was individualized behavior changes and medical care. A minority of articles described the social determinants of diabetes, upstream policy solutions, and disparities in diabetes; such articles appeared in a select subset of news outlets. These findings suggest the potential for great variability in public awareness of disparities in diabetes or its social determinants, with implications for the public's likelihood of supporting policies that may improve population health.Population health Diabetes Media Content analysis Health inequalities USA