The ageing society: analyzing the coverage of the population ageing in a Belgian quality newspaper

This study has examined how the ‘Ageing Society’ -a society with a rapidly ageing population, a growing share of older persons and a decreasing share of younger persons- and its implications for the Belgian population are represented in the Belgian quality newspaper De Standaard (2011-2013). As such, the study delivered first-time Belgian empirical findings about the coverage of the Ageing Society. For most people, media are a central information source and an important factor in their opinion building. It is therefore highly important to increase the knowledge regarding the Ageing Society-media coverage they are provided with, and will possibly act upon. The study has applied a mixed methods approach. First, a qualitative content analysis inductively identified the labels and frames in the Ageing Society-coverage. Subsequently the frequencies of these labels and frames have been assessed. This two-step approach allowed identifying new labels and frames while considering their individual importance in the coverage as well. The Ageing Society mostly appeared in the newspaper De Standaard as a threat for the public budget, labour market and health- and social systems. The newspaper dominantly applied political- and economic frames to cover the Ageing Society, and hence established the Ageing Society mainly as a political-economic concern. Frequently applied as well in the coverage of the Ageing Society was the health frame. To a much lesser extent, the Ageing Society was also framed in terms of education and awareness. Several Ageing Society-related topics appeared seldom in the coverage; e.g. the (non- financial) contributions of older persons to society, the connectedness between the various generations, the implications of the Ageing Society for the individual and the human-made element in population ageing. Also, the dominant normative perspective of the Ageing Society as threat for the welfare state excluded other, more positive perspectives. Such perspectives could nevertheless complement the existing coverage by exploring the opportunities of the Ageing Society, and reporting about alternative policies to address its implications. The policies to address the Ageing Society were critically reflected upon in the newspaper’s comments and opinion articles. Most of these opinionating articles nevertheless did not attribute responsibility to specific persons or instances deemed accountable for addressing the Ageing Society. Sources for the Ageing Society-coverage in De Standaard were mainly professional experts, such as politicians or researchers. Other potential non-professional expert sources, such as representatives from the civil society, communities or individual (possibly ageing) persons were less represented. The research findings and theoretical insights have been translated into journalistic recommendations for a more varied and balanced media coverage of the Ageing Society

Understanding the effects of communication and engagement in a social marketing intervention on children’s eating behavior: design, measurement and evaluation

The prevalence of overweight and obesity represents a serious health problem, and is a risk factor for several non- communicable diseases. Poor nutrition and lack of regular physical activity are among the primary determinants of overweight and obesity. Data show that overweight and obesity rates are high in, and that the Swiss population does not adhere to the nutritional guidelines provided by the Swiss Society for Nutrition, nor to the physical activity guidelines provided by the Swiss Federal Office of Public Health. To address and counteract the issue of overweight and obesity, effective interventions are needed. Social Marketing is a framework grounded on Marketing concepts that focuses on behavior and aims at benefiting society by enhancing the social good. The evidence shows that the Social Marketing framework has been widely and effectively used in interventions aiming at changing different health behaviors, with different populations, including overweight and obesity in children. However, it is imperative to understand what makes interventions work, and what, on the contrary, impedes their success. In particular, there is need to improve knowledge and build up the evidence base on Social Marketing use in Europe. Hence it is critical to develop and implement Social Marketing interventions and to share consistently methodologies and results, in particular by operationalizing the Social Marketing benchmark criteria, and by reporting behavioral outcomes. “Famiglia, Attività fisica, Nutrizione” (FAN) was one of the interventions developed by the Department of Health and Social Affairs of Canton Ticino to address the issue of overweight and obese children. It was developed in collaboration with the BeCHANGE Research Group at the Università della Svizzera italiana, following the Social Marketing framework. FAN was addressed to families with school-aged children, and delivered to parents via Web, e-mail, SMS and via print letters to children, with the ultimate goal to help children and their parents eat healthy and practice regular physical activity. Since no validated tool existed to collect children’s food consumption data in Switzerland, a new instrument was developed and tested. This dissertation includes five complementary articles about measuring and improving children’s eating behaviors, each published in, or submitted to, a relevant scientific peer-reviewed journal in the field of Social Marketing or Public Health research. Each article presents the examination and discussion of one of the following four aspects related to the promotion of healthy nutrition in the FAN Social Marketing intervention: 1) The operationalization and implementation of Social Marketing; 2) The measurement of children’s food consumption; 3) The role of different communication channel bundles; 4) The role of engagement. To address the first aspect, the FAN intervention with the operationalization of the Social Marketing benchmark Criteria is described. Rates of participation and satisfaction with the intervention are also presented (Chapter II). To examine the second aspect, agreement between parents and their children in reporting the child’s food consumption was assessed, using two different instruments (7-day food diary vs. 2-day food record). These were then compared, to assess which one was more reliable with this population (Chapter III and Chapter IV). The third aspect examined the role of Web plus e-mail and Web plus SMS communication compared to Web-only communication using a Randomized Controlled Trial design. The study assessed children’s food consumption at pre- and post-intervention, by group assignment in the FAN intervention (Chapter V). Finally, to examine the fourth aspect, the role of online versus offline engagement in FAN was assessed using data from a self-reported questionnaire and data from a log of the FAN Website (Chapter VI). The description of the FAN intervention with the operationalization of the Social Marketing benchmark criteria helps to build the evidence on Social Marketing, defining how each benchmark was operationalized and allowing comparisons across studies. The analyses conducted in the second study, demonstrate that children are accurate reporters of their food consumption. The effects of the communication channels show that FAN had an overall positive effect on food consumption behavior, and in particular on that of fruit and sweets. The analyses of the role of engagement in intervention outcomes suggest that improved consumption of fruit, sweets and sugar drinks was associated with engagement. The world is facing a variety of health-related challenges that result from choices on nutrition, physical activity, smoking, alcohol consumption and other behaviors, and that negatively impact populations’ health, as well as health, social and economic systems and welfare. Among those, the prevalence of overweight and obesity needs urgent attention. Indeed, despite some efforts to decrease them, the rates of overweight and obesity are still high. Hence, cost-effective and urgent solutions are required. Social Marketing offers a systematic and detailed guide for developing, implementing, managing, and evaluating health behavior interventions. Evidence so far shows that Social Marketing has been effectively used in different settings, with different populations and for different health behaviors (including nutrition). This framework is also recommended in policy documents. However, the evidence on its use and effectiveness, in particular in Europe, still needs to be built up. Adhering to the eight benchmark criteria resulted in an intervention that was appropriate and relevant to the participants, and that had a positive effect on participation, retention, satisfaction rates, and behavior change. Future online interventions promoting healthy food consumption should adhere to the Social Marketing framework. The research described above tested two different food consumption measurement tools designed for children, to address the issue of gathering data about children’s food consumption, which is particularly difficult. The results suggest that children can provide accurate and useful data. The research also emphasizes the need to incorporate different complementary communication channels and that promoting engagement in a social marketing campaign can make a positive contribution to behavior change. All things considered, this research contributes to building knowledge and evidence about Social Marketing’s use and the promotion and measurement of healthy food consumption in children. The results provide an optimistic foundation that can be used and extended to other populations, behaviors and settings

Social Media for Public Health: An Exploratory Policy Analysis

Background: To accomplish the aims of public health practice and policy today, new forms of communication and education are being applied. Social media are increasingly relevant for public health and used by various actors. Apart from benefits, there can also be risks in using social media, but policies regulating engagement in social media is not well researched. This study examined European public health-related organizations' social media policies and describes the main components of existing policies. Methods: This research used a mixed methods approach. A content analysis of social media policies from European institutions, non-government organizations (NGOs) and social media platforms was conducted. Next, individuals responsible for social media in their organization or projects completed a survey about their social media policy. Results: Seventy-five per cent of institutions, NGOs and platforms had a social media policy available. The primary aspects covered within existing policies included data and privacy protection, intellectual property and copyright protection and regulations for the engagement in social media. Policies were intended to regulate staff use, to secure the liability of the institution and social responsibility. Respondents also stressed the importance of self-responsibility when using social media. Conclusions: This study of social media policies for public health in Europe provides a first snapshot of the existence and characteristics of social media policies among European health organizations. Policies tended to focus on legal aspects, rather than the health of the social media user. The effect of such policies on social media adoption and usage behaviour remains to be examine

Reasons for participating and not participating in a e-health workplace physical activity intervention

Purpose – The purpose of this paper is to investigate the reasons for participating and not participating in an e-health workplace physical activity (PA) intervention. Design/methodology/approach – Semi-structured interviews and two focus groups were conducted with a purposive sample of employees who enrolled and participated in the intervention and with those who did not complete enrolment, hence did not participate in it. Data were examined using thematic analysis according to the clusters of “reasons for participation” and for “non-participation”. Findings – Reported reasons for participation included a need to be more active, to increase motivation to engage in PA, and to better manage weight. Employees were attracted by the perceived ease of use of the programme and by the promise of receiving reminders. Many felt encouraged to enrol by managers or peers. Reported reasons for non-participation included lack of time, loss of interest towards the programme, or a lack of reminders to complete enrolment. Practical implications – Future e-health workplace behavioural interventions should consider focusing on employees’ needs and motivators to behaviour change, provide regular reminders for participants to complete enrolment and ensure that procedures are completed successfully. Barriers to participation could be identified through formative research with the target population and feasibility studies. Originality/value – This study combines a qualitative analysis of the reasons why some employees decided to enrol in a workplace PA intervention and why some others did not. This study highlights factors to consider when designing, implementing and promoting similar interventions and that could inform strategies to enhance participation in workplace PA interventions

Active8! Technology-based intervention to promote physical activity in hospital employees

Purpose: Increase physical activity in healthcare employees using health messaging, and compare email with mobile phone short-message service (SMS) as delivery channels. Design: Randomised controlled trial Setting: UK hospital workplace Subjects: 296 employees (19-67 years, 53% of study website visitors) Intervention: 12-week messaging intervention designed to increase physical activity and delivered via SMS (n=147) or email (n=149); content tailored using Theory of Planned Behaviour (TPB) and limited to 160 characters. Measures: Baseline, 6, 12 and 16 weeks. Online measures included TPB constructs; physical activity behaviour on the Global Physical Activity Questionnaire; health-related quality of life on the Short-Form 12. Analysis: General linear models for repeated measures. Results: Increase in duration (mean hours/day) of moderate work-related activity and moderate recreational activity from baseline to 16 weeks. Short-lived increase in frequency (days/week) of vigorous recreational activity from baseline to 6 weeks. Increase in duration and frequency of active travel from baseline to 16 weeks. Emails generated greater changes than SMS in active travel and moderate activity (work and recreational). Conclusion: Minimal physical activity promotion delivered by SMS or email can increase frequency and duration of active travel, and duration of moderate-intensity physical activity at work and for leisure, which is maintained up to one-month after messaging ends. Both channels were useful platforms for health communication; emails were particularly beneficial with hospital employees

Tick-Talk: Parental online discourse about TBE vaccination

This study aimed to understand parental discourse about vaccination, and to provide guidance for communication that addresses the needs of parents. We analyzed parental discourse on child vaccination in general and tick-borne encephalitis (TBE) specifically in a Swiss parental online community. For this purpose, a data set containing 105k posts written by parents between 2007 and 2019 was analyzed using a combination of linguistic discourse analysis and qualitative content analysis. Results show that parents enter into a multidimensional decision-making process, characterized by elaborate practices of negotiation, consideration of vaccination recommendations as well as six distinct influencing thematic factors (vaccination safety, development and control, effectiveness, epidemiology, necessity, alternatives or additional prevention methods). The study shows a clear pattern of seasonality, with parents talking about TBE vaccination mostly triggered by events such as tick bites in spring and summer. From a public health perspective, the study emphasizes the need for sufficient, balanced, and tailored information about TBE vaccination. Online forums provide valuable information about what matters to parents and when, which can help public health authorities and practitioners provide information according to these concerns and enhance health literacy among parents

Family Physician attitudes about prescribing using a drug formulary

<p>Abstract</p> <p>Background</p> <p>Drug formularies have been created by third party payers to control prescription drug usage and manage costs. Physicians try to provide the best care for their patients. This research examines family physicians' attitudes regarding prescription reimbursement criteria, prescribing and advocacy for patients experiencing reimbursement barriers.</p> <p>Methods</p> <p>Focus groups were used to collect qualitative data on family physicians' prescribing decisions related to drug reimbursement guidelines. Forty-eight family physicians from four Ontario cities participated. Ethics approval for this study was received from the Hamilton Health Sciences/Faculty of Health Sciences Research Ethics Board at McMaster University. Four clinical scenarios were used to situate and initiate focus group discussions about prescribing decisions. Open-ended questions were used to probe physicians' experiences and attitudes and responses were audio recorded. NVivo software was used to assist in data analysis.</p> <p>Results</p> <p>Most physicians reported that drug reimbursement guidelines complicated their prescribing process and can require lengthy interpretation and advocacy for patients who require medication that is subject to reimbursement restrictions.</p> <p>Conclusion</p> <p>Physicians do not generally see their role as being cost-containment monitors and observed that cumbersome reimbursement guidelines influence medication choice beyond the clinical needs of the patient, and produce unequal access to medication. They observed that frustration, discouragement, fatigue, and lack of appreciation can often contribute to family physicians' failure to advocate more for patients. Physicians argue cumbersome reimbursement regulations contribute to lower quality care and misuse of physicians' time increasing overall health care costs by adding unnecessary visits to family physicians, specialists, and emergency rooms.</p