Evaluating Health Information

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Transcript Evaluating Health Information

Evaluating Health
Information
Health Communication
Impact of Health Info
• Negative effect (fear, denial, etc.)
• Positive effect (empowering, knowledge, etc.)
Health Literacy
• One’s ability to understand, process and have access to
accurate health information is integral to:
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decision-making,
relations b/t providers and patients,
patient rights,
informed consent, etc.
• Degree to which individuals have capacity to obtain,
process and understand basic health info and services
determines ability to make appropriate health decisions.
Factors Affecting Health
Information
• Quantity and quality
• Accessibility
• Foundational values
Quantity and Quality
• Health educators try to figure what is the right amount
of information, and the right formats to give different
audiences
• Laypersons are often not recognized as legitimate
sources of health information (knowledge of
symptoms, explanatory models, etc.) –
– when providers discount patients’ health info as subjective or
irrelevant, the recommended health behaviors are less likely
to be followed.
– “Subjective-objective dichotomy” doesn’t make any sense
since all data must be interpreted by someone –
• it is always subjective – and the layperson’s experiential evidence
could also be seen as a kind of data
Quantity and Quality
• Informed consent is seen as a catch-all to relieve
doctors from discounting patients’ rights or
failing to give full disclosure, but unless its done
in an educational manner with full permission
for the patient to withhold consent it is
meaningless.
Questions of Values
• No info is value-neutral (it all reflects our
foundational values, definitions or principles of
right/wrong, etc.)
• (e.g. condom promotion depicts clash between
propriety and disease prevention) (see. P. 276)
Questions of Values
• Most messages have hidden agendas –
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What goals are chosen
What claims or arguments are made
How are health problems defined
What are the values of those proposing a health intervention
What values underlie the evaluations conducted of health
campaigns
– What are the social and political circumstances that may favor
some interventions over others
– Who is likely to benefit ad who will be disadvantaged as a
result of choices made in health messages and interventions
Questions of Value
• Example: U.S. vs. Canadian drug campaigns –
– abstinence vs. harm-reduction
• (Just Say NO and DARE lack specific advice on how to
resist temptations for drug use or how to quit; lack of
detail; mixed results)
– Harm reduction campaigns recognize that people
will use drugs and try to decrease negative
consequences, by given specific instructions on
which drugs are most harmful, and ways to reduce
use or avoid disease, such as needle exchange; lots of
positive evidence!
Accessibility
• Literacy levels in this country are low!
• Paternalism –
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restricts information to patients;
lofty language;
demeanor of control;
less info given to disadvantaged groups who also feel
less powerful to ask for it; class gap;
– CDC Director Vicki Freimuth calls for cultural and
economic tailoring of health information.
Accessibility
• Increasing info –
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all classes equally want more info than providers give;
mass media is useful;
entertainment education has also been effective;
telecommunication (hotlines) and Web (although risks of
assessing information are a problem);
– health advertising is generally liked by consumers
• Locus of control –
– those who feel in control of their health are more likely to
seek info and act on it (internal vs. external)
Accessibility
• Extended Paralell Process Model (Kim Witte) –
– People’s behaviors vary based on fear of health
threat; those who feel at risk and there is an effective
response will be more likely to act, but if the threat
exceeds the belief in the proposed response then
people may turn to denial or fear.