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1.
Med Care ; 62(5): 296-304, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38498875

RESUMEN

BACKGROUND: Many older women are screened for breast cancer beyond guideline-recommended thresholds. One contributor is pro-screening messaging from health care professionals, media, and family/friends. In this project, we developed and evaluated messages for reducing overscreening in older women. METHODS: We surveyed women ages 65+ who were members of a nationally representative online panel. We constructed 8 messages describing reasons to consider stopping mammograms, including guideline recommendations, false positives, overdiagnosis, and diminishing benefits from screening due to competing risks. Messages varied in their format; some presented statistical evidence, and some described short anecdotes. Each participant was randomized to read 4 of 8 messages. We also randomized participants to one of 3 message sources (clinician, family member, and news story). We assessed whether the message would make participants "want to find out more information" and "think carefully" about mammograms. RESULTS: Participants (N=790) had a mean age of 73.5 years; 25.8% were non-White. Across all messages, 73.0% of the time, participants agreed that the messages would make them seek more information (range among different messages=64.2%-78.2%); 46.5% of the time participants agreed that the messages would make them think carefully about getting mammograms (range =36.7%-50.7%). Top-rated messages mentioned false-positive anecdotes and overdiagnosis evidence. Ratings were similar for messages from clinicians and news sources, but lower from the family member source. CONCLUSIONS: Overall, participants positively evaluated messages designed to reduce breast cancer overscreening regarding perceived effects on information seeking and deliberation. Combining the top-rated messages into messaging interventions may be a novel approach to reduce overscreening.


Asunto(s)
Neoplasias de la Mama , Humanos , Femenino , Anciano , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/prevención & control , Mamografía , Encuestas y Cuestionarios
2.
Proc Natl Acad Sci U S A ; 118(2)2021 01 12.
Artículo en Inglés | MEDLINE | ID: mdl-33419923

RESUMEN

Does college change students' political preferences? While existing research has documented associations between college education and political views, it remains unclear whether these associations reflect a causal relationship. We address this gap in previous research by analyzing a quasi-experiment in which university students are assigned to live together as roommates. While we find little evidence that college students as a whole become more liberal over time, we do find strong evidence of peer effects, in which students' political views become more in line with the views of their roommates over time. This effect is strongest for conservative students. These findings shed light on the role of higher education in an era of political polarization.


Asunto(s)
Vivienda/ética , Influencia de los Compañeros , Estudiantes/psicología , Escolaridad , Femenino , Humanos , Masculino , Grupo Paritario , Política , Estados Unidos , Universidades , Adulto Joven
3.
Health Commun ; : 1-9, 2024 May 12.
Artículo en Inglés | MEDLINE | ID: mdl-38736132

RESUMEN

Despite considerable evidence that exposure to conflicting health information can have undesirable effects on outcomes including public understanding about and trust in health recommendations, comparatively little is known about whether such exposure influences intentions to engage in two communication behaviors central to public health promotion: information sharing and information seeking. The purpose of the current study is to test whether exposure to conflicting information influences intentions to share and seek information about six health topics. We analyzed data from two waves of a longitudinal survey experiment with a nationally representative sample of U.S. adults (N = 3,920). Participants were randomly assigned to either a conflict or no-conflict message condition, in which they read news stories and social media posts about three (of six) randomly selected health topics at Time 1 and the remaining three at Time 2. The dependent variables, which were measured at Time 2, asked participants whether they intended to share or seek information about the three topics they had just viewed. Linear mixed effects models showed that exposure to conflict reduced intentions to share and seek information, regardless of health topic. These findings suggest that exposure to conflicting health information discourages two important types of health information engagement, thus adding to the growing evidence base documenting the adverse consequences of conflicting information for public health.

4.
Milbank Q ; 101(S1): 61-82, 2023 04.
Artículo en Inglés | MEDLINE | ID: mdl-37096631

RESUMEN

Policy Points Medicalization is a historical process by which personal, behavioral, and social issues are increasingly viewed through a biomedical lens and "diagnosed and treated" as individual pathologies and problems by medical authorities. Medicalization in the United States has led to a conflation of "health" and "health care" and a confusion between individual social needs versus the social, political, and economic determinants of health. The essential and important work of population health science, public health practice, and health policy writ large is being thwarted by a medicalized view of health and an overemphasis on personal health services and the health care delivery system as the major focal point for addressing societal health issues and health inequality. Increased recognition of the negative consequences of a medicalized view of health is essential, with a focus on education and training of clinicians and health care managers, journalists, and policymakers.


Asunto(s)
Equidad en Salud , Medicalización , Humanos , Estados Unidos , Disparidades en el Estado de Salud , Política de Salud , Atención a la Salud
5.
Milbank Q ; 101(2): 349-425, 2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37096590

RESUMEN

Policy Points Many studies have explored the impact of message strategies to build support for policies that advance racial equity, but few studies examine the effects of richer stories of lived experience and detailed accounts of the ways racism is embedded in policy design and implementation. Longer messages framed to emphasize social and structural causes of racial inequity hold significant potential to enhance support for policies to advance racial equity. There is an urgent need to develop, test, and disseminate communication interventions that center perspectives from historically marginalized people and promote policy advocacy, community mobilization, and collective action to advance racial equity. CONTEXT: Long-standing racial inequities in health and well-being are shaped by racialized public policies that perpetuate disadvantage among Black, Brown, Indigenous, and people of color. Strategic messaging can accelerate public and policymaker support for public policies that advance population health. We lack a comprehensive understanding of lessons learned from work on policy messaging to advance racial equity and the gaps in knowledge it reveals. METHODS: A scoping review of peer-reviewed studies from communication, psychology, political science, sociology, public health, and health policy that have tested how various message strategies influence support and mobilization for racial equity policy domains across a wide variety of social systems. We used keyword database searches, author bibliographic searches, and reviews of reference lists from relevant sources to compile 55 peer-reviewed papers with 80 studies that used experiments to test the effects of one or more message strategies in shaping support for racial equity-related policies, as well as the cognitive/emotional factors that predict their support. FINDINGS: Most studies report on the short-term effects of very short message manipulations. Although many of these studies find evidence that reference to race or use of racial cues tend to undermine support for racial equity-related policies, the accumulated body of evidence has generally not explored the effects of richer, more nuanced stories of lived experience and/or detailed historical and contemporary accounts of the ways racism is embedded in public policy design and implementation. A few well-designed studies offer evidence that longer-form messages framed to emphasize social and structural causes of racial inequity can enhance support for policies to advance racial equity, though many questions require further research. CONCLUSIONS: We conclude by laying out a research agenda to fill numerous wide gaps in the evidentiary base related to building support for racial equity policy across sectors.


Asunto(s)
Salud Poblacional , Racismo , Política de Salud , Política Pública , Salud Pública
6.
Health Commun ; 38(2): 349-362, 2023 02.
Artículo en Inglés | MEDLINE | ID: mdl-34259097

RESUMEN

As scientific evidence evolves and clinical guidelines change, a certain amount of conflicting health information in the news media is to be expected. However, research is needed to better understand the public's level of exposure to conflicting health information and the possible consequences of such exposure. This study quantifies levels of public exposure to one paradigmatic case: conflicting information about breast cancer screening for women in their 40s. Using a nationally-representative survey of U.S. adults aged 18-59 in 2016, we implemented four distinct types of measures of exposure to conflicting mammography information: an ecological measure based on keyword counts of local news closed-captioning, an inferred exposure measure based on a series of knowledge questions, a thought-listing exercise where respondents described their perceptions of mammography without prompting, and an explicit measure of self-assessed exposure to conflict. We examined the relationship between these exposure measures and four outcomes: confusion about mammography, backlash toward mammography recommendations, and confusion and backlash about health information more generally. We found moderate amounts of exposure to conflicting information about mammography, more among women than men. Exposure to conflicting information - across multiple measures - was associated with more confusion about mammography, more mammography-related backlash, and general health information backlash, but not general confusion about health information. These observational findings corroborate experimental-based findings that suggest potentially undesirable effects of exposure to conflicting health information. More research is needed to better understand how to mitigate these possible outcomes, in the context of a media landscape that proliferates exposure to multiple scientific perspectives.


Asunto(s)
Neoplasias de la Mama , Mamografía , Masculino , Adulto , Humanos , Femenino , Prevalencia , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/prevención & control , Medios de Comunicación de Masas , Encuestas y Cuestionarios
7.
J Health Polit Policy Law ; 48(3): 351-378, 2023 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-36441634

RESUMEN

CONTEXT: Although the COVID-19 pandemic has affected all Americans, its effects have been unequally distributed across geographic areas. These variations in the pandemic's severity-and public perceptions thereof-likely have political consequences. This study examines the factors that shape perceptions of COVID-19 at the local level and assesses the consequences of these perceptions for public opinion and political behaviors. METHODS: The authors use questions from the 2020 Cooperative Election Study linked with county-level COVID-19 rates to examine predictors of respondents' perceptions of the pandemic's severity in their county, including demographic, political, and informational characteristics. The study also examines whether these perceptions are associated with public opinion and voter behavior. FINDINGS: Respondents' perceptions are correlated with case rates. Liberals and Democrats estimate the pandemic to be more severe than Republicans and conservatives do, as do CNN viewers compared to Fox News viewers. The study found only limited evidence of a relationship between perceptions of the pandemic in a respondent's county and political outcomes. CONCLUSIONS: The results add to the accumulating evidence that both news media and political predispositions shape perceptions of COVID-19, and they raise important questions about whether and how the pandemic has shaped-and will continue to shape-political outcomes.


Asunto(s)
COVID-19 , Humanos , Estados Unidos/epidemiología , COVID-19/epidemiología , Pandemias , Opinión Pública , Medios de Comunicación de Masas , Política
8.
Artículo en Inglés | MEDLINE | ID: mdl-37987174

RESUMEN

Republicans and Democrats responded in starkly different ways to the COVID-19 pandemic, from their attitudes in 2020 about whether the virus posed a threat to whether the pandemic ended in 2023. The consequences of COVID-19 for health equity has been a central concern in public health, and the concept of health equity has also been beset by partisan polarization. In this essay, we present and discuss nationally-representative survey data from 2023 on U.S. public perceptions of disparities in COVID-19 mortality (building on a multi-wave previous survey effort), as well as causal attributions for racial disparities, the contribution of structural racism, and broader attitudes about public health authority. We find anticipated gulfs in perspectives between Democrats on the one hand, and Independents and Republicans on the other. The results offer a somewhat pessimistic view on the likelihood of finding common ground in how the general public understands health inequities or the role of structural racism in perpetuating them. However, we show that those who acknowledge racial disparities in COVID-19 are more likely to support state public health authority to act for other infectious disease threats. We explore the implications of these public opinion data for advocacy, communication, and future needed research.

9.
Artículo en Inglés | MEDLINE | ID: mdl-37987197

RESUMEN

CONTEXT: Media messaging matters for public opinion and policy, and analyzing patterns of campaign strategy can provide important windows into policy priorities. METHODS: We used content analysis supplemented with keyword-based text analysis to assess the volume, proportion and distribution of attention to race-related issues in comparison to gender-related issues during the general election period of the 2022 midterm campaigns for federal office. FINDINGS: Race-related mentions were overwhelmingly focused on crime and law and order with very little attention to racism, racial injustice, and the structural barriers that lead to widespread inequities. In stark contrast to mentions of gender, racial appeals were less identity focused and were competitively contested between the parties in their messaging, but much more likely to be led by Republicans. CONCLUSIONS: Our results suggest that discussion of race and gender were highly polarized with consequences for public understanding of and belief in disparities and policies important to population health.

10.
Ann Behav Med ; 56(5): 498-511, 2022 05 18.
Artículo en Inglés | MEDLINE | ID: mdl-34398961

RESUMEN

BACKGROUND: Accumulating evidence suggests that exposure to conflicting health information can adversely affect public understanding of and trust in health recommendations. What is not known is whether prior exposure to such information renders people less receptive to subsequent unrelated health messages about behaviors for which the evidence is clear and consistent. PURPOSE: This study tests this "carryover" effects hypothesis, positing that prior exposure to conflict will reduce receptivity to subsequent unrelated health messages, and examines potential affective and cognitive pathways through which such effects might occur. METHODS: A three-wave, online, population-based survey experiment (N = 2,716) assessed whether participants who were randomly assigned to view a series of health news stories and social media posts featuring conflict at Times 1 and 2 were ultimately less receptive at Time 3 to ads from existing health campaigns about behaviors for which there is scientific consensus, compared to those who saw the same series of stories and posts that did not feature conflict. RESULTS: Structural equation modeling revealed evidence of carryover effects of exposure to conflict on two dimensions of message receptivity: greater resistance to the unrelated ads and lower perceptions of the health behaviors featured in the ads. Modeling indicated that carryover effects were a function of generalized backlash toward health recommendations and research elicited by prior exposure to conflicting information. CONCLUSIONS: Findings suggest that the broader public information environment, which is increasingly characterized by messages of conflict and controversy, could undermine the success of large-scale public health messaging strategies.


Asunto(s)
Medios de Comunicación Sociales , Promoción de la Salud , Humanos
11.
Prev Med ; 154: 106912, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34921834

RESUMEN

While clinical and public health researchers have produced a high volume of research evidence about the consequences of ACEs, there is limited research on public understanding of ACEs or how to most effectively communicate about this body of science. The objective of this study was to determine which messages describing evidence about the consequences of adverse childhood experiences (ACEs) affect public perceptions. We conducted an online experiment with a nationally-representative sample of U.S. adults in July-August 2020. Participants were randomized to control groups receiving messages describing ACE prevalence or resilience, or treatment groups receiving messages describing consequences of ACEs on mental health and substance use, economics, racial equity, or biology. We compared respondents' perceptions of prevention policies and likelihood of policy engagement, attributions of multi-sector responsibility, and blame and stigma across experimental groups. Messages about economic consequences increased respondents' support for policy and attributions of multi-sector responsibility relative to control groups, while also increasing parental blame. The message describing racial equity lowered respondents' perceptions of importance of state policy action and attributions of responsibility to health care. None of the messages affected stigmatizing attitudes. Describing the economic consequences of ACEs on public systems boosts public support for policy action. More research is needed on how the public responds to messaging connecting systemic racism with childhood adversity and health.


Asunto(s)
Experiencias Adversas de la Infancia , Estigma Social , Adulto , Política de Salud , Humanos , Salud Mental , Conducta Social
12.
Prev Med ; 162: 107135, 2022 09.
Artículo en Inglés | MEDLINE | ID: mdl-35803354

RESUMEN

COVID-19 has illuminated health inequity in the United States. The burdens of disease are much higher among Black and Indigenous people and other people of color. Disparities by income are also profound, as lower-wage workers were less able to adopt mitigating behaviors compared to higher-income counterparts. These disparities became part of public health discourse in 2020, with commentators frequently highlighting the connection between racism, socioeconomic position, and COVID-19. But what proportion of the public-and among key subgroups-recognized these social group disparities, relative to disparities associated with age and chronic illness, and did public recognition change over the first year of the pandemic? To address these questions, we analyzed data from three nationally-representative cross-sectional public opinion surveys, collected using the NORC AmeriSpeak panel in April 2020 (N = 1007), August 2020 (N = 2716), and April 2021 (N = 1020). The key outcomes were respondents' agreement with statements about disparities in COVID-19 mortality by age, chronic illness, income, and race. We found little change from 2020 to 2021 in Americans' recognition of disparities. At all three time points, most respondents acknowledged age and chronic illness disparities, while no more than half at any time point recognized income- and race-based disparities. Political party affiliation was not statistically associated with agreement with age or illness-related disparities, but was strongly associated with views about income- and race-based disparities. Efforts to promote recognition of racial and socioeconomic health disparities in the United States need to be mindful of the ways in which public understanding of health inequities is linked to partisanship.


Asunto(s)
COVID-19 , Negro o Afroamericano , Estudios Transversales , Disparidades en el Estado de Salud , Humanos , Pandemias , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Población Blanca
13.
J Med Ethics ; 48(7): 497-500, 2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-34972692

RESUMEN

Implementing equity principles in resource allocation is challenging. In one approach, some US states implemented race-based prioritisation of COVID-19 vaccines in response to vast racial inequities in COVID-19 outcomes, while others used place-based allocation. In a nationally representative survey of n=2067 US residents, fielded in mid-April 2021 (before the entire US population became eligible for vaccines), we explored the public acceptability of race-based prioritisation compared with place-based prioritisation, by offering vaccines to harder hit zip codes before residents of other zip codes. We found that in general, a majority of respondents supported the place-based approach, and a substantial proportion supported the race-based plan. Support was higher among Democrats compared with Republicans. All US residents became eligible for vaccines on 19 April 2021 but as of this writing, equitable uptake of vaccines remains urgent not only for first doses for adults but also for boosters and for children. Our findings also provide a benchmark for future pandemic planning that racial and social justice in vaccine allocation are salient considerations for the public. The findings may furthermore be of interest to policy makers designing vaccine allocation frameworks in countries with comparable health disparities across social, ethnic and racial groups, and more broadly, for those exploring ways of promoting equity in resource allocation outside of a pandemic setting.


Asunto(s)
COVID-19 , Vacunas , Adulto , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19 , Niño , Etnicidad , Humanos , Pandemias/prevención & control
14.
J Med Ethics ; 48(12): 993-999, 2022 12.
Artículo en Inglés | MEDLINE | ID: mdl-35927020

RESUMEN

Equity was-and is-central in the US policy response to COVID-19, given its disproportionate impact on disadvantaged communities of colour. In an unprecedented turn, the majority of US states used place-based disadvantage indices to promote equity in vaccine allocation (eg, through larger vaccine shares for more disadvantaged areas and people of colour).We conducted a nationally representative survey experiment (n=2003) in April 2021 (before all US residents had become vaccine eligible), that examined respondents' perceptions of the acceptability of disadvantage indices relative to two ways of prioritising racial and ethnic groups more directly, and assessed the role of framing and expert anchors in shaping perceptions.A majority of respondents supported the use of disadvantage indices, and one-fifth opposed any of the three equity-promoting plans. Differences in support and opposition were identified by respondents' political party affiliation. Providing a numerical anchor (that indicated expert recommendations and states' actual practices in reserving a proportion of allocations for prioritised groups) led respondents to prefer a lower distribution of reserved vaccine allocations compared with the randomised condition without this anchor, and the effect of the anchor differed across the frames.Our findings support ongoing uses of disadvantage indices in vaccine allocation, and, by extension, in allocating tests, masks or treatments, especially when supply cannot meet demand. The findings can also inform US allocation frameworks in future pandemic planning, and could provide lessons on how to promote equity in clinical and public health outside of the pandemic setting.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Humanos , COVID-19/prevención & control , Etnicidad , Pandemias/prevención & control , Opinión Pública
15.
Milbank Q ; 99(1): 99-125, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33320389

RESUMEN

Policy Points As Medicaid programs grow in scale and complexity, greater consumer input may guide successful program design, but little is known about the extent to which state agencies are engaging consumers in the design and implementation of programs and policies. Through 50 semistructured interviews with Medicaid leaders in 14 states, we found significant variation in consumer engagement approaches, with many common facilitators, including leadership commitment, flexible strategies for recruiting and supporting consumer participation, and robust community partnerships. We provide early evidence on how state Medicaid agencies are integrating consumers' experiences and perspectives into their program design and governance. CONTEXT: Consumer engagement early in the process of health care policymaking may improve the effectiveness of program planning and implementation, promote patient-centric care, enhance beneficiary protections, and offer opportunities to improve service delivery. As Medicaid programs grow in scale and complexity, greater consumer input may guide successful program design, but little is known about the extent to which state agencies are currently engaging consumers in the design and implementation of programs and policies, and how this is being done. METHODS: We conducted semistructured interviews with 50 Medicaid program leaders across 14 states, employing a stratified purposive sampling method to select state Medicaid programs based on US census region, rurality, Medicaid enrollment size, total population, ACA expansion status, and Medicaid managed care penetration. Interview data were audio-recorded, professionally transcribed, and underwent iterative coding with content and thematic analyses. FINDINGS: First, we found variation in consumer engagement approaches, ranging from limited and largely symbolic interactions to longer-term deliberative bodies, with some states tailoring their federally mandated standing committees to engage consumers. Second, most states were motivated by pragmatic considerations, such as identifying and overcoming implementation challenges for agency programs. Third, states reported several common facilitators of successful consumer engagement efforts, including leadership commitment, flexible strategies for recruiting and supporting consumers' participation, and robust community partnerships. All states faced barriers to authentic and sustained engagement. CONCLUSIONS: Sharing best practices across states could help strengthen programs' engagement efforts, identify opportunities for program improvement reflecting community needs, and increase participation among a population that has traditionally lacked a political voice.


Asunto(s)
Participación de la Comunidad , Planificación en Salud/métodos , Medicaid/organización & administración , Agencias Estatales de Desarrollo y Planificación de la Salud , Planes Estatales de Salud/organización & administración , Centers for Medicare and Medicaid Services, U.S. , Planificación en Salud/organización & administración , Política de Salud , Humanos , Entrevistas como Asunto , Medicaid/legislación & jurisprudencia , Patient Protection and Affordable Care Act , Gobierno Estatal , Estados Unidos
16.
Milbank Q ; 99(4): 1088-1131, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34402554

RESUMEN

Policy Points  Investments in early childhood education can have long-lasting influence on health and well-being at later stages of the life course.  Widespread public support and strategies to counter opposition will be critical to the future political feasibility of enhancing early childhood policies and programs.  Simple advocacy messages emphasizing the need for affordable, accessible, high-quality childcare for all can increase public support for state investments in these policies.  Policy narratives (short stories with a setting, characters, and a plot that unfolds over time and offers a policy solution to a social problem) that describe structural barriers to childcare and policy solutions to address these barriers may be particularly effective to persuade individuals inclined to oppose such policies to become supportive.  Inoculation messages (messages designed to prepare audiences for encountering and building resistance to opposing messages) may protect favorable childcare policy attitudes in the face of oppositional messaging. CONTEXT: Early childhood education (ECE) programs enhance the health and social well-being of children and families. This preregistered, randomized, controlled study tested the effectiveness of communication strategies to increase public support for state investments in affordable, accessible, and high-quality childcare for all. METHODS: At time 1 (August-September 2019), we randomly assigned members of an online research panel (n  =  4,363) to read one of four messages promoting state investment in childcare policies and programs, or to a no-exposure control group. Messages included an argument-based message ("simple pro-policy"), a message preparing audiences for encountering and building resistance to opposing messages ("inoculation"), a story illustrating the structural nature of the problem and solution ("narrative"), and both inoculation and narrative messages ("combined"). At time 2 (two weeks later) a subset of respondents (n  =  1,436) read an oppositional anti-policy message and, in two conditions, another narrative or inoculation message. Ordinary least squares regression compared groups' levels of support for state investment in childcare policies and programs. FINDINGS: As hypothesized, respondents who read the narrative message had higher support for state investment in childcare policies than those who read the inoculation message or those in the no-exposure control group at time 1. Among respondents who were initially opposed to such investments, those who read the narrative had greater support than respondents who read the simple pro-policy message. Those who received the inoculation message at time 2 were more resistant to the anti-policy message than respondents who did not receive such a message, but effects from exposures to strategic messages at time 1 did not persist at follow-up. CONCLUSIONS: Results offer guidance for policy advocates seeking to increase public support for early childhood policies and programs and could inform broader efforts to promote high-value policies with potential to improve population health.


Asunto(s)
Opinión Pública , Relaciones Públicas/tendencias , Adulto , Práctica Clínica Basada en la Evidencia/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad
17.
Health Commun ; 36(3): 303-314, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-31690128

RESUMEN

In recent years, there has been a shift toward promoting informed decision making for mammography screening for average-risk women in their 40s. Professional organizations such as the American Cancer Society and U.S. Preventive Services Task Force recommend that women weigh the potential benefits and harms of mammography prior to initiating screening. This decision-making process assumes that women are aware of both the benefits and harms of screening, yet little is known about the prevalence and antecedents of such awareness. Moreover, it is conceivable that women who are aware of both the benefits and harms may interpret this information as conflicting - which could be concerning, as researchers have documented adverse effects of exposure to conflicting health information in prior research. Using data from a population-based survey of U.S. women aged 30-59 (N = 557), the current study found that awareness of mammography's harms is relatively low compared to awareness of benefits. Health news exposure and interpersonal communication about health were associated with greater awareness of harms. In addition, women's awareness of both the benefits and harms was positively associated with confusion about breast cancer screening recommendations, ambivalence about getting a mammogram, and mammogram-related information seeking from online sources. Implications for cancer screening communication are discussed.


Asunto(s)
Neoplasias de la Mama , Detección Precoz del Cáncer , Neoplasias de la Mama/diagnóstico , Femenino , Humanos , Conducta en la Búsqueda de Información , Mamografía , Tamizaje Masivo , Estados Unidos
18.
J Health Polit Policy Law ; 46(3): 381-407, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-33647977

RESUMEN

CONTEXT: Understanding the role of drug-related issues in political campaign advertising can provide insight on the salience of this issue and the priorities of candidates for elected office. This study sought to quantify the share of campaign advertising mentioning drugs in the 2012 and 2016 election cycles and to estimate the association between local drug overdose mortality and drug mentions in campaign advertising across US media markets. METHODS: The analysis used descriptive and spatial statistics to examine geographic variation in campaign advertising mentions of drugs across all 210 US media markets, and it used multivariable regression to assess area-level factors associated with that variation. FINDINGS: The share of campaign ads mentioning drugs grew from 0.5% in the 2012 election cycle to 1.6% in the 2016 cycle. In the 2016 cycle, ads airing in media markets with overdose mortality rates in the 95th percentile were more than three times as likely to mention drugs as ads airing in areas with overdose mortality rates in the 5th percentile. CONCLUSIONS: A small proportion of campaign advertising mentioned drug-related issues. In the 2016 cycle, the issue was more prominent in advertising in areas hardest hit by the drug overdose crisis and in advertising for local races.


Asunto(s)
Publicidad/estadística & datos numéricos , Sobredosis de Droga/mortalidad , Política , Televisión , Humanos , Estados Unidos
19.
J Public Health Manag Pract ; 27 Suppl 1, COVID-19 and Public Health: Looking Back, Moving Forward: S5-S10, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33239557

RESUMEN

Two polls were conducted by an independent polling firm in September 2018 and July 2020 to assess public perceptions of public health departments and services among voters in the United States. The poll also sought to uncover changes in perception before and after the onset of COVID-19. A random sample was drawn from state voter files proportional to the national registered voter population by state, with quotas set by specific demographics to ensure representativeness. Overall, 1800 individuals participated between the 2 polls and weights were used in the analysis to adjust for nonresponse. From 2018 to 2020, respondents' familiarity with local public health departments rose 11% and their perception of the importance of the public health department to community health increased by 16%. In addition, support for public health departments and services differed significantly by political affiliation. In 2020, 85% of Democrats perceived the public health department to be very important while only 62% of their Republican counterparts felt similarly. Public health advocates have a unique opportunity to demand sustained funding for public health as American voters are more familiar and supportive of public health departments now than they were before the pandemic. In addition, policy makers, elected officials, and political candidates have the opportunity to leverage these data to fight for the health of their communities.


Asunto(s)
COVID-19/prevención & control , Pandemias/legislación & jurisprudencia , Pandemias/prevención & control , Política , Salud Pública/legislación & jurisprudencia , Salud Pública/normas , Opinión Pública , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias/estadística & datos numéricos , SARS-CoV-2 , Estados Unidos/epidemiología
20.
Prev Med ; 141: 106278, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33027615

RESUMEN

As with many other infectious and chronic conditions, the COVID-19 crisis in the United States (U.S.) reveals severe inequities in health. The objective of this study was to describe public perceptions of disparities in mortality from COVID-19 and examine correlates of those perceptions. We fielded a nationally-representative survey in late April 2020, asking participants how much they agreed with four statements describing group-level COVID-19 disparities: older people compared to younger, people with chronic health conditions compared to those without, poorer people compared to wealthier, and Black people compared to white people. We also measured personal characteristics, experience with COVID-19, and information sources. Overall agreement with age- and health condition-related disparities was high (>80%) while agreement with socioeconomic (SES) and racial disparities was lower (52%). Higher education and income were generally associated with greater agreement with disparities. Partisanship and information sources used were associated with perceptions of SES- and racial-disparities, with Democrats and those attune to national news-but not Fox cable news-more likely to perceive these disparities. As of April 2020, information about age- and health condition-related disparities in COVID-19 was well known by the U.S. public, while information about social disparities was less recognized and varied along socioeconomic and partisan lines.


Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , COVID-19/mortalidad , Disparidades en el Estado de Salud , Hispánicos o Latinos/estadística & datos numéricos , Pandemias/estadística & datos numéricos , Población Blanca/estadística & datos numéricos , Adolescente , Adulto , Negro o Afroamericano/psicología , Factores de Edad , Anciano , Anciano de 80 o más Años , COVID-19/epidemiología , Femenino , Hispánicos o Latinos/psicología , Humanos , Masculino , Persona de Mediana Edad , Percepción , Factores Raciales , SARS-CoV-2 , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Población Blanca/psicología , Adulto Joven
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