Pot Song as a Novel Cancer Communication Intervention: Lessons Learned from Developing, Implementing, and Evaluating a Culturally Grounded Intervention for Breast Cancer Education in Rural Bangladesh.

Targeted public education may offer an approach to achieving more effective treatment in countries like Bangladesh, where breast cancer is a leading cause of cancer death in women. Effective cancer education interventions address the target population's cultural and contextual needs. However, there is little published literature to guide the development of educational cancer interventions in a region where lack of resources combined with cultural stigma about cancer contribute to poor breast health outcomes for women. The goal of the current study was to design, test, and evaluate a culturally grounded intervention to promote breast problem care among women in rural Bangladesh. The current manuscript first describes the process of formative evaluation that led to the development of the intervention, including decisions about the audience, message construction, and mode of intervention delivery. Second, we describe the testing process, including process and outcome evaluation. Finally, we describe the lessons learned from the process. We conclude with recommendations related to cultural grounding for message development, questionnaire design, data collection procedures, and analysis.

Integrating patient-centeredness into online patient-clinician communication: a qualitative analysis of clinicians' secure messaging usage.

PURPOSE: Patient-centered communication (PCC) in cancer care is helpful to nurture the patient-clinician relationship and respond to patients' emotions. However, it is unknown how PCC is incorporated into electronic patient-clinician communication. METHODS: In-depth, semi-structured qualitative interviews with clinicians were conducted to understand how PCC was integrated into asynchronous communication between patients and clinicians; otherwise, known as secure messaging. The constant comparative method was used to develop a codebook and formulate themes. RESULTS: Twenty clinicians in medical and radiation oncology participated in audio-recorded interviews. Three main themes addressed how clinicians incorporate PCC within messages: (1) being mindful of the patient-clinician relationship, (2) encouraging participation and partnership, and (3) responding promptly suggests accessibility and approachability. Clinicians recommended that patients could craft more effective messages by being specific, expressing concern, needs, and directness, summarized by the acronym S.E.N.D. CONCLUSIONS: Clinicians value secure messaging to connect with patients and demonstrate their accessibility. They acknowledge that secure messaging can influence the patient-clinician relationship and make efforts to include considerate and supportive language. As secure messaging is increasingly relied upon for patient-clinician communication, patients' message quality must improve to assist clinicians in being able to provide prompt responses inclusive of PCC.

What did the pandemic teach us about effective health communication? Unpacking the COVID-19 infodemic.

BACKGROUND: The spread of unvetted scientific information about COVID-19 presents a significant challenge to public health, adding to the urgency for increased understanding of COVID-19 information-seeking preferences that will allow for the delivery of evidence-based health communication. This study examined factors associated with COVID-19 information-seeking behavior. METHODS: An online survey was conducted with US adults (N = 1800) to identify key interpersonal (e.g., friends, health care providers) and mediated (e.g., TV, social media) sources of COVID-19 information. Logistic regression models were fitted to explore correlates of information-seeking. RESULTS: Study findings show that the first sought and most trusted sources of COVID-19 information had different relationships with sociodemographic characteristics, perceived discrimination, and self-efficacy. Older adults had greater odds of seeking information from print materials (e.g., newspapers and magazines) and TV first. Participants with less educational attainment and greater self-efficacy preferred interpersonal sources first, with notably less preference for mass media compared to health care providers. Those with more experiences with discrimination were more likely to seek information from friends, relatives, and co-workers. Additionally, greater self-efficacy was related to increased trust in interpersonal sources. CONCLUSION: Study results have implications for tailoring health communication strategies to reach specific subgroups, including those more vulnerable to severe illness from COVID-19. A set of recommendations are provided to assist in campaign development.

Identifying the mechanisms of patient-centred communication in secure messages between clinicians and cancer patients.

Objective: Identify how patients and clinicians incorporate patient-centered communication (PCC) within secure messaging. Methods: A random sample of 199 secure messages from patient portal communication between patients and clinicians were collected and analyzed. Via manual annotation, the task of tagging target words/phrases in text, we identified five components of PCC: information giving, information seeking, emotional support, partnership, and shared decision-making. Textual analysis was also performed to understand the context of PCC expressions within messages. Results: Information-giving was the predominant (n = 346, 68.1%) PCC category used in secure messaging, more than double of the other four PCC codes, information-seeking (n = 82, 16.1%), emotional support (n = 52, 10.2%), shared decision making (n = 5, 1.0%), combined. The textual analysis revealed that clinicians informed patients about appointment reminders and new protocols while patients reminded clinicians about upcoming procedures and outcomes of test results conducted by other clinicians. Although less common, patients expressed statements of concern, uncertainty, and fear; enabling clinicians to provide support. Conclusion: Secure messaging is mainly used for exchanging information, but other aspects of PCC emerge using this channel of communication. Innovation: Meaningful discussions can occur via secure messaging, and clinicians should be mindful of incorporating PCC when communicating with patients through secure messaging.

When text simplification is not enough: could a graph-based visualization facilitate consumers' comprehension of dietary supplement information?

OBJECTIVE: Dietary supplements are widely used. However, dietary supplements are not always safe. For example, an estimated 23 000 emergency room visits every year in the United States were attributed to adverse events related to dietary supplement use. With the rapid development of the Internet, consumers usually seek health information including dietary supplement information online. To help consumers access quality online dietary supplement information, we have identified trustworthy dietary supplement information sources and built an evidence-based knowledge base of dietary supplement information-the integrated DIetary Supplement Knowledge base (iDISK) that integrates and standardizes dietary supplement related information across these different sources. However, as information in iDISK was collected from scientific sources, the complex medical jargon is a barrier for consumers' comprehension. The objective of this study is to assess how different approaches to simplify and represent dietary supplement information from iDISK will affect lay consumers' comprehension. MATERIALS AND METHODS: Using a crowdsourcing platform, we recruited participants to read dietary supplement information in 4 different representations from iDISK: (1) original text, (2) syntactic and lexical text simplification (TS), (3) manual TS, and (4) a graph-based visualization. We then assessed how the different simplification and representation strategies affected consumers' comprehension of dietary supplement information in terms of accuracy and response time to a set of comprehension questions. RESULTS: With responses from 690 qualified participants, our experiments confirmed that the manual approach, as expected, had the best performance for both accuracy and response time to the comprehension questions, while the graph-based approach ranked the second outperforming other representations. In some cases, the graph-based representation outperformed the manual approach in terms of response time. CONCLUSIONS: A hybrid approach that combines text and graph-based representations might be needed to accommodate consumers' different information needs and information seeking behavior.

Propagandizing anti-vaccination: Analysis of Vaccines Revealed documentary series.

Politically charged health propaganda films may have public health ramifications through decreased vaccination uptake, especially with expansive dissemination potential on social media. The nine-episode documentary series Vaccines Revealed, touted as foremost truth within the largest anti-vaccination closed Facebook group, advocates for non-medical childhood vaccination exemptions - a policy actively opposed by the American Academy of Pediatrics. This series is recommended specifically to parents who are on the fence about whether or not to vaccinate their children as well as new, first-time, and expectant mothers. Fourteen 'expert' panelists included: six M.D,'s who reportedly prefer natural approaches for everything from chiropractic to cardiology practice, a vaccine injury attorney, two professors, one psychiatrist, the founder of natural search engine Greenmedinfo.com, a nationally-recognized clinical research expert on the HPV vaccine, the president of the National Vaccine Information Center, and three parents of vaccine-injured children. Additionally, voiceover clips from an epidemiologist and former senior scientist at the CDC were played throughout the series as evidence of governmental conspiracy. Inclusion of these testimonies, particularly from white coat doctors, led to a perception of high source credibility. Qualitative analysis of this documentary series revealed five overarching themes: (perceived) solidified science, collusion and conspiracy, canary in the coal mine, fear appeals, and the morality and necessity of individual choice. As opposed to formulating a priori theoretical assumptions, grounded theory allowed an integrative theoretical explanation to emerge from the data. Researchers expanded cognitive dissonance, parasocial interaction, and social identification theories and described how viewers of Vaccines Revealed could come to align their views on vaccinations with those of the panelists featured in the videos.