Development of a Community-Driven Mosquito Surveillance Program for Vectors of La Crosse Virus to Educate, Inform, and Empower a Community.

The fields of entomology, geospatial science, and science communication are understaffed in many areas, resulting in poor community awareness and heightened risks of vector-borne diseases. This is especially true in East Tennessee, where La Crosse encephalitis (LACE) causes pediatric illness each year. In response to these problems, we created a community engagement program that includes a yearlong academy for secondary STEM educators in the 6-12 grade classroom. The objectives of this program were to support inquiry-driven classroom learning to foster student interest in STEM fields, produce community-driven mosquito surveillance, and enhance community awareness of LACE. We trained educators in medical entomology, geospatial science, and science communication, and they incorporated those skills into lesson plans for a mosquito oviposition experiment that tested hypotheses developed in the classroom. Here, we share results from the first two years of the MEGA:BITESS academy, tailored for our community by having students ask questions directly related to Aedes mosquito oviposition biology and La Crosse encephalitis. In year one, we recruited 17 educators to participate in the project, and 15 of those educators returned in year two. All participating educators completed the academy, conducted the oviposition experiment, and informed over 400 students about a variety of careers and disciplines for their students. Here, we present a community-based program that helps to address the problems associated with long-term mosquito surveillance, health and science education and communication, career opportunities, and the community needs of Appalachia, as well as the initial data on the effectiveness of two years of an educator-targeted professional-development program.

Social Representation of Cyberbullying and Adolescent Suicide: A Mixed-Method Analysis of News Stories.

Cyberbullying has provoked public concern after well-publicized suicides of adolescents. This mixed-methods study investigates the social representation of these suicides. A content analysis of 184 U.S. newspaper articles on death by suicide associated with cyberbullying or aggression found that few articles adhered to guidelines suggested by the World Health Organization and the American Foundation for Suicide Prevention to protect against suicidal behavioral contagion. Few articles made reference to suicide or bullying prevention resources, and most suggested that the suicide had a single cause. Thematic analysis of a subset of articles found that individual deaths by suicide were used as cautionary tales to prompt attention to cyberbullying. This research suggests that newspaper coverage of these events veers from evidence-based guidelines and that more work is needed to determine how best to engage with journalists about the potential consequences of cyberbullying and suicide coverage.

Nutrition Information In Community Newspapers: Goal Framing, Story Origins, and Topics.

Obesity rates are high in the rural United States. Because small communities often have few health care practitioners, nutrition news in community newspapers may be a useful source of information. This content analysis of a random sample of 164 nutrition stories from 10 community newspapers in the rural West North Central Midwest was guided by concepts from goal-framing theory. Locally generated stories comprised nearly half of the sample, suggesting that nutrition is a salient topic in many rural communities. Hedonic frames related to food enjoyment were twice as frequent as health improvement frames. Results suggest food promotion was the most common topic of nutrition stories, with guidelines for a healthy diet appearing about half as often. Stories about a healthy diet and food promotion were most often written locally. Findings are discussed with recommendations for improvement of community news coverage of nutrition.

Improving rural newspaper coverage of nutrition stories: an educational assessment of editors' attitudes and learning needs.

Local newspapers are an important source of information for rural residents but often lack accurate or helpful nutrition-related information. To improve the quantity and quality of nutrition stories in rural, local newspapers, it is important to understand the perspective of editors. An online survey of 51 rural Midwest editors was conducted to assess attitudes toward writing nutrition stories, sources of information, perceived challenges, and interest in learning more about writing such stories. Of respondents, 49% were female, and 63% had at least a 4-year college degree. Through a mix of closed- and open-ended questions, the majority indicated positive attitudes toward nutrition stories, were confident in their abilities to write them, and expressed interest in learning more. Challenges cited include lack of print space, small staff, lack of specific requests from readers for nutrition stories, and the need to avoid offending local agricultural businesses. Results should be useful in planning an educational intervention for editors. Meanwhile, public health practitioners should provide concise press releases to their local newspapers about their activities. Also, greater expressions of appreciation from public health professionals and other readers may lead to higher prioritization of nutrition-related stories, and ultimately to an environment more supportive of healthy eating.

The rural restaurant healthy options program: response of rural, local newspapers to a program press release.

Local media should be used to raise awareness of health promotion programs. In rural areas, local newspapers provide an opportunity to reach large numbers of residents. Although there are expert guidelines describing the process for successfully engaging local media, little has been documented regarding the range of responses that local, rural newspapers might have when approached about covering health promotion programs. This study describes the response of rural, local newspapers to a press release about a health promotion program taking place in 28 restaurants in different rural towns. The most common reason for not publishing a story was that it would constitute free advertising for the restaurant. Twenty-two stories were analyzed using descriptive statistics. The majority of the responding newspapers were weeklies, and 16 published the full press release verbatim. Three stories included photos, and five included quotes. Headlines typically included the name of the restaurant and the university partner. The overall response rate is encouraging; however, there is considerable room for improvement in terms of personalizing the story with photos or quotes. Greater efforts may be required to obtain this depth of coverage, including training for local journalists to increase their interest and confidence in covering health promotion issues.

Managing uncertainty in the context of clubfoot care: exploring the value of uncertainty management theory and the sense of virtual community.

Serious health conditions, such as clubfoot, could be a major source of uncertainty and stress for parents of children affected. How parents deal with uncertainty and stress as related to their child's health condition is of interest for medical professionals and health communicators alike. While physicians remain a preferred source of health information, during medical encounters or via phone and email communication, many individuals seek out health information on the Internet, including in online support communities. This study explored the connections between Uncertainty Management Theory (UMT) constructs and the potential contribution of the sense of virtual community (SOVC) to the UMT framework. The results of this research suggest that the UMT needs to be adapted for use in online contexts. One way is to include theoretical constructs, such as the sense of virtual community, specifically developed to measure online interactions. A modified and updated Uncertainty Management Theory could be useful in exploring, analyzing and understanding online behaviors related to health conditions such as clubfoot and thus contribute substantially to what we know about caregivers in their role as uncertainty managers.

Online information exchanges for parents of children with a rare health condition: key findings from an online support community.

BACKGROUND: The Internet provides new opportunities for parents of children with difficult illnesses and disabilities to find information and support. The Internet is particularly important for caregivers of children with special needs due to numerous health-related decisions they face. For at-risk populations, online support communities can become key settings and channels for health promotion and communication. OBJECTIVE: This study is an initial exploration of the information-seeking and information-provision processes present in an online support community, which is an area of opportunity and interest for Internet-based medical research and practice. The aim of this study was to explore and describe information-related processes of uncertainty management in relationship to clubfoot. Specifically, the study explored interpersonal communication (information seeking and provision) in an online support community serving the needs of parents of children with clubfoot. METHODS: The study population consisted of messages posted to an online community by caregivers (parents) of children with clubfoot. The theoretical framework informing the study was the Uncertainty Management Theory (UMT). The study used content analysis to explore and categorize the content of 775 messages. RESULTS: Women authored 664 of 775 messages (86%) and men authored 47 messages (6%). Caregivers managed uncertainty through information seeking and provision behaviors that were dynamic and multilayered. The ratio of information-seeking messages to information-provision responses was 1 to 4. All five types of information-seeking behaviors proposed by Brashers' schema were identified, most of them being correlated. Information seeking using direct questions was found to be positively correlated to self-disclosure (r=.538), offering of a candidate answer (r=.318), and passive information seeking (r=.253). Self-disclosure was found to be positively correlated to provision of a candidate answer (r=.324), second-guessing (r=.149), and passive information seeking (r=.366). Provision of a candidate answer was found to be positively correlated with second-guessing (r=.193) and passive information seeking (r=.223). Second-guessing was found to be positively correlated to passive information seeking (r=.311). All correlations reported above were statistically significant (P<0.01). Of the 775 messages analyzed, 255 (33%) identified a medical professional or institution by name. Detailed medical information was provided in 101 (13%) messages, with the main source of information identified being personal experience rather than medical sources. CONCLUSION: Online communities can be an effective channel for caregivers, especially women, to seek and offer information required for managing clubfoot-related uncertainty. To enhance communication with parents, health care institutions may need to invest additional resources in user-friendly online information sources and online interactions with caregivers of children with special illnesses such as clubfoot. Furthermore, explorations of information-seeking and information-provision behaviors in online communities can provide valuable data for interdisciplinary health research and practice.

The birds, the bees, and the HPVs: what drives mothers' intentions to use the HPV vaccination as a chance to talk about sex?

Parent-child communication about sex is a way to protect adolescents from engaging in risky behavior. The human papillomavirus vaccine provides mothers with a teachable moment to communicate about sex. This study examines mothers' intentions to talk about sex in conjunction with the vaccination of daughters ages 9 to 15 years, using the Theory of Planned Behavior as a framework. A random sample of mothers was surveyed (N=217). Findings indicated that mothers' intentions were driven by attitudes, subjective norms, and the age at which they intended to vaccinate. Efforts to encourage vaccination should concentrate on strengthening mothers' attitudes about the value of talking about sex and highlight referent persons who support communication about sex.

Factors related to physicians' willingness to vaccinate girls against HPV: the importance of subjective norms and perceived behavioral control.

This study assessed factors related to physicians' intentions to vaccinate patients against human papillomavirus. A random sample of physicians was surveyed. The survey questions focused on the constructs of the Theory of Planned Behavior. Structural equation modeling was used to estimate the relationship of theoretical constructs to intention to vaccinate. Of the 207 physicians who responded, intentions to vaccinate were very high (86.5%). On a scale of 1 to 7 (strongly disagree to strongly agree) physicians had positive attitudes toward the vaccine. Physicians reported the vaccine was a good idea (M = 6.65, SD = 0.79), beneficial (M = 6.64, SD = 0.76), and protected against cervical cancer (M = 6.63, SD = 0.77). Intention to vaccinate was driven by subjective norms (provided by guidelines or standards of practice by important professional and general referent groups) (beta = 1.00, p < 0.05) and perceived behavioral control (beta = 0.39, p < 0.05). These findings indicate that public health efforts to encourage physicians to adopt the human papillomavirus vaccine should focus on subjective norms, such as those provided by professional organizations.

Using the theory of planned behavior to predict mothers' intentions to vaccinate their daughters against HPV.

This study assessed mothers' intentions to vaccinate their daughters against human papillomavirus (HPV) using the theory of planned behavior (TPB). Experience with sexually transmitted infections (STIs), beliefs about the vaccine encouraging sexual activity, and perception of daughters' risk for HPV were also examined for a relationship with intention. A random sample of mothers in a rural, Midwestern state were mailed a survey with questions pertaining to the intention to vaccinate. Attitudes were the strongest predictor of mothers' intentions to vaccinate, but intentions were not high. Subjective norms also influence intention. Mothers' risk perceptions, experience with STIs, and beliefs about the vaccine encouraging sexual activity were not related to intention. Mothers' perceptions of the daughters' risks for HPV were surprisingly low. This research provides a foundation for designing interventions to increase HPV vaccination rates. Further research should explore ways to influence mothers' attitudes and to uncover the referent groups mothers refer to for vaccination behavior.

Sexual health and stigma in urban newspaper coverage of methamphetamine.

The epidemic use of methamphetamine in the United States is a growing public health problem. Recently its use has increased among gay men who live in urban areas, with accompanying increases in sexually transmitted diseases. This study examined how methamphetamine and sexual health are framed. It investigated the stigma associated with heterosexuals and gay men. Stories from 13 urban newspapers in cities with large populations of gay men published from 2000 to 2006 were analyzed. Results indicated that methamphetamine and sexual health were framed primarily as an individual, present problem. Stories framed methamphetamine as a health problem slightly more often than as a crime problem, but health was the dominant frame in stories mentioning gay men. Crime was the dominant frame in stories with heterosexuals. Articles tied gay men to sexual health issues. Findings indicate gay men and heterosexuals are stigmatized in news coverage of sexual issues and methamphetamine but in different ways.

Health disparities and direct-to-consumer prescription drug advertising: a content analysis of targeted magazine genres, 1992-2002.

Health disparities exist in the United States based on race, gender, and socioeconomic status. One way to alleviate some of the disparities regarding certain diseases or conditions is to increase awareness among populations most affected. Physicians have suggested that direct-to-consumer advertising (DTCA) of prescription drugs could play a role in awareness. Social identity theory suggests that individuals are likely to attend messages if they can identify, often based on race or gender, with people portrayed in the messages. This study analyzed DTCA in 11 years of Black, women's, news, and entertainment magazines to determine whether models in the ads targeted specific populations. Black magazines were more likely to contain ads featuring Black models only than were other genres, which had more DTCA picturing White models only. Health conditions the drugs were intended for varied by genre and over time, with STD drugs appearing primarily in Black magazines, and DTCA for heart disease not published in Black magazines, despite cardiovascular diseases being the No. 1 cause of death for Blacks (and Whites). Women's magazines featured DTCA for a wide variety of drugs, reinforcing their roles as caretakers, with proportionally few ads for women's health. Implications for targeted use of magazine genres as a means of providing health information to specific populations are discussed.

Framing breastfeeding and formula-feeding messages in popular U.S. magazines.

Media framing of infant feeding has the ability to influence knowledge and views of the barriers, benefits, and solutions inherent in breastfeeding or formula-feeding. This study examined how seven popular U.S. parenting, general women's, and African American magazines framed breastfeeding and formula-feeding messages to determine whether a sense-making approach was used and the extent to which visual images portrayed feeding practices. Analysis included 615 articles published from 1997 to 2003 that referred to infant feeding. Text and images were analyzed. The magazines provided more information on breastfeeding than formula feeding. Parenting magazines included more advice than barriers or benefits. African American magazines presented more breastfeeding benefits, and general women's magazines contained the least infant-feeding information. Messages were focused on individualized breastfeeding barriers and advice, seldom covered social and environmental issues, and placed much of the responsibility of infant feeding on the mother, while the role of social and partner support was diminished. Bottle-feeding images were nearly as common as breastfeeding images. Findings can be used by public health practitioners to increase the likelihood of reaching certain target audiences through popular magazines.

Content analysis of drug offenders' sketches on the draw-an-event test for risky sexual situations.

OBJECTIVES: To evaluate the utility of the Draw-an-Event Test for risky sexual situations (DET-RS), a nonverbal memory-based assessment tool used for productions of spontaneous content associated with risky sex. METHODS: Traditional holistic coding analysis of 298 drug offenders' content productions. RESULTS: Content analyses of DET-RS sketches provided increased understanding of substance use and other context preceding risky sexual situations with different types of sex partners. None of the sketches including drugs depicted condoms, only one of the sketches with alcohol included a condom, and only 2 sketches mentioned sexually transmitted diseases. CONCLUSIONS: The DET-RS is a useful research tool for generating nonverbal context-specific stimuli associated with risky sexual situations.

Medicalization vs. adaptive models? Sense-making in magazine framing of menopause.

Women over the age of 40 are largely absent from media imagery. This study examined how magazines have framed menopause over the past two decades, as an increasing number of women have entered the phase. Using a traditional content analysis, we analyzed author and source gender, topics, and photographs in menopause articles in seven news and women's magazines. A computerized content-analysis program was used to determine how the magazines framed menopause. "Framing" refers to the emphasis and theme(s) of an article. Women's magazines provided a broad range of topics to help women prepare and cope; news magazines reported scientific developments, particularly in fertility. More frames, including clearer descriptions of symptoms and effects, occurred in women's magazines. Female authors included menopausal women as sources, but males did not. Photos of menopausal women appeared in a small portion of articles, and the women shown were predominantly white. Findings indicate some consistency with media coverage of other women's health issues, but with greater differences between news and women's magazines.