Promoting sexual health equity in the United States: implications from exploratory research with African-American adults.

In an effort to inform communication efforts to promote sexual health equity in the United States, the Centers for Disease Control and Prevention sought to explore African-Americans' perceptions of the sexually transmitted disease (STD) problem in their communities, reactions to racially comparative STD data and opinions about dissemination of such information. Semi-structured triads and individual interviews were conducted with African-American adults (N = 158) in the Southeastern and Midwestern United States. Most participants believed that STDs are a problem in their communities but were unaware of the extent to which STDs disproportionately affect African Americans. Once informed about racial differences in STD rates, participants commonly reacted with shock, fear and despair; a minority raised questions about the information's source and credibility. Most felt it was critical to get the information out to African-American communities as a 'wake-up call' to motivate change, though some raised concerns about its dissemination. Findings suggest that information about racial differences in STD rates must be strategically crafted and delivered through targeted channels to be acceptable to African Americans. So as not to further harm communities burdened by other social/health inequities, alternative (strength-based) approaches should be considered for motivating positive change.

Preferences for patient medication information: what do patients want?

This study investigated respondent preferences on how best to display patient medication information (PMI) that accompanies prescription medications to promote comprehension and appropriate usage. The authors identified 30 individuals diagnosed with select immune disorders, 30 with other chronic diseases, and 30 from the general public and had them review one of two PMI handouts that varied by format, organization, and content. The authors explored preferences for the PMI handout using one-on-one interviews. The authors analyzed the qualitative data to identify relevant themes and patterns using NVivo9 qualitative software. The majority of respondents noted that the formats of the two PMI handouts were more informative than those they currently receive from the pharmacist, with a preference for the 2-column, segmented design. However, respondent PMI preferences varied by age, education, and health status. Patients need simpler and more concise drug information to make better decisions about their health. Current PMI handouts are dense and complex, which can be confusing and not reader friendly. To improve PMI understandability and usefulness, the U.S. Food and Drug Administration is working with stakeholders, consumer advocates, and academics. Findings from this study may help inform future development of more user-friendly PMI.

Bundling of STDs and HIV in Prevention Messages.

PURPOSE ­: This study aims to explore peoples cognitive perceptions of HIV and other sexually transmitted diseases (STDs) to inform decisions on message development with regard to message bundling, with limited research on the concept of bundling-related prevention messages and no studies that consider the bundling of HIV and other STD prevention messages. DESIGN/METHODOLOGY/APPROACH ­: Individual and small-group interviews were conducted with 158 African American men and women to explore perceptions of STDs and communication preferences. Open-ended questions and a pile-sort exercise were used to elicit individuals' judgments on similarities of 12 STDs, including HIV. Interview data were coded and analyzed for themes and patterns; pile sort data were analyzed using multidimensional scaling (MDS) and cluster analysis to visualize the set of relations identified from the piles. FINDINGS ­: STDs and HIV are associated with stigma, risk behaviors and personal responsibility. The card sorting activity revealed two primary dimensions by which people organized STDs: seriousness and curability. Potential clusters of STDs that correspond to participants described sorting strategies were identified and they may have implications for message bundling. Disaggregation of the data by sex and age revealed slight variations in the relationships of HIV and human papillomavirus (HPV) to other STDs. ORIGINALITY/VALUE ­: By identifying a set of cognitive attributes people use in organizing the overall semantic domain of STDs, ideas can be generated for how best to combine STD and HIV messages to meet public health communication goals.

Consumers' perceptions of preconception health.

PURPOSE: To inform the development of a preconception health (PCH) social marketing plan, we conducted qualitative research with prospective consumers. APPROACH: We present formative findings based on the four Ps of social marketing: product, price, promotion, and place. SETTING: We conducted focus groups with 10 groups of women in Atlanta, Georgia, in fall 2010. PARTICIPANTS: We classified women aged 18 to 44 into five groups based on their pregnancy plans, and then further segmented the groups based on socioeconomic status for a total of 10 groups. METHOD: The focus group guide was designed to elicit participants' responses about the product, price, promotion, and placement of PCH. We used NVivo 9 software to analyze focus group data. RESULTS: Women planning a pregnancy in the future had different perspectives on PCH as a product than women not planning a pregnancy. Barriers to PCH included lack of social support, addiction, and lack of awareness about PCH. Participants preferred to think of PCH behaviors as "promoting" a healthy baby rather than preventing an unhealthy birth outcome. Many women in the focus groups preferred to hear PCH messages from a health care provider, among other channels. CONCLUSION: The results from this research will inform the development of a social marketing plan for PCH and the development of concepts that will be tested with consumers to determine their viability for use in a national campaign.

Adolescents' perceptions of smoking and stress reduction.

The present study examined how adolescents perceive the relationship between smoking and stress and where they learn that smoking cigarettes may be an effective stress-reduction mechanism. Eight focus groups were conducted with low-income African American and European American 14- to 16-year-olds in urban and rural locations, in which they suggested that the primary reasons why they smoked-namely, as a coping mechanism (to calm nerves), for social acceptance, and because of environmental influences. Family issues, boyfriend/girlfriend problems, and school were common stressors. Although participants overwhelmingly believed that people smoke to reduce their stress, a few believed that cigarettes do not actually reduce stress. When asked for examples of smoking in popular media, teens predominantly generated examples of individuals smoking to reduce stress. Ethnic and gender differences were found among the types of media in which they had seen smoking, their opinions of anti-smoking messages, and the media's perceived influence.