Communication 620: Health Communication

Communication 620: Health Communication

Social Science Approaches to Behavioral Prevention

Annenberg School for Communication

Fall 2008

Section 20724D

ASC331

Thursday 2-4:50

Instructor: Professor Lynn Carol Miller: http://www-rcf.usc.edu/~lmiller/

Email:

Class time: Tues 6:45-9:45pm

Office hours: Tues 5:30—6:30 PM and by appointment

Instructor: Professor Miller is and has been Principal Investigator on more than $11 Million in Grants ($2.5M in other grants), most in the health communication field. She recently received a new 5-year $3.5M R01 grant from the National Institute of Mental Health (NIMH/NIH) to develop a virtual gaming environment with realistic intelligent agents to change risky behavior for high risk populations “on-line” nationally. A past panelist and an invited speaker/consultant for the National Institutes of Health, Centers for Disease Control and Prevention, and the Department of Defense, her work focuses on how we can develop/use interactive environments and intelligent agents to assess and change risky behavior.

Texbook:

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: Theory, Research, and Practice (4th edition). San Francisco, CA: John Wiley & Sons. This volume will be available “on line” the first week of September. You can pre-order at Amazon.com.

http://www.amazon.com/Health-Behavior-Education-Research Practice/dp/0787996149/ref=cm_cr_pr_pb_t#productPromotions

Readings as assigned (see below); will be posted via blackboard.

Requirements/Evaluation Criteria:

10% Class Participation

20% Assignments

20% Oral Presentation of Final Review & Meta-Analysis Paper

50% Final Review & Meta-Analysis Paper

Final Project Papers will consist of a data-based review (i.e., meta-analysis). Meta-analyses are often the first (publishable) step in getting a handle on a research area, planning a grant, and identifying what research is most needed (and therefore more likely to be published, funded, etc.)

Review Paper Due Dates:

(1)  Specify Review Area (theoretical relationship of interest) in Consultation with Professor Miller (ideally your relationship of interest involves one of NIH’s 4 P’s and is specific enough that it is “doable” within the context of the semester’s project. Specify explicit inclusion and exclusion criteria; decide on criteria for “Methodological Quality” and Justify; Search strategies for articles (published and not) specified (due September 11).

(2)  Collect all studies in specified population providing data on that relationship. Provide all abstracts (due: September 25).

(3)  Code studies and compute effect sizes (distribution of). (due October 9).

(4)  Examine effect sizes (distribution of) and examine/analyze potential role of moderators. (due: October 23).

(5)  Revisions to above (due: November 6).

(6)  Review Paper Draft Submission Due: November 20.

(7)  Project Presentation (due: December 4).

(8)  Final project paper (due: December 10)

Course Description:

Health Communication takes place at every levels of analysis (i.e., individual, interpersonal, group/network, organizational, and societal). Communicating about health can also involve mass media as well as online and via new/emerging technologies. Health communication is a broad, growing, and exciting field with exceptional career opportunities (e.g., for academic positions in health communication; for a visible national/international presence and impact beyond, as well as within, the field of communication, for large federal research grants). Many of our faculty at USC’s Annenberg School for Communication conduct research in and have federal and other grants this area http://healthcommunication.net/USouthern_CA.html.

Researchers in health communication tend to focus on communication approaches in support of one of two broad behavioral goals: (1) preventing, via behavioral action, diseases/adverse physical and mental health outcomes in the first place, or (2) understanding/supporting early and accurate disease/health condition diagnosis, effective treatment, and adequate maintenance of a drug/therapy regimen to ameliorate or best control adverse effects of that health condition. This course is designed to provide an overview of health communication approaches aimed at the prevention (or pre-emption) of diseases (e.g., cancers, infections) or other adverse physical (e.g., injury, violence, suicide, birth defects) or mental health outcomes by the promotion of behavior change (away from risky; towards healthier decisions/behavior). Another Annenberg course (i.e., on Medical Communication) is focused on providing an overview of the second domain. In addition to a focus on health communication theory and research on prevention and pre-emption, this course is focused on enhancing participation and personalization of interventions, especially using new communication technologies (e.g., interactive technologies, games, intelligent agents, etc.). These new technologies afford exceptional opportunities for communication interventions that can incorporate and test new interventions while reaching and personalizing interventions for diverse individuals.

The specific objectives of this course are to provide students with:

• Knowledge of:

a.  major theories of behavioral prevention.

b.  a sampling of empirical research in health communication relevant to behavioral prevention.

c.  major methodological approaches in this domain, including the use of randomized longitudinal designs and meta-analyses.

d.  how researchers link theory to research and practice,

e.  cutting-edge domains (e.g., using interactive technologies and gaming environments to produce communication interventions over the web).

f.  funding priorities in health communication (by major

funding organizations such as the National Institutes of Health, Centers for Disease Control and Prevention) that will help shape the future of research in this area.

g. key socialization information in this domain (e.g., Where should I

look for information in this domain? What conferences should I go to? Who should I network with?; where grant funding is available (how would I start thinking about grants?) Etc.)

g.  health communication overview/slides for teaching in this domain at the undergraduate level.

• Opportunities to develop skills in:

a.  Approaching problems encountered in health communication (prevention).

b.  Critiquing/Reviewing literature in this domain (as well as searching the literature in health communication and allied disciplines).

c.  Meta-analysis.

d.  Orally presenting work in conference-like format.

• Opportunities to develop a professional portfolio of work (e.g., conference presentations /potentially publishable work) that can further your career.

These include:

a.  Presentation slides for research and teaching health communication (your own associated with a given topic (for your review) as well as those developed by the class). These are associated with weekly assignments.

b.  Meta-Analysis: Review of the prevention literature in a given domain to address a theoretical question using meta-analysis. This could be submitted to a conference/provide the basis for a potentially publishable paper and serve to specify what research questions in an area need to be addressed.

c.  Conference Style Presentation Slides on your individual project.

Background

Many of the leading causes of death domestically and internationally, such as chronic diseases, acute infections, accidents, suicide, and homicide, are preventable with health education/promotion efforts, or other behavioral interventions. That change may involve reducing individuals’ risky decision-making behaviors, encouraging them to engage in healthier choices, or persuading individuals to be tested for diseases. For example, reducing tobacco use, moderating alcohol use, maintaining a healthy diet, engaging in safer sexual practices, exercising regularly, reducing -- or learning to cope more effectively with --chronic stressors, and behaving in ways that reduce toxin/foodborne illness and illicit drug exposure could reduce the incidence of many chronic diseases. Changing health behaviors, however, often involves more than the individual level of analysis alone: Successful health communication interventions often address social and behavioral factors at one or more levels of analysis (e.g., individual, interpersonal, institutional, community, and policy levels).

Successful prevention (or pre-emption) interventions may use interpersonal or community or media-based, increasingly are using interactive media and advanced communication technologies (e.g., interactive agents, games) and interventions delivered “on-line” are part of the mix. Targeting diverse populations, tailoring messages and interventions to those audiences, and personalizing those interventions to optimize risk reduction and health promotion are also major foci in health communication. Increasingly, there is also a focus at major federal agencies charged with promoting the nation’s health (e.g., National Institutes of Health, Centers for Disease Control and Prevention) on encouraging the participation of diverse populations at risk for specific deleterious health outcomes in the research process and reaching (and reducing health disparities in) diverse, often hard to reach audiences. An additional week is devoted to international health communication.

Prevention often involves changing decision-making and behavior. Historically, many of these “decisions” have been thought to involve primarily more rational factors such as cognitions (that implicate more cognitive educational efforts to change beliefs and skills, etc.): And the theories underlying these approaches are typically consistent with that view. Increasingly, we are realizing and formulating theory consistent with the view that many risky decisions are automatic and affectively-based. And, in fact, both cognitive and affective factors appear to predict change in behavior (e.g., change in risky behavior).

Virtual environments (and intelligent agents and games) and on-line interventions for changing behaviors are proving to be especially promising tools for challenging and changing risky behaviors, including changing HIV risk behaviors. We discuss some of these enabling communication technologies and the communication theory and research that underpin their use.

Another topic we discuss throughout is how to review the literature to determine what needs to be done and to evaluate the effectiveness of interventions for changing behavior. As relevant, we discuss methods that are used in brief “modules” for clarification, drawing on the examples that we are discussing in class. Students will conduct their own potentially publishable meta-analysis for their project paper.

Classes Content

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August 28 Introduction

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). The scope of health behavior and health education. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons. Available free at the Wiley site,

http://he-cda.wiley.com/WileyCDA/HigherEdTitle/productCd-0787996149,courseCd-HBE110,pageType-copy,page-excerpt.html

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Theory, research, and practice in health behavior and health education. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons. Available free at the Wiley site,

http://he-cda.wiley.com/WileyCDA/HigherEdTitle/productCd-0787996149,courseCd- HBE110,pageType-copy,page-excerpt.html

Note: By next week identify a “health area of focus” that you will investigate more deeply during the course of the semester.

Prediction & Pre-Emption

September 4-11 Individual Health Behavior

Champion, V.L. & Skinner, C. S. (2008). The Health Belief Model. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Montano, D. E. & Kasprzyk, D. (2008). Theory of Reasoned Action, Theory of Planned Behavior and the Integrated Behavioral Model. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Prochaska, J. O., Redding, C.A., Evers, K.E. (2008). The Transtheoretical Model and Stages of Change. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

*optional: Weinstein, N. D., Sandman, P. M., Blalock, S. J. (2008). The Precaution Adoption Process Model. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

*optional: Brewer, N. T., & Rimer, B. K. (2008). Perspectives on intrapersonal theories of health behavior. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Methods:

Synder, L. B., & Hamilton, M. A. (2002). A meta-analysis of U. S. health campaign effects on behavior: Emphasize enforcement, exposure, and new information, and beware the secular trend. In R. C. Hornick (Ed.). Public health communication: Evidence for behavior change.

Module: September 4.

Glasgow, R. E., & Linnan, L. A. (2008). Evaluation of Theory-Based Interventions. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Module: September 11; Use as a reference throughout.

Assignment #1, Due by 10 AM September 4:

Part I: Preliminary Search for Focus

•What is your health area of focus? (e.g., What interventions, when, are effective in changing risky sexual behaviors for African American adolescents?)

•What are the meta-analyses in your area that are most relevant? (Be clear that no-one has done a meta-analysis in your focus area of concern).

Part 2: Identify an article that has addressed your “health focus”using one or more of the theories above. Address each of the following questions using 3 or more powerpoint slides:

•What was(were) the research question or hypothesis(es)? Be able to discuss why this is interesting/important. •How do these models above apply?

•What did the authors do? What methods were used?

•What did the authors find? What were the results?

•Discuss these findings and implications for the 4 P’s in your area of focus.

•What questions remain that additional research/theory should address? Your review should go beyond merely repeating what’s in the article. Use your critical skills.

September 11 Due today: Specify Review Area (theoretical relationship of interest in health communication) in Consultation with Professor Miller (your relationship of interest should involve one of NIH’s 4 P’s and is specific enough that it is “doable” within the context of the semester’s project. Specify explicit inclusion and exclusion criteria; decide on criteria for “Methodological Quality” and Justify; Provide your planned search strategies for articles (published and not)).

September 18-25 Models of Interpersonal Health Behavior

McAlister, A. L., Perry, C.L., & Parcel, G. S. (2008). How individuals, environments, and

health behavior interaction: Social Cognitive Theory. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Heaney, C. A., & Isreal, B. A. (2008). Social networks and social support. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.