Browsing by Subject "health communication"

Now showing 1 - 10 of 22
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    After Visit Summary: Not an Afterthought
    (Sage, 2019-09) Sieferd, Edward; Mohanty, Nivedita; Holden, Richard J.; Medicine, School of Medicine
    The After Visit Summary (AVS) is provided to patients after clinical visits to summarize what happened during the visit and guide future care. Despite its potential to improve shared decision-making, self-management, and communication, the design of the typical AVS is not optimized to communicate useful information in an understandable way. The AVS usability challenge is magnified in vulnerable patient populations such as those served by community health centers (CHCs). The purpose of this research was to evaluate and refine a redesigned AVS intended to better communicate information to CHC patients.
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    Caregiver Engagement in Serious Illness Communication in a Long-Term Acute Care Hospital Setting
    (Sage, 2024-10) Levoy, Kristin; Ashare, Rebecca L.; Ganta, Niharika; O'Connor, Nina; Meghani, Salimah H.; Ashare, Rebecca; School of Nursing
    Context Prolonged management of critical illnesses in long-term acute care hospitals (LTACH) makes serious illness communication (SIC), a clinical imperative. SIC in LTACH is challenging as clinicians often lack training and patients are typically unable to participate—making caregivers central. Objectives This qualitative descriptive study characterized caregiver engagement in SIC encounters, while considering influencing factors, following the implementation of Ariadne Labs’ SIC training at a LTACH in the Northeastern United States. Methods Clinicians’ documented SIC notes (2019-2020) were analyzed using directed content analysis. Codes were grouped into four categories generated from two factors that influence SIC—evidence of prognostic understanding (yes/no) and documented preferences (yes/no)—and caregiver engagement themes identified within each category. Results Across 125 patient cases, 251 SIC notes were analyzed. In the presence of prognostic understanding and documented preferences, caregivers acted as upholders of patients’ wishes (29%). With prognostic understanding but undocumented preferences, caregivers were postponers of healthcare decision-making (34%). When lacking prognostic understanding but having documented preferences, caregivers tended to be searchers, intent on identifying continued treatment options (13%). With poor prognostic understanding and undocumented preferences, caregivers were strugglers, having difficulty with the clinicians or family unit over healthcare decision-making (21%). Conclusion The findings suggest that two factors—prognostic understanding and documented preferences—are critical factors clinicians can leverage in tailoring SIC to meet caregivers’ SIC needs in the LTACH setting. Such strategies shift attention away from SIC content alone toward factors that influence caregivers’ ability to meaningfully engage in SIC to advance healthcare decision-making.
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    Communication About Lifestyle Change Between Cardiac Patients and Their Partners
    (2006) Goldsmith, Daena J.; Gumminger, Kristin Lindholm; Bute, Jennifer J.
    Although adherence to a heart-healthy lifestyle can improve recovery from a heart attack or bypass surgery, compliance with recommended behavior modifications is generally low. A spouse or partner can influence patient lifestyle change but much remains to be learned about what types of interactions facilitate adherence versus produce overprotection or resistance. We interviewed 25 persons who experienced a cardiac event in the past year and 16 partners. Our goals were to describe how couples talk about adherence and to identify features of communication that were variable, meaningful, and potentially consequential. Couples varied in how often they talked about adherence and those who talked a little, a lot, or occasionally differed not just in quantity of talk but also in the meaning of talk and strategies for regulating its frequency. Adherence talk occurred in various speech events, including praise, problem-solving discussion, acknowledgment, meta-communication, argument, and compliance-gaining. Different types of episodes entailed different roles and relational qualities. When partners engaged in compliance-gaining, the style in which they attempted social control (e.g., direct or indirect, humorous or serious, ritualistic or not, verbal or nonverbal) shaped its meaning. Our findings are consistent with Goldsmith’s (2004) theory of social support and have implications for how we conceptualize and measure couple communication about adherence. Our descriptions of behavior may help couples understand why they experience interactions as supportive or not. Describing behaviors can also give validation to couples experiencing communication challenges as well as offer a range of possible alternatives for interacting.
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    Creating Choice and Building Consensus: Invitational Rhetoric as a Strategy to Promote Vasectomies in the United States
    (University of Florida Press, 2022-03-03) Longtin, Krista; Binion, Kelsey; Communication Studies, School of Liberal Arts
    According to a recent study by the Brookings Institution (Reeves & Krause, 2016), vasectomies are safer, more effective, and less expensive than most other voluntary sterilization methods. While the procedure has grown in popularity in recent years, particularly in the United Kingdom and Canada, it is much less common in the United States. This discrepancy can be attributed to both social (a perception that contraception is “women’s work”) and policy-­based factors (lack of coverage under the Affordable Care Act). This paper examines the role and extent to which invitational rhetoric could be a useful communicative lens for both partners and providers considering vasectomies, thus increasing access to and utilization of the safe, effective, and affordable procedure. In this policy brief, we suggest strategies for incorporating invitational rhetoric into health professions education curricula, patient counseling literature, and policy language in order to address some of the social stigma around the procedure.
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    Current Smokers’ Preferences for Receiving Cessation Information in a Lung Cancer Screening Setting
    (Springer, 2017) Carter-Harris, Lisa; Schwindt, Rhonda; Bakkoyannis, Giorgos; Ceppa, DuyKhanh Pham; School of Nursing
    The purpose of this study was to identify current smokers’ communication format preferences for receiving smoking cessation information in a lung cancer screening setting. A cross-sectional correlational design using survey methodology with 159 screening-eligible current smokers was the method used. Data was dichotomized (digital versus traditional preference) and analyzed using Pearson’s chi-squared test, Mann-Whitney U test, and logistic regression. Race was a statistically significant predictor with White participants having four times greater odds of reporting preference for a digital format for receiving smoking cessation information such as social media and/or supportive text messages (OR: 4.06; p = 0.004). Lung cancer screening is a new venue where current long-term smokers can be offered information about smoking cessation while they are engaging in a health-promoting behavior and potentially more likely to contemplate quitting. It is important to consider the communication format preference of current smokers to support cessation uptake. This study is the first to examine communication format preference of current smokers in the context of the lung cancer screening venue. Key differences noted by race support the need for further research examining multiple formats of communication with efforts to maximize options in the cancer screening setting.
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    Development of patient-centric linguistically tailored psychoeducational messages to support nutrition and medication self-management in type 2 diabetes: a feasibility study
    (Dove Press Ltd, 2014-10-07) Bartlett Ellis, Rebecca J.; Connor, Ulla; Marshall, James; School of Nursing
    Purpose: This study evaluated the feasibility of developing linguistically tailored educational messages designed to match the linguistic styles of patients segmented into types with the Descriptor™, and to determine patient preferences for tailored or standard messages based on their segments. Patients and methods: Twenty patients with type 2 diabetes (T2DM) were recruited from a diabetes health clinic. Participants were segmented using the Descriptor™, a language-based questionnaire, to identify patient types based on their control orientation (internal/external), agency (high/low), and affect (positive/negative), which are well studied constructs related to T2DM self-management. Two of the seven self-care behaviors described by the American Association of Diabetes Educators (healthy eating and taking medication) were used to develop standard messages and then linguistically tailored using features of the six different construct segment types of the Descriptor™. A subset of seven participants each provided feedback on their preference for standard or linguistically tailored messages; 12 comparisons between standard and tailored messages were made. Results: Overall, the tailored messages were preferred to the standard messages. When the messages were matched to specific construct segment types, the tailored messages were preferred over the standard messages, although this was not statistically significant. Conclusion: Linguistically tailoring messages based on construct segments is feasible. Further - more, tailored messages were more often preferred over standard messages. This study provides some preliminary evidence for tailoring messages based on the linguistic features of control orientation, agency, and affect. The messages developed in this study should be tested in a larger more representative sample. The present study did not explore whether tailored messages were better understood. This research will serve as preliminary evidence to develop future studies with the ultimate goal to design intervention studies to investigate if linguistically tailoring com - munication within the context of patient education influences patient knowledge, motivation, and activation toward making healthy behavior changes in T2DM self-management.
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    The effects of HIV testing advocacy messages on test acceptance: a randomized clinical trial
    (2014-11) Kasting, Monica L.; Cox, Anthony D.; Cox, Dena S.; Fife, Kenneth H.; Katz, Barry P.; Zimet, Gregory D.
    Background Nearly 1 in 5 people living with HIV in the United States are unaware they are infected. Therefore, it is important to develop and evaluate health communication messages that clinicians can use to encourage HIV testing. Methods The objective was to evaluate health communication messages designed to increase HIV testing rates among women and evaluate possible moderators of message effect. We used a randomized four-arm clinical trial conducted at urban community outpatient health clinics involving 1,919 female patients, 18 to 64 years old. The four health message intervention groups were: i) information-only control; ii) one-sided message describing the advantages of HIV testing; iii) two-sided message acknowledging a superficial objection to testing (i.e., a 20 minute wait for results) followed by a description of the advantages of testing; and iv) two-sided message acknowledging a serious objection (i.e., fear of testing positive for HIV) followed by a description of the advantages of testing. The main outcome was acceptance of an oral rapid HIV test. Results Participants were randomized to receive the control message (n = 483), one-sided message (n = 480), two-sided message with a superficial objection (n = 481), or two-sided message with a serious objection (n = 475). The overall rate of HIV test acceptance was 83%. The two-sided message groups were not significantly different from the controls. The one-sided message group, however, had a lower rate of testing (80%) than the controls (86%) (OR, 0.66; 95% CI, 0.47–0.93; P = 0.018). “Perceived obstacles to HIV testing” moderated this effect, indicating that the decrease in HIV test acceptance for the one-sided message group was only statistically significant for those who had reported high levels of obstacles to HIV testing (OR, 0.36; 95% CI, 0.19–0.67; P = 0.001). Conclusions None of the messages increased test acceptance. The one-sided message decreased acceptance and this effect was particularly true for women with greater perceived obstacles to testing, the very group one would most want to persuade. This finding suggests that efforts to persuade those who are reluctant to get tested, in some circumstances, may have unanticipated negative effects. Other approaches to messaging around HIV testing should be investigated, particularly with diverse, behaviorally high-risk populations.
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    The effects of message framing and healthcare provider recommendation on adult hepatitis B vaccination: A randomized controlled trial
    (Elsevier, 2019-08-09) Kasting, Monica L.; Head, Katharine J.; Cox, Dena; Cox, Anthony D.; Zimet, Gregory D.; Pediatrics, School of Medicine
    Many adults in the U.S. do not receive recommended vaccines, and the research literature remains inconclusive on the best communication strategies for increasing this behavior. This study examined the association of message framing (gained-framed vs. loss-framed vs. control), and healthcare provider (HCP) recommendation (offered vs. recommended) on uptake of adult hepatitis B virus (HBV) vaccination in a high risk population using a 3×2 block design randomized controlled trial. Fear of shots, fear of vaccines, and perceived message framing were examined in secondary analyses. Of the 1,747 participants, 47.7% (n=833) received 0 doses of HBV vaccine, 27.8% (n=485) received 1 dose, 10.4% received 2 doses, and 14.1% received all 3 recommended doses. There was not a significant interaction between message framing and HCP recommendation (p =.59). Mean number of doses received by the gain-framed group (m=.96) was not significantly different from the loss-framed group (m=.97, RR=.99, 95% CI=.88–1.12). However, those receiving any framing message received significantly more doses (m= .96) than those in the control condition (m=.81, RR=1.17, 95%CI=1.06–1.31). Participants who received a HCP recommendation received significantly more vaccine doses (m=.95) than those in the vaccine-offered condition (mean=.82, RR=1.16, 95%CI=1.05–1.28). These results suggest there is no difference in vaccine uptake between gain-frame and loss-frame messages, but both are better than a control message. These results also support advising HCP to provide a strong recommendation for vaccinations beyond merely offering it to patients. This study has implications for vaccine uptake beyond HBV, and can inform future research on effective vaccine communication research.
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    Exploring How the Terms “Black” and “African American” May Shape Health Communication Research
    (Taylor & Francis, 2021) Ridley-Merriweather, Katherine E.; Hoffmann-Longtin, Krista; Owusu, Raiven K.; Communication Studies, School of Liberal Arts
    Several distinct terms are used to identify descendants of the African diaspora (DADs) as fellow members of a racialized population. However, “Black” and “African American” are the two labels most commonly used. Given the recent calls for examining institutionalized racism in the United States, health scholars must contemplate the problems that may arise when these two terms are used interchangeably, namely the extent to which mislabeling may reify already significant health disparities. This essay examines the histories and meanings of “Black” and “African American” as identity labels and explores their importance in relationship to the effective recruitment of DADs to health research and clinical trials. In this paper, we employ the communication theory of identity and critical race theory as lenses to call attention to the discursive challenges associated with recruitment of DADs in health research. We also encourage health communication scholars to explore and extend the scope of this research. We do this by first describing the unintended consequences in health research through disregard of DADs’ chosen identity labels. We then use the various terms to describe DADs to illuminate existing tensions between “Black” and “African American.” We describe how each moniker is used and perceived, broadly and in health contexts. Finally, we call for more research into the effects of mislabeling and propose a plan for researchers’ next steps.
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    Factors Predicting Emotional Cue-Responding Behaviors of Nurses in Taiwan: An Observational Study
    (Wiley, 2017) Lin, Mei-Feng; Lee, An-Yu; Chou, Cheng-Chen; Liu, Tien-Yu; Tang, Chia-Chun; School of Nursing
    Objective Responding to emotional cues is an essential element of therapeutic communication. The purpose of this study is to examine nurses' competence of responding to emotional cues (CRE) and related factors while interacting with standardized patients with cancer. Methods This is an exploratory and predictive correlational study. A convenience sample of registered nurses who have passed the probationary period in southern Taiwan was recruited to participate in 15-minute videotaped interviews with standardized patients. The Medical Interview Aural Rating Scale was used to describe standardized patients' emotional cues and to measure nurses' CRE. The State-Trait Anxiety Inventory was used to evaluate nurses' anxiety level before the conversation. We used descriptive statistics to describe the data and stepwise regression to examine the predictors of nurses' CRE. Results A total of 110 nurses participated in the study. Regardless of the emotional cue level, participants predominately responded to cues with inappropriate distancing strategies. Prior formal communication training, practice unit, length of nursing practice, and educational level together explain 36.3% variances of the nurses' CRE. Conclusions This study is the first to explore factors related to Taiwanese nurses' CRE. Compared to nurses in other countries, Taiwanese nurses tended to respond to patients' emotional cues with more inappropriate strategies. We also identified significant predictors of CRE that show the importance of communication training. Future research and education programs are needed to enhance nurses' CRE and to advocate for emotion-focused communication.