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1.  Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership 
One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice.
Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics.
In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data.
Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and “tweeting” more frequently were associated with having a higher percentage of local followers.
Social media has the potential to reach a wide and diverse audience. Understanding audience characteristics can help public health organizations use this new tool more effectively by tailoring tweet content and dissemination strategies for their audience.
PMCID: PMC3961708  PMID: 24571914
local health department; Twitter; social media
2.  Assessing Parents' Perception of Children's Risk for Recreational Water Illnesses 
Emerging Infectious Diseases  2005;11(5):670-676.
Understanding people's risk perceptions and motivations to adopt preventive behavior is important in preventing the spread of recreational water illnesses (RWI) and other emerging infectious diseases. We developed a comprehensive scale measuring parents' perceived risk of their children contracting RWI. Parents (N = 263) completed a self-administered questionnaire with scale items based on 4 constructs of the Protection Motivation Theory: perceived vulnerability, perceived severity, response efficacy, and self-efficacy. Exploratory factor analysis identified 7 underlying factors, indicating 7 subscales of perceived risk for RWI. Cronbach α ranged from 0.60 to 0.81. The Precaution Adoption Process Model supported scale construct validity. This study provides the first perceived risk scale for exploring psychosocial factors that may predict or mediate the adoption of behaviors that prevent the spread of infectious diseases contracted by children while swimming. Findings from this study also provide implications for encouraging preventive behavior against other emerging infectious diseases.
PMCID: PMC3320386  PMID: 15890117
Communicable Diseases; Emerging; Risk Assessment; water; Recreation; Swimming; Parent; Infant
3.  Online Pediatric Information Seeking Among Mothers of Young Children: Results From a Qualitative Study Using Focus Groups 
Pre-natal and post-natal periods are times when many women actively seek health information from multiple sources, including the Internet. However, little is known about how pregnant women and mothers of young children seek and process online pediatric health information.
To explore why and where mothers of young children look for online health information and how they determine if the information they receive is trustworthy.
Focus groups were conducted in a Southeastern US city to provide an in-depth exploration of web-related behaviors and beliefs among mothers who work inside and outside of the home. Data from the focus groups were coded using deductive and inductive coding schemes and content was analyzed for the existence of themes.
Twenty mothers of young children participated in four focus groups. Most participants sought information on the Internet during pregnancy and nearly all sought online information after their child was born, primarily to diagnose or treat pediatric conditions and to seek advice on parenting and development. Participants mainly used commercial information websites for health information and many expressed disdain for commercial product websites. Many also expressed concerns about the reliability of health information on the web and described strategies for determining how much they trust each website.
Women appear to be high information seekers during pregnancy and the first few years following delivery, and this period represents an important window of time for providing online health information. Participants suggested that online information sources and motives for providing online information should be clear in order to increase perceptions of trust. Participants expressed preference for online clinical health information that is presented by clinical professionals, and online parenting advice that is presented from other parents.
PMCID: PMC1550581  PMID: 15111273
Internet; Pediatrics; Focus Groups; Mothers; Health Education
5.  The Scientific Foundation for Personal Genomics: Recommendations from a National Institutes of Health–Centers for Disease Control and Prevention Multidisciplinary Workshop 
The increasing availability of personal genomic tests has led to discussions about the validity and utility of such tests and the balance of benefits and harms. A multidisciplinary workshop was convened by the National Institutes of Health and the Centers for Disease Control and Prevention to review the scientific foundation for using personal genomics in risk assessment and disease prevention and to develop recommendations for targeted research. The clinical validity and utility of personal genomics is a moving target with rapidly developing discoveries but little translation research to close the gap between discoveries and health impact. Workshop participants made recommendations in five domains: (1) developing and applying scientific standards for assessing personal genomic tests; (2) developing and applying a multidisciplinary research agenda, including observational studies and clinical trials to fill knowledge gaps in clinical validity and utility; (3) enhancing credible knowledge synthesis and information dissemination to clinicians and consumers; (4) linking scientific findings to evidence-based recommendations for use of personal genomics; and (5) assessing how the concept of personal utility can affect health benefits, costs, and risks by developing appropriate metrics for evaluation. To fulfill the promise of personal genomics, a rigorous multidisciplinary research agenda is needed.
PMCID: PMC2936269  PMID: 19617843
behavioral sciences; epidemiologic methods; evidence-based medicine; genetics; genetic testing; genomics; medicine; public health
6.  Profiling Characteristics of Internet Medical Information Users 
The Internet's potential to bolster health promotion and disease prevention efforts has attracted considerable attention. Existing research leaves two things unclear, however: the prevalence of online health and medical information seeking and the distinguishing characteristics of individuals who seek that information.
This study seeks to clarify and extend the knowledge base concerning health and medical information use online by profiling adults using Internet medical information (IMI). Secondary analysis of survey data from a large sample (n = 6,119) representative of the Atlanta, GA, area informed this investigation.
Five survey questions were used to assess IMI use and general computer and Internet use during the 30 days before the survey was administered. Five questions were also used to assess respondents' health care system use. Several demographic characteristics were measured.
Contrary to most prior research, this study found relatively low prevalence of IMI-seeking behavior. Specifically, IMI use was reported by 13.2% of all respondents (n = 6,119) and by 21.1% of respondents with Internet access (n = 3,829). Logistic regression models conducted among respondents accessing the Internet in the previous 30 days revealed that, when controlling for several sociodemographic characteristics, home computer ownership, online time per week, and health care system use are all positively linked with IMI-seeking behavior.
The data suggest it may be premature to embrace unilaterally the Internet as an effective asset for health promotion and disease prevention efforts that target the public.
PMCID: PMC2744722  PMID: 19567794
9.  Depictions of substance use in reality television: a content analysis of The Osbournes 
BMJ : British Medical Journal  2005;331(7531):1517-1519.
Objective To determine the source and slant of messages in a reality television programme that may promote or inhibit health related or risky behaviours.
Design Coding visual and verbal references to alcohol, tobacco, and other drug (ATOD) use in The Osbournes.
Review methods Three reviewers watched all 10 episodes of the first season and coded incidents of substance use according to the substance used (alcohol, tobacco, or drugs), the way use was portrayed (visually or verbally), the source of the message (the character in the show involved in the incident), and the slant of the incident (endorsement or rejection).
Main outcome measures The variation in number of messages in an average episode, the slant of messages, and message source.
Results The average number of messages per episode was 9.1 (range 2-17). Most drug use messages (15, 54%) implied rejection of drugs, but most alcohol messages (30, 64%) and tobacco messages (12, 75%) implied endorsements for using these substances. Most rejections (34, 94%) were conveyed verbally, but most endorsements (36, 65%) were conveyed visually. Messages varied in frequency and slant by source.
Conclusions The reality television show analysed in this study contains numerous messages on substance use that imply both rejection and endorsement of use. The juxtaposition of verbal rejection messages and visual endorsement messages, and the depiction of contradictory messages about substance use from show characters, may send mixed messages to viewers about substance use.
PMCID: PMC1322251  PMID: 16373737

Results 1-9 (9)