Search

An entertainment-education radio soap opera introduced in Tanzania in 1993 was evaluated by means of a field experimental design in which the radio program was broadcast by seven mainland stations of Radio Tanzania. An eighth station broadcast alternative programming from 1993 to 1995, its listenership serving as a comparison area in which contemporaneous changes in family planning adoption were measured. The soap opera was subsequently broadcast nationwide from 1995 to 1997. Data about the effects of the radio soap opera were gathered in five annual surveys of about 2,750 households in the comparison and the treatment areas and from a sample of new family planning adopters in 79 health clinics. The soap opera had strong behavioral effects on family planning adoption; it increased listeners' self-efficacy regarding family planning adoption and influenced listeners to talk with their spouses and peers about contraception. [ABSTRACT FROM AUTHOR]

Objectives: To describe a medical center policy designed to contain the cost of using the lipid-lowering drug lovastatin in a primary care setting, to examine the effect of the policy on cost containment, and to examine physician acceptance of the policy.Setting: A Veterans Affairs medical center.Interventions: The policy made lovastatin available to physicians when failure of therapy with diet and two first-line drugs was documented on an order form. The form also contained educational information including prices and recommended niacin as the drug treatment of first choice for most patients.Design: To evaluate the effect of the policy, lipid-lowering drug use at the medical center was compared with that at a similar center that did not restrict lovastatin use, and with lipid-lowering drug use in the United States as a whole. A written questionnaire was used to survey physician reaction to the policy.Results: The use of lovastatin as a percentage of total lipid-lowering drug use at the center with the lovastatin policy was one-fourth that at the other center or nationwide, and the use of niacin was four times greater (p less than 0.0001). The estimated savings in drug costs to the center with the lovastatin policy due to these differences was more than $30,000 per year. In the survey of physicians affected by the policy (n = 78, response rate = 100%), less than one-fourth viewed it unfavorably, and 90% favored this policy over restricting the drug to a subspecialty clinic.Conclusion: The authors' experience indicates that a formulary policy that permits limited use of an expensive drug in a primary care setting can contain costs in a way that is acceptable to physicians. A policy of this type could be useful to the increasing number of health care provider organizations that cover the cost of outpatient medications. [ABSTRACT FROM AUTHOR]

This article reports that communication is viewed as an interpersonal matter between a communicator and a communicatee whether in the face to face situation or through the medium of picture, print or radio. The interpersonal dyad is seen as the most elemental social relationship and with an added degree of stability as the most elemental unit of social structure. Viewed as an interpositional dyadic construct it provides a suitable unit for the analysis of complex social structures relevant to the communication of farm information. The central purpose of the paper is to distinguish and meaningfully to interrelate, aspects of the dyadic construct relevant to interpersonal communication and influence. These include the purpose, continuity and interactional qualities of the relationship, their external associations and lines of communication, the manner in which the dyadic pairs combine into complex aggregates and the special qualities of the aggregates themselves which are likely to influence the communication of information and the exercise of influence. This model is presented as only one way or approach to studying communication conditions and processes, not as an appropriate model for assessing implemented change in human behaviour.

The Internet is a promising new tool for disseminating cancer prevention information. Barriers to full implementation include disparities in access and skill and availability of information relevant at the local level. A nutrition education Web site to promote fruit and vegetable intake is being produced for a tri-ethnic adult population in Colorado and New Mexico. Development is guided by findings from formative research including focus groups with local residents, a survey on computer and Internet use with 200 adults in 1998, an assessment of public access computer sites, and in-depth discussion with local community computer skills trainers.

The authors draw on (1) the hierarchy-of-effects (HOE) model, (2) the stages-of-change (SOC) model, (3) social learning theory (SLT), and (4) the diffusion of innovations (DOI) to synthesize a staged model through which communication messages have effects on individual behavior change by stimulating (1) involvement with media characters and role modeling of their actions, and (2) interpersonal communication. Data from a field experiment in Tanzania on the effects of an entertainment-education radio soap opera, Twende na Wakati (Let's Go With the Times), on the adoption of family planning, are analyzed in light of a six-staged model of communication effects. It is found that (1) the model provides a useful framework for understanding the effects of an entertainment-education program, and (2) the radio soap opera promoted progress through the stages for family planning adoption in the treatment area in three of the four years of broadcast, and in the comparison area after broadcasts of the radio program began there.

Entertainment-education is the process of designing and implementing an entertainment program to increase audience members' knowledge about a social issue, create more favorable attitudes, and change their overt behaviors regarding the social issue. The results of a field experiment in Tanzania to measure the effects of a long-running entertainment-education radio soap opera, Twende na Wakati (Let's Go with the Times), on knowledge, attitudes, and adoption of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) prevention behaviors are presented. Multiple independent measures of effects and the experimental design of this study confer strong internal and external validity regarding the results of this investigation. The effects of the radio program in Tanzania include (1) a reduction in the number of sexual partners by both men and women, and (2) increased condom adoption. The radio soap opera influenced these behavioral variables through certain intervening variables, including (1) self-perception of risk of contracting HIV/AIDS, (2) self-efficacy with respect to preventing HIV/AIDS, (3) interpersonal communication about HIV/AIDS, and (4) identification with, and role modeling of, the primary characters in the radio soap opera.

TNF-alpha transcriptionally regulates murine monocyte chemoattractant protein-1 (MCP-1) expression. Three approaches were used to determine the mechanism by which TNF regulates MCP-1. Mutation analysis showed that two distal kappa B sites, a novel dimethylsulfate-hypersensitive sequence, and a promoter proximal SP-1 site were required for TNF induction. Although the kappa B sites and the hypersensitive sequence function as a NF-kappa B-mediated enhancer, regulating induction by TNF, stereospecific alignment of the kappa B sites was not critical. Trans-activation studies conducted by cotransfection of p50 and/or p65 expression vectors with MCP-1 constructions showed that TNF regulates MCP-1 through NF-kappa B. Examination of MCP-1 induction in NF-kappa B-disrupted embryonic fibroblasts showed that p65 was necessary for both the induction and the TNF-induced protein occupancy of the enhancer in vivo. The action of the antioxidant inhibitor of NF-kappa B activation, pyrrolidine dithiocarbamate, in wild-type and NF-kappa B mutant cells was examined. The results suggested that TNF activates NF-kappa B through both pyrrolidine dithiocarbamate-sensitive and -insensitive mechanisms. This study illustrates the crucial role for NF-kappa B p65 in the induction of the MCP-1 gene by TNF and in the assembly of a NF-kappa B dependent enhancer in vivo.

Four case studies of the adoption of work-site AIDS programs are investigated, two of which were modifications of the Centers for Disease Control and Prevention's Business Responds to AIDS (BRTA) program. AIDS work-site programs were mainly initiated by the four study companies as a result of the efforts of a champion (defined as an individual who gains attention and resources for an issue in a system) or the occurrence of a tragic event, such as a company employee contracting AIDS. The BRTA program is an innovation that has not yet reached critical mass, which is the point after which further rates of adoption occur rapidly in a self-sustaining process.

We conducted a 2-year investigation of the extent to which strategies based on social marketing and diffusion of innovations concepts are used in preventive health communication with unique (highly ostracized) populations. Of the 49 organizations in San Francisco that operate HIV prevention programs (N = 100), programs that most highly targeted unique populations were surveyed. Personal interviews were then conducted with 38 staff leaders who operated the most and least effective programs. Audiotapes and transcripts were content analyzed to identify the strategies used by program staff. Strategies based on social marketing concepts were more prevalent than strategies based on the diffusion of innovations: More effective programs were characterized by emphasis on homophily, audience segmentation, compatibility-based strategies, and interorganizational collaboration.

One important starting point for the field of health communication was the Stanford Heart Disease Prevention Program, a multiyear community intervention that began 25 years ago. Health communication is a specialty field of communication study that includes the media agenda-setting process for health issues; media advocacy for health; scientific communication among biomedical scientists; doctor-patient communication; and, particularly, the design and evaluation of preventive health communication campaigns, the focus of this article. Health communication study today is a well-established, expanding specialty in the United States and abroad.

Objectives: To describe a medical center policy designed to contain the cost of using the lipid-lowering drug lovastatin in a primary care setting, to examine the effect of the policy on cost containment, and to examine physician acceptance of the policy., Setting: A Veterans Affairs medical center., Interventions: The policy made lovastatin available to physicians when failure of therapy with diet and two first-line drugs was documented on an order form. The form also contained educational information including prices and recommended niacin as the drug treatment of first choice for most patients., Design: To evaluate the effect of the policy, lipid-lowering drug use at the medical center was compared with that at a similar center that did not restrict lovastatin use, and with lipid-lowering drug use in the United States as a whole. A written questionnaire was used to survey physician reaction to the policy., Results: The use of lovastatin as a percentage of total lipid-lowering drug use at the center with the lovastatin policy was one-fourth that at the other center or nationwide, and the use of niacin was four times greater (p less than 0.0001). The estimated savings in drug costs to the center with the lovastatin policy due to these differences was more than $30,000 per year. In the survey of physicians affected by the policy (n = 78, response rate = 100%), less than one-fourth viewed it unfavorably, and 90% favored this policy over restricting the drug to a subspecialty clinic., Conclusion: The authors' experience indicates that a formulary policy that permits limited use of an expensive drug in a primary care setting can contain costs in a way that is acceptable to physicians. A policy of this type could be useful to the increasing number of health care provider organizations that cover the cost of outpatient medications.

An outpatient pharmacy redesign in which a pharmacist located outside the dispensing area speaks with each patient before the prescription is processed is described, and the effect of patients' waiting time and satisfaction is reported. Adoption of an open pharmacy plan at a Veterans Administration outpatient pharmacy allows patients to present their prescriptions to pharmacists in consultation booths equipped with computer terminals. The pharmacist promptly identifies and resolves any problem associated with a prescription or medication profile. The prescription then enters the dispensing work area, which was also redesigned to improve efficiency; patients now pick up their medications at a window on the opposite end of the dispensing area from where the pharmacist initially receives the prescription. Workload data and waiting times before and after implementation of the open pharmacy showed that prescriptions could be processed more quickly under the new system; average waiting times decreased from more than one hour to 30 minutes. Interviews of randomly selected patients indicated that the reduced waiting times led to increased patient satisfaction. The open pharmacy design appeared to improve work flow and to improve patient satisfaction by decreasing waiting times.

The objectives of this article are (1) review the contribution of traditional midwives to family planning communication in several Asian countries; (2) organize knowledge gathered from various studies into general guidelines for the most effective use of traditional midwives in family planning programs; and (3) present hypotheses for future research. In certain countries where pilot projects have tested the potential performance of traditional midwives in family planning programs, results have been encouraging. In other nations, more research is needed to determine the contribution traditional midwives can make to the family planning program.