Week 5 - Segmentation

Hi,

So I just wanted to give you an update and say that I have completed my interviews. I was out of town for the weekend so I wanted to have them done before leaving. How should we bring our findings to class on Tuesday. Should we write up the results or organize them in tables so that it is easier to put all of the interview results together?

On another note I am including the information on the workshop that was held last week.

It was entitled: Health care workshop- Learn were to obtain Affordable health care

As we all know we live in a society where many are uninsured, and therefore have no access
to care. However, there are options available that you can take advantage of, and with
proper resources and information, you can obtain affordable Medical and Dental Care within
your community! To learn more, attend the Health Care Workshop held at SDSU!

Date: Wednesday, Feb 24.
Where: International Student Center
Time: 4 - 5:30 p.m.

Topics to be covered are as follows:

Medical services that SDSU Student Health Services offers, which include dentistry and
optometry. Prices will be presented as a way to show the best deals that are offered;

Community clinics for medical and dental health that San Diego County offers;

College of Health and Human Services study abroad programs.

We will also be giving out "bags of health goodies," that contain lists of public
health/community health clinics and websites (provided by HHSA Maternal Child and Family
Health Services) to participants of the workshop.

We hope you can join us!

I was not able to make it to the workshop to see how it was organized. However, it made me think that we could try to incorporate workshops into our intervention design. We can find ways to make it informative, interesting, and entertaining so that our target population. I guess we can discuss later on.

This weeks lecture and readings were very interesting and will be very helpful as we continue to move forward with our projects. I really liked the PRIZM Market Segmentation I found it incredible that with the click of a mouse we could get information about different geo-graphic locations and the people that populate these areas. Week 4 and Week 5 readings and lectures are our protocols for the type of health campaigns we want to develop and to ensure that we reach our desired population and that we achieve some success with our specific behavior. Segmentation of populations helps to not have one large umbrella represent other segments of the population which should be considered as individual entities. As we discussed this I kept on thinking of the term Latino and how it is used in research. Under the Latino label different groups are represented (i.e. peruvian, argentinian, mexican, etc) but in research it is important to understand how different factors affect different groups in order to tailor interventions. What might work for the mexican community might not work for the peruvian community and the same can be said for how to deal with communication strategies.

- liliana

The Intimidation of Segmentation

First of all, as we enter the discussion about population segmentation, I have to share that it reminds me of the famous blunder made by Chevrolet in the 70's when attempting to market the "Nova" in Mexico. Who wants a car whose name means "it doesn't go" in Spanish? It seems that simple formative research and segmentation could have prevented such an oversight.

Given the readings and our class lecture, the fact is clear that it is truly important to consider segmentation when identifying the target audience for campaign messages. However, I have to be perfectly honest that the idea of conducting segmentation is an intimidating venture to attempt - especially in regards to our group's particular class project regarding HIV/STI prevention.

Initially, we thought to focus our attention on the priori group of African-American women specifically because the research notes that this group makes up one of the fastest growing segments of the population of new cases of HIV/STIs. Developing campaign materials to target African-American women specifically seemed like the most effective place to start in order to put an end to this growing trend.

While we continued to mull over the details unique to this segment of the target population and speculated how to effectively communicate the proposed health message, we quickly realized that this was a daunting task. After all, none of us on the team personally belongs to this priori group. Furthermore, none of us has direct access to a representative sample of members from this group for information. I cannot speak for the other members of our team, but I recognize within myself an overwhelming sense of incompetence and inadequacy when it comes to this challenge of segmentation. Without personal access to the population for formative research and accurate research, how can I possibly learn about the specific needs, values, and interests of this segmented population in order to develop effective and far-reaching health campaign messages? Where do we begin to identify a source for a representative sample? How do we develop culturally-appropriate campaigns that engage the specific members respond to the message with action.

As a result, our project group decided to go with a practical option and identify a more generalized age group to target instead - much like other researchers have done in the past (I'm sure). I am interested to learn more about how to begin the process of segmentation when the starting point for a particular segment is not obvious.

Segmentation - Week 5

This week I found the VALS survey and the PRIZM Market Segmentation tools to be very enlightening. I have given my zip code countless times in stores, however I have never seen the outcome from those data collection processes. I found it interesting to see the trends in my neighborhood as well as the funny titles they give each area. I enjoyed figuring out where and if I fit into my neighborhoods trends. I think these tools will be valuable when creating our sexual health campaign/message.

Again, the theme of this weeks lecture seems to reiterate the importance of thoroughly understanding your target audience. This weeks lecture on psychographics added depth to the multifaceted approach necessary to understand target audiences. Not only must we understand the culture, acculturation, language and need of our audience, we also need to understand their knowledge, attitudes, skills, intentions to change a behavior, etc.

I agree with Melissa's post this week regarding the difficulties associated with choosing the most appropriate variables of interest for each target audience. On the surface, it seems adequate to group people as vegetarian, vegan, meat eaters and so forth. However, the reasons they are in each category can vary drastically. This will be an important factor to focus on while creating our STI screening message(s). I look forward to analyzing the feedback from our individual interviews with SDSU women regarding their needs and reason for accessing gynecological care from Student Health Services. This step will assist us in further narrowing our target audience and matching a message to meet their needs.

Cody

Just two quick things I saw 'round the old internet, before I forget about them

First: Isn't this a cool concept?. A free text info service that is amazingly simple to sign up for. I wonder if there's a way we could use this sort of idea for our topic/population?

Second: An unfortunate example of trying to target your audience.... and not quite getting it right.

segmentation

This week's lesson focused on segmentation of the audience to identify clusters (segments) of a population that differ on variables of interest. Aside from getting the requisite data, perhaps the hardest part of the segmentation process is determining which variables are of interest. The example given in class of food types-- red meat, poultry, fish, green leafy veggies, root veggies, milk, yogurt, etc -- and clustering them by diet style -- carnivore, pescatarian, lacto-ovo-vegetarian, vegan-- helped me conceptualize the process better. It also made me realize how easy it would be to create a homogeneous group just from diet alone. Imagine all the different reasons someone might be vegetarian: religion, animal rights, environmentalism, health concerns, general hippie status, relationship with someone who is vegetarian, lack of available meat, lack of resources to purchase available meat, allergy, etc. Also, is vegetarianism defined as not-meat? Perhaps vegetarians should be further separated into healthy and junk-food vegetarians by not-meat + fruits, veggies, whole grains, healthy non-animal proteins (i.e., healthy diet) and not-meat + few healthy foods and lots of unhealthy carbs and dairy products.

I thought the short-names applied to the groups presents an interesting dilemma. The PRIZM project provides a great example with catchy, but potentially offensive, names like "God's Country" and "Money & Brains." These may help as mental-shortcuts but it would also be easy to misconstrue the characteristics of the group because it overly generalizes. For instance, I imagined "God's Country" to be a highly religious, middle income family, but it's the name for upscale, highly educated, white, childless couple aged 35-54 who live in towns, buy from zappos.com, go on golf vacations and read about skiing. The Maibach (1996) article suggested this was a risk, stating "names will oversimplify the healthstyles which are, in fact, quite complex and rich with subtlety" (p269). I noticed this in one of the articles presented, particularly for the group called something like "Disinterested Males" which was composed of 85% males. It would be easy to forget that 15% are female, and if the communication campaign was heavily gendered, this might leave out a large number of the segment audience, particularly if done on a large or national scale.

My thesis, which is currently in the planning stages, will (probably) involve an intervention with a group of college men aimed at primary prevention of sexual assault. Initially I thought I'd focus on a single fraternity or fraternity men in general, but I worried that men who would not be receptive to the message would be included in the group and cause the whole thing to fail due to side-tracking or derailing the conversation. Now I'm wondering if I should include screening questionnaires to ensure that I have a more homogeneous and appropriate group. My best bet might be to simply conduct the formative research rather than be too ambitious and put together a program rather blindly. I've been pouring over the existing literature to figure out what strategies have been tried and what seems to have worked and ran across an interesting article in the journal Trauma Violence Abuse by Casey and Lindhorst (2009) called Toward a Multi-Level, Ecological Approach to the Primary Prevention of Sexual Assault: Prevention in Peer and Community Contexts. It brings in examples of successful prevention programming in other areas (alcohol abuse, bullying, and HIV) to make suggestions for how to tackle sexual assault. I'm excited to be in this class and learning the public health perspective because otherwise I likely would have overlooked these important considerations in planning my thesis.

-Melissa

For module one I found the McGuire’s Processing Model, the role of Formative research within the health communication process, and Diffusion of Innovations to be key insights. The McGuire’s Information-Processing Model classification of antecedents of advertising effects (Sender, Message, Receiver, Channel, and Destination) was really helpful when it came to understanding the different aspects that make up communication. It is important to understand how the source/ sender affects the messages/ advertisement of specific topics as well as, the message, to achieve a successful destination. For health promotion purposes the ideal outcome would be to have behavior change in response to the message campaign that follows the McGuire’s model. As I mentioned in one of my previous blog’s this model will definitely be helpful as our groups develop interventions for different health topics. My group is looking at STI screening and condom use among female college students. Therefore, the receivers in our intervention would be college-aged women. This is important in determining what channels we will use for our messaging. Since we are trying to reach college age women we could work with campuses or social network sites, etc. However, assignment 1 will be very helpful in understanding how our target population perceives STI screening and condom use and how interested they are in these topics. If they are interested it is more likely they will pay attention to the messages in interventions and actually have and effect in their day to day behaviors.

Formative research is highly important in all disciplines but in public health I believe it is imperative. In order to develop appropriate and successful interventions we must find out what are the needs of different groups and what it is they would like help with. Yes, as public health professionals we understand that certain populations are at greater risk for diseases or illnesses but this might not be as evident to the population at risk. Through formative research we can pursue a research topic of interest but we can also create rapport by talking to people before hand and seeing where they stand and what are some of the things they would like to get out of the research. Focus groups and interviews are two methods used to gain more familiarity and baseline information about a population and health topic. For instance, my group would like to gain more insight when it comes to women’s reasoning for using/ not using condoms and STI screenings. What motivates them to seek these things and if they are not what would make them more comfortable/ empowered to do so.

The Diffusion of Innovation was another thing I found interesting in this first module. This process can be extremely helpful in the dissemination of an intervention. With a topic like condoms or STI testing this process could be very productive if the right types of people are a part of the campaigns. For instance promoting STI testing could become a trend if celebrities were to join different campaigns that promote testing to ensure better quality of life. Obviously, the same could be said for condoms if there was a new product or branding for condoms and this were adopted by segments of the population that are followed by teenagers, adults, etc we could have a more educated and actively involved people when it comes to issues related to sexual practices. Overall, this module provided a very good foundation for health communication and how theories can be incorporated into different communication strategies whether it is for education or intervention purposes.

- Liliana

Module One Thoughts

While reviewing the various topics of this first module, one thought that just occurred to me about health communication in regards to HIV/STI is that we as a nation generally don’t talk about it. I guess like many cultures around the world, talking seriously about sex in the public realm is seen as taboo. There's a negative view about the idea of telling someone how they should behave behind closed doors in their own private lives. I guess, because of this, the few messages regarding safe sex and condom use have little effectiveness.

However, on the flip side, messages of “sex” are plastered everywhere as marketing ploys for various products (e.g., Carl’s Jr. commercials, Cosmopolitan magazine). Sex (or sexual content) is also the icing and edge added to many prime-time TV dramas (e.g., Grey’s Anatomy) or comedies (e.g., Family Guy) keeping viewers interested and attentive. It’s no wonder that our youth demonstrates erroneous beliefs and indifferent attitudes about prevention when the majority of messages promoted make fun and light of sexual behavior.

The dissonance astounds me. While we can be blatant with promiscuous sexuality, we are closed to blatant persuasion for sexual behavior.

Other insights and thoughts from the module?

I enjoyed reading the Cameron (2009) article providing a review of common persuasion theories. I think the reason liked it was because it appealed to my own academic background in cognitive studies and learning behavior. I have held various positions in which I have had to utilize such theories in order to teach children, youth, and adults new concepts - many of which held existing opinions or ideas of what is "true" (whether right or wrong). The delicate manner in which I had to reveal possible errors in the individual's thinking required careful consideration of the individual's vantage point, of starting points of agreement to bridge gap between differing messages, and developing effective illustrations or analogies to make the information understandable and relevant.

I was struck by the basic concepts (or the mediating processes to learning), noted throughout many of the readings, that are regularly used in sales/marketing to sell a product: attention, comprehension, intention (yielding), and retention. A well-known model, which I was surprised was neglected in many of the readings in the Hook-Book-Look-Took method of training design (see link below for more detailed description and visual examples). While this method is used often in corporate training settings, it is also commonly used when training or teaching children. The HOOK serves as a creative way to draw the audiences attention to the material. The BOOK is the presentation of the material in a logical manner that makes sense and works to ensure accurate understanding of the material/message. The link provided suggests a variety of BOOK patterns to fit a variety of topics (e.g., chronological, topical, cause-effect). The LOOK includes the provision of examples and illustrations that appeal to the senses, whether visually or through hands-on exercises, that strengthen likelihood that the individual will yield or intend to adopt the new behavior in the future. The TOOK provides the individual with some object to literally take away from the message to remind them of the lessons learned. For example, a wallet-sized, laminated card displaying CPR steps for quick reference.

http://lacpcce.org/Hook,%20Book,%20Look,%20Took%20-%201.pdf

Mod 1 wrap.

I do a little bit of interning with a nutrition-based non-profit, and right now we're working on using social media etc to get the word out. It struck me, though, how much easier this is to do with something like nutrition than it is for sexual health sometimes. Start talking about kids or food, and everybody supports you with enthusiasm. The campaigns tend to focus on cute, on needy, on pulling on altruistic heartstrings, on making us feel good about what we already do for our own health; they are easily to identify with and generally well received by a really wide range of people. But, when you start talking about sex, I feel like you can easily lose half of your audience right away, another big chunk when you start in with details ("oh, that's not me"), and what's left might be mostly people who were already interested anyway. It seems like the subject matter creates a much wider gap between high and low involvement groups, and makes reaching the latter more difficult. Here's a video of a continuing ed lecture that talks about the issues of sexual health education/marketing and more. (I won't embed it because it's pretty loooong and not dramatically well presented, but the info is good if you've got the patience). I'm interested in what we can come up with as a group to overcome this challenge! As sort of tangential example, the free women's clinic I used to volunteer with had two very different logos for different purposes. The first and official representation of the clinic is an abstracted outline of a woman, highlighting the importance of, including sexual/repro/gyn health into holistic well-being, and is found on all official documents, letterhead, signage, education materials, etc. The other, less frequently circulated logo, is a uterus (well, not just a uterus- whole female reproductive system, actually). This image is on the sweatshirts, t-shirts, pins and underwear that staff and volunteers at the clinic wear and that patients buy to support it. It's a pretty usual image for clothing, and works with humor, "surprise" value, and the idea of an "inside" image that works well in getting people to ask and learn about the clinic or women's health in general. However, this image obviously works much better in certain settings than others-- for example, I was wearing my sweatshirt once in an upscale grocery store in La Jolla, and rather than a casual "sex ed op", I got a very stern lecture from an older woman about the "appropriateness" of my clothing choices :/ Related to this (I swear), I really appreciated the way the Elder, Ayala, and Vega articles emphasized the importance of knowing your audience (and the variations within it!), well before even thinking about developing an intervention. These were both "right on" as well as "aha" moments for me- the Vega article specifically.

Also, it's always nice to read about the work done by the people we're learning from and working with- glad these were included.

In terms of open questions and general feeling for this module, the biggest one in mind for me keeps returning to the idea of contextual information (what people are picking up through what's not necessarily being said, but taken as implication) and whether addressing it as a communication concern is the best way to handle it. I think it makes sense to do it this way- but I'm interested to learn more as we go forward.

end of module 1

Reflecting on the content of the first module, the most fundamental lesson I learned was what what constitutes "health communication." It was interesting that in the class discussion on the "Code your own communication" project that most people who volunteered their definitions included an intended, benevolent effect, or destination. Health communications arising from peoples and organizations concerned with improving public health should specifically aim for a desirable "destination." The sources of many (most?) health communications are not do-gooders--they are companies seeking profit, such as pharmaceutical companies, food and beverage industries, and weight loss industries. The marketing/communication strategies employed by public health sources need to be grounded in different theories that go beyond explanations of consumer behavior.

One example of a communications strategy that I became introduced to in Kilmartin & Berkowitz's book Sexual Assault in Context: Teaching College Men about Gender, employs theory in its strategy to reduce sexism toward women, which also serves the mission of sexual assault prevention. Most college men are uncomfortable with displays of sexism, but they tend to underestimate their peers' discomfort and think they are more sensitive. The perception of having an ally present increases the likelihood of dissent. An idea for a social-norms media campaign is to publicize a message like "Seventy-five percent of all male students at Central University are uncomfortable when men make derogatory comments about women. Speak up and challenge this kind of talk when you hear it." (p 64-65). A similar campaign targeting binge drinking appealed to the social norms by citing data on the average number of drinks students consume at a party. I remember seeing posters like this at my undergraduate university and was surprised to learn GW students only consumed 0-3 drinks at a party.

A second insight in this module was that "places" can be targets of public health communication and marketing. I had previously narrowly conceptualized the receiver of health communications as people. (It seems so obvious now!) This lesson tied in with the book I just finished reading for the extra credit project (Rinku Sen's Stir it Up: Lessons in Community Organizing and Advocacy). None of the examples of community organizations in the book focused on public health issues directly, so the Maibech et al (2007) article on People & Places Framework was helpful for making the link.

The importance of formative research to get to know your audience became clear to me over the course of the module. Gathering qualitative data provides insights on the "whys" and "hows" of health behavior that go beyond what quantitative data can reveal; focus groups are crucial for developing communication campaigns. It seems like a lot of extra work up-front, but may mean the difference between success and failure of the message to effect change (or even reach the target audience).

-Melissa

Module 1 Aha's

Week 4:

I found the first module to be a great review as well as an effective means of providing a fresh perspective on the use of theory. I found the Theory at a Glance reading to be extremely useful. It is easy to overlook the numerous ways theory can, and should be applied. I have never used theory to create communication campaigns. Therefore, learning to do so in Module 1 has helped add depth and clarity to the already complex process of selecting a theory to assist in promoting a desired health behavior.

I was especially interested in reading Elder et al (2009). I enjoyed reading this article for several reasons. First, I have had several classes with Dr. Ayala. Dr. Ayala has discussed the importance of understanding acculturation and the multiple barriers Latino's face on several occasions. It was extremely fascinating to gain further insight into her area of expertise. Secondly, I was excited to read this article because so many key players in the SDSU GSPH co-authored it. This article did a great job of tying together multiple themes we have been exposed to in our studies as MPH students at SDSU.

Being based in San Diego, I think it is especially important to understand the Latino population. Elder et al (2009) was incredibly helpful in explaining the major barriers that the Latino community face. I was particularly interested in the fact that this population will tune in to messages that show how the family unit will be affected vs how the individuals would be affected. Prior to reading this article, I would have though it would be most effective to target individuals. I will definitely keep this article in the forefront of my mind when working with any specific culture in the future.

Finally, I found the Pinkbook to be an excellent resource as well. I think this reading will be especially helpful when designing our health messages. Page 70 has a great outline of how to break down and create a TV campaign. Between the Pinkbook and Chelsea's presentation on Vega and Roland (2005) I will attempt to keep in mind the necessary steps to create an effective media campaign for different regions. As Chelsea illustrated, each community will receive messages differently. It is imperative to pretest the messages to ensure they will be received well by each region.

In closing, the first module provided a great base for our upcoming projects. The major theme I took away from Module 1 is the importance of conducting extensive research on your target population. You must know the common language used by the population, acculturation, vibe of each target city (i.e. Chelsea's presentation), who does the population trust, what do the want to hear, etc. The only way for messages to make a large impact is to be as specific as possible.

Cody

Week 3 response

Hello Ladies,

I was browsing some websites and thought you might enjoy browsing the Kaiser Family Foundation website especially their HIV/AIDS section: http://www.kff.org/hivaids/index.cfm there are a lot of fact sheets and policy initiatives surrounding the topic.

I like Cody's idea about starting off with a broad target population instead of narrowing it down to just a particular ethnic group. Yes, there are limitations to this but at the same time we want to make people aware that HIV/AIDS is not only a problem for a specific sector of the population. Since, statistics are showing that the African American population are the one's with a growing rate of HIV/AIDS cases some might misconstrue these statistics. All women should be aware that they are at risk of contracting HIV/AIDS and that testing is important in order to ensure a healthy life. As we had discussed in our group many a times married women believe that they are not at risk because they only have one sexual partner. However, the reality is that infidelity whether we want to accept it or not can play a major role when it comes to being infected with the disease. Since we do want to reach large audience of women we might consider looking more into HIV/AIDS and lesbian issues. I did read one article that discussed women-who-have sex with women and their risk for HIV. We should be prepared for the different populations we might encounter during our intervention.

Since we were considering working with an older population it might be useful to use the process of adopting an innovation. Our population would probably fall under the "die-hards" in these case it might have to do with protection for HIV/AIDS or testing. There are many campaigns targeting the innovators and early adopters but there need to be more targeting the late majority and laggards.

I thought this commercial was interesting because it has young women but then you have the older women who is a part of this innovation:

http://www.youtube.com/watch?v=xWNtoLgcD-o

we can try and use this as a model for our intervention and incorporating more mature women.

- Liliana

Fear-Based Ads

After this week's lecture and readings, I guess I am still hung-up on the concept of fear-based ads, especially in terms of communicating with an audience that has low-involvement (or low motivation to engage). While I understand the argument that there is a risk that fear-based ads can be a bit extreme and too graphic for public TV. The content may not be appropriate for all ages exposed to the ads on TV and could cause harm by the images portrayed. However, I do feel that in some cases, the fear-based ads may be appropriate when the emotion suits the consequences to the undesirable behavior if it continues.

We have discussed how the central route of communicating health messages is not usually effective when targeting an audience with low-involvement like young adults who typically believe they are invincible or "it will never happen to me."

I brought up the issue of drunk driving PSAs in class on Tuesday, and I believe this is a very good example of a health issue in which fear-based ads are very effective in communicating the very real and tragic consequences of the behavior, especialy to the audience of teens/young adults. For this age group in particular, research and studies in education and learning note that kids of this age have trouble imagining the future consequences of their behavior choices. They can't connect-the-dots, so to speak. Despite all the lectures from parents or discussions in school warning them about the dangers of drunk driving (or other problems like drug-use and unprotected sex), most kids choose to learn the lesson the hard way. When they see a PSA or health education campaign with statistics and information, they rarely see themselves as the "one" the commerical is targeting - unless, of course, the teen or young adult has personally experienced the loss of a loved one to a drunk driving accident (but, then, at this point the teen would be considered to have high-involvement).

While learning lessons the hard way is very effective for individuals of this age, we cannot afford the continued consequences of such results. The point about the dangers of drunk driving needs to be made loud and clear in a way that gets the attention of this audience and helps them see themselves in the driver's seat. While we need to consider the balance between effective and appropriate, we also need to balance the costs of showing a somewhat disturbing, breath-catching fear-based PSA vs. the costs of continuing to do things the same old way.

I have attached some examples I found of various "don't drink & drive" ads that use various emotional hooks (peripheral) to convey the message. I am curious to know which one(s) do you think would be most effective in communicating the message and prompting behavior change in teens/young adults.

1) Here's an example of a PSA in which humor is used to communicate the message. Given that it was an MTV ad, we can assume that they correctly targeted an audience consisting of teens and young adults.

http://www.youtube.com/watch?v=gBX_3SU50LE

2) Here's one in which shame was used as an emotional motivator (aimed at young adult males specifically). It focused on speeding as the undesirable behavior:

http://www.youtube.com/watch?v=TvC6RryUn0Y

3) This one is a mix of grief and shame-based, not aimed at youth specifically, but adults in general:
http://www.youtube.com/watch?v=tm1JByRQRhY

These examples are fear-based:
http://www.youtube.com/watch?v=qpYq9CBZoKQ

http://www.youtube.com/watch?v=J6dTGlLpZkc (from the UK)


Here's an article noting the statistical results of effectiveness from the UK ad above (12 days of Xmas) since it aired on TV and the radio in December 2006.

http://www.yourthanet.co.uk/kent-news/Christmas-drink-driving-figures-down,-say-police-newsinkent32068.aspx?news=local

I look forward to your comments.

Shannon

HIV Stats for Women in the US

I found some interesting statistics on CDC's website which may help narrow our focus a little. I'm not sure if any of you were aware, but March 10th is National Women and Girls HIV/AIDS Awareness Day. I thought it might be fun to tie this into our assignment somehow. Maybe this could be one of our focuses.

The CDC stated that African American women are the largest growing group of new HIV cases, however women as a whole accounted for over 1/4 of new HIV cases in 2006. The CDC estimated that infection rates for African American women are 15 times higher than white women and four times higher than Hispanic women. Another scary estimation was that approximately 1 in 5 people living with HIV in the US are not aware of their status. More specifically, HIV/AIDS was the number one cause of death among African American women aged 25-34. The primary mode of transmission listed was having sex with a man who was HIV positive.

I also found a new websites dedicated to various concerns surrounding HIV prevention and care for women. The website was womenscollective.org. They have a link to all the free local HIV testing sites, list of referral services and a description of their mission. Their approach is peer-based, family-centered, culturally appropriate and focuses on women and girls.

After reading these figures my vote is to focus primarily on screening. As discussed in class, I think it is necessary to discuss condom use as a barrier method, but not have condom use be our primary focus. I would be interested in targeting unmarried women ages 25-45 (or 50). I vote to begin our project on women as a whole. If we need to narrow our view in a few weeks, we can try targeting either Latino or African American women. After reviewing Elder et al (2009) and the various websites dedicated to HIV, it seems that focusing on the family unit is the most effective approach.

One large barrier I see if we focus on women as a whole rather than a specific ethnic group is the lack of cultural appropriateness of our message. If subgroups of women are not able to identify with the messages we deliver, we run the risk of missing key groups. On the other hand, we could illustrate power in numbers and how HIV is a colorless disease. We could try to empower the women to stand together to fight this disease through preventative measures and screening.

Enjoy the rest of your weekend everyone,

Cody

wk 3

I'm going to keep this week's blog post short. I'm home with my family in Pennsylvania getting ready for my grandmother's funeral. Health communication should be the farthest thing from my mind, but I began thinking about it when helping clean out her house today we found an enema in her bedroom closet. My grandmother was a big believer in drug therapy--surprising to me, since she never seemed to get the right balance of laxative to anti-diarrheal. It made me wonder what about her or her environment made her think that using medications was the better way to deal with problems than diet or exercise. Did the advertising get to her? Did it seem the cheaper or easier solution? Was she not aware of other alternatives (e.g., fruits & veggies)? Did a doctor suggest it? Is it how her family or peers handled it? A couple weeks ago my boyfriend had an intestinal bug and refused drugs for many hours. I went out and purchased Pepto Bismol, recalling a clever commercial that includes a dance/song that highlights each of the symptoms/body regions targeted, as well as Immodium. Somehow I sold him on the Pepto Bismol when all he really wanted was some Pedialyte and crackers. Later we learned that he should have just starved the bug and let it pass--taking an antidiarrheal can actually do harm and lengthen the illness by trapping the bacteria or virus in the intestinal tract and allowing it to reproduce when it ought to be flushed out. This isn't the most serious consequence, but it made me wonder how the message about anti-diarrheal medications could/should get out to the greater public. It also made me realize the impact of advertising on my health decision-making as well as the advice I passed on. This could be seen as an example of the people & places framework.

"Sex has no age limit. Neither does protection"

So, we've started to segment our target group. We're still finalizing the details, but we're interested in addressing the needs for HIV prevention and screening in older women. Of course, by "older", I don't necessarily mean old- I just mean adult women, maybe single, maybe kids, husbands, ex-husbands...grandkids. Or not. But say, 30+ maybe. (And yeah, we're going to have to find a new adjective here unless we increase our age limits, because I'm personally treading dangerously close to the "old" line by this definition- and I am just not comfortable with that.) Anecdotally, we all had stories of women in this age group who have contracted or were at risk for contracting HIV (often because they weren't aware of their susceptibility), and heterosexual women are becoming one of the fastest increasing HIV+ subsets of certain populations (more on this later). In Brazil, a great new campaign slogan is "Sex has no age limit. Neither does protection", and I really like that concept. We're still debating whether to go with working to increase HIV screenings or to promote condom use; each is important and I hope we'll be able to incorporate both.

In terms of communication, one of the things we'd noticed was the general lack of condom advertisement and marketing to groups other than hot 20-somethings (I'm sure you've seen some of those). Here's one of my favorites with not such an obvious narrow audience, but still not our target necessarily... (ok really, I just think it's cute and wanted to share)

From here on out, I'll post existing messages that get closer to what we'd like to see happening, as well as our suggestions. We're thinking of ways to make condom use more "normal" and expected for our target population, and figuring out what sort of marketing topics and images are relevant to them.

As an example, here's a cute-but-not-cutesy eye-catching packaging idea as noted by condomunity.com (a fun site in itself!), and here's an article from a couple years ago that discusses some other marketing issues.

Week 2 - Communication Theory

First thing, I found the coding assignment to be ideal to get our minds going and start thinking about health communication and communication at large. The theory at a Glance reading was also helpful and a refresher on the theories that were introduced in 661. The five dimensions of McGuire's information Processing model definitely made it easier to understand how to develop a plan/strategy to get a health issue across. From this second lecture the take home point for me was that we have to not only focus on getting a message across but we must also keep take into consideration how the message will be received and processed by the target audience. Lastly, we need to recognize that health communication alone cannot sustain change. It is a combination of getting messages across and having programs and services available for the specific health issue being tackled and the population being worked with. I'm looking forward to work with my sexual practices group.

- Liliana

how theory shapes health campaigns

What I am trying to take from this course is a public health perspective on how to approach public health problems and communicate with the targeted community. I come to this as an outsider—I’m a master’s student in women’s studies department and hope to go on to a clinical/community psychology program and work in the area of sexual violence prevention and intervention. My understanding is that the public health field is increasingly taking on violence as a public health issue, but I will need to constantly try to apply what I’m learning towards that orientation because it is a bit different than attacking nutrition, exercise, sexual health, cancer, etc. Learning the theories was incredibly helpful to ground me and focus my thoughts. Eventually I will use them to help select the right model for approaching a given problem and target audience.

The Health Belief Model (HBM) details theoretical constructs that influence people’s decisions to take action to prevent, screen for, or treat a health problem including perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cue to action, and self-efficacy. While this may be appropriate for high-risk sexual behavior (e.g., HIV infection), I argue that it may be inappropriate to apply HBM when planning sexual assault (SA) prevention programs. Many SA programs are directed at women to reduce risk. They seek to evoke a heightened sense of risk for SA and emphasize the seriousness of SA (trauma, STDs, pregnancy, etc). Some prescribed risk-avoidance (or “prevention”) actions include not walking alone at night, refusing to accept a drink from a stranger, drinking alcohol in moderation, and carrying mace. Depending on the person’s lifestyle and community, the recommendations for action may have a different balance of perceived benefits to perceived barriers. As an undergraduate student in Washington DC, if I followed much of the advice given I would hardly have been able to leave my dorm room past 5pm. This leads to my main criticism of these programs: at what cost to women’s freedom does following the SA risk-reduction recommendations? Perceived barriers may be barriers that should not be surmounted. If following the desired actions to prevent SA affects quality of life, are they appropriate recommendations? Self-efficacy in terms of self-defense techniques may increase with physical self defense training. Interestingly, a risk reduction program shown to impact non-SA survivors failed with SA survivors, which suggests a barrier to high self-efficacy (and perhaps most other HBM constructs) may be previous failure to be able to prevent SA.

I learned from the Sholton (1996) article that central routes to attitudinal change are more important for someone with a high investment in the content. It was easiest for me to understand in terms of traditional marketing rather than health marketing. For instance, I may develop an opinion about a car from an unintelligent but entertaining ad, but if I am thinking of buying it I will need better, more logical information to base my decision on. The reference in class to using peripheral route to attitudinal change in pregnancy prevention efforts by playing with body image issues and the thinness ideal by suggesting “you’ll get fat if you have a baby in high school” seems grossly unethical to me. A successful pregnancy prevention campaign should not have the unintended consequence of increasing eating disorders in the targeted group. There must be peripheral route methods that do not stoop so low, but the example heightened my awareness of the possibility. Again, bringing the learning back to sexual violence, a major goal of mine is to avoid painting women with a broad brush as victims in need of rescue or as women who end up in high-risk situations as sluts.

Throughout the semester I intend to put a lot more thought into this and hopefully come up with and become acquainted with ideas that are not as easily picked apart when viewed through a feminist lens.

-Melissa

Week 2

Hi all,

I am trying this out to see how it works. I believe comments we post on blackboard are the same as we post here. So I have copied those comments and pasted below. I am looking forward to researching HIV and middle age women. I think we have chosen a great target audience.

The overview of the models was a great way to start the semester. I took theory 5 semesters ago. Needless to say, the refresher of the models was much needed! During class Tuesday, I was reminded how specific each model is and the vast amount of work required for each model to be a success.

I was relieved to hear that a few other people struggled with Scholten's article. I found it slightly difficult to sift through the information and pull out the main theme's/ideas. This week's readings are a little more tangible.

On a final note, I enjoyed the homework assignment last week. It was fun to broaden my usually limited observations of communication messages. I enjoyed taking a few extra minutes to think critically about each message and attempt to code them.

Enjoy the rest of the weekend!
Cody