Charlene A. Caburnay

Cancer Coverage in General-Audience and Black Newspapers

This article presents findings from the first study of cancer news coverage in a national sample of Black and general-audience newspapers. We compared 2,439 health news stories from 23 weekly Black newspapers to 2,767 health news stories from a constructed week sample of 12 daily general-audience newspapers, both collected between April 1, 2004, and March 31, 2005. Analyses examined differences in the amount and nature of cancer coverage, specifically cancer sites, disparities, localization, and personally mobilizing health information for readers. Cancer was the main topic in a higher proportion of health stories in Black newspapers than in general-audience newspapers (13.6% vs. 9.6%; p = .001). Among cancer stories, those in Black newspapers had more localization (p = .004), disparity information (p = .001), and personal mobilization information (p = .001) than those in general-audience newspapers. In neither type of newspaper did the distribution of stories by cancer site accurately reflect the impact of different cancers on population mortality.

Effectiveness of Individually Tailored Calendars in Promoting Childhood Immunization in Urban Public Health Centers

OBJECTIVES We examined the effectiveness of tailored calendars in increasing childhood immunization rates. METHODS Parents of babies aged birth to 1 year (n = 321) received individually tailored calendars promoting immunization from 2 urban public health centers. For each baby, an age- and sex-matched control was selected from the same center. Immunization status was tracked through age 24 months. RESULTS A higher proportion of intervention than of control babies were up to date at the end of a 9-month enrollment period (82% vs 65%, P <.001) and at age 24 months (66% vs 47%, P <.001). The younger the babys age at enrollment in the program, the greater was the intervention effect. CONCLUSIONS Tailored immunization calendars can help increase child immunization rates.

Evaluating Diabetes Mobile Applications for Health Literate Designs and Functionality, 2014

Introduction The expansion of mobile health technologies, particularly for diabetes-related applications (apps), grew exponentially in the past decade. This study sought to examine the extent to which current mobile apps for diabetes have health literate features recommended by participants in an Institute of Medicine Roundtable and compare the health literate features by app cost (free or not). Methods We used diabetes-related keywords to identify diabetes-related apps for iOS devices. A random sample of 110 apps (24% of total number of apps identified) was selected for coding. The coding scheme was adapted from the discussion paper produced by participants in the Institute of Medicine Roundtable. Results Most diabetes apps in this sample addressed diabetes management and therapeutics, and paid apps were more likely than free apps to use plain language strategies, to label links clearly, and to have at least 1 feature (a “back” button) that helps with the organization. Conclusion Paid apps were more likely than free apps to use strategies that should be more useful and engaging for people with low health literacy. Future work can investigate ways to make free diabetes mobile apps more user-friendly and accessible.

How Much Is Enough? New Recommendations for Using Constructed Week Sampling in Newspaper Content Analysis of Health Stories

Researchers frequently use constructed week samples to approximate content for larger populations of textual data in content analysis projects. To date, this sampling method has not been validated in longitudinal contexts necessary for the conduct of large-scale health communication research. This study uses Monte Carlo bootstrap sampling to determine the number of constructed weeks necessary to accurately estimate one- and five-year population values for different types of variables in a quantitative content analysis. Five years (1999–2004) of four different daily newspapers were coded for four variables that varied on type (count vs. rating), amount of missing data, and distribution (normal vs. nonnormal). Results suggest that sampling a minimum of six constructed weeks was most efficient for both time frames. Missing data lowers sampling precision, although a correction can be calculated if the amount of missing data can be estimated. Using an efficient method of sampling newspapers such as constructed week sampling can help communication researchers to more easily study health coverage in the media.

Disseminating effective health promotion programs from prevention research to community organizations.

Promising programs developed through health promotion and disease prevention research are not always disseminated to the agencies, organizations, and individuals that can benefit from them most. Systematic and practical approaches to dissemination are needed to ensure that effective programs more often reach end users in communities. This article describes six steps used in translation and dissemination of the ABC Immunization Calendar program to public health centers in St. Louis, Missouri. The authors discuss how one health center successfully adopted this program and provide recommendations for other researchers seeking to disseminate innovative, effective health promotion programs.

What can health communication science offer for ACA implementation? Five evidence-informed strategies for expanding Medicaid enrollment.

CONTEXT Implementing the Affordable Care Act (ACA) in 2014 will require effective enrollment and outreach efforts to previously uninsured individuals now eligible for coverage. METHODS From 1996 to 2013, the Health Communication Research Laboratory conducted more than 40 original studies with more than 30,000 participants to learn how to improve the reach to and effectiveness of health information for low-income and racial/ethnic minority populations. We synthesized the findings from this body of research and used them to inform current challenges in implementing the ACA. FINDINGS We found empirical support for 5 recommendations regarding partnerships, outreach, messages and messengers, life priorities of low-income individuals and families, and the information environment. We translated these into 12 action steps. CONCLUSIONS Health communication science can inform the development and execution of strategies to increase the publics understanding of the ACA and to support the enrollment of eligible individuals into Medicaid or the Health Insurance Marketplace.

Alcohol and Tobacco Advertising in Black and General Audience Newspapers: Targeting with Message Cues?

This study content analyzed 928 tobacco- and alcohol-related advertisements from a 3-year national sample of Black (n = 24) and general audience (n = 11) newspapers from 24 U.S. cities. The authors compared the frequency of tobacco and alcohol product and control advertising in Black versus general audience newspapers, as well as the presence of 5 message cues: model ethnicity, presence of health official, referral to resources, personal behavior mobilization, and localization. Results within health issues show that Black newspapers had more alcohol product advertising than did general audience newspapers. In contrast, Black newspapers had less alcohol and tobacco control advertising than general audience newspapers. Black newspapers’ tobacco/alcohol product advertisements had more African American models than did general audience newspapers’ tobacco/alcohol advertising, whereas general audience newspapers’ tobacco control advertisements were significantly more likely to feature public health officials than ads in Black newspapers. Fewer message cues such as personal behavior mobilization, referral to resources, and localization were present in Black versus general audience newspapers. Results suggest that Black newspapers may have greater dependency than do general audience newspapers on these risk-related advertisements that target African American consumers. Given the current advertising environment, public health initiatives are needed to counter unhealthy alcohol product advertising messages that target vulnerable populations.

Diabetes topics associated with engagement on Twitter

Introduction Social media are widely used by the general public and by public health and health care professionals. Emerging evidence suggests engagement with public health information on social media may influence health behavior. However, the volume of data accumulating daily on Twitter and other social media is a challenge for researchers with limited resources to further examine how social media influence health. To address this challenge, we used crowdsourcing to facilitate the examination of topics associated with engagement with diabetes information on Twitter. Methods We took a random sample of 100 tweets that included the hashtag “#diabetes” from each day during a constructed week in May and June 2014. Crowdsourcing through Amazon’s Mechanical Turk platform was used to classify tweets into 9 topic categories and their senders into 3 Twitter user categories. Descriptive statistics and Tweedie regression were used to identify tweet and Twitter user characteristics associated with 2 measures of engagement, “favoriting” and “retweeting.” Results Classification was reliable for tweet topics and Twitter user type. The most common tweet topics were medical and nonmedical resources for diabetes. Tweets that included information about diabetes-related health problems were positively and significantly associated with engagement. Tweets about diabetes prevalence, nonmedical resources for diabetes, and jokes or sarcasm about diabetes were significantly negatively associated with engagement. Conclusion Crowdsourcing is a reliable, quick, and economical option for classifying tweets. Public health practitioners aiming to engage constituents around diabetes may want to focus on topics positively associated with engagement.

What makes African American health disparities newsworthy? An experiment among journalists about story framing

News stories reporting race-specific health information commonly emphasize disparities between racial groups. But recent research suggests this focus on disparities has unintended effects on African American audiences, generating negative emotions and less interest in preventive behaviors (Nicholson RA, Kreuter MW, Lapka C et al. Unintended effects of emphasizing disparities in cancer communication to African-Americans. Cancer Epidemiol Biomarkers Prev 2008; 17: 2946-52). They found that black adults are more interested in cancer screening after reading about the progress African Americans have made in fighting cancer than after reading stories emphasizing disparities between blacks and whites. This study builds on past findings by (i) examining how health journalists judge the newsworthiness of stories that report race-specific health information by emphasizing disparities versus progress and (ii) determining whether these judgments can be changed by informing journalists of audience reactions to disparity versus progress framing. In a double-blind-randomized experiment, 175 health journalists read either a disparity- or progress-framed story on colon cancer, preceded by either an inoculation about audience effects of such framing or an unrelated (i.e. control) information stimuli. Journalists rated the disparity-frame story more favorably than the progress-frame story in every category of news values. However, the inoculation significantly increased positive reactions to the progress-frame story. Informing journalists of audience reactions to race-specific health information could influence how health news stories are framed.

Evaluating the Ozioma cancer news service: A community randomized trial in 24 U.S. cities

OBJECTIVE This community randomized trial evaluated effects of the Ozioma News Service on the amount and quality of cancer coverage in Black weekly newspapers in 24 U.S. cities. METHOD We created and operated Ozioma, the first cancer information news service specifically for Black newspapers. Over 21 months, Ozioma developed community- and race-specific cancer news releases for each of 12 Black weekly newspapers in intervention communities. Cancer coverage in these papers was tracked before and during the intervention and compared to 12 Black newspapers in control communities. RESULTS From 2004 to 2007, we coded 9257 health and cancer stories from 3178 newspaper issues. Intervention newspapers published approximately 4 times the expected number of cancer stories compared to control newspapers (p(12,21 mo)<.01), and also saw an increase in graphics (p(12,21 mo)<.01), local relevance (p(12 mo)=.01), and personal mobilization (p(12 mo)<.10). However, this increased coverage supplanted other health topics and had smaller graphics (NS), had less community mobilization (p(21 mo)=.01), and is less likely to be from a local source (NS). CONCLUSION Providing news releases with localized and race-specific features to minority-serving media outlets can increase the quantity of cancer coverage. Results are mixed for the journalistic and public health quality of this increased cancer coverage in Black newspapers.