Crystale Purvis Cooper

Report from the CDC. Telephone focus groups: an emerging method in public health research.

BACKGROUND The focus group is a widely used qualitative method in public health research. Typically, focus groups involve face-to-face interaction, although focus groups have also been conducted via telephone conference calls. METHODS The indexed medical and social sciences literature was reviewed to assess what is empirically known about the telephone focus group method and how this method has been used to explore health topics. RESULTS Thirteen studies reported in 16 publications were found that used telephone focus groups. Of the 13 studies, 12 investigated health topics, and none explored any methodological issues. Some health studies used the telephone focus group method exclusively, whereas others used it in conjunction with additional methods. The studies involved a variety of lay and professional populations in six countries and explored a range of topics. Several of the studies included participants from a wide geographic area, such as across the entire United States. Two rationales for using the telephone focus group method were reported: assembling geographically disparate participants and increasing participant anonymity by eliminating visual contact. CONCLUSIONS Health researchers appear to be the primary users of the telephone focus group method for academic research. The telephone focus group method may be especially useful in health studies involving populations that do not have adequate representation in any single region and studies investigating sensitive topics. Methods studies are needed to compare the group dynamics of telephone and in-person focus groups and determine the most appropriate size and duration for telephone focus groups.

Women's Knowledge and Awareness of Gynecologic Cancer: A Multisite Qualitative Study in the United States

BACKGROUND U.S. womens awareness and knowledge of gynecologic cancer have not been well studied, with the exception of cervical cancer screening and risk factors. METHODS Fifteen focus groups were conducted with women aged 40-60 years in Miami, New York City, Chicago, and Los Angeles. RESULTS Most participants said they had heard of cervical, ovarian, and uterine cancers but were unfamiliar with vaginal and vulvar cancers. The misconception that the Pap test screens for multiple gynecologic cancers was prevalent and engendered a false sense of security in some women. An annual Pap screening interval was most familiar to participants; some mentioned a shorter screening interval for high-risk women; few mentioned an extended screening interval. A few participants thought the pelvic examination could detect a variety of conditions, including ovarian cancer. Some knew that the human papillomavirus (HPV) could cause cervical cancer, but no other risk factors for specific cancers were mentioned with any consistency. Although some recognized unexplained vaginal bleeding as a symptom of cervical cancer, participants generally were unfamiliar with gynecologic cancer symptoms. Participants reported learning about the discussion topics from a variety of sources, including the mass media. CONCLUSIONS Participants lacked critical knowledge needed to understand their gynecologic cancer risk and seek appropriate care. Pap tests and routine examinations offer ideal opportunities to educate women about the purpose of the Pap test as well as risk factors and symptoms associated with various gynecologic cancers. The reported influence of the mass media also supports the viability of multimedia educational strategies.

An Expectancy-Value Analysis of Viewer Interest in Television Prevention News Stories

Understanding what drives viewer interest in television news stories about prevention topics is vital to maximizing the effectiveness of interventions that utilize this medium. Guided by expectancy-value theory, this experiment used regression analysis to identify the salient beliefs associated with viewer attitudes towards these types of news stories. The 458 study participants were recruited over 30 days from a municipal jury pool in an eastern U.S. city. Out of the 22 beliefs included in the experiment, 6 demonstrated salience. Personal relevance, novelty, shock value, and the absence of exaggeration were the core values reflected in the identified salient beliefs. This study highlights the importance of explaining the relevance of prevention stories to viewers and framing these stories with a new spin or a surprising twist. However, such manipulations should be applied with savvy and restraint, as hyping prevention news was found to be counterproductive to educating the public.

Why the Pap Test? Awareness and Use of the Pap Test Among Women in the United States

OBJECTIVE To inform campaign development by assessing awareness, previous receipt, and knowledge of the purpose of Papanicolaou (Pap) testing among women aged ≥ 18 years and to identify differences in awareness, receipt, and knowledge by demographic characteristics. METHODS Data were analyzed from the 2008 HealthStyles survey, an annual mail survey conducted in the United States covering trends in health-related behavior. Women were asked questions on awareness, past use, and knowledge of the purpose of the Pap test and other gynecologic tests and procedures; 2991 women participated. RESULTS Although 96.7% of the women had heard of and 93.0% reported having received a Pap test, these proportions were lower among those who were 18-34 years old and among those who had lower levels of education and income. Over 80% knew the Pap test was used to screen for cervical cancer, but 63.3% believed it also was used to screen for vaginal cancer (44.9%), sexually transmitted diseases (STDs) other than human papillomavirus (HPV) (41.7%), ovarian cancer (40.6%), and other cancers and infections. CONCLUSIONS General familiarity and past receipt of the Pap test were high, but misconceptions about its purpose were prevalent. It is important that women understand what a routine Pap test is and is not capable of detecting so that signs and symptoms of gynecologic conditions other than cervical cancer may be recognized and addressed appropriately.

Developing English and Spanish Television Public Service Announcements to Promote Colorectal Cancer Screening

Screen for Life: National Colorectal Cancer Action Campaign (SFL) is a federally funded campaign to promote understanding of colorectal cancer and the importance of regular screening for adults aged 50 years and older. SFL uses a variety of communication strategies, including television public service announcements (PSAs). SFL materials are developed using the Health Communication Process endorsed by the U.S. Department of Health and Human Services, which has four stages: (a) planning and strategy development; (b) developing and pretesting concepts, messages, and materials; (c) implementing the program; and (d) assessing effectiveness and making refinements. This article describes SFLs application of this process to develop television PSAs in English and Spanish.

Analysis of the Benefits and Costs of a National Campaign to Promote Colorectal Cancer Screening CDC’s Screen for Life—National Colorectal Cancer Action Campaign

The Centers for Disease Control and Prevention’s Screen for Life: National Colorectal Cancer Action Campaign (SFL) is one of the longest running national multimedia campaigns to promote colorectal cancer screening. Since its inception in 1999, no study has quantified the benefits and costs of SFL. We modeled the impact of SFL campaign on screening rates, assuming that the effect size would range from 0.5% to 10% of the unscreened population exposed to the campaign in the last 14 years. Given the estimated benefits of the campaign and costs, we calculated the cost per person screened (2012 dollars). We hypothesize that if 0.5% of the population exposed to campaign messages were screened for colorectal cancer, an additional 251,000 previously unscreened individuals would be screened. The average cost of SFL per person screened would be

Life cycle of television public service announcements disseminated through donated airtime.

2.44. On the other hand, if 10% of the population exposed to campaign messages were screened, an additional 5.01 million individuals would be screened. The average cost per person screened would be

Recruitment of research participants from U.S. jury pools.

0.12. Results indicate that SFL improves screening rates at a relatively low cost per person screened. The findings in this study provide an important starting point and benchmark for future research efforts to determine the benefits and costs of health communication campaigns to promote cancer prevention.

To screen or not to screen, when clinical guidelines disagree: primary care physicians' use of the PSA test.

Objective To investigate the longevity and reach of television public service announcements (PSAs) developed by the Centers for Disease Control and Preventions Screen for Life: National Colorectal Cancer Action Campaign. Methods Television airtime donated to Screen for Life PSAs was tracked, and the impressions (a broadcasting metric for audience size) generated by PSAs in circulation ≥ 5 years were analyzed in 2014. The sample consisted of 8 PSAs, including English and Spanish PSAs, PSAs featuring celebrities, and PSAs redistributed multiple times after their initial release. Results During the most recent year of circulation (5–9 years after initial release), each PSA generated 15.7 million to 251.7 million impressions. Peak annual impressions were achieved as late as 9 years after a PSAs initial release. When PSAs were redistributed 2 years or longer after the prior distribution, annual impressions increased over the preceding year by > 20 million in 80.0% of instances. Among English PSAs, those featuring celebrities produced the highest mean and peak annual impressions. Conclusions Donated-placement television PSAs can be a long-lived health promotion strategy. Redistribution may enhance PSA longevity, and featuring celebrities, particularly in English PSAs, may expand reach.

Report from the CDC. Pap Test Intervals Used by Physicians Serving Low-Income Women through the National Breast and Cervical Cancer Early Detection Program

Psychological research is often criticized for routine use of a narrow and unrepresentative study population—college students. This study investigated the feasibility of recruiting research participants from U.S. jury pools, which by law must include a representative cross-section of the public. A questionnaire was mailed to the jury administrators in the 217 U.S. state court jurisdictions with populations of 250,000 or more. Court officials representing 79 jurisdictions in 30 states and the District of Columbia returned surveys (36% response rate). In addition, respondents who indicated in the mail survey that their court had previously allowed outside investigators to recruit jurors also completed a follow-up telephone interview. While the majority of jurisdictions (61%) opposed participation of jurors in research, 31 jurisdictions (39%) did not object to this practice. Only 8 of the nonopposed jurisdictions had been asked to host research, and 7 had agreed to do so. The jurisdictions that opened their jury pools to researchers employed a number of strategies to circumvent potential problems and generally reported that hosting research was a positive experience. Jury pools represent a viable and relatively untapped source of research participants. Many courts are open to the possibility of hosting research but have never been asked to do so. Both researchers and court officials should be reassured by the positive experiences of courts that have hosted research.