J. Don Chaney

New Media for Health Education A Revolution in Progress

In a 2001 editorial titled, “Health Education and the Internet: The Beginning of a Revolution,” the authors noted that the Internet had the potential to completely revolutionize health education research and practice by providing far more powerful ways of “. . . compiling, facilitating, developing, packaging and delivering health information to and between individuals and communities” (Bernhardt & Hubley, 2001, p. 643). In 2013, Internet-enabled new media continue to have enormous potential to revolutionize health education with diverse populations by enhancing our ability to implement evidence-based behavior change strategies in manners that are often far more effective and efficient than were possible in the past. For example, new media can now be used to do the following: improve the ability to deeply engage large numbers of targeted individuals and communities over a sustained period of time; facilitate the real-time solicitation and analysis of in-depth health-related data and feedback from participants and collaborators to identify and aggregate health needs and priorities for planning health education programs; design and deliver highly relevant and personalized health education messages that are sent through the most accessible and persuasive channels at the most appropriate and influential times; and assess the effectiveness of interventions by enabling the electronic collection and storage of process and impact data from participants. Therefore, new media can contribute to and improve on virtually all steps in the health education planning, intervention development, and evaluation process. In 2001, there were an estimated 500 million Internet users throughout the world (Bernhardt & Hubley, 2001) and more than 20,000 health-related websites (Eng et al., 1998). The International Telecommunication Union (2013) currently estimates that there are more than 2.3 billion global Internet users; and there are almost 3.5 billion results available when searching for “health” on Google. In 2001, the dominant Internet-based channels besides the web and e-mail included newsgroups, chat rooms, instant messaging, and file exchange servers (Bernhardt & Hubley, 2001). In 2013, social media and information sharing sites, such as Facebook, YouTube, and Twitter, are among the most accessed websites on the Internet with more than 1 billion, 800 million, and 500 million users, respectively (Facebook, 2013; Lawler, 2012; Lunden, 2012). The technology revolution has spawned the rapid growth of new media channels, tools, devices and gadgets that leverage the Internet’s access to vast collections of information. The Pew Internet & American Life Project (2013) data show that laptop computer use is now favored over desktop computer use, and music players, video game consoles, electronic book readers, and tablet computers have all grown rapidly since their introduction (see Figure 1). However, the most explosive growth has been in the use of mobile phones, most of which feature the ability to make voice phone calls and send and receive SMS (or text) messages. At the turn of the millennium, it was estimated that nearly two thirds of the world’s population did not and would not possess the ability to make a phone call (Wang, 2000). Yet total mobile cellular subscriptions reached almost 6 billion by the end of 2011, representing a global penetration of 86% (International Telecommunication Union, 2013). Smartphones, which contain many features in addition to voice and SMS, such as mobile web access, sending and receiving e-mails, and running small downloadable programs called “apps,” have also grown rapidly. According to Nielsen, smartphones represent approximately half of all mobile phones used in the United States and two thirds of new phones that are purchased (Pollicino, 2012). Additionally, there were more than 1 billion mobile-broadband subscriptions globally by the end of 2011 (International Telecommunication Union, 2013). Health education researchers have continued to explore creative new ways to leverage the Internet and diverse new media applications to increase the efficacy of their interventions. The number of new media and health education studies continues to grow, as does the number of manuscripts related to new media that are submitted to Health Education & Behavior. In this issue, we selected five articles (each were submitted and accepted through the journal’s standard peerreview process) to be published together as a “theme section” on the topic of New Media for Health Education. These articles explore many of the most popular new media channels available for health education research and practice today, including smartphone apps, mobile-based text messages, webbased tailored messages, and video games. Together, these 483140 HEBXXX10.1177/1090198113483140 Health Education & BehaviorBernhardt et al. 2013

Using exploratory focus groups to inform the development of targeted COPD self-management education DVDs for rural patients

This exploratory study assessed the self-management learning needs, experiences, and perspectives of COPD patients treated at a Certified Federal Rural Health Clinic to inform the development of a COPD self-management DVD. A purposive, homogeneous sample of COPD patients participated in focus group interviews. Data from these interviews were referenced to edit a library of Rvision COPD self-management DVDs into a single condensed DVD containing only the most pertinent self-management topics. Patients reported a lack of knowledge and skill development related to purse lipped breathing, controlled coughing, and stress management; while medication management skills were found to be quite adequate. Engaging rural communities in formal qualitative inquiries to describe COPD specific needs for self-management may lead to future use of educational technologies aimed at improving quality of life for these rural, hard to reach populations.

A Critical Review of Effects of COPD Self-Management Education on Self-Efficacy

Chronic obstructive pulmonary disease (COPD) causes progressive airflow limitation which results in prolonged episodes of coughing and shortness of breath. COPD self-management education (COPDSME) programs attempt to enhance patient self-efficacy for managing symptoms. The purpose of this paper was to conduct a critical literature review that identified peer-reviewed articles assessing the effects of COPDSME on self-efficacy outcomes. Seven articles were located after an exhaustive search. Most studies (𝑛=6) reported statistically significant improvements in self-efficacy following intervention. Almost all of the studies tested interventions that drew upon at least 2 recommended sources of efficacy information. Two studies specifically noted increased self-efficacy for controlling physical exertion following COPDSME. Within the reviewed studies, the content within each educational treatment varied widely and showed a lack of standardization, and the types of instruments used to assess self-efficacy varied. This paper highlights the need for more controlled trials that investigate potential between-subjects effects of different types of COPDSME programs on self-efficacy outcomes. Incorporating practice models for patient-centered primary care in COPD requires the use of tailored efficacy building strategies for specific self-management behaviors.

Lifestyle behaviors and mental health of American adults

The purpose of this study was to test the hypothesis that individuals reporting healthy lifestyle behaviors would also report better self-rated mental health. Logistic regression analyses were conducted utilizing SUDAAN on the Behavioral Risk Factor Surveillance Survey data set. This descriptive analysis suggests that persons reporting poor mental health were more likely to report unhealthy lifestyle behaviors. This set of findings encourages careful design of experimental studies of empirically based associations of mental health and life style, using psychometrically sound measures. Then public health programs focused on change of health-related behaviors might be more suitably devised.

Establishing Cause for Developing and Implementing a Broad-Based Marketing Effort for the Health Education Field

What exactly is health education? Professionals with advanced degrees in health education have most likely encountered questions such as these either during introductory coursework or from those inquiring about the field. These queries can prove quite perplexing when asked by individuals who are unaware of the health education profession. Because the act of marketing health education is crucial to the sustainability of the field, the purpose of this article is to (a) explore the issue of describing and promoting health education, (b) establish ideas that can facilitate the provision of coordinated marketing efforts, and (c) offer marketing management and implementation principles that can assist in marketing both health education and health educators. Based on this discussion, the authors suggest building mainstream consensus in regards to marketing message development and implementation to better position health education.