Kim Walsh-Childers

Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review

Background Participatory Web 2.0 interventions promote collaboration to support chronic disease self-management. Growth in Web 2.0 interventions has led to the emergence of e-patient communication tools that enable older adults to (1) locate and share disease management information and (2) receive interactive healthcare advice. The evolution of older e-patients contributing to Web 2.0 health and medical forums has led to greater opportunities for achieving better chronic disease outcomes. To date, there are no review articles investigating the planning, implementation, and evaluation of Web 2.0 chronic disease self-management interventions for older adults. Objective To review the planning, implementation, and overall effectiveness of Web 2.0 self-management interventions for older adults (mean age ≥ 50) with one or more chronic disease(s). Methods A systematic literature search was conducted using six popular health science databases. The RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model was used to organize findings and compute a study quality score (SQS) for 15 reviewed articles. Results Most interventions were adopted for delivery by multidisciplinary healthcare teams and tested among small samples of white females with diabetes. Studies indicated that Web 2.0 participants felt greater self-efficacy for managing their disease(s) and benefitted from communicating with health care providers and/or website moderators to receive feedback and social support. Participants noted asynchronous communication tools (eg, email, discussion boards) and progress tracking features (eg, graphical displays of uploaded personal data) as being particularly useful for self-management support. Despite high attrition being noted as problematic, this review suggests that greater Web 2.0 engagement may be associated with improvements in health behaviors (eg, physical activity) and health status (eg, HRQoL). However, few studies indicated statistically significant improvements in medication adherence, biological outcomes, or health care utilization. Mean SQS scores were notably low (mean=63%, SD 18%). Studies were judged to be weakest on the Maintenance dimension of RE-AIM; 13 reviewed studies (87%) did not describe any measures taken to sustain Web 2.0 effects past designated study time periods. Detailed process and impact evaluation frameworks were also missing in almost half (n=7) of the reviewed interventions. Conclusions There is need for a greater understanding of the costs and benefits associated with using patient-centered Web 2.0 technologies for chronic disease self-management. More research is needed to determine whether the long-term effectiveness of these programs is sustainable among larger, more diverse samples of chronically ill patients. The effective translation of new knowledge, social technologies, and engagement techniques will likely result in novel approaches for empowering, engaging, and educating older adults with chronic disease.

Friendly Advice? Beauty Messages in Web Sites of Teen Magazines

Studies suggest that adolescent girls are going online in droves and that theWeb sites of teen magazines are among their top destinations. This qualitative analysis of the Web sites of CosmoGIRL!, Teen People, Seventeen, and Teen magazines identified three major themes: Beauty is a requirement, beauty can be achieved only through the purchase of products, and we can help you find the right products. The use of youth-targeted language, combined with offers of expert advice in the management of beauty problems, suggests that these sites wish to present themselves as friends rather than marketers of beauty products. Like their print counterparts, the sites may play an important role-in a private, personalized, and interactive setting-in reinforcing the messages concerning the centrality of female beauty inWestern societies.

Cultivating the Science Internet Audience Impact of Brand and Domain on Source Credibility for Science Information

This two-part study examines factors that can influence the perceived credibility of a science Web site. In the first part, respondents answered questions about their perceptions of science sites with the .com and .gov domain. Findings suggest that sites with a .gov domain are perceived to be more credible. Part 2 is an experiment in which respondents read a short science article from a site. Participants were randomly assigned to experimental conditions in which they were led to believe the site was from either a high- or moderate-credibility source and from a domain that contained either a .gov or .com extension. Ratings of the author, source, and the article were systematically influenced by the manipulations. Implications for science Web sites are presented in the discussion.

Sexual Harassment of Women Journalists

A survey of 227 women newspaper journalists revealed that more than 60 percent believe sexual harassment is at least somewhat a problem for women journalists; more than one-third said harassment has been at least somewhat a problem for them personally. Two-thirds experience nonphysical sexual harassment at least sometimes, and about 17 percent experience physical sexual harassment at least sometimes. News sources were the most frequent harassers, and harassment ranged from degrading comments to sexual assault._

Covering Women's Greatest Health Fear: Breast Cancer Information in Consumer Magazines

Women identify consumer magazines as a key source of information on many health topics, including breast cancer, which continues to rank as womens greatest personal health fear. This study examined the comprehensiveness and accuracy of breast cancer information provided in 555 articles published in 17 consumer magazines from 2002 through 2007. Accuracy of information was determined for 33 key breast cancer facts identified by an expert panel as important information for women to know. The results show that only 7 of 33 key facts were mentioned in at least 5% of the articles. These facts all dealt with breast cancer risk factors, screening, and detection; none of the key facts related to treatment or outcomes appeared in at least 5% of the articles. Other topics (not key facts) mentioned centered around controllable risk factors, support for breast cancer patients, and chemotherapy treatment. The majority of mentions of key facts were coded as fully accurate, although as much as 44% of mentions of some topics (the link between hormone replacement therapy and breast cancer) were coded as inaccurate or only partially accurate. The magazines were most likely to emphasize family history of breast cancer or genetic characteristics as risk factors for breast cancers; family history was twice as likely to be discussed as increasing age, which is in fact the most important risk factor for breast cancer other than being female. Magazine coverage may contribute to womens inaccurate perceptions of their breast cancer risk.

Sculpting the Female Breast: How College Women Negotiate the Media's Ideal Breast Image

Through focus group interviews, this study examined how college women negotiate exposure to media images of disproportionately large-breasted women. The results showed that media images directly and indirectly influence womens breast satisfaction. Personal experiences; self-confidence; and interactions with men, family, and friends influenced their views of ideal breast size.

Newspaper Influence on Health Policy Development

In three of four situations studied, newspaper coverage did not lead to changes in health policies; but all four situations suggest that such impact is possible.

Newspaper Coverage Portrays Managed Care Negatively

Health care coverage presents managed care organizations in a negative light, according to an analysis of articles published in major newspapers.

Daily Newspaper Coverage of the Organization, Delivery and Financing of Health Care

Health car egot far less coverage than crime, education or sports in 1993 when a critical national dialogue was taking place.

Engaging Community Stakeholders to Evaluate the Design, Usability, and Acceptability of a Chronic Obstructive Pulmonary Disease Social Media Resource Center

Background Patients with chronic obstructive pulmonary disease (COPD) often report inadequate access to comprehensive patient education resources. Objective The purpose of this study was to incorporate community-engagement principles within a mixed-method research design to evaluate the usability and acceptability of a self-tailored social media resource center for medically underserved patients with COPD. Methods A multiphase sequential design (qual → QUANT → quant + QUAL) was incorporated into the current study, whereby a small-scale qualitative (qual) study informed the design of a social media website prototype that was tested with patients during a computer-based usability study (QUANT). To identify usability violations and determine whether or not patients found the website prototype acceptable for use, each patient was asked to complete an 18-item website usability and acceptability questionnaire, as well as a retrospective, in-depth, semistructured interview (quant + QUAL). Results The majority of medically underserved patients with COPD (n=8, mean 56 years, SD 7) found the social media website prototype to be easy to navigate and relevant to their self-management information needs. Mean responses on the 18-item website usability and acceptability questionnaire were very high on a scale of 1 (strongly disagree) to 5 (strongly agree) (mean 4.72, SD 0.33). However, the majority of patients identified several usability violations related to the prototype’s information design, interactive capabilities, and navigational structure. Specifically, 6 out of 8 (75%) patients struggled to create a log-in account to access the prototype, and 7 out of 8 patients (88%) experienced difficulty posting and replying to comments on an interactive discussion forum. Conclusions Patient perceptions of most social media website prototype features (eg, clickable picture-based screenshots of videos, comment tools) were largely positive. Mixed-method stakeholder feedback was used to make design recommendations, categorize usability violations, and prioritize potential solutions for improving the usability of a social media resource center for COPD patient education.