L. Suzanne Suggs

SMS for disease control in developing countries : a systematic review of mobile health applications

Mobile phones provide a low cost method of addressing certain health system needs in developing countries. We examined SMS-supported interventions for prevention, surveillance, management and treatment compliance of communicable and non-communicable diseases in developing countries. We searched both peer-reviewed and grey literature reporting the use of SMS messages for disease prevention, surveillance, self-management and compliance in developing countries. A total of 98 applications fulfilled the inclusion criteria (33 prevention, 19 surveillance, 29 disease management and 17 patient compliance applications). In 31 projects, the SMS applications were evaluated. The majority of applications focused on HIV/AIDS and were located in India, South Africa and Kenya. Most used bulk (push) messaging. In general, they were well accepted by the population. The review provides further evidence that mobile phones are an appropriate and promising tool for disease control interventions in developing countries.

A 10-Year Retrospective of Research in New Technologies for Health Communication

The use of new technologies is growing in virtually all areas of health communication, including consumer, patient, and provider education; decision and social support; health promotion; knowledge transfer; and the delivery of services. Many applications have the potential to make major contributions in meeting the needs of an unhealthy and aging population. Key questions confronting health communication research reflect long-standing concerns about effects of new technology on health knowledge, health behavior, health delivery, and health outcomes. A review of the literature provides useful insights about how technology has been used to communicate health messages and their associated outcomes. Focus is placed on effective health communication, lessons learned, and implications for the future. During the next 10 years, the application of new technologies in health communication will be enriched by a tradition that has evolved to reflect a more dynamic connection between health users and providers. Future applications have the potential to provide cost-effective communications tailored to large numbers of individuals and achieve positive health outcomes. Consequently, we should strive to answer research questions about tailoring communication content, the channel used to deliver the message, and evaluation models that are best suited for examining outcomes of multicomponent tailored, technology-based communication.

Culture Counts: Why Current Treatment Models Fail Hispanic Women With Type 2 Diabetes

PURPOSE The purpose of this article is to evaluate whether current treatment models adequately address the cultural factors involved in treatment adherence in Hispanic females with Type 2 diabetes. METHODS A review of relevant professional literature was conducted. RESULTS Established health behavior models do not adequately address the unique needs of the female Hispanic population, especially those older women who hold traditional religious and cultural beliefs. CONCLUSIONS To decrease the devastating effects of Type 2 diabetes among Hispanic women, interventions must be based on a comprehensive, culturally sensitive model that works with cultural values, not against them.

Theory and Model Use in Social Marketing Health Interventions

The existing literature suggests that theories and models can serve as valuable frameworks for the design and evaluation of health interventions. However, evidence on the use of theories and models in social marketing interventions is sparse. The purpose of this systematic review is to identify to what extent papers about social marketing health interventions report using theory, which theories are most commonly used, and how theory was used. A systematic search was conducted for articles that reported social marketing interventions for the prevention or management of cancer, diabetes, heart disease, HIV, STDs, and tobacco use, and behaviors related to reproductive health, physical activity, nutrition, and smoking cessation. Articles were published in English, after 1990, reported an evaluation, and met the 6 social marketing benchmarks criteria (behavior change, consumer research, segmentation and targeting, exchange, competition and marketing mix). Twenty-four articles, describing 17 interventions, met the inclusion criteria. Of these 17 interventions, 8 reported using theory and 7 stated how it was used. The transtheoretical model/stages of change was used more often than other theories. Findings highlight an ongoing lack of use or underreporting of the use of theory in social marketing campaigns and reinforce the call to action for applying and reporting theory to guide and evaluate interventions.

Strategies for the Social Marketing Mix: A Systematic Review

The marketing mix is a key component of social marketing providing one of the differential points in bringing about behavior and social change. There is a dearth of information regarding the strategies used for the mix in social marketing interventions. This systematic review identifies the strategies used in the social marketing mix, product, price, place, promotion, policy, and partnerships, and their associated outcomes, in health behavior change interventions. A systematic literature search was conducted for peer-reviewed articles published in English from 1990 to 2009 that reported social marketing interventions addressing disease prevention, cancer, heart disease, diabetes, HIV, STDs, reproductive health, physical activity, nutrition, and tobacco. Articles must have identified at least 3 of the Ps of the marketing mix, reported the evaluation, and met the 6 social marketing benchmarks criteria. Twenty-four studies describing 17 interventions met the inclusion criteria. The complete marketing mix was identifiable in 5 interventions. Strategies such as removing perceived barriers, using the Internet for placement, applying innovative promotion, involving communities, and supporting policies were identified as current practices. The results identified a number of strategies that showed potential for the marketing mix with important implications for practice.

Are We There Yet? An Examination of Online Tailored Health Communication

Increasingly, the Internet is playing an important role in consumer health and patient—provider communication. Seventy-three percent of American adults are now online, and 79% have searched for health information on the Internet. This study provides a baseline understanding of the extent to which health consumers are able to find tailored communication online. It describes the current behavioral focus, the channels being used to deliver the tailored content, and the level of tailoring in online-tailored communication. A content analysis of 497 health Web sites found few examples of personalized, targeted, or tailored health sites freely available online. Tailored content was provided in 13 Web sites, although 15 collected individual data. More health risk assessment (HRA) sites included tailored feedback than other topics. The patterns that emerged from the analysis demonstrate that online health users can access a number of Web sites with communication tailored to their needs.

Application of a Web-Based Tailored Health Risk Assessment in a Work-Site Population

This article presents an examination of the feasibility of implementing a Web-based tailored health risk assessment (HRA) as part of a University-based work-site health promotion program. Although the effectiveness of tailoring has been well established in the research literature, tailoring health messages for the purposes of health promotion and behavior change is only now starting to be used and evaluated in real-world settings. Key issues to be examined include the feasibility of delivery of a web-based tailored HRA, utility of data gathered for program planning, participation rates compared to traditional programming, usability, and participant satisfaction with the HRA.

Reasons for participating and not participating in a e-health workplace physical activity intervention

Purpose – The purpose of this paper is to investigate the reasons for participating and not participating in an e-health workplace physical activity (PA) intervention. Design/methodology/approach – Semi-structured interviews and two focus groups were conducted with a purposive sample of employees who enrolled and participated in the intervention and with those who did not complete enrolment, hence did not participate in it. Data were examined using thematic analysis according to the clusters of “reasons for participation” and for “non-participation”. Findings – Reported reasons for participation included a need to be more active, to increase motivation to engage in PA, and to better manage weight. Employees were attracted by the perceived ease of use of the programme and by the promise of receiving reminders. Many felt encouraged to enrol by managers or peers. Reported reasons for non-participation included lack of time, loss of interest towards the programme, or a lack of reminders to complete enrolment. Practical implications – Future e-health workplace behavioural interventions should consider focusing on employees’ needs and motivators to behaviour change, provide regular reminders for participants to complete enrolment and ensure that procedures are completed successfully. Barriers to participation could be identified through formative research with the target population and feasibility studies. Originality/value – This study combines a qualitative analysis of the reasons why some employees decided to enrol in a workplace PA intervention and why some others did not. This study highlights factors to consider when designing, implementing and promoting similar interventions and that could inform strategies to enhance participation in workplace PA interventions.

European Union public opinion on policy measures to address childhood overweight and obesity

Increases in pediatric overweight and obesity throughout the European Union (EU) generate concern because of the many associated co-morbidities, psychosocial effects, and economic costs. A variety of policy approaches have been implemented, but counteracting weight gain has proven challenging. Do differences in public opinion about policy options to fight the problem exist among EU countries? We obtained data for our study from the Eurobarometer and include representative samples from all EU Member States plus four prospective countries. Our results suggest strong consistency among EU countries in support for two policies: providing information to parents and more physical activity in schools. For improving childrens diets, our data show widespread support for providing parents with information, education programs in schools, and restrictions on advertising. For reducing childhood obesity, more physical activity in schools received the most support followed by education and advertising restrictions. There was very little support for imposing taxes on unhealthy food.

Active8! Technology-Based Intervention to Promote Physical Activity in Hospital Employees

Purpose. Increase physical activity in health care employees using health messaging, and compare e-mail with mobile phone short-message service (SMS) as delivery channels. Design. Randomized controlled trial Setting. U.K. hospital workplace. Subjects. Two hundred ninety-six employees (19–67 years, 53% of study Web site visitors). Intervention. Twelve-week messaging intervention designed to increase physical activity and delivered via SMS (n =147) or e-mail (n =149); content tailored using theory of planned behavior (TPB) and limited to 160 characters. Measures. Baseline and 6, 12, and 16 weeks. Online measures included TPB constructs, physical activity behavior on the Global Physical Activity Questionnaire, and health-related quality of life on the Short-Form 12. Analysis. General linear models for repeated measures. Results. Increase in duration (mean h/d) of moderate work-related activity and moderate recreational activity from baseline to 16 weeks. Short-lived increase in frequency (d/wk) of vigorous recreational activity from baseline to 6 weeks. Increase in duration and frequency of active travel from baseline to 16 weeks. E-mails generated greater changes than SMS in active travel and moderate activity (work and recreational). Conclusion. Minimal physical activity promotion delivered by SMS or e-mail can increase frequency and duration of active travel and duration of moderate intensity physical activity at work and for leisure, which is maintained up to 1 month after messaging ends. Both channels were useful platforms for health communication; e-mails were particularly beneficial with hospital employees.