Sara Minsky

The H1N1 pandemic: media frames, stigmatization and coping.

BackgroundThroughout history, people have soothed their fear of disease outbreaks by searching for someone to blame. Such was the case with the April 2009 H1N1 flu outbreak. Mexicans and other Latinos living in the US were quickly stigmatized by non-Latinos as carriers of the virus, partly because of news reports on the outbreak’s alleged origin in Mexican pig farms.MethodsIn this exploratory study we examined the psychological processes of cue convergence and associative priming, through which many people likely conflated news of the H1N1 outbreak with pre-existing cognitive scripts that blamed Latino immigrants for a variety of social problems. We also used a transactional model of stress and coping to analyze the transcripts from five focus groups, in order to examine the ways in which a diverse collection of New England residents appraised the threat of H1N1, processed information about stereotypes and stigmas, and devised personal strategies to cope with these stressors.ResultsTwelve themes emerged in the final wave of coding, with most of them appearing at distinctive points in the stress and coping trajectories of focus group participants. Primary and secondary appraisals were mostly stressful or negative, with participants born in the USA reporting more stressful responses than those who were not. Latino participants reported no stressful primary appraisals, but spoke much more often than Whites or Non-Hispanic Blacks about negative secondary appraisals. When interactions between participants dealt with stigmas regarding Latinos and H1N1, Latinos in our focus groups reported using far more negative coping strategies than Whites or Non-Hispanic Blacks. When discussions did not focus on stereotypes or stigmas, Latino participants spoke much more often about positive coping strategies compared to members of these same groups.ConclusionsParticipants in all five focus groups went through a similar process of stress and coping in response to the threat of H1N1, though individual responses varied by race and ethnicity. Stigmatization has often been common during pandemics, and public health and emergency preparedness practitioners can help to mitigate its impacts by developing interventions to address the social stressors that occur during outbreaks in highly-localized geographic regions.

Much ventured, much gained: Community-engaged data collection by adolescents and young adults

Abstract:Background: Community-engaged data collection offers an important opportunity to build community capacity to harness the power of data and create social change.Objectives: To share lessons learned from engaging 16 adolescents and young adults from a partner community to collect data for a public opinion survey as part of a broader community-based participatory research (CBPR) project.Methods: We conducted an analysis of archival documents, process data, and an assessment of survey assistants’ experiences.Lessons Learned: High-quality data were collected from a hard-to-reach population. Survey assistants benefited from exposure to research and gained professional skills. Key challenges included conducting surveys in challenging environments and managing schedule constraints during the school year. The tremendous investment made by project partners was vital for success.Conclusions: Investments required to support engaged data collection were larger than anticipated, as were the rewards, prompting greater attention to the integration of adolescents and young adults in research efforts.

Does Segmentation Really Work? Effectiveness of Matched Graphic Health Warnings on Cigarette Packaging by Race, Gender and Chronic Disease Conditions on Cognitive Outcomes among Vulnerable Populations

We examined the differential impact of exposure to smoking-related graphic health warnings (GHWs) on risk perceptions and intentions to quit among different audience segments characterized by gender, race/ethnic group, and presence of chronic disease condition. Specifically, we sought to test whether GHWs that portray specific groups (in terms of gender, race, and chronic disease conditions) are associated with differences in risk perception and intention to quit among smokers who match the portrayed group. We used data from Project CLEAR, which oversampled lower SES groups as well as race/ethnic minority groups living in the Greater Boston area (n = 565). We fitted multiple linear regression models to examine the impact of exposure to different GHWs on risk perceptions and quit intentions. After controlling for age, gender, education and household income, we found that women who viewed GHWs portraying females reported increased risk perception as compared to women who viewed GHWs portraying men. However, no other interactions were found between the groups depicted in GHWs and audience characteristics. The findings suggest that audience segmentation of GHWs may have limited impact on risk perceptions and intention to quit smoking among adult smokers.

Building practitioner networks to support dissemination and implementation of evidence-based programs in community settings

Insufficient capacity to use evidence-based programs (EBPs) limits the impact of community-based organizations (CBOs) to improve population health and address health disparities. PLANET MassCONECT was a community-based participatory research (CBPR) project conducted in three Massachusetts communities. Researchers and practitioners co-created an intervention to build capacity among CBO staff members to systematically find, adapt, and evaluate EBPs. The project supported development of trainee social networks and this cross-sectional study examines the association between network engagement and EBP usage, an important goal of the capacity-building program. Trainee cohorts were enrolled from June 2010 to April 2012 and we collected community-specific network data in late 2013. The relationship of interest was communication among network members regarding the systematic approach to program planning presented in the intervention. For Communities A, B, and C, 39/59, 36/61, and 50/59 trainees responded to our survey, respectively. We conducted the full network analysis in Community C. The average degree, or number of connections with other trainees, is a useful marker of engagement; respondents averaged 6.6 reported connections. Degree was associated with recent use of EBPs, in a linear regression, adjusting for important covariates. The results call for further attention to practitioner networks that support the use of research evidence in community settings. Consideration of key contextual factors, including resource levels, turnover rates, and community complexity will be vital for success.

Beliefs about smoking-related lung cancer risk among low socioeconomic individuals: the role of smoking experience and interpersonal communication:

Introduction: Previous research has documented that smoking prevalence is generally high among low socioeconomic groups and that tobacco industries continue to target these population groups. However, little research has investigated the beliefs of individuals with low socioeconomic position (SEP) about the association between smoking and cancer risks. In this study, we examined beliefs about smoking-related lung cancer risk and the role of smoking experience, mass media exposure and health-related interpersonal communication among a sample of low SEP population. Methods: Data were gathered from 324 urban poor recruited from adult education centers in the greater Boston area, Massachusetts, USA as part of a larger project called Click to Connect. While we collected a variety of data at baseline and follow-up, the data for this study come from the baseline survey alone. Results: We found that individuals with smoking experience tend to be better than those without in perceiving the lung cancer risks of smoking. Moreover, we found that health-related interpersonal communication with friends and family members is positively associated with beliefs about the link between smoking and lung cancer. Conclusion: Our findings suggest that low SEP individuals with smoking experience might be more exposed to anti-tobacco messages than are low SEP individuals without smoking experience. This could suggest that anti-tobacco interventions thus far may have done very little in raising the awareness of low SEP nonsmokers about the dangers of smoking and that they may have little potential to avert the initiation of smoking in this population.

Comparing perceived effectiveness of FDA-proposed cigarette packaging graphic health warnings between sexual and gender minorities and heterosexual adults

BackgroundIn 2012, the U.S. Food and Drug Administration proposed nine graphic health warnings (GHWs) on cigarette packaging that were rated equally effective across racial/ethnic, education, or income groups of adult smokers. However, data on GHW effectiveness among sexual and gender minority (SGM) adults, who have higher smoking prevalence, are currently lacking. This study analyzed whether perceived effectiveness of GHWs differed by gender and sexual orientation.MethodsData came from a randomized experiment among 1,200 adults with an oversample from low socioeconomic status groups, conducted between 2013 and 2014 in three Massachusetts communities. Participants viewed and rated the effectiveness of nine GHWs. Mixed effects regression models predicted perceived effectiveness with gender and sexual orientation, adjusting for repeated measurements, GHWs viewed, age, race, ethnicity, smoking status, and health status.ResultsFemale heterosexuals rated GHWs as more effective than male heterosexual, lesbian, and transgender and other gender respondents. There was no significant difference between female and male heterosexuals versus gay, male bisexual, or female bisexual respondents. Differences by gender and sexual orientation were consistent across all nine GHWs. Significant correlates of higher perceived effectiveness included certain GHWs, older age, being African-American (vs white), being Hispanic (vs non-Hispanic), having less than high school education (vs associate degree or higher), and being current smokers (vs non-smokers).ConclusionsPerceived effectiveness of GHWs was lower in certain SGM groups. We recommend further studies to understand the underlying mechanisms for these findings and investments in research and policy to communicate anti-smoking messages more effectively to SGM populations.