Communication 620: Health Communication



Communication 616

Health Communication:

Social Science Approaches to Behavioral Prevention

Annenberg School for Communication

Spring 2012

Instructor: Professor Lynn Carol Miller:

Email: lmiller@usc.edu

Class time: Tues 2-4:50 PM

Room: ASC G38

Office hours: Tues

Instructor: Professor Miller

Texbook:

Borenstein, M., Hedges, L.V., Higgins, J. P. T., Rothstein, H. R. (2009). Introduction to Meta-Analysis. SanFrancisco, CA: John Wiley & Sons.

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Health behavior and health education: Theory, Research, and Practice (4th edition). San Francisco, CA: John Wiley & Sons.This volume will be available “on line” the first week. You can pre-order at . Practice/dp/0787996149/ref=cm_cr_pr_pb_t#productPromotions

Pérez, M. A., & Luquis (2008). Cultural Competence in Health Education and Health

Promotion [E-Book] ISBN: 978-0-470-43249-5 E-Book

Recommended Software: Comprehensive Meta-Analysis



(student version – annual fee for students using meta-analysis in a course is $95 if 5 or more copies) You can use a trial version (but wait to do this until you are ready).

Readings as assigned will be posted via blackboard.

Requirements/Evaluation Criteria:

10% Class Participation

20% non-MH Assignments

15% Oral Presentation of Final Review & Meta-Analysis Paper (April 24th)

25% Meta-Analysis Homework (MH)

25% Final Meta-Analysis Paper (April 27th)

Final Project Papers will consist of a data-based review (i.e., meta-analysis). Meta-analyses are often the first (publishable) step in getting a handle on a research area, planning a grant, and identifying what research is most needed (and therefore more likely to be published, funded, etc.). Assuming you get out your meta-analysis in an area before a similar one in a given time frame, this should be highly publishable. It’s a great way for new scholars to establish credentials in an area even when they haven’t themselves done any primary research in that area.

Graded Assignments

| # |Date Due |Nature of Assignment |Points |

|1 |January 17th |a. MH: Preliminary Search for Focus |R+2 |

| |10 AM |b. Individual Models: Identify article | |

| | |addressing possible health focus (see detailed | |

| | |description) relevant to individual models. PP slides due | |

|2 |January 24th |a. MH:Specify Review Area (see detailed description) |2+2 |

| |10 AM |b. Review an article from one of the meta-analyses for | |

| | |individual models. Discuss mapping within that meta-analysis | |

| | |(see detailed assignment) | |

|3 |January 31st |Review a research article that has addressed this |2 |

| |10AM |focus using one or more of the interpersonal theories reviewed | |

| | |(also see articles in meta-analysis from readings). | |

| | |PP slides due. | |

|4 |February 7 |MH: Collect 10 studies in specified focus area suitable for planned meta-analysis. Provide all |2 |

| |10AM |abstracts with | |

| | |references; Be prepared to discuss in class; powerpoint slides. | |

|5 |February 14th |Review article that has addressed this focus using |2 |

| |10 AM |one or more of the theories (community and | |

| | |group models reviewed). Powerpoint presentation due | |

|6 |February 21st |MH:Collect all studies; Code studies and compute effect sizes (distribution of). Be prepared to |3 |

| |10AM |present powerpoint | |

| | |presentation of this. | |

|7 |February 28, |a. Review article from meta-analysis or one that has addressed your |2+4 |

| |10AM |focus involving participation. Powerpoint presentation due | |

| | |b. MH: Initial draft of Method section due | |

|8 |March 6, |a. MH: Examine effect sizes (distribution of) and |2+4 |

| |10AM |examine/analyze potential role of moderators. Powerpoint presentation prepared due | |

| | |b. MH: Initial Draft of Outline for Introduction due | |

|9 |March 20, |Review article from meta-analysis or one that has addressed |2 |

| |10AM |your focus involving personalization. | |

| | |Powerpoint presentation due | |

|10 |March 27 |a. MH: Review paper results draft due |4+2 |

| |10AM |b. Review article from e-health meta-analysis or one | |

| | |involving your focus on online samples. | |

| | |Powerpoint presentation due. | |

|11 |April 3 |Review article from mobile health meta-analysis or |2 |

| |10AM |one involving your focus on mobile health. | |

| | |Powerpoint presentation due. | |

|12 |April 10 |Review article from serious games meta-analysis or one |4+2 |

| |10AM |involving your focus serious games. | |

| | |Powerpoint presentation due. | |

| | |MH: Revised Draft of Intro, Methods, Results with discussion | |

| | |due | |

|13 |April 17 |SOLVE assignment (see more detail below) |2 |

|OR |April 24 |Oral Report on Meta-Analysis |15% |

|MF |April 27 |Final Draft of Meta-Analysis Due |25% |

Course Description:

Health Communication takes place at every levels of analysis (i.e., individual, interpersonal, group/network, organizational, and societal). Communicating about health can also involve mass media as well as online and via new/emerging technologies. Health communication is a broad, growing, and exciting field with exceptional career opportunities (e.g., for academic positions in health communication; for a visible national/international presence and impact beyond, as well as within, the field of communication, for large federal research grants). Many of our faculty at USC’s Annenberg School for Communication conduct research in and have federal and other grants this area .

Researchers in health communication tend to focus on communication approaches in support of one of two broad behavioral goals:

1) preventing, via behavioral action, diseases/adverse physical and mental health outcomes in the first place, or

(2) understanding/supporting early and accurate disease/health condition diagnosis, effective treatment, and adequate maintenance of a drug/therapy regimen to ameliorate or best control adverse effects of that health condition.

This course is designed to provide an overview of health communication approaches aimed at the prevention (or pre-emption) of diseases (e.g., cancers, infections) or other adverse physical (e.g., injury, violence, suicide, birth defects) or mental health outcomes by the promotion of behavior change (away from risky; towards healthier decisions/behavior). Another Annenberg course (i.e., on Medical Communication) is focused on providing an overview of the second domain. In addition to a focus on health communication theory and research on prevention and pre-emption, this course is focused on enhancing participation and personalization of interventions, especially using new communication technologies (e.g., interactive technologies, games, intelligent agents, mobile technologies, social media, etc.). These new technologies afford exceptional opportunities for communication interventions that can incorporate and test new interventions while reaching and personalizing interventions for diverse individuals.

The specific objectives of this course are to provide students with background in:

a. major theories of behavioral prevention.

b. a sampling of empirical research in health communication relevant to behavioral prevention.

c. major methodological approaches in this domain, including the use of randomized longitudinal designs and meta-analyses.

d. how researchers link theory to research and interventions,

e. cutting-edge domains (e.g., using interactive technologies and gaming environments to produce communication interventions over the web).

f. funding priorities in health communication (by major

funding organizations such as the National Institutes of Health, Centers for Disease Control and Prevention) that will help shape the future of research in this area.

g. key socialization information in this domain (e.g., Where should I

look for information in this domain? What conferences should I go to? Who should I network with?; where grant funding is available (how would I start thinking about grants?) Etc.)

• Opportunities to develop skills in:

a. Approaching problems encountered in health communication (prevention).

b. Critiquing/Reviewing literature in this domain (as well as searching the literature in health communication and allied disciplines).

c. Meta-analysis.

d. Orally presenting work in conference-like format.

• Opportunities to develop a professional portfolio of work (e.g., conference presentations /potentially publishable work) that can further your career.

These include:

a. Presentation slides for research and teaching health communication (your own associated with a given topic (for your review) as well as those developed by the class). These are associated with weekly assignments.

b. Meta-Analysis: Review of the prevention literature in a given domain to address a theoretical question using meta-analysis. This could be submitted to a conference/provide the basis for a potentially publishable paper and serve to specify what research questions in an area need to be addressed.

c. Conference Style Presentation Slides on your individual project.

Background

Many of the leading causes of death domestically and internationally, such as chronic diseases, acute infections, accidents, suicide, and homicide, are preventable with health education/promotion efforts, or other behavioral interventions. That change may involve reducing individuals’ risky decision-making behaviors, encouraging them to engage in healthier choices, or persuading individuals to be tested for diseases. For example, reducing tobacco use, moderating alcohol use, maintaining a healthy diet, engaging in safer sexual practices, exercising regularly, reducing -- or learning to cope more effectively with --chronic stressors, and behaving in ways that reduce toxin/foodborne illness and illicit drug exposure could reduce the incidence of many chronic diseases. Changing health behaviors, however, often involves more than the individual level of analysis alone: Successful health communication interventions often address social and behavioral factors at one or more levels of analysis (e.g., individual, interpersonal, institutional, community, and policy levels).

Successful prevention (or pre-emption) interventions may use interpersonal or community or media-based, increasingly are using interactive media and advanced communication technologies (e.g., interactive agents, games) and interventions delivered “on-line” are part of the mix. Targeting diverse populations, tailoring messages and interventions to those audiences, and personalizing those interventions to optimize risk reduction and health promotion are also major foci in health communication. Increasingly, there is also a focus at major federal agencies charged with promoting the nation’s health (e.g., National Institutes of Health, Centers for Disease Control and Prevention) on encouraging the participation of diverse populations at risk for specific deleterious health outcomes in the research process and reaching (and reducing health disparities in) diverse, often hard to reach audiences. An additional week is devoted to international health communication.

Prevention often involves changing decision-making and behavior. Historically, many of these “decisions” have been thought to involve primarily more rational factors such as cognitions (that implicate more cognitive educational efforts to change beliefs and skills, etc.): And the theories underlying these approaches are typically consistent with that view. Increasingly, we are realizing and formulating theory consistent with the view that many risky decisions are automatic and affectively-based. And, in fact, both cognitive and affective factors appear to predict change in behavior (e.g., change in risky behavior).

Virtual environments (and intelligent agents and games) and on-line interventions for changing behaviors are proving to be especially promising tools for challenging and changing risky behaviors, including changing HIV risk behaviors. We discuss some of these enabling communication technologies and the communication theory and research that underpin their use.

Another topic we discuss throughout is how to review the literature to determine what needs to be done and to evaluate the effectiveness of interventions for changing behavior. As relevant, we discuss methods that are used in brief “modules” for clarification, drawing on the examples that we are discussing in class. Students will conduct their own potentially publishable meta-analysis for their project paper.

Classes Content

______________________________________________________________________

January 10, 2012 Introduction

Glanz, K., Rimer, B. K., & Viswanath, K. (2008). The scope of health behavior and health education. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons. Available free at the Wiley site,



Glanz, K., Rimer, B. K., & Viswanath, K. (2008). Theory, research, and practice in health behavior and health education. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons. Available free at the Wiley site,

HBE110,pageType-copy,page-excerpt.html

Note: By January 17th identify a potential “health area of focus” that you will investigate more deeply during the course of the semester. This needs to be more “firmed up” by January 24th.

Arrange time to meet with Prof. Miller the week of the 15th to work out your focus for the semester

Prediction and Pre-Emption

January 17, 2012 Individual Models of Health Behavior

Theory – review

Champion, V.L. & Skinner, C. S. (2008). The Health Belief Model. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Montano, D. E. & Kasprzyk, D. (2008). Theory of Reasoned Action, Theory of Planned Behavior and the Integrated Behavioral Model. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Prochaska, J. O., Redding, C.A., Evers, K.E. (2008). The Transtheoretical Model and Stages of Change. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Glasgow, R. E., & Linnan, L. A. (2008). Evaluation of Theory-Based Interventions. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

January 24, 2012 Meta-analysis Overview (Individual Model examples)

Albarracín, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: A meta-analysis. Psychological Bulletin, 127(1), 142-161. doi:10.1037/0033-2909.127.1.142

Albarracin, D.; Gillette, J. C.; Earl, A. N.; Glasman, L, R., Durantini, M. R.; et al. A Test of Major Assumptions About Behavior Change: A Comprehensive Look at the Effects of Passive and Active HIV-Prevention Interventions Since the Beginning of the Epidemic. Psychological Bulletin, 131. 6 (Nov 2005): 856-897.

Bornstein Chapters 1 and 2, How a meta-analysis works and Why perform a meta-analysis; Also Read Chapters 39,40, (41),43

January 31, 2012 Interpersonal Models of Health Behavior

Theory/research-review

McAlister, A. L., Perry, C.L., & Parcel, G. S. (2008). How individuals, environments, and

health behavior interaction: Social Cognitive Theory. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Heaney, C. A., & Isreal, B. A. (2008). Social networks and social support. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Glanz, K., & Schwartzk M. D. (2008). Stress, coping, and health behavior. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Street, Richard L., Jr., & Epstein, R. M. (2008). Key interpersonal functions and health outcomes: Lessons from theory and research on clinician-patient communication. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Lewis, M. A., DeVellis, B. M., Sleath, B. (2002). Social influence and interpersonal

communication in health behavior. In Glanz, K, Rimer, B. K., & Lewis, F. M. (Eds.). Health behavior and health education: Theory, research, and practice (3rd edition). San Francisco, John Wiley & Sons.

Viswanath, K. (2008). Perspectives on Models of Interpersonal Health Behavior. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

February 7, 2012 Meta-analysis (Interpersonal Model Examples)

Durantini, M. R.; Albarracin, D.; Mitchell, A. L.; Earl, A. N.; Gillette, J. C. (2006). Conceptualizing the influence of social agents of behavior change: A meta-analysis of the effectiveness of HIV-prevention interventionists for different groups. Psychological Bulletin 132,2: 212-248.

Graves, K. D. (2003). Social cognitive theory and cancer patients quality of life: A meta-analysis of psychosocial intervention components. Health Psychology, 22(2), 210-219. doi:10.1037/0278-6133.22.2.210

Bornstein Chapters 3-9 Effect Size and Precision

February 14, 2012 Community and Group Models of Health Behavior Change

Minkler, M., Wallerstein, N., & Wilson, N. (2008). Improving health through communication organization and community building. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Oldenburg, B., & Glanz, K. (2008). Diffusion of Innovations. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Butterfoss, F. D., Kegler, M.C., & Francisco, V. T. (2008). Mobilizing organizations for health enhancement: Theories of Organizational Change. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Finnegan, J. R., Jr., & Viswanath, K. (2008). Communication theory and health behavior change: The media studies framework. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

Kegler, M. C., & Glanz, K. (2008). Perspectives on group, organization, and community interventions. In Glanz, K., Rimer, B. K., & Viswanath, K. (Eds.), Health behavior and health education: Theory, research, and practice (4th edition). San Francisco, CA: John Wiley & Sons.

February 21, 2012 Meta-analysis (Community and Group models of Health

Behavior Change)

Synder, L. B., & Hamilton, M. A. (2002). A meta-analysis of U. S. health campaign effects on behavior: Emphasize enforcement, exposure, and new information, and beware the secular trend. In R. C. Hornick (Ed.). Public health communication: Evidence for behavior change.

Selected articles (on blackboard as assigned) from

Preiss, R. W. (2007). Mass media effects research : advances through meta-analysis. Mahwah, N.J. : Lawrence Erlbaum Associates.

Bornstein: Fixed Effects vs. Random Effects Models

Chapters 10-14

Personalization & Participation

February 28, 2012 Health Communication Interventions: Enhancing

Participation

Perloff, R. M. (2006). Introduction: Communication and Health Care Disparities. American Behavioral Scientist, 49, pp. 755-759. (read in order)

Kreps, Gary L.
 (2006). Communication and Racial Inequities in Health Care.

American Behavioral Scientist, 49, 760-774.

Kreuter, M. W., & Haughton, L. T.
(2006). Integrating Culture Into Health Information for African American Women. American Behavioral Scientist, 49, 794-811.

Schneider, T. R.
 (2006). Getting the Biggest Bang for Your Health Education Buck: Message Framing and Reducing Health Disparities. American Behavioral Scientist, Feb 2006; vol. 49: pp. 812-822.

Shaw, B., Gustafson, D. H., Hawkins, R., McTavish, F., McDowell, H., Pingree, S., & Ballard, D.
 (2006). How Underserved Breast Cancer Patients Use and Benefit From eHealth Programs: Implications for Closing the Digital Divide. American Behavioral Scientist, 49, 823-834.

Cegala, D. J., & Post, D. M.
 (2006). On Addressing Racial and Ethnic Health Disparities: The Potential Role of Patient Communication Skills Interventions. American Behavioral Scientist, 49, 853-867.

Hornik, R. C., Ramirez, A. S. (2006). Racial/Ethnic Disparities and Segmentation in Communication Campaigns. American Behavioral Scientist; 49, pp. 868-884

Perloff, R. M., Bonder, B., Ray, G. B., Ray, E. B., & Siminoff, L. A.
 (2006). Doctor-Patient Communication, Cultural Competence, and Minority Health: Theoretical and Empirical Perspectives. American Behavioral Scientist, 49, 835-852.

March 6, 2012 Meta-analyses (Participation)

Webb, M. S. (2008). Treating tobacco dependence among african americans: A meta-analytic review. Health Psychology, 27(3), S271-S282. doi:10.1037/0278-6133.27.3(Suppl.).S271

Seo, D. & Sa J. (2010). A Meta-Analysis of Obesity Interventions Among U.S. Minority Children 
Journal of Adolescent Health, Volume 46, Issue 4, 309-323


Bornstein Heterogeneity in Meta-Analysis Chapters 15-21

March 13, 2012 Spring Break

March 20, 2012 Enhancing Personalization Using Technologies:

Theory/research and Meta-analysis examples

Campbell, M. K., & Quintiliani, L. M.
 (2006). Tailored Interventions in Public Health: Where Does Tailoring Fit in Interventions to Reduce Health Disparities? American Behavioral Scientist, 49, 775-793.

Kreuter, M. , Farrell, D., Olevitch, I., & Brennan, L. (2000). Tailoring health messages: customizing communication with computer technology. Mahway, NJ: Erlbaum.

Chapters 1-3..

Noar, S. M., Benac, C. N., & Harris, M. S. (2007). Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. Psychological Bulletin, 133(4), 673-693. doi:10.1037/0033-2909.133.4.673

Interactive Mobile, Game, and Intelligent Communication Health Interventions

March 27, 2012 –April 3, 2012 E-health: Preventions and meta-analyses

Selected chapters from:

Noar, S. M., & Harrington, N. G. (Eds., 2012). eHealth applications: Promising strategies for behavior change.  New York: Routledge.

April 3, 2012 Meta-analyses

Additional Readings as Assigned

Bornsten: Complex Data Structures Chapters 22-26

April 10, 2012 Serious Games for Health Communication

Baranowski, T., Buday, R., Thomson, D., Baranowski, J. (2008). Playing for real video games and stories for health-related behavior change. American Journal of Prevention Medicine, 34, 74-82. (review article)

Baranowski, T, et al. (2003). Squire’s quest! Dietary outcome ealuation of a multimedia game. American Journal of Preventative Medicine, 24, 52-61.

Huss, K., Winkelstein, M., Nanda, J., Naumann, PI, Sloan, ED, Huss, R.W. (2003). Computer game for inner-city children does not improve asthma outcomes. Journal of Pediatric Health Care. 17, 72-78.

Kato, P. M., Cole, S.W., Bradlyn, A.S., & Pollock, B. H (2008). A video game improves behavioral outcomes in adolescents and young adults with cancer: A randomized trial. Pediatrics, 122, e305-317. Learn more about this online (and see video) at

Lieberman, D. A. (2001). Management of chronic pediatric diseases with interactive health games: Theory and research findings. Journal of Ambulatory Care Management, 24, 26-38.

Miller, C.K. (2007). Evaluation of a computer-based game about the glycemic index among college age students. Topics in Clinical Nutrition, 22, 299-306.

April 17, 2012 SOLVE (Socially Optimized Learning in Virtual Environments):

Interactive videos/on-line usage/intelligent agents in animated games

Miller, L.C., Christensen, J. L., Godoy, C.G., Appleby, P. R., Corsbie-Massay, C., & Read, S. J. (2008). Reducing risky sexual decision-making in the virtual and in the real-world: Serious games, intelligent agents, and a SOLVE approach. In U. Ritterfeld, M. Cody, P. Vorderer (Eds.) Serious Games: Mechanisms and effects.  London: Routledge/LEA Press.

Read, S. J., Miller, L. C., Appleby, P. R., Nwosu, M. E., Reynaldo, S., Lauren, A. & Putcha, A. (2006). Socially optimized learning in a virtual environment: Reducing risky sexual behavior among men who have sex with men. Human Communication Research, 32, 1-34.

April 24, 2012 Oral Reports

April 27. 2012 Final Paper Due

Academic Integrity Policy:

The Annenberg School for Communication is committed to upholding the University’s Academic Integrity code as detailed in the SCampus Guide. It is the policy of the School of Communication to report all violations of the code. Any serious violation or pattern of violations of the Academic Integrity Code will result in the student’s expulsion from the Communication degree program.

It is particularly important that you are aware of and avoid plagiarism, cheating on exams, fabricating data for a project, submitting a paper to more than one professor, or submitting a paper authored by anyone other than yourself. If you have doubts about any of these practices, confer with a faculty member.

Resources on academic dishonesty can be found on the Student Judicial Affairs Web site (.)

“Guide to Avoiding Plagiarism” addresses issues of paraphrasing, quotations, and citation in written assignments, drawing heavily upon materials used in the university’s writing program; “Understanding and avoiding academic dishonesty” addresses more general issues of academic integrity, including guidelines for adhering to standards concerning examinations and unauthorized collaboration.

The “2005-2006 SCampus” () contains the university’s student conduct code and other student-related policies.

Disabilities Policy:

Students requesting academic accommodations based on a disability are required to register with Disability Services and Programs (DSP) each semester. A letter of verification for approved accommodations can be obtained from DSP when adequate documentation is filed. Please be sure the letter is delivered to me as early in the semester as possible. DSP is open Monday-Friday, 8:30-5:00. The office is in Student Union 301 and their phone number is (213) 740-0776.

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