Introduction: Colon cancer incidence and mortality rates in Canada are among the highest worldwide. If detected early colon cancer is highly curable and regular screening can significantly decrease risk of colon cancer mortality. Despite this, screening rates in Canada are consistently low and immigrant and senior populations are particularly vulnerable due to low health literacy and language barriers. This research consists of three studies that were designed to explore the cancer prevention experiences of older English-as-a-Second Language (ESL) Chinese immigrant women in Canada. This includes an investigation of colon and breast cancer screening utilization, health literacy skills and comprehension of colon cancer prevention information, and experiences and preferences when seeking cancer information by these immigrant women. Methods: A convenience sample of 110 Mandarin and Cantonese-speaking ESL immigrant women were recruited from two Southern Ontario communities. For study inclusion participants were required to: (1) be 50 years of age or older, (2) have immigrated to Canada, (3) have Cantonese or Mandarin as their first language and English as their second language, and (4) be able to read in English. Participants were excluded if they or their spouse had been previously diagnosed with any type of cancer. Participants completed a battery of questionnaires assessing demographic characteristics, use of breast and colon cancer screening, acculturation, self-efficacy, health beliefs and health literacy. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and comprehension of a colon cancer prevention information sheet from Cancer Care Ontario was assessed using the cloze procedure. Participants participated in a semi-structured interview to explore cancer information seeking preferences and experiences, and their understanding of cancer prevention information. Multivariate logistic regression was used to identify predictors of colon and breast cancer screening. To identify variables significantly associated with performance on the S-TOFHLA and cloze test regression analyses were performed. Directed content analysis was used to identify themes associated with barriers to cancer information seeking and understanding that emerged from the interviews. Results: Study #1: There was high self-reported screening for breast and colon cancer. Eighty-five percent of the women were current mammography screeners and 75% were current colon cancer screeners. Recommendation from a physician (OR=.140; 95% CI= .044, -.448), having a female physician (OR=.141; 95% CI= .033, .591), and high or moderate proficiency in English (OR=.283; 95% CI= .089, .902) significantly predicted mammography screening. Physician recommendation (OR=.103; 95% CI= .031, .349), first language (OR= 1.85; 95% CI= .055, .628) and higher self-efficacy (OR= 3.613; 95% CI= 1.179, 11.070) predicted use of colon cancer screening. Other important predictors included greater health literacy and longer residency in Canada. Study #2: Only 38.7% of the women had adequate health literacy on S-TOFHLA and 54.3% had adequate comprehension of the colon cancer information. Comprehension of the colon cancer information was significantly lower among women who received the information in English, compared to those who received the information in Chinese (p<0.01). Age, acculturation, self-reported proficiency reading English, and education were significant predictors of health literacy but varied depending on the measure (S-TOFHLA, cloze) and language of information (English, Chinese). Study #3: There were unique health information seeking preferences among the older Chinese immigrant women including a strong preference for interpersonal and interactive cancer information from their physician and trusted others, such as friends and family. Barriers to cancer information seeking included language difficulties and limited time with physicians. Differences in health literacy did not distinguish the women on any of the major themes. Conclusion: Language, culture, health literacy and the role of the physician emerged across all three studies examining the cancer prevention experiences of older Chinese immigrant women. While language concordant educational materials may improve understanding of cancer information, the results from this study suggest that it is important to consider factors other than language alone and to address important cultural issues that play a role in the access, use, and understanding of cancer information.

Our study illustrates health communication in order to find out how widespread the knowledge is about osteoporosis and how to reach out with health information to the public.   Our essay was conducted through quantitative surveys, which included 402 respondents. This in order to highlight the prevailing uncertainty about the public disorder osteoporosis, which is common in Sweden. We wish to examine trough which channels our respondents choose to collect their health information. The thesis framework includes theories such as McGuire’s ProcessingTheory, Agenda setting, Two-step hypothesis and Diffusion of innovation. Through these theories, we analyzed our empirical data that emerged.   The results showed that our respondents had very low knowledge of osteoporosis, although theyshowed interest for health information. The results also showed that respondents were consistent intheir actions regarding which channels they came to turn to. They prefered their health informationfrom news papers and family, friends and work colleagues. When asked where they got their information from, the respondents answered mostly from family, friends and work colleagues, followed closely by newspapers. This shows that respondents are more receptive to informationfrom the channels of their own choice. The results also showed that the propensity to change behavior increases with the age of the respondents.

This study examined a specific and controversial issue in health communication: the complementary and alternative medicine (CAM). Recent studies have shown that both online newsgroups and traditional newspapers have involved in communicating CAM information, but research has not answered whether there are differences between the new and old media. From the perspective of uses and gratifications, this study first investigated that how people are using newsgroups to solve CAM-related problems. Then contents of newsgroup messages and newspaper stories were analyzed to do the comparison in topics, source types, efficacy claims, and CAM categories. The results showed that both similarities and differences existed between the two media.

Title: Hälsa i sociala medier - En kvalitativ studie om hur hälsoinformatörer upplever och påverkas  av hälsobudskap i sociala medier. Title: Health in social media - A qualitative study of how health communicators perceive and are affected by health messages in social media. Author: Anna Hedström Institute: Karlstad University. Faculty of health, nature and engineering sciences. Tutor: Owe Stråhlman Date: 150615 Number of pages: 34 Keywords: eHealth literacy, health communication, health informers, health literacy, health messages, media literacy, social media   Background: With an increased interest in diet and exercise, also health and fitness messages have increased in both traditional and social media. The general guidelines on physical activity and diet are forgotten as training tips increase in the media. Research shows that it is common for individuals to retrieve information from the media when it comes to their own health. In doing so media literacy, health literacy and eHealth literacy becomes increasingly important for health communicators and for those who receive health information.   Objectives: The aim of this study was to examine health communicators’ experiences of health messages in social media, and how they are affected by them.   Method: Qualitative interviews were chosen as a method to collect data. Six individuals participated in the study, four of them were females and two were men. The criterion for participation was to somehow work to inform about health. To analyze the data collected, qualitative contained analysis were used.   Results: The analysis revealed four categories; the health informer experiences of social media content, social media's impact on customers, social media's impact on the health informer work and the health informers use of social media in their work. The results show that health informers experience a certain lack of knowledge among health messages in social media and that many of them are too extreme. These health informers experience that their customers are more well-informed now than a few years ago, due to the use of Facebook, Instagram and blogs. Using social media to search information about diet and exercise is good because it is easily accessible and it is fast, but if one does not have the knowledge of what should be weeded out, these advantages can easily become disadvantages. Respondents feel that it has become a larger equality on diet and exercise that they believe may be due to health messages disseminated on social media. Health communicators can work with to get their customers to be more critical of what they read.   Conclusion: The conclusion of the result is that the health communicators indirectly affected by health messages on social media by their clients that often come with questions about things they read or want help to look like some bloggers they follow. Health communicators work is affected in the way that they need to take advantage of social media to help its customers as well as possible and they must also talk to their customers about the source criticism and that they should focus on what feels good for the customer .

This research examines the social construction of hope in a community mental health system of care. Groopman (2004) defines hope as the elevating feeling we experience when we see a path to a better future. A year-long ethnographic study of a children's mental health system of care team found that members of the mental health care team construct hope for themselves and for the family they're helping by cycling through the dialectical tensions of hegemony and equality, marginalization and normalization, relating and othering, empowerment and disempowerment, and control and emotionality. They reconcile these tensions in dialogic moments of empathy toward the family and other team members, engagement of all team members in the process, creation of a human connection within the team, vulnerability to each other, creation of possibilities for themselves and for each other, social support, and blended voices.

Family caregivers encounter immense negative consequences including decreased quality of life and increased rates of morbidity and mortality that stem from physical burdens, emotional distress, depression, social isolation, and loss of financial security. Although communication is an important aspect of caregiving, communication tasks are reportedly difficult for end-of-life family caregivers. The goal of this study was to explore the variety of communication stressors experienced by end-of-life family caregivers to gain insight into the communication tasks caregivers perceive as most difficult and the reasons why. Qualitative data was achieved through in-depth, face-to-face interviews with 40 caregivers currently providing care for a family member diagnosed with Alzheimer’s disease and related dementias (n=20; ADRD) and Glioblastoma (n=20; brain tumor [GBM]). A grounded theory approach was employed to gain insight into end-of-life family caregiver communication experiences. The results revealed that communication is perceived as a burden for end-of-life family caregivers. Not only does communication burden exist, end-of-life family caregivers experience immense tension and stress regarding a variety of relational contexts when communicating with the care recipient, others (family, friends), and clinicians. The results further revealed that communication burden stems from the caregiver’s attempt to negotiate between two opposing extremes: a desire to protect the patient and others versus a need to protect oneself. Thus, internal tension occurs when end-of-life family caregivers contemplate whether and how to engage in difficult conversations, and then again when following through. The presence of these contradictory tensions induced the emergence of barriers and therefore communication burden within various aspects of the end-of-life caregiver experience. Added insight into communication burden was achieved through a supplementary scale development study in a sample of ADRD and oncology end-of-life caregivers (N=263), which revealed communication burden as significantly associated with caregiver burden and quality of life. Implications for the advancement of interpersonal and health communication theory as well as practical tailored interventions targeting end-of-life family caregivers are discussed.

Research is necessary to uncover ways to improve adolescent nutrition and reduce obesity rates, particularly in the Appalachian region, which has high rates of food insecurity and adolescent obesity. The current study examines rural cultural norms about food, memorable messages adolescents received about nutrition, and the sources of identified memorable messages. Adolescents shared memorable messages during comprehensive, semi-structured, small group interviews in which participants revealed their individual experiences. Thematic framework analysis is used to present the range and nature of memorable messages about nutrition and to develop strategies for future health campaigns and interventions. This qualitative method of sequential inductive analysis provides transparency of data and resulting interpretations through thematic identification and indexing. Analysis revealed themes of messages that featured critical pieces of the rule-structure of memorable messages – specifically, adherence and consequence regarding nutritional behaviors. Prominent memorable messages of adherence included topics of balance (e.g., MyPlate), type (e.g., junk food), and timing (e.g., “don’t eat after 7 p.m.”). Messages with elements of consequence included communication of short-term (e.g., “breakfast gets your blood flowing) and long-term consequence (e.g., obesity, etc.). Adolescents identified family members, educators, and media as salient sources of memorable messages.

This is a study about hiv/aids communication between low- and non-educated women andhiv/aids organisations in Uganda. The purpose of the thesis is to define potential disturbance inthe communication using three organisations and 9 women as examples. The research is made with qualitative methods and most of the data is collected through field studies and group interviews. The result of the study is that there are a lot of disturbance causing problems in the communication between the women and the organisations. Most of the disturbances can be connected to the women’s limited access to media exposure. It is also a problem that the interviewed women are more or less isolated in their villages, which mean they are directly excluded from all the information activities placed on billboards, posters, fairs, and events thattake place in the city centre or elsewhere. Even though there are a lot of community based information activities arranged by the organisations, these women will not be reached since most of the activities take place in schools where they don’t have access.The poor level of education results in two problems, first, the women cannot read and will therefore not access any print material and second, their English skills are not good enough to understand the meaning of the majority of the information material.It is pointed out that all disturbances are not communication problems. One of them is the gender inequality in Uganda. The gender roles and structures are too unequal and dominating that even if the women, despite all disturbances, receive information it is often impossible for her to implement the knowledge without consensus from her man.

Introduction: Colon cancer incidence and mortality rates in Canada are among the highest worldwide. If detected early colon cancer is highly curable and regular screening can significantly decrease risk of colon cancer mortality. Despite this, screening rates in Canada are consistently low and immigrant and senior populations are particularly vulnerable due to low health literacy and language barriers. This research consists of three studies that were designed to explore the cancer prevention experiences of older English-as-a-Second Language (ESL) Chinese immigrant women in Canada. This includes an investigation of colon and breast cancer screening utilization, health literacy skills and comprehension of colon cancer prevention information, and experiences and preferences when seeking cancer information by these immigrant women. Methods: A convenience sample of 110 Mandarin and Cantonese-speaking ESL immigrant women were recruited from two Southern Ontario communities. For study inclusion participants were required to: (1) be 50 years of age or older, (2) have immigrated to Canada, (3) have Cantonese or Mandarin as their first language and English as their second language, and (4) be able to read in English. Participants were excluded if they or their spouse had been previously diagnosed with any type of cancer. Participants completed a battery of questionnaires assessing demographic characteristics, use of breast and colon cancer screening, acculturation, self-efficacy, health beliefs and health literacy. Health literacy was assessed using the Short Test of Functional Health Literacy in Adults (S-TOFHLA) and comprehension of a colon cancer prevention information sheet from Cancer Care Ontario was assessed using the cloze procedure. Participants participated in a semi-structured interview to explore cancer information seeking preferences and experiences, and their understanding of cancer prevention information. Multivariate logistic regression was used to identify predictors of colon and breast cancer screening. To identify variables significantly associated with performance on the S-TOFHLA and cloze test regression analyses were performed. Directed content analysis was used to identify themes associated with barriers to cancer information seeking and understanding that emerged from the interviews. Results: Study #1: There was high self-reported screening for breast and colon cancer. Eighty-five percent of the women were current mammography screeners and 75% were current colon cancer screeners. Recommendation from a physician (OR=.140; 95% CI= .044, -.448), having a female physician (OR=.141; 95% CI= .033, .591), and high or moderate proficiency in English (OR=.283; 95% CI= .089, .902) significantly predicted mammography screening. Physician recommendation (OR=.103; 95% CI= .031, .349), first language (OR= 1.85; 95% CI= .055, .628) and higher self-efficacy (OR= 3.613; 95% CI= 1.179, 11.070) predicted use of colon cancer screening. Other important predictors included greater health literacy and longer residency in Canada. Study #2: Only 38.7% of the women had adequate health literacy on S-TOFHLA and 54.3% had adequate comprehension of the colon cancer information. Comprehension of the colon cancer information was significantly lower among women who received the information in English, compared to those who received the information in Chinese (p<0.01). Age, acculturation, self-reported proficiency reading English, and education were significant predictors of health literacy but varied depending on the measure (S-TOFHLA, cloze) and language of information (English, Chinese). Study #3: There were unique health information seeking preferences among the older Chinese immigrant women including a strong preference for interpersonal and interactive cancer information from their physician and trusted others, such as friends and family. Barriers to cancer information seeking included language difficulties and limited time with physicians. Differences in health literacy did not distinguish the women on any of the major themes. Conclusion: Language, culture, health literacy and the role of the physician emerged across all three studies examining the cancer prevention experiences of older Chinese immigrant women. While language concordant educational materials may improve understanding of cancer information, the results from this study suggest that it is important to consider factors other than language alone and to address important cultural issues that play a role in the access, use, and understanding of cancer information.

Sverige har under många decennier sett en minskning av tuberkulos (TBC), men infektionen har kontinuerligt ökat från 2003. Majoriteten av TBC-fallen är personer som är födda utanför Sverige. Hälsotillståndet har förbättrats i Sverige men det finns fortfarande problem. Kommunikationen mellan flyktingar och sjukvårdsspecialister är bristande idag, vilket resulterar att endast ett fåtal genomgår hälsokontroller. Detta kan leda till en ökning av infektioner och sjukdomar i Sverige. Denna studie undersöker hur hälsokommunikationen idag fungerar mellan den svenska sjukvården, nyanlända immigranter, asylsökande och flyktingar, samt vilken typ av vård som finns tillgänglig för flyktingar med hög risk för att utveckla TBC. Specifikt syftar studien till att förstå på vilket sätt kommunikation brister på samt analysera vilka sätt det finns för att en reducering av TBC i Sverige ska kunna ske och hur kommunikationen kan förbättras. Studien har genomförts med hjälp av både primära källor i form av intervjuer och sekundära källor. Baserat på de intervjuer och sekundära källor som genomförts i studien dras slutsatsen att trots att den svenska sjukvården utvecklas positivt så finns det en hel del brister - hälsokommunikation är bristande idag mellan nyanlända flyktingar, sjukvårdspersonal och myndigheter. En av huvudorsakerna som informanterna i studien nämnt är språket, mycket av det som skrivs och sägs är på svenska. Det är viktigt att en mer välfungerad hälsokommunikation utvecklas mellan de nyanlända flyktingarna, sjukvårdspersonal och myndigheterna för att det ska kunna underlättas för flyktingar att söka vård och samarbeta med sjukvårdspersonal med deras arbete för att kunna förhindra spridning av TBC och andra sjukdomar och infektioner i Sverige. / Sweden has for many decades witnessed a decrease of the spread of tuberculosis (TB), but between the years of 2003-2012 a new pattern has emerged with refugees carrying TB entering the country and contributing to a situation where the infection has slowly begun to spread again. The communication between the refugees and the health professionals has been inefficient, which inevitably results in fewer refugees undergoing health examinations. This in turn can lead to an increase of infections and diseases. The purpose of this study is to examine the current health communication between Swedish health professionals and immigrants, asylum seekers and refugees, and to give an overview of what type of health care currently exist for refugees with a high risk of TB. This is done to understand what is missing in the communication process, what has been done in order to improve the situation, and how it can be further improved in order to prevent TB. In order to fulfill the purpose of this study, a qualitative method has been used combining text analysis of interviews and secondary sources. This study has shown based on the interviews and secondary sources that the Swedish prevention work regarding TB is developing positively in general, but the communication between newly arrived refugees, health professionals and authorities in Sweden is lacking due to the fact that most of what is written and said in this communication process is in Swedish. This makes it difficult for the refugees to understand what is communicated and is stated as one of the main reasons why many refugees do not undergo health examinations, combined with the lack of awareness. Therefore a better functioning health communication between refugees, authorities and health professionals is required to support refugees seeking health care, as well as co-operating with health professionals to prevent the spread of not only TB but other infections and diseases in Sweden.