abstract: Currently, there has been limited research on evaluating the social media use and competency level of registered dietitian/nutritionists (RD/N). With health information increasingly sought on social media, it is imperative to understand the social media competency of health professionals. The social media use, reach, and competency level of a nationwide RD/N sample was assessed utilizing an online survey. The sample (n=500) while mostly female (97%) was representative of RD/Ns compared to the nationwide statistics from the Commission on Dietetic Registration. The sample included RD/Ns from forty-six states with California (n=44), New York (n=42), and Texas (n=34) having the largest proportion of respondents. The majority of RD/Ns engage in social media for personal use (92.4%) and 39.2% engage for professional use. One hundred and twenty-five RD/Ns reported 777 ± 1063 (mean ± SD) social media followers. As compared to non-millennial RD/Ns, millennial RD/Ns engaged significantly more in social media for personal and professional use (+10% and +13.5% respectively, p<0.001) and scored significantly higher for social media competency (p<0.001). Additionally, food and nutrition management and consultant/private practice/industry RD/Ns had significantly higher competency scores than clinical RD/Ns (p=0.015 and p=0.046, respectively). RD/Ns who use social media personally and professionally had a significantly higher competency score than RD/Ns who did not (p<0.001). There were significant associations of Facebook, Twitter, total followers and total average followers with the social media competency score (r=0.265, 0.404, 0.338, & 0.320, respectively) in RD/Ns. Specifically, the social media competency score, was found to explain 16% of the variation in the number of Twitter followers and 10% of the variation in the average number of followers by platform. These data suggest an opportunity to increase RD/Ns’ social media reach (i.e. following) by improving competency level. / Dissertation/Thesis / Doctoral Dissertation Physical Activity, Nutrition and Wellness 2017

La France n’a pas encore de système de collecte d’informations sur les immigrants standardisé. Ainsi, l’état de santé des immigrants est, aujourd’hui encore, déterminé de manière irrégulière. La seule information de santé des immigrants disponible correspond au statut de santé déclaré par l’immigrant. Ceci est à la fois problématique et surprenant car la France est considérée comme une des nations au monde à avoir le meilleur système de santé malgré le manque de données concrètes sur l’état de santé des immigrants. Une question se pose alors : « comment les immigrants se fraient un chemin dans le système de soin français ? ».Les Philippins vivant dans le sud de la France sont la cible de cette étude. Cette étude utilise le sondage, le « Key Informant Interview » et l’observation directe pour rassembler des données afin de comprendre comment leur culture et leur langage maternel interfèrent avec le système de soin français.Dans cette étude, l’hypothèse émise était que le langage est une barrière pour les immigrants Philippins cherchant l’accès aux soins médicaux. De plus, la culture traditionnelle de santé joue aussi un rôle important dans la pratique de santé des Philippins, même si ces derniers sont en France depuis de nombreuses années. Ils ont réussi malgré tout, à s’adapter au système de soin français. Cependant, cette adaptation doit être clairement identifiée et décrite. A l’interface de la culture, du langage et du système de sin de santé du pays d’accueil, les immigrants, consciemment ou non, créent une culture de santé émergente, différente de leur culture d’origine, qui identifie mieux un bon ou un mauvais état de santé ainsi que la manière de l’exprimer.Cette étude révèle que malgré le temps passé dans le sud de la France, la culture de santé traditionnelle des Philippins joue toujours un rôle dans leur pratique de santé. Les problèmes de santé sont toujours une affaire de famille. Ainsi certains médicaments sont importés des Philippines. D’un autre côté, ils profitent aussi des avantages du système de soin de santé français. Ils rendent visite à leur docteur plus souvent, ils prennent religieusement leurs médicaments et ils profitent des nombreuses options de traitements disponibles en France. Ils peuvent profiter de tout cela parce qu’ils sont couverts par le système universel d’assurance maladie français.D’un autre côté, les immigrants Philippins restent des patients passifs. A cause de la langue qui reste encore une barrière, leur comportement vis à vis de médecin est fait de hauts et de bas. Les Philippins sont d’un naturel timide. Ainsi ils essayent toujours de ne pas avoir de longues conversations. Ceci reste un défi pour les professionnels de santé qui ne sont ni formés ni préparés à gérer des patients parlant un langage étranger. / France is yet to have a standardized immigrant health data collectionsystem. As such, data of immigrants’ health is still irregularly determined. Theclosest immigrant health data available is the self-reported status of health. Thisis a both a problematic state and surprising because France enjoyed the title ofbeing one of the countries in the world with best health care system despite thelack of concrete immigrant health data. This put into question how immigrants aremoving around the health care system of France.Filipino immigrants living in the South of France are the main respondentsof this research. Focusing on how their native culture and language interplay withthe health system of France, this study utilized Survey, Key Informant Interviewand Direct Observation to gather data.This research hypothesized that language is still a barrier for Filipinoimmigrants seeking medical care. In addition to this, the traditional health culturealso plays a very important part in the Filipino immigrants’ practice of healthdespite their long years of stay in France. Despite this however, they were ableto adopt to the French health care system however, this adoption needs to beproperly identified and described. Within the interplay of culture, language andthe health system of the host country, immigrants –knowingly or unknowinglycreatean emerging health culture that is distinct to their cultural origin,understanding of a good or bad state of health and manner of expression.This study revealed that despite the fact that Filipino immigrants in theSouth of France have been living here for a considerable amount of time,traditional health beliefs are still part of their health practices. Health matters arestill a family affair and there some of their medicines are imported from thePhilippines. On the other hand, they have also adopted some ways to takeadvantage of the French health care system. They visit their doctors more often,they religiously take their medications and they enjoy more treatment options.They were able to enjoy all these because they are covered by the UniversalHealth Insurance System of France.On the other hand, Filipino immigrants remain a passive patient. Hemaintains a come and go attitude with their medical providers because languageremains a barrier. In addition, Filipinos are natural shy people and they always trynot to have long conversations. This remains a challenge for healthprofessionals for they themselves are not properly trained and prepared tohandle patients speaking another language.

Introdução: A comunicação é o processo pelo qual ocorrem compreensão e compartilhamento de mensagens enviadas e recebidas, sendo que o conteúdo destas mensagens exerce influência no comportamento das pessoas envolvidas. Atualmente, a área da saúde tem utilizado ferramentas de cuidado à distância para prestar assistência aos pacientes em diversos contextos - a chamada Telessaúde. A influência desta modalidade de cuidado sobre a natureza e o conteúdo da comunicação deve ser muito bem compreendida, visto que o processo de comunicação humana adequado é essencial na assistência à saúde com qualidade. Objetivos: avaliar a percepção do profissional da saúde referente a elementos de Comunicação Humana no cuidado por Telessaúde. Os objetivos específicos foram: verificar que elementos de Comunicação Humana o enfermeiro e o médico identificam no cuidado por Telessaúde, e discutir, por meio dos achados, em que aspectos essa modalidade de cuidado pode impactar na comunicação interpessoal entre os profissionais de saúde e, consequentemente, na assistência aos pacientes. Método: pesquisa descritiva, com abordagem qualitativa, realizada com 20 profissionais que atuam em telessaúde no Brasil. Os dados foram coletados com médicos e enfermeiros por meio de sistema de vídeo ou áudio, no período de junho a outubro de 2014. O número de participantes foi determinado pela saturação de dados, conforme metodologia adotada. Os dados foram analisados pela proposta de análise de conteúdo de Bardin. Resultados: Dos discursos emergiram quatro categorias principais, sendo a maioria composta de subcategorias: Entendendo a importância da comunicação (Comunicação adequada é fundamental, pois interfere na conduta; Identificando as barreiras de comunicação); O relacionamento interpessoal interferindo na comunicação; Comunicando-se por meio da tecnologia (Tecnologia facilita a prática; Entendendo os fatores que dificultam a comunicação à distância; Identificar o não verbal por telessaúde é mais difícil) e Aprendendo o processo de comunicação (Não há dificuldades em comunicar-se; Importância do aprendizado da comunicação verbal e não verbal; Importância do aprendizado da telessaúde). Conclusão: Concluímos com este estudo que a comunicação interpessoal adequada na área da saúde é considerada primordial por médicos e enfermeiros que atuam em Telessaúde no Brasil porque acreditam interferir em sua conduta profissional. O relacionamento interpessoal é o principal fator de interferência nesse processo. A tecnologia tem facilitado a prática profissional, porém, do ponto de vista comunicacional, o cuidado à distância apresenta nuances que dificultam o processo de comunicação, principalmente devido à dificuldade de percepção do não verbal na assistência por telessaúde. Para superar estas dificuldades, médicos e enfermeiros concordam que a comunicação é uma competência que deve ser lecionada aos profissionais durante sua formação e, especificamente para atuação à distância, esta habilidade deve ser ensinada considerando as nuances que a distância pode trazer no processo comunicacional entre as pessoas. / Introduction: Communication is the process through which understanding and sharing of sent and received messages occur, considering that the content of these messages influences the behaviour of people involved. Nowadays, the health care segment has used distance care tools to serve patients in different contexts - the so-called Telehealth. The influence of this type of care on the nature and content of communication must be well understood, since the adequate process of human communication is essential in quality health assistance. Objectives: evaluate the perception of the health care professional regarding Human Communication elements in Telehealth care. The specific objectives were: verifying which elements of Human Communication the nurse and the doctor identify in Telehealth care, and dissussing, through findings, in which aspects this type of care can impact the interpersonal communication among health care professionals and, consequently, patients care. Method: descriptive research, with qualitative approach, performed with 20 professionals who work in Telehealth in Brazil. Data were collected from doctors and nurses through audio or video system, from June to October 2014. The number of participants was determined by saturation of data, according to adopted methodology. Data were analyzed by the content analysis proposal of Bardin. Results: From the discourses, four main categories emerged, and most are composed of subcategories: understanding the importance of communication (dequate communication is fundamental, because it interferes in behaviour; Identifying the limitations of communication); The interpersonal relationship interfering in the communication; Communicating through technology (Technologies facilitates practice; Understanding the factors that make distance communication difficult; Identifying the non-verbal through Telehealth is more difficult) and Learning the process of communication (There are no difficulties in communicating; The Importance of learnig verbal and non-verbal communication; The importance of Telehealth learning). Conclusion: We have concluded in this study that adequate interpersonal communication in health care is considered fundamental by doctors and nurses that work in Telehealth in Brazil because it is believed that it interferes with their professional behaviour. Interpersonal relationship is the main factor of interference in this process. Technology has facilitated professional practice, however, from a communicational perspective, distance health care presents nuances that make the process of communication difficult , maily due to the difficulty of perception of non-verbal aspects in Telehealth care. To overcome these difficulties, doctors and nurses agree that communication is a competence that must be taught to professionals during their professional education and, especifically to work at distance, this ability must be taught taking into consideration the nuances that distance may bring in the communication process among people.

Over the last decade, electronic cigarettes (e-cigarettes) have emerged as novel and popular nicotine delivery devices. Although many smokers use e-cigarettes, evidence suggests these products are also growing in popularity among young adult non-smokers. It is therefore important to examine factors that may contribute to onset of electronic cigarette use among young adult non-smokers. Critics and supporters of electronic cigarettes have been disseminating anti and pro e-cigarette messages (respectively) and it is currently unclear what effect, if any, these messages exert on young adult non-smokers. Critics of electronic cigarettes advocate caution towards these products, while supporters of electronic cigarettes argue these products can serve as healthier replacements for conventional cigarettes. The present study sought to investigate the influence of caution and replacement messages on young adult non-smokers’ dispositions towards future e-cigarette use. Two hundred and four young-adult non-smokers participated in a between subjects single session design where they viewed one of three possible audiovisual presentations (a caution message, replacement message or control message). After viewing the presentation, participants completed measures and tasks assessing their likelihood of future e-cigarette use, including willingness and intention to try e-cigarettes, as well as a measure of e-cigarette outcome expectancies. Results indicated the caution message decreased self-reported willingness to use e-cigarettes and was associated with higher negative and lower positive e-cigarette expectancies. The replacement message did not influence self-reported willingness and intention to use e-cigarettes but was associated with decreases in negative e-cigarette expectancies. These findings suggest that public health e-cigarette messages could be developed to simultaneously advocate using e-cigarettes as a smoking alternative and caution against e-cigarette use for individuals not already dependent on nicotine.

Background: According to Stockholm’s Public Health report refugees have lowest selfreported health and there are indicators of inadequate access to health care. All asylum seekers are offered a health assessment opportunity which less than half of them utilize. To address health problems within the group Stockholm County decided to extend an educational program for those who receive residence permit, with 12 hours health communication. Uppsala University was given the responsibility to evaluation the initiative.   Purpose: The purpose of this study was to illustrate the experiences of the involved officials of the initiative, the pros and cons of the initiative and areas of improvement.   Method: The data for this study was collect through semi-structured interviews with three different categories of officials. The collected data was analyzed using content analysis.   Results: One of the key benefits of the initiative was that it helped participants use health care. The partnership was perceived as successful because of the good communication. The officials expressed challenges regarding the length of the health communication and the struggle to meet the participant’s needs.    Conclusion: This study shows that the initiative addressed some of the barriers migrants face regarding utilizing health care. The partnership was success due to factors similar to those for other successful health promotion projects and partnerships. The challenges related to the length of the programme, which can be attributed to poor initial analysis of the problem, is together with linkage of the initiative areas of improvement. / Bakgrund: Enligt folkhälsorapporten Stockholm lider gruppen flyktingar av ohälsa och det finns indikatorer för bristande tillgång till vården. Hälsoundersökningar erbjuds till alla asylsökande men mindre än hälften av dem utnyttjar det. I Stockholms län har man beslutat att utöka samhällsorinteringen, som är obligatoriskt för de som har fått upphållstillstånd, med 12 timmar hälsokommunikation för att behandla ohälsa. Uppsala Universitet har fått ansvar för utvärderingen.  Syfte: Syftet med studien är att belysa genomförandet av den utökade samhällsorienteringeni Stockholms län, för- och nackdelar samt förbättringsområden ur tjänstemännens perspektiv.   Metod: Studien har en kvalitativ design där semi-strukturerade intervjuer med tre olika grupper av tjänstemän i samverkansprojektet användes för att samla in data. Den insamlade data analyserades med hjälp av innehållsanalys.  Resultat: En av de upplevda fördelarna med insatsen är att man har lyckats hjälpa deltagarna att använda sig av hälso- och sjukvården. Samverkan upplevs ha varit framgångsrikt tack vara bland annat bra kommunikation. Hälsokommunikationens längd är en av utmaningarna man har haft i projektet, där man har haft svårigheter att tillgodose deltagarnas behov inom tidsramen.    Slutsats: Enligt studien upplever tjänstemännen att man med insatsen behandlat en del barriärer som nyanlända möter. Samverkan upplevs ha varit framgångsrik tack vare faktorer så som bra kommunikation som även varit framgångsfaktorer för likande samverkan. Problemet med hälsokommunikationens längd kan bero på en bristfällig initial analys vilket är tillsammans med förankringsarbetet förbättringsområden för samverkan.

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This study examines the depth of audience engagement with six dimensions of Corporate Social Responsibility (CSR) via the Instagram platforms of pharmaceutical companies. Recent research on the relationship between CSR and health communication has established a robust link between both variables but created a gap on the level of audience engagement. Drawing on Voluntary Disclosure, Agenda Setting and Media System Dependency theories, this study finds that voluntary communication of CSR strategies has the maximum potential to set the agenda for audience engagement on social media. The remodeled digitization of the media has increased the level of media dependency making social media a tool to be leveraged for effective health communication. The results revealed that Community Volunteering had the strongest impact on total audience engagement and revealed that engagement is higher with image posts than video posts. This study is important for the burgeoning field of CSR in the healthcare industry.

Endometriosis is a gynaecological disorder that affects an estimated 176 million women worldwide. Endometriosis causes serious societal impacts, such as loss of work productivity and effectiveness of non-work-related activities. Regardless that a significant number of women are impacted, many clinical questions remain unanswered, treatment failures are common, diagnosis takes an average of seven and a half years, and there is little investment in investigating disease mechanisms. At the same time, in the last few decades, endometriosis has been repeatedly mislabelled, which still presents indications on the current endometriosis care. Furthermore, there is still a tendency to exclude women's experiential knowledge, which presents one of the biggest burdens of endometriosis. The Degree Project demonstrates communication barriers to early diagnosis from 262 women using survey data and aims to understand women and medicine's power relations. Through this analysis, women's perspective is presented and discussed. The analytical discussion is divided into four chapters: medical knowledge, pain communication, desired communication support and experiential support. The study identifies how the relationship of knowledge and power impact pain communication and consequently the diagnosis of endometriosis. This study contributes to endometriosis, gender and communication for development studies by suggesting the incorporation of women’s experiential knowledge to address the challenges of pain communication and the diagnostic delay.