Master of Arts / Department of Communication Studies, Theatre, and Dance / William Schenck-Hamlin / According to the Centers for Disease Control and Prevention, overweight and obesity rates in the United States continue to increase. And yet, despite their resources to encourage healthy lifestyles, college campuses reflect the national trend. Colleges and universities often utilize health campaign strategies such as social norms marketing and peer health education to encourage campus-wide health initiatives. However, based on an application of effective health communication attributes, both strategies demonstrate limitations that must be addressed in future collegiate health campaign approaches. I analyzed the effectiveness of adopting an induced hypocrisy health campaign to encourage nutrition. The induced hypocrisy paradigm has resulted in successful behavioral change by having participants create a pro-attitudinal message. Then, participants are reminded of their past failure to engage in the behaviors they advocated. It was hypothesized that hypocritical subjects would purchase more nutrition bars than subjects in any of the other conditions. The results indicate that, although more hypocritical subjects purchased more nutrition bars than subjects in the other conditions, the findings were not found to be statistically significant. Interpretations of the study findings as well as implications for future nutrition campaign initiatives are discussed.

Este trabalho analisa quatro campanhas de Saúde Pública realizadas em Alexandria, no Egito; Macaé, São Paulo e Petrópolis, no Brasil, do ponto de vista da penetrabilidade e rendimento dos métodos utilizados para a educação do público com respeito à vacinação. Tece também considerações sobre o histórico da comunicação, a situação atual das comunicações no Brasil e a metodologia da Educação em Saúde PÚblica. / This paper is intended to analyze four Public Health campaigns conducted in Alexandria, Egypt ; Macaé, São Paulo e Petrópolis, Brazil, from two stand-points: the percentage of people reached and the efficiency of the methods to promote public education with regards to immunization. It also relates to the history of communication, the present communication trend in Brazil and the methodology for Public Health Education.

Este trabalho analisa quatro campanhas de Saúde Pública realizadas em Alexandria, no Egito; Macaé, São Paulo e Petrópolis, no Brasil, do ponto de vista da penetrabilidade e rendimento dos métodos utilizados para a educação do público com respeito à vacinação. Tece também considerações sobre o histórico da comunicação, a situação atual das comunicações no Brasil e a metodologia da Educação em Saúde PÚblica. / This paper is intended to analyze four Public Health campaigns conducted in Alexandria, Egypt ; Macaé, São Paulo e Petrópolis, Brazil, from two stand-points: the percentage of people reached and the efficiency of the methods to promote public education with regards to immunization. It also relates to the history of communication, the present communication trend in Brazil and the methodology for Public Health Education.

This paper explores public health campaigns as they relate to tweens and their use of technology. After considering how this demographic utilizes both traditional and new media, further examination was done on general health problems that affect this group. Three major health issues were then chosen for analysis. A relevant campaign for each issue was also evaluated, as were its overall marketing and communication efforts. The health problems and corresponding campaigns chosen include childhood obesity and the “Let’s Move” campaign, electronic aggression and the “Stop Bullying” campaign and youth suicide and the “WeCanHelpUs” campaign. From these analyses, recommendations for ways to improve each campaign were provided, as were general conclusions for reaching this demographic more efficiently and effectively. / text

This thesis is concerned with the health-related effects of perspective-taking in response to a narrative health campaign. To begin, the thesis outlines the health promotion strategies currently in use (i.e., statistical vs. narrative), presents research discussing their relative effectiveness, and considers the potential for perspective-taking to influence the impact of narrative health campaigns (Chapter 1). The thesis then defines two types of perspective-taking, cognitive and emotional, and explores the processes underlying these (Chapter 2). Each type of perspective-taking is then considered in the context of the health promotion literature (Chapter 3). It was proposed that, whereas cognitive perspective-taking should have a relatively straightforward and positive effect on the impact of narrative health campaigns, the effects of emotional perspective-taking should be more variable. Seven studies were conducted to test this basic premise and identify mediators and moderators of the observed effects. In Chapter 4, two studies are presented that aim to establish the effects of perspective-taking on health-related outcomes (Studies 1 & 2). A broadly consistent pattern was observed across these studies: encouraging cognitive perspective-taking led to more positive health-related outcomes than did encouraging emotional perspective-taking. Having established the basic effect, two studies are presented in Chapter 5 that explore a potential mediator: perspective-takers’ self-efficacy concerning a health promoting behaviour (chlamydia testing: Studies 3 & 4). These studies found a consistent indirect effect of perspective-taking on intentions to get tested for chlamydia through self-efficacy: encouraging cognitive perspective-taking increased participants’ perceived self-efficacy relative to encouraging emotional perspective-taking, which in turn positively predicted intentions to get tested in the future. The three studies presented in Chapter 6 explore potential moderators of the effects of perspective-taking (Studies 5-7). Specifically, these studies test whether the relative effects of perspective-taking are moderated by features of the relationship between the perspective-taker and a target presented in a narrative health campaign. The broad pattern observed across these studies suggests that the perception of a shared categorisation (or social identity) between the perspective-taker and target moderates the effect of perspective-taking on health-related outcomes. Specifically, the final study, Study 7, demonstrated that encouraging cognitive perspective-taking in response to a narrative health campaign leads to more positive health-related effects than encouraging emotional perspective-taking when perspective-takers’ personal (unshared) identity is made salient; however, these effects are attenuated (and potentially even reversed) when a social (or shared) identity is made salient. Considered as a whole, the research presented in this thesis represents the first empirical examination of the relative health-related effects of different types of perspective-taking in response to a narrative health campaign. The research demonstrates that perspective-taking is an important factor in determining whether or not narrative health promotion campaigns are likely to be effective. However, it also makes clear that the processes through, and conditions under, which cognitive and emotional perspective-taking can help to ensure the effectiveness of narrative health campaigns are not yet fully understood. Nevertheless, the studies presented herein successfully identify several such conditions and mechanisms ready for further study. Theoretical and practical implications, alongside limitations and more specific suggestions for further research are discussed.

This thesis consists of three chapters. The first chapter explores the effects of prenatal nutritional deficiency on depression in adulthood. It is well established that maternal behaviour during pregnancy has a lasting effect on the child for years to come. Studies show that in utero nutritional shocks can have prolonged effects on health and labour market outcomes later in life of the offspring. In this paper I investigate whether such nutritional deficiencies during gestation can have an extended impact on mental health in adulthood. Using the fourth wave of Indonesian Family Life Survey (IFLS), I find that Muslim individuals who were potentially exposed to Ramadan in the first and third trimester have significantly higher scores on the depression scale than those who were not exposed. This effect is particularly significant among Muslim males who were exposed in the first trimester and Muslim females who were exposed in the third trimester. Similar effects of exposure are also found on the probability of being depressed in the Muslim population. The absence of such impact of exposure in the non-Muslim population suggests that nutritional deficiencies during the gestation period can have lasting effects on mental health and may increase the possibility of developing depression later in life. Next, the literature on socioeconomic health inequality uses individuals' socioeconomic rank (p) to develop the concentration index. In the second chapter of the thesis, I construct an alternative framework by directly using individuals' income level (y) to rank them and develop stochastic dominance conditions to investigate whether this method leads to the same conclusion as using the socioeconomic ranks (p). Using World Health Survey data for five South Asian countries, I conclude that using the socioeconomic ranks (p) and income levels (y) to rank individuals lead to different results in dominance tests adjusted for different equivalence scales. Lastly, to address the arbitrariness problem of the health concentration index's value caused by assuming the existence of a ratio-scaled variable, Makdissi and Yazbeck (2014) adopted a counting approach to measure health inequality. In the third chapter of the thesis, I apply this counting approach in a two-fold way. Firstly, I estimate the values of population health status and health inequality in United States using the National Health Interview Survey (2010) data. Then, assuming increased government expenditure on health awareness, I simulate the effects such policy interventions and see what improvements in the public health can be achieved. Also, I propose the count-approach incremental cost effectiveness ratio (C-ICER) which is a simple measure to assess the cost effectiveness of public health awareness campaigns.

This is a study of the creation and negotiation of different forms of knowledge about dengue fever. I explore how anthropology, in collaboration with ideas and practices drawn from science and art, may transform public understandings of dengue. Dengue is a vector-borne disease transmitted to humans by the bite of a mosquito which is infected with the dengue virus. Mosquito-borne diseases have normally been treated through vector control and the elimination of breeding sites. Until 1960, the use of the pesticide DDT allowed the virtual eradication of Aedes aegypti (Ae. aegypti) in many places of the world. DDT was banned in most of the world by 1970 and by 1980 the focus on vector-control was replaced by a discourse of sanitation, in which health authorities tried to ‘educate’ populations and ‘teach’ proper hygienic habits to avoid mosquito-human contact. At present, these practices are changing again. The World Health Organisation (WHO) suggests that dengue incidence could be reduced at least 50% by 2020 through applying health campaigns and social interventions that involve having people participating in the control of dengue outbreaks. In this thesis I explore how WHO guidelines are applied in the control of dengue in Medellín, and how we can think about the concepts of ‘knowledge’, ‘education’ and public health campaigns through ethnographic methods. My project has been about looking at how different understandings – or different forms of knowledge – are part of interactions of different ‘publics’, non-expert citizens, virologists, entomologists and artists. My argument is that health campaigns should be re-designed – privileging relations and stimulating debate – by focusing on experience and moving towards managing the disease and living with the mosquito. Contrary to the different models enacted in health campaigns – which neglect the value of everyday experiences – I advocate for interdisciplinary collaboration as a relational art strategy that can generate an intersubjective exchange of experiences.

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In the U.S., work-related death is an all too familiar occurrence on farms. Tractor overturns continue to be the most frequent cause of these fatalities. Efforts to alter farming’s ranking as one of the most deadly occupations in the country must provide proven strategies for the elimination of these preventable deaths. In the past, efforts to decrease the rate of overturn fatalities and injuries have largely focused onincreasing the proportion of tractors with a rollover protective structure (ROPS). These devices, in combination with seatbelts, are 99% effective in protecting the tractor operator from death or injury. Unfortunately, only 59% of U.S. tractors are currently equipped with ROPS. Due to the relative lack of political willpower to legislate ROPS installation and the less than encouraging response to education and awareness programs to date, it appeared necessary to explore alternative intervention strategies. The over-arching purpose of this thesis project has been to assess the utility of social marketing as a framework for developing effective health and safety interventions in the farm community. However, our specific objectives included; a more thorough understanding of the perceived barriers and motivators that influence farmer’s safety decisions, the design and evaluation of social marketing incentives developed to encourage safe behaviors and the evaluation of a social marketing campaign designed to positively impact farmer’s intentions and readiness to retrofit unsafe tractors. The research was by and large conducted in New York State and supported by grants from the National Institutes of Occupational Safety and Health (NIOSH). Previous research conducted in the New York farm community had indicated that small crop and livestock farmers would be an ideal intervention target for a social marketing tractor overturn intervention as their farms accounted for close to 85% of New York farms which lack or have only one ROPS protected tractor. A qualitative assessment of perceived barriers and motivators regarding retrofitting behaviors was performed with representatives of the small crop and livestock community. Grounded theory analysis of these in-depth interviews revealed several key categories which include: 1) risk becomes “normal”, 2) risk becomes part of a “farming identity”, and 3) risk becomes “cost-effective”. This information was used to design potential intervention incentives, such as toll-free assistance finding and purchasing ROPS, financial rebates, and campaign messages designed to address farmer’s stated concerns. Subsequent research included testing and revising messages and evaluating the effect of the different campaign incentives in a prospective quasirandomized controlled trial conducted in different regions of New York and Pennsylvania. The results indicate that social marketing offers a promising framework for the development of injury or fatality prevention programs in farm communities. Farmers in the social marketing region demonstrated the most significant changes in both behavioral intention and readiness to retrofit compared to farmers from other regions. Data also indicated that social norms strongly influence farmer’s decisions to work safely, as demonstrated by the strong correlations between behavioral intention measures and measures of social norms. As well as providing an assessment of the utility of social marketing as an intervention framework, the thesis provides a cogent example of how behavioral theories can be used in the design and evaluation of intervention programs. Both stages of change theory and the theory of planned behavior proved to be valuable for measuring dispositional and behavioral changes and for finetuning future interventions.

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