Made available in DSpace on 2011-05-04T12:42:03Z (GMT). No. of bitstreams: 0 Previous issue date: 2010 / O propósito desta Tese de Doutorado foi avaliar a efetividade de duas estratégiasde comunicação ao longo do tempo, moderada pelo grau de dependência à nicotina do fumante, em aumentar a motivação do indivíduo para procurar um serviço de aconselhamento telefônico. O embasamento teórico do estudo proposto, bem como os detalhamentos da metodologia utilizada e dos resultados encontrados, são descritos ao longo do texto e são complementados pelos sete artigos científicos que compõem esta Tese.Um estudo de intervenção foi conduzido durante 4 semanas no dia-a-dia de duas estações de metrô da cidade do Rio de Janeiro. Foram escolhidas estações de começo de linha, consecutivas, próximas uma da outra e que serviam áreas prioritariamente residenciais. Em uma das estações, cartazes de conteúdo positivo envolvendo o tema da falta de fôlego (parar de fumar é ganhar fôlego) foram expostos nas pilastras centrais divisórias das plataformas de embarque. Cartazes de conteúdo negativo (fumar éperder fôlego) foram expostos da mesma forma na segunda estação.Durante o período do estudo, os fumantes leves expostos à intervenção de conteúdo positivo ligaram em média 2,2 vezes mais do que aqueles expostos à intervenção de conteúdo negativo. Ademais, para cada 1087 fumantes leves-dia seguidos, 1 ligação a mais foi registrada para a estação de conteúdo positivo, quando comparada à de conteúdo negativo (diferença de taxas igual a 9,2 ligações por 10000 fumantes leves-dia). A diferença nas taxas de ligações diminuiu após a primeira semana de estudo (p interação aditiva = 0,02). No que diz respeito aos fumantes pesados, não houve diferença estatisticamente significativa entre as estações, tanto nas razões de taxas quanto nas diferenças de taxas. Uma interação qualitativa entre tipo de fumante e estratégia utilizada foi encontrada (p interação = 0,02).Os resultados deste estudo sugerem que várias campanhas de curta duração deconteúdo positivo, abordando temas relacionados com o dia-a-dia dos indivíduos, poderiam ser bem eficazes na captação de um número maior e mais heterogêneo de fumantes. / The objective of this Thesis was to explore the effectiveness over time of two communications strategies in encouraging calls to a Quitline, according to smoker’s degree of dependence. Thesis text encompasses the study’s theoretical background as well as details on the methodology used and results found. It also includes seven scientific papers. A study was conducted for four weeks among passengers of two selected subway stations in the city of Rio de Janeiro. Consecutive boarding stations at one end of a subway line, mainly serving residential areas, were selected. Posters highlighting gains from quitting smoking (“to stop smoking is to gain breathing capacity”) were exposed on the central dividing columns of the boarding platforms in one subway station, whereas the alternative message — highlighting losses (“to smoke is to loose breathing capacity”) — were assigned to the second station. During the study period, light smokers exposed to the positive-content message called on average 2.2 times more often than those exposed to the negative-content message. In addition, for every 1087 light smoker-days followed, one more call was recorded for the positive-content message, compared with the negative-content message (rate difference equivalent to 9.2 calls per 10 000 light smoker-days). The absolute difference in call rates decreased after the first week of the study (p additive interaction, 0.02). For heavy smokers, no differences between the two stations were observed. Qualitative interaction was found between type of smoker and intervention (p= 0.02). The results suggest that short-term positive-content campaigns based on issues pertaining to individuals’ daily routine could be effective in capturing a larger and more heterogeneous smoking population.

O Programa Saúde da Família, proposto em 1994 pelo Ministério da Saúde, definiu-se como uma estratégia de reorganização da Atenção Primária à Saúde no Brasil. Gradualmente, ele foi sendo implantado também em grandes centros urbanos, até que, em 2001, ocorreu a municipalização da saúde na cidade de São Paulo, com a implantação desse modelo no bairro do Bom Retiro, região central da capital paulista. Esse bairro constitui uma paisagem única, marcado, desde sua origem, no final do século XIX, pela presença de diversas etnias, constituindo um microcosmo social, tendo recebido, ao longo de sua história, grandes contingentes de imigrantes com características culturais bastante particulares. Atualmente, entre a população que o frequenta e habita, os coreanos e os bolivianos passaram a constituir os dois grupos de imigrantes com presença marcante no bairro, ambos inseridos na base material da indústria de confecção, uma vez que a produção têxtil é um dos eixos econômicos estruturantes do Bom Retiro. A inserção de uma Unidade de Saúde da Família nesse bairro provocou a reflexão sobre as potencialidades e as dificuldades do Programa Saúde da Família em grandes centros urbanos; trouxe para discussão questões relativas à presença desses imigrantes; e exigiu análises diversas, em torno da interação entre profissionais dos serviços de saúde e seus usuários. Assim, o objetivo deste trabalho é analisar a interação entre o Programa Saúde da Família e os imigrantes coreanos e bolivianos localizados no bairro do Bom Retiro na cidade de São Paulo, redundando em uma experiência particular. Trata-se de uma pesquisa de referencial qualitativo, que utilizou a técnica de entrevistas semiestruturadas com três coreanos, três bolivianos e seis trabalhadores da saúde da Unidade de Saúde da Família do Bom Retiro. Para a análise das entrevistas, utilizou-se a técnica de análise temática de conteúdo, considerando as conjunturas, as razões e as lógicas, bem como as ações e as inter-relações estabelecidas com o coletivo e as instituições. Os resultados exibem as particularidades da inserção desses dois grupos de imigrantes no bairro do Bom Retiro e flagram, particularmente, dimensões do mundo do trabalho e de moradia e grande mobilidade espacial imigratória, exigindo a flexibilização da lógica cartográfica do Programa Saúde da Família, com a ampliação do conceito de família, e as diversas estratégias comunicativas de que a equipe de Saúde da Família lançou mão para implementar a comunicação com os imigrantes coreanos e bolivianos / The Family Health Program, proposed in 1994 by the Ministry of Health, was defined as a strategy for reorganizing Primary Health Care in Brazil. It was gradually implemented in major urban areas. In 2001, health care services in the city of São Paulo were municipalized, with the implementation of this model in Bom Retiro, in the downtown area of the city of São Paulo. Such neighborhood has a unique landscape, marked since its beginnings, at the end of the 19th century, by the presence of several ethnic groups. It is a social microcosm, which received large groups of immigrants throughout its history, bringing their own unique cultural characteristics to the area. Nowadays, Koreans and Bolivians have become the two most significant immigrant groups among the population living and working in the area. Both groups are integrated into the material base of clothing industry, since textile manufacture is one of the economic structural axes of Bom Retiro. The establishment of a Family Health Unit in Bom Retiro, besides evoking a reflection on the potential and difficulties for the Family Health Program in large urban areas, also brings issues related to the presence of these immigrants to the discussion, requiring various analyses on the theme of interaction between health care professionals and users. Thus, the purpose of this work is to analyze the interaction between the Family Health Program and Korean and Bolivian immigrants located in the neighborhood of Bom Retiro, in the city of São Paulo, which results in a unique experience. This is a qualitative research, which used the technique of semi-structured interviews with three Koreans, three Bolivians and six health care workers from the Bom Retiro Family Health Unit. With regard to the analysis of the interviews, the technique of thematic content analysis was used, considering the conjunctures, reasons and logic, as well as actions and interrelations established between the collective and the institutions. The results show the particularities of the insertion of these two immigrant groups in Bom Retiro, and highlight in particular the dimensions of the world of work, housing and the large spatial mobility of immigrants, requiring Family Health Program\'s map-based logic to become more flexible, with the enlargement of the concept of family and several communication strategies used by the Family Health team to establish communication with the Korean and Bolivian immigrants

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Obesity is one of the major public health issues in the United States, often regarded as part of a global crisis. Companies invest billions of dollars each year towards television advertising campaigns aimed at convincing audiences how their ground-breaking discovery 'battles the bulge' or somehow offers an increased health benefit. This study examined how advertisers presented health-related claims, including health and nutrient-content claims, in U.S. adult-targeted television food commercials. The claims were compared to FTC, FDA, and USDA laws, regulations, and recommendations. A content analysis of food advertising was conducted of commercials from major and cable network programs broadcast during prime-time in the first quarter of 2009. The majority of claims match current regulations when compared to Federal references. The results show that Nutrient and Wellness claims were the most frequently cited. The type of benefit, Healthy Eating, emerged almost 3 times more than any other benefit type. This is also similar to those results which suggest advertisers' intentions were to promote overall wellness in their content delivery. As such, the Wellness Approach was identified and conceptualized, leading towards full development of a Wellness Effect theory. Implications and future research opportunities are discussed on both a theoretical and practical level.

Text in English / Interactive health communication between the health-care professional (HCP) and patient relationship for diabetes health-care positively contributes to patient-centred care. Hence individual patient concerns are addressed and catered for in the medical system. The purpose of this study was to analyse in-depth how HCP-patient relationships and HCP-HCP teamwork dynamics positively contribute to effective diabetes patient care and treatment adherence. Different health communication models and theories were reviewed and a conceptual framework was developed from the literature. A qualitative case study approach was used to collect data at Stanger Hospital’s diabetes clinic. Data was collected using three different methods, namely in-depth interviews with HCPs and patients individually, observations conducted at the clinic analysing both the HCPs and patients, and finally, documentation that emerged as a third data collection method where patient files and diabetes educational material were analysed at the clinic. Triangulation by means of the three methods ensured that reliable, valid and credible data was collected in the field. Diabetes health-care and treatment management are affected by the social context/social system which includes family and culture. These social factors are acknowledged as core in the literature. However, a single comprehensive health communication model did not exist solely in this regard. The data indicated that at the Stanger Hospital’s diabetes clinic, patient-centred (individual tailor-made treatment plans) care was only implemented after patients had defaulted treatment for reasons linked to their social circumstances. The findings of the study indicate that teamwork was favoured in the HCP-HCP relationship at the diabetes clinic, and that this made a positive contribution to effective diabetes patient care. HCPs were overburdened at the clinic since patient numbers were high and there were staff shortages. The patients’ empirical data indicated that interactive communication positively contributed to their medical concerns being catered for at the diabetes clinic, but this tended to occur only after non-adherence. Patients required care and support from HCPs in order to learn to accept diabetes and manage their illness. / Sociology / D. Litt. et Phil. (Sociology)