Thesis (Ph. D.)--University of Montana, 2007. / Title from title screen. Description based on contents viewed Apr. 2, 2007. Includes bibliographical references (p. 87-92).

Hypotheses on the efficiency of evidence-based printed materials can be directed by health communication concepts. These concepts can provide a general framework that goes beyond the traditional vulgarization point of view: instead, it points towards a strategy to obtain health outcomes and provoke behavior change, from a disease prevention, management and health promotion perspective. The present study proposes a comprehensive framework based on concepts from health risk communication, Tarde's theory of social values, usability, readability and plain language. Using the mapping approach, an evaluation grid was applied to printed evidence-based materials with proven effectiveness, in order to reveal the underlying strategy and isolate the characteristics of effective materials. The results allowed us to define two types of printed evidence-based materials, according to the robustness of the evidence they contain and the target audience. It was also possible to identify indicators of notions that are translated into operationalized items, frequent in those materials that might be responsible for their efficiency: clear purpose of the documents, limited scope, learning motivation and correspondence to the logic, experience and language of readers. Effectiveness of printed evidence-based materials could also be correlated to numeracy, objectiveness, standard definitions, constant timeframes and denominators, risks enumerated in order of importance, effective response, and high degree of threat, urgency, novelty and visibility of the disease. It was also possible to identify some missing communication concepts: cultural diversity, narrative, increased easiness of procedures and aesthetic advantage for the patient. In the process of work, the theory of social values emerged as a dynamic component that can bring together and explain many concepts, as well as physician’s acceptance of the guidelines. Value in terms of usefulness and truth plays a major role in cognitive appreciation of the documents. This concept gives a strategic meaning to the whole work and allows us to better understand attitude and behavior change.

The hazards literature has identified many factors as being influential in the decision making process during high risk, short-notice disasters. Risk perception and previous disaster experience are commonly identified as two of the more influential factors in this complex process. However, few studies adequately address the complex role(s) that these factors play in self-protective decision-making during successive high-risk events. In particular, the role of previous disaster experience during subsequent events is still a matter of considerable discussion and inconsistent findings. This thesis examines two events that occurred in August, 2011 in Goderich, Ontario: an F-3 tornado that struck the community on August 21st and a tornado warning that was posted for the region three days later on August 24th. This case study provided the opportunity to examine the roles of risk perception and previous disaster experience in the decision-making process during successive high-risk events. Semi-structured interviews (n=35) and close-ended questionnaires (n=268) were conducted to learn about the ways that individuals obtained and understood risk information, and to explore whether and how such information guided protective behaviors during the two events. The interviews were analyzed using thematic coding to identify response patterns, and the questionnaires were analyzed using IBM SPSS software. It was found that a sizable portion of the sample population took protective actions on August 24th in ways that were inconsistent with their actions on August 21st. Also, a significant portion of respondents chose not to take any form of protective action on August 24th despite having previously experienced the damaging tornado. The findings of this research suggest that the significance of previous disaster experience in the decision-making process is highly variable and context-dependent. A second significant research finding involves the impact of the tornado on the place attachments of Goderich residents. It was found that the disaster had significant impacts, both positive and negative, on participants' sense of place. These findings have implications for both short- and long-term disaster recovery.

Individuals have become more involved in health-related decisions, in part due to an unprecedented access to information that can be used to enhance both physical and mental health. Much of this health-related information is presented in a numerical format; unfortunately, research suggests many Americans may not possess the literacy skills necessary to comprehend numerical health-related information. More research needs to be conducted to examine numeracy and its role in cancer risk perceptions, and how those risk perceptions relate to cancer self-protective behaviors. The purpose of the current study was to: (a) examine socio-demographic variables associated with numeracy, (b) determine which factors are associated with cancer risk perceptions, and (c) apply the Risk Perception Attitude (RPA) Framework to examine associations between risk perception groups and cancer self-protective behaviors. The study used data from the 2007 Health Information National Trends Survey (HINTS), which was developed by the National Cancer Institute to collect nationally representative data on the U.S. public's use of cancer-related information. Logistic regression was used to assess the association between each dependent variable and independent variables associated with each research question. Results indicated age and education were associated with objective numeracy, whereas age, education, and occupational status were associated with subjective numeracy. Among participants with a previous cancer diagnosis, objective numeracy and smoking status were associated with a somewhat high/very high perceived risk of developing cancer in the future. Age, race/ethnicity, family cancer history, smoking status, and self-reported general health were associated with a somewhat high/very high perceived risk of developing cancer in the future among participants without a previous cancer diagnosis. RPA group was not significantly associated with cancer self-protective behaviors. Findings from this study have important implications for public health, including health communication and interventions designed to enhance health behaviors. Future research should focus on using a full objective numeracy scale with a nationally representative population and examining temporal relationships between cancer risk perceptions and health behaviors.

Background: New genomic tests are being developed to predict an individual’s risk of cancer recurrence by analyzing the expression of multiple genes. However, it is unclear how to report the test results so that they would be most useful to clinicians. A mail-out questionnaire has the potential to help a) describe physicians’ attitudes towards the clinical use of new genomic tests, b) determine what information physicians prefer to have included in the test reports, and c) explore how physicians think the test results would impact their treatment recommendations. Objectives: To design such a questionnaire that could be used in the eventual large-scale survey, and to ensure that the questionnaire a) is comprehensible, b) has face validity, c) appears interesting to, and d) does not place undue response burden on, the target population. Methods: The first draft, based on a specific genomic test for breast cancer recurrence (Oncotype DX) and on two case scenarios, was created. Cognitive interviews with practicing oncologists were conducted to identify problems in the questionnaire. The evaluation involved face-to-face interviews with Kingston oncologists who treat breast cancer, followed by telephone interviews with medical oncologists who treat breast cancer in other places in Ontario. Three-to-four oncologists were included in each round of interviewing after which the questionnaire was revised based on that round’s recommendations. Additional rounds of interviews were conducted until no new problems/issues were raised in one entire round. Results: A medium-length questionnaire was drafted. Four rounds of interviews were conducted with no new problems/issues being raised in the fourth round. Most of the problems identified in the questionnaire related to comprehensibility, followed by logical issues which detected fundamental problems in the questionnaire design. There was no evidence of fatigue or disinterest in participants and they deemed the response burden reasonable. Conclusion: The results suggest that the proposed questionnaire is comprehensible and has face validity. Additionally, it appears to be an interesting questionnaire to, and would not place undue burden on, the target population. Thus, the questionnaire is now ready for the field administration. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2009-05-05 17:23:10.551

This dissertation, through the case study approach, investigates the role of environmental action groups in raising public awareness of environmental hazards in Merewent. Merewent is a residential suburb that lies in the heart of the South Durban Basin adjacent to two oil refineries, a paper mill and other small industries. The sulphur -rich gases released by these refineries over the more than forty years have affected the health of the residents. Many today have respiratory ailments, with some of them developing related cancers. With the emergence of environmental action groups in the area, the awareness of the problem has increased. This has resulted in pressure being applied by the community on the refineries to adopt less hazardous methods of refining crude oil. Most of the people who make up these action groups had limited knowledge of the environmental pollution. However, through their involvement in the activities of these groups, they learnt and became active participants in these organisations. Using science literacy, popular education and social learning theory as the underlying theoretical basis, this study investigates the learning that took place when people participated in social action. / Thesis (M.Ed.)-University of Natal, Durban, 2002.

This research emerges within the context of rapidly rising levels of Human Immunodeficiency Virus (HIV) infection amongst young adults and the escalation of deaths from the Acquired Immunodeficiency Syndrome (AIDS). This study critically examines the commonly used theories and models that guide HIV/AIDS communication campaigns. However, it notes that the broad ranging theories and models used during HIV/AIDS preventative and care campaigns emphasise communication linearity and individualism and therefore fail to acknowledge culture. In view of the multiplicity of cultural and language groups that exist in South Africa, culture plays a crucial role in HIV/AIDS communication interventions. Failure to acknowledge the cultural context in campaign theory has various negative implications. One is that, because these theories and models are linear, they are sender-oriented. The recipients are therefore unable to identify with the message as they are divorced from the context of its production. Furthermore, because of a lack of engagement by the recipient in the development of messages, retention of knowledge is minimal and this leads to a lack of acceptance of the message. Clearly then, there exists a need for these theories and models to be re-articulated so that they are less linear and individualistic, but rather more flexible so that they may be adapted for application within various cultural contexts. This study suggests that one of the ways of alleviating campaign linearity and including culture is by borrowing Paulo Freire's (1990) underlying principles of participation and incorporating them into communication campaign theory in the form of audience participation. Communication campaign theory would therefore include audience participation as a central component during its planning, implementation and evaluation phases. The appropriateness of this suggestion is demonstrated by applying it to and evaluating a HIV/AIDS awareness campaign targeted at young adults at a tertiary institution in KwaZulu Natal. / Thesis (M.A.)-University of Natal, Durban, 2002.

The hazards literature has identified many factors as being influential in the decision making process during high risk, short-notice disasters. Risk perception and previous disaster experience are commonly identified as two of the more influential factors in this complex process. However, few studies adequately address the complex role(s) that these factors play in self-protective decision-making during successive high-risk events. In particular, the role of previous disaster experience during subsequent events is still a matter of considerable discussion and inconsistent findings. This thesis examines two events that occurred in August, 2011 in Goderich, Ontario: an F-3 tornado that struck the community on August 21st and a tornado warning that was posted for the region three days later on August 24th. This case study provided the opportunity to examine the roles of risk perception and previous disaster experience in the decision-making process during successive high-risk events. Semi-structured interviews (n=35) and close-ended questionnaires (n=268) were conducted to learn about the ways that individuals obtained and understood risk information, and to explore whether and how such information guided protective behaviors during the two events. The interviews were analyzed using thematic coding to identify response patterns, and the questionnaires were analyzed using IBM SPSS software. It was found that a sizable portion of the sample population took protective actions on August 24th in ways that were inconsistent with their actions on August 21st. Also, a significant portion of respondents chose not to take any form of protective action on August 24th despite having previously experienced the damaging tornado. The findings of this research suggest that the significance of previous disaster experience in the decision-making process is highly variable and context-dependent. A second significant research finding involves the impact of the tornado on the place attachments of Goderich residents. It was found that the disaster had significant impacts, both positive and negative, on participants' sense of place. These findings have implications for both short- and long-term disaster recovery.

Vid pågående och långvariga miljö- och hälsorisker är det viktigt att kommunicera med invånare kontinuerligt. Denna enkätstudie undersöker därför informationsbehovet hos invånare vid förorenade områden och hur det överensstämmer med myndigheternas syn på kommunikationen. Vidare undersöks oro och riskuppfattning hos invånarna samt hos kommunikatörerna på kommunerna och länsstyrelserna. Undersökningen görs med glasbruksområden som exempel då studier pekar på förorening vid och i närheten av dessa områden men risken för människors hälsa inte är helt fastställd. Resultatet visar att en stor andel av, både invånare och myndigheternas kommunikatörer, tror att det finns risk för och är oroliga för hälsa, miljö och kommande generationers hälsa i närheten av de förorenade områdena. Oron för att bo i närheten är inte lika stor som oron för hälsa och miljö. Både riskuppfattningen och oron är större för miljö än för hälsa. Av dem som bor närmre än 5 km från närmsta glasbruk vill 68 % ha mer information vilket är fler än bland dem som bor längre ifrån, 31%. Tidigare information har de flesta fått från lokala media. Helst vill invånarna kommunicera med kommunen, länsstyrelsen, Naturvårdsverket och till viss del även med lokala media. De som bor närmre än 5 km från ett glasbruk vill ha information via papperstidning, informationsmöten och brev. Detta överensstämmer inte helt med myndigheternas åsikt där kommunikation främst skett via hemsidan och där hemsida, informationsmöten och sociala media är de kommunikationsvägar myndigheterna vill använda. Kommunen, länsstyrelsen och Naturvårdsverket anses som ansvariga för kommunikationen och det är flest som litar på dessa aktörer. Sammantaget visar studien att kommunikationen hittills kan ses som bristfällig och att det behövs förbättrad kommunikation vid långvariga miljö- och hälsorisker. Det finns, i det specifika fallet, utrymme för att förbättra kommunikationen och förutsättningarna är goda om kommunicerande aktörer ser upp för fallgroparna. / At ongoing and long-term environmental- and health risks is it important to communicate with the inhabitants continuously. This study therefore uses a survey to investigate the need for information among inhabitants and how it aligns with the authorities view on the communication. Further, worry and risk perception is examined among inhabitants and the municipalities and the county administration. The study is done with glasswork areas as an example since earlier research indicate contamination on and near these areas but the risk for human health is not yet established. The result show that a substantial share, of both inhabitants and the authority’s employees, thinks there is risk for and is worried about health, environment, and future generations health at contaminated sites. The worry about living close by is not as big as the worry about health and environment. Both risk perception and worry are greater for the environment than for health. Of the inhabitants living closer than 5 km from nearest glasswork, 68% wants more information which is more than among the inhabitants living further away, 31%. Previous information has most people got from local media. The inhabitants prefer to communicate with the municipality, the county administration, and the Swedish EPA and to some extent even with local media. The ones living closer than 5 km from a glasswork want information through newspapers, briefings and letters. This is not fully consistent with what the authorities think, where communication mainly occurred through the website and the website, briefing and social media are the ways authorities want to use for communication. The municipality, county administration and the Swedish EPA considers as responsible for the communication and these authorities got most trust among the inhabitants. Altogether this study shows that the communication so far can be considered as inadequate and that there is a need for improved communication at long term environmental and health risks. There is, in the specific case, room to improve the communication and the conditions are good, if the communicating actors watch out for pitfalls.

abstract: Public risk communication (i.e. public emergency warning) is an integral component of public emergency management. Its effectiveness is largely based on the extent to which it elicits appropriate public response to minimize losses from an emergency. While extensive studies have been conducted to investigate individual responsive process to emergency risk information, the literature in emergency management has been largely silent on whether and how emergency impacts can be mitigated through the effective use of information transmission channels for public risk communication. This dissertation attempts to answer this question, in a specific research context of 2009 H1N1 influenza outbreak in Arizona. Methodologically, a prototype agent-based model is developed to examine the research question. Along with the specific disease spread dynamics, the model incorporates individual decision-making and response to emergency risk information. This simulation framework synthesizes knowledge from complexity theory, public emergency management, epidemiology, social network and social influence theory, and both quantitative and qualitative data found in previous studies. It allows testing how emergency risk information needs to be issued to the public to bring desirable social outcomes such as mitigated pandemic impacts. Simulation results generate several insightful propositions. First, in the research context, emergency managers can reduce the pandemic impacts by increasing the percent of state population who use national TV to receive pandemic information to 50%. Further increasing this percent after it reaches 50% brings only marginal effect in impact mitigation. Second, particular attention is needed when emergency managers attempt to increase the percent of state population who believe the importance of information from local TV or national TV, and the frequency in which national TV is used to send pandemic information. Those measures may reduce the pandemic impact in one dimension, while increase the impact in another. Third, no changes need to be made on the percent of state population who use local TV or radio to receive pandemic information, and the frequency in which either channel is used for public risk communication. This dissertation sheds light on the understanding of underlying dynamics of human decision-making during an emergency. It also contributes to the discussion of developing a better understanding of information exchange and communication dynamics during a public emergency and of improving the effectiveness of public emergency management practices in a dynamic environment. / Dissertation/Thesis / Ph.D. Public Administration 2012