Background: The digital divide is a recognized public health problem caused by social determinant... more Background: The digital divide is a recognized public health problem caused by social determinants that exacerbate health disparities. Despite the " tectonic shift " in how most of the public obtains cancer information, underserved communities are at increased risk of being digitally marginalized. However, research that examines factors underlying eHealth information seeking in diverse health contexts is lacking.
Internet cancer communities (ICCs) provide a new and unique collective setting for people with ca... more Internet cancer communities (ICCs) provide a new and unique collective setting for people with cancer. Thus, these communities have the potential to advance public health and to promote health by encouraging collective action. The current study utilized a qualitative analysis of participation in ICCs to examine advocacy processes in ICCs. The analysis included over 1,000 email messages posted to two different ICCs. Findings: the content of email messages in these groups included attempts to promote three types of advocacy: (a) self-advocacy in communication with health care providers, (b) rallies and fund-raising for awareness, research and treatment for the type of cancer the community suffered from. To a lesser degree, communication in ICCs related to (c) issues related to health insurance and/or to larger health-policy issues. In addition, communication in the lung-cancer ICC related to Tobacco Companies were raised. Finally, grass-root organization utilized lung ICCs to gain vis...
Thesis (Ph. D.)--University of New Mexico, 2002. Includes bibliographical references (leaves 184-... more Thesis (Ph. D.)--University of New Mexico, 2002. Includes bibliographical references (leaves 184-197).
This study analyzes Israeli students' memories of television in the context of family life, a... more This study analyzes Israeli students' memories of television in the context of family life, and considers culture and systems as well. The study was geared toward broadening the understanding of individuals' perceptions of the role of television in the family, as well as gaining insight into the collective story or stories of life with television in Israel. Forty-three Israeli university students were asked to write about their personal histories and experiences of and with television; similar autobiographies by American students from a study in the late 1980s were used for comparison. The analysis of the autobiographies covered the categories of television use, interaction, play and imitation, cognition, emotions, consumer behavior, and national identity/world knowledge. The analysis showed that most respondents had pleasant memories of watching the children's programs on ITV, remembered the introduction of color television, and grew up in families that did not limit vi...
Cancer prevention information (CPI) needs are common among cancer patients and their families, bu... more Cancer prevention information (CPI) needs are common among cancer patients and their families, but processes of CPI seeking following cancer diagnosis are largely unknown. The goal of this study was to examine antecedents of CPI seeking among a diverse sample of patients and their caregivers. Findings revealed high levels of perceived personal importance of CPI and motivational factors (health consciousness), but almost half of respondents never sought CPI. Non-seekers were more likely to have lower household income and educational attainment. Minority respondents were less likely to seek CPI compared with non-Hispanic Whites, with increased risk among Spanish-speaking Hispanics. However, only educational attainment, health consciousness, and marital status were significant predictors of CPI seeking in the final logistic regression model. These disparities demonstrate the need for communication interventions in healthcare settings.
One of the major challenges facing those working with people living with HIV (PLWH) is the increa... more One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p < .005, R(2) = .18). Further negative organizational culture (i.e., critical appraisal) was positively related to depersonalization (p < .005, R(2) = .18). These findings suggest that effective organizational communication interventions might protect HIV health-care providers from burnout.
In the era of highly active antiretroviral therapy era, medication adherence and health-related q... more In the era of highly active antiretroviral therapy era, medication adherence and health-related quality of life (HRQOL) have become critical issues for people living with HIV/AIDS (PLWH). The purpose of this study was to test explanatory models of how patient-provider interaction and patient satisfaction are related to medication adherence and HRQOL for PLWH. A total of 344 PLWH receiving health-care services from a federally funded clinic in the southwest USA completed a survey questionnaire about their perception of interactions with providers, their satisfaction with services, their medication adherence, and their HRQOL. Comparing four latent variable structural equation models of direct and mediated effects of patient-provider interaction and patient satisfaction, the findings illustrate that the best model is one in which patient-provider interaction has a direct and positive effect on patient satisfaction, medication adherence, and HRQOL. These findings suggest that quality pa...
The innovative educational communication interventions described in this paper include the use of... more The innovative educational communication interventions described in this paper include the use of bi-lingual, low literacy level websites and training created by low income Latina women to increase access to health care, health information, and the internet. We focus on one grassroots intervention, aimed at increasing access to health care for under and uninsured Latino/a. We also outline a proposal for an academic-community intervention to increase mental health service utilization of young Latino/a children to indicate future possibilities of such collaborations. We describe the rationale, conceptual framework, theoretical underpinnings, design and implementation, evaluation and institutionalization of this strategy, as well as its challenges and lessons learned.
Low-income Hispanics are the most digitally underserved population in the U.S. This article exami... more Low-income Hispanics are the most digitally underserved population in the U.S. This article examines the potential of community-based participatory research approach to e-health to decrease the disparities in access to technology and health information in low-income Hispanic communities. To demonstrate this framework, we describe the process of designing a community-based e-health intervention to increase knowledge and parental self-efficacy in coping with young children's mental health problems including mental health service utilization. Our model incorporates utilizing promotoras de salud (lay community health educators) and community media principles to create the content of e-health interventions and train community members in using the technology. This case study illustrates the processes involved in using this approach, barriers for participatory e-health interventions in bridging the Digital Divide, and lessons learned.
Despite international efforts, national and ethnic disparities in utilization of breast cancer (B... more Despite international efforts, national and ethnic disparities in utilization of breast cancer (BC) screenings prevail. In the United States, Hispanic women have one of the lowest BC screening rates. The purpose of our study was to examine how Hispanic women in New Mexico described their breast care behavior (BCB; BC screening practices, motivation to act, and breast care information behavior). Analysis of focus groups revealed five types of approaches to BCB. These findings have global implications for health care practitioners in directing attention toward the complexity of BC preventive behavior. Implications for other ethnic groups are discussed.
The purpose of this study was to investigate the influence of 3 subjective cultural variables—sel... more The purpose of this study was to investigate the influence of 3 subjective cultural variables—self-construals (independence and interdependence), ethnic identity (bicultural, assimilation, traditional, and marginal), and cultural health attributions (equity and behavioral–environmental attributions)—on source, message, and channel preferences for receiving breast health information by Hispanic women age 35 or older. Subjective cultural variables collectively accounted for 2% to 28% of the variance in communication preferences. In addition, several associations were discovered: (a) having an interdependent self-construal was associated positively with preferences for significant other as a source, family sources, fear messages, media channels, and face-to-face channels; (b) having a bicultural identity was associated positively with preferences for family sources and media channels, but negatively with a desire for no information; and (c) having a marginal identity and equity attributions were associated positively with preferences for fear messages and a desire for no information, but negatively with preferences for expert sources. These findings are discussed in the context of tailoring breast health information to Hispanic women using computer technology and entertainment–education.
Background: The digital divide is a recognized public health problem caused by social determinant... more Background: The digital divide is a recognized public health problem caused by social determinants that exacerbate health disparities. Despite the " tectonic shift " in how most of the public obtains cancer information, underserved communities are at increased risk of being digitally marginalized. However, research that examines factors underlying eHealth information seeking in diverse health contexts is lacking.
Internet cancer communities (ICCs) provide a new and unique collective setting for people with ca... more Internet cancer communities (ICCs) provide a new and unique collective setting for people with cancer. Thus, these communities have the potential to advance public health and to promote health by encouraging collective action. The current study utilized a qualitative analysis of participation in ICCs to examine advocacy processes in ICCs. The analysis included over 1,000 email messages posted to two different ICCs. Findings: the content of email messages in these groups included attempts to promote three types of advocacy: (a) self-advocacy in communication with health care providers, (b) rallies and fund-raising for awareness, research and treatment for the type of cancer the community suffered from. To a lesser degree, communication in ICCs related to (c) issues related to health insurance and/or to larger health-policy issues. In addition, communication in the lung-cancer ICC related to Tobacco Companies were raised. Finally, grass-root organization utilized lung ICCs to gain vis...
Thesis (Ph. D.)--University of New Mexico, 2002. Includes bibliographical references (leaves 184-... more Thesis (Ph. D.)--University of New Mexico, 2002. Includes bibliographical references (leaves 184-197).
This study analyzes Israeli students' memories of television in the context of family life, a... more This study analyzes Israeli students' memories of television in the context of family life, and considers culture and systems as well. The study was geared toward broadening the understanding of individuals' perceptions of the role of television in the family, as well as gaining insight into the collective story or stories of life with television in Israel. Forty-three Israeli university students were asked to write about their personal histories and experiences of and with television; similar autobiographies by American students from a study in the late 1980s were used for comparison. The analysis of the autobiographies covered the categories of television use, interaction, play and imitation, cognition, emotions, consumer behavior, and national identity/world knowledge. The analysis showed that most respondents had pleasant memories of watching the children's programs on ITV, remembered the introduction of color television, and grew up in families that did not limit vi...
Cancer prevention information (CPI) needs are common among cancer patients and their families, bu... more Cancer prevention information (CPI) needs are common among cancer patients and their families, but processes of CPI seeking following cancer diagnosis are largely unknown. The goal of this study was to examine antecedents of CPI seeking among a diverse sample of patients and their caregivers. Findings revealed high levels of perceived personal importance of CPI and motivational factors (health consciousness), but almost half of respondents never sought CPI. Non-seekers were more likely to have lower household income and educational attainment. Minority respondents were less likely to seek CPI compared with non-Hispanic Whites, with increased risk among Spanish-speaking Hispanics. However, only educational attainment, health consciousness, and marital status were significant predictors of CPI seeking in the final logistic regression model. These disparities demonstrate the need for communication interventions in healthcare settings.
One of the major challenges facing those working with people living with HIV (PLWH) is the increa... more One of the major challenges facing those working with people living with HIV (PLWH) is the increased potential for burnout, which results in increased turnover and reduces quality of care provided for PLWH. The goal of this study was to examine the relationship among HIV health-care providers' burnout (emotional exhaustion and depersonalization) and organizational culture including teamwork, involvement in decision-making, and critical appraisal. Health-care providers for PLWH (N = 47) in federally funded clinics in a southwestern state completed a cross-sectional survey questionnaire about their perceptions of organizational culture and burnout. The results of multiple regression analysis indicated that positive organizational culture (i.e., teamwork) was negatively related to emotional burnout (p < .005, R(2) = .18). Further negative organizational culture (i.e., critical appraisal) was positively related to depersonalization (p < .005, R(2) = .18). These findings suggest that effective organizational communication interventions might protect HIV health-care providers from burnout.
In the era of highly active antiretroviral therapy era, medication adherence and health-related q... more In the era of highly active antiretroviral therapy era, medication adherence and health-related quality of life (HRQOL) have become critical issues for people living with HIV/AIDS (PLWH). The purpose of this study was to test explanatory models of how patient-provider interaction and patient satisfaction are related to medication adherence and HRQOL for PLWH. A total of 344 PLWH receiving health-care services from a federally funded clinic in the southwest USA completed a survey questionnaire about their perception of interactions with providers, their satisfaction with services, their medication adherence, and their HRQOL. Comparing four latent variable structural equation models of direct and mediated effects of patient-provider interaction and patient satisfaction, the findings illustrate that the best model is one in which patient-provider interaction has a direct and positive effect on patient satisfaction, medication adherence, and HRQOL. These findings suggest that quality pa...
The innovative educational communication interventions described in this paper include the use of... more The innovative educational communication interventions described in this paper include the use of bi-lingual, low literacy level websites and training created by low income Latina women to increase access to health care, health information, and the internet. We focus on one grassroots intervention, aimed at increasing access to health care for under and uninsured Latino/a. We also outline a proposal for an academic-community intervention to increase mental health service utilization of young Latino/a children to indicate future possibilities of such collaborations. We describe the rationale, conceptual framework, theoretical underpinnings, design and implementation, evaluation and institutionalization of this strategy, as well as its challenges and lessons learned.
Low-income Hispanics are the most digitally underserved population in the U.S. This article exami... more Low-income Hispanics are the most digitally underserved population in the U.S. This article examines the potential of community-based participatory research approach to e-health to decrease the disparities in access to technology and health information in low-income Hispanic communities. To demonstrate this framework, we describe the process of designing a community-based e-health intervention to increase knowledge and parental self-efficacy in coping with young children's mental health problems including mental health service utilization. Our model incorporates utilizing promotoras de salud (lay community health educators) and community media principles to create the content of e-health interventions and train community members in using the technology. This case study illustrates the processes involved in using this approach, barriers for participatory e-health interventions in bridging the Digital Divide, and lessons learned.
Despite international efforts, national and ethnic disparities in utilization of breast cancer (B... more Despite international efforts, national and ethnic disparities in utilization of breast cancer (BC) screenings prevail. In the United States, Hispanic women have one of the lowest BC screening rates. The purpose of our study was to examine how Hispanic women in New Mexico described their breast care behavior (BCB; BC screening practices, motivation to act, and breast care information behavior). Analysis of focus groups revealed five types of approaches to BCB. These findings have global implications for health care practitioners in directing attention toward the complexity of BC preventive behavior. Implications for other ethnic groups are discussed.
The purpose of this study was to investigate the influence of 3 subjective cultural variables—sel... more The purpose of this study was to investigate the influence of 3 subjective cultural variables—self-construals (independence and interdependence), ethnic identity (bicultural, assimilation, traditional, and marginal), and cultural health attributions (equity and behavioral–environmental attributions)—on source, message, and channel preferences for receiving breast health information by Hispanic women age 35 or older. Subjective cultural variables collectively accounted for 2% to 28% of the variance in communication preferences. In addition, several associations were discovered: (a) having an interdependent self-construal was associated positively with preferences for significant other as a source, family sources, fear messages, media channels, and face-to-face channels; (b) having a bicultural identity was associated positively with preferences for family sources and media channels, but negatively with a desire for no information; and (c) having a marginal identity and equity attributions were associated positively with preferences for fear messages and a desire for no information, but negatively with preferences for expert sources. These findings are discussed in the context of tailoring breast health information to Hispanic women using computer technology and entertainment–education.
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