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Month: February 2019

Improving Health Communication in Three Minority Populations with Photographic Images that Increase Identification

Improving Health Communication in Three Minority Populations with Photographic Images that Increase Identification

In a recent e-publication in Health Education Research, Mary Buller, President of Klein Buendel, and her coauthors report the results of an evaluation using Real Health Photos in health communication messaging with three racial/ethnic populations (i.e., African Americans, Hispanics, and Native Americans). The study explored an approach to more effectively reach underserved populations with health messages using the homophily principal.

The homophily principle, that perceived similarities among people produce positive reactions, is a cross-cultural, global phenomenon. It is grounded in the power of identification. The study tested the prediction that photographs depicting models very similar to the target population would improve health communication by increasing perceived identification and increase the target populations’ intentions to change behavior in a favorable, more healthful direction.

To test the hypothesis, three nationally-representative stratified samples of adults (n=1,638) who were African American, Hispanic, or Native American were selected from a large national survey panel. Participants read an identical message promoting increased moderate to vigorous physical activity and decreased intake of high fat, high sugar, and high carbohydrate foods. Photographs from a commercial stock photograph service versus photographs created for the research project to match the three populations — from Real Health Photos®– were included in the messages. Participants responded to assessments of behavioral intentions, outcome and self-efficacy expectations, and identification.

Structural equation modeling confirmed the theoretical hypothesis that Real Health Photos which matched the minority population increased behavioral intentions and was mediated by identification in all three racial/ethnic minority samples. Messages with only half of the matched Real Health Photos images had these same positive indirect effects among African Americans and Hispanics. The impact of matching visual images in health messages to recipients derived from identification with the people in the images. Homophily and identification are hard-wired, evolutionary, biological phenomena that can be capitalized on by health educators with minority populations to improve message effectiveness.

Real Health Photos is a unique collection of images of people with diversity of age, gender, race, ethnicity, income level, and health condition. The collection was produced by Klein Buendel to portray the diversity of health through photography and promote the inclusion of all populations in health promotion materials and media.

The development of Real Health Photos and this research were funded by a Small Business Innovation Research grant from the National Institute of Minority Health and Health Disparities (MD003338; Mary Buller, Principal Investigator). Coauthors include Dr. Peter Andersen from San Diego State University, Dr. Michael Slater from The Ohio State University, Lyndsay Fluharty from Telligen, Inc., Dr. Kim Henry from Colorado State University, and Dr. Erwin Bettinghaus, Xia (Lucia) Liu, Steven Fullmer, and Dr. David Buller from Klein Buendel. Many of the Real Health Photos used in this study were taken by Delia Palmisano from Blue House Photography in Denver, Colorado.

Development of Educational Modules to Enhance Care of Aged and Dying Inmates

Development of Educational Modules to Enhance Care of Aged and Dying Inmates

The United States has the highest rate of incarceration in the world and the demographics of the prison inmate population are shifting and aging. Many older adults are serving extended sentences and will age and die in place — making geriatric and end-of-life care an essential educational foci for prison staff. Consequently, resources are needed to adequately prepare prison staff to address this growing concern.

In a recent publication in Public Health Nursing, a research team led by Dr. Susan Loeb from Penn State University and including Klein Buendel (KB) Senior Scientist, Dr. Valerie Myers, reports on the development of educational modules to enhance the care of aged and dying inmates in prisons. The article describes the strategies used to “set-up” the Enhancing Care for the Aged and Dying in Prisons (ECAD-P) educational modules. “Set-up” is the first of four phases in the Institute for Healthcare Improvement (IHI) Framework for Going to Full Scale, which served as the conceptual framework for this study. Objectives achieved during the Set-up phase include: (a) establishing an approach for infusing the intervention into the target system; (b) identifying the product that needs scaling-up; and (c) determining what will be accomplished in the full-scale phase. Also, program buy-in within the given context and identification of the test sites, as well as support by early adopters, are essential.

The design approach for the educational modules included an environmental scan, a modified Delphi study, and a usability study.

An environmental scan provided a foundational understanding of the complex, contextual factors that impact correctional settings in the United States. Specifically, the environmental scan of diverse correctional settings helped to determine current educational approaches, education and learning preferences of personnel, and the technological capacity to deliver computer-based educational modules. Gaining knowledge was essential for the targeted development of modules that are tailored to address the health needs of the growing numbers of older inmates, many of whom will remain incarcerated through their end of life.

The Delphi process uses iterative group facilitation to forge reliable consensus on the opinion of experts through a series of structured questionnaires or rounds. The goal is to secure expert judgment based on experience. A Delphi survey was conducted early in the Set-Up phase to identify essential geriatric content for integration into the new prototype learning modules. The outcome was a reliable consensus on essential geriatric content for inclusion into the newly rebranded ECAD-P modules. An Expert Advisory Board reviewed the findings and validated the results.

For the usability assessment, the research team collaborated to design and program three media-rich, interactive computer-based prototype modules designed for the corrections context. The prototype, containing three modules, was built using Axure development software. The prototype was self-contained on a laptop computer. Each module had learning objectives, content delivered through multiple interactive features (for example: drag and drop, hover, click and reveal, video) and a final comprehension check quiz. Usability and acceptability testing were assessed following an established protocol examine navigability, detect problems, observe time spent solving problems, identify problem severity, and develop recovery strategies. After usability testing, the participants completed the System Usability Scale, a validated tool for assessing the usability and acceptability of technology-based products. Testing was conducted with 16 participants at two state correctional institutions in one mid-Atlantic state.

A full description of the methods, results, conclusions, and limitations of this study, as well as the implications for public health nursing, can be found in Public Health Nursing. This research was funded by a Small Business Technology Transfer (STTR) grant to KB from the National Institute on Aging at the National Institutes of Health (AG049570; Dr. Susan Loeb, Principal Investigator). Other collaborators/coauthors include Dr. Janice Penrod, Dr. Erin Kitt-Lewis, Dr. Rachel Wion, and Brenda Baney from Penn State University; and Sophia Strickfaden from Johnson & Wales University. KB’s Creative Team produced the ECAD-P prototype modules.

Skin Cancer Awareness for Winter Enthusiasts

Skin Cancer Awareness for Winter Enthusiasts

Last month, Klein Buendel (KB) teamed up with the Colorado Skin Cancer Task Force (CSCTF) and Rocky Mountain Sunscreen (RMS) at the Annual Outdoor Retailer and Snow Show to spread skin cancer awareness to outdoor winter enthusiasts.

Per their website, the Outdoor Retailer Snow Show is the largest outdoor snow sports industry gathering in North America. The trade show brings outdoor industry brands, suppliers, retailers, and leaders together for a three-day expo at the Colorado Convention Center. Although the trade show is closed to the public, last year the event attracted over 29,000 attendees with representatives from over 1,000 brands.

The extensive Snow Show provides the opportunity to reach thousands of individuals who work and recreate outdoors. Every year, for over a decade, KB has partnered with the CSCTF and RMS to raise awareness about UV radiation and skin cancer prevention at the event. We stress the importance of practicing sun safety at high elevation during the winter months when UV can reach very high levels.

Specifically, KB increases people’s awareness of their personal risk for skin cancer by taking individual’s UV photographs using a Reveal Imager. The imager by Canfield, has the ability to capture and expose a lifetime of sun damage in a single image of someone’s face that is otherwise invisible to the naked eye. From the image, KB staff point out problem areas that have received damage from the sun and suggested simple sun safety practices for people to better protect themselves from accruing further UV damage.

Other members of the CSTF, including Colorado dermatologists and dermatology interns, were also present to help field questions and to perform free skin examinations on request.

African Heritage and Health Week

African Heritage and Health Week

The first week of February is African Heritage and Health Week – a celebration of the flavors and healthy cooking techniques that were central and vital to the well-being of African ancestors from Africa, South America, the Caribbean, and the American South. February is the perfect time to honor and explore this healthy culinary history because it is also Black History Month.

African Heritage and Health Week was pioneered by Oldways to promote healthier, happier living through cultural food traditions. Studies have shown that many chronic conditions such as diabetes, heart disease, and obesity, now prevalent in African American communities, tend to appear in populations as traditional diets are changed or abandoned. The program is designed to raise awareness about the health benefits and exciting flavors of traditional African heritage cuisines, and to invite people everywhere to taste these traditional foods, whether at a restaurant, a community event, or at home with friends and family.

Klein Buendel’s Real Health Photos® can help increase the effectiveness of health campaigns – such as those promoting healthy cultural cooking in African American communities – by providing photographs for print and digital media that represent and appeal to the target population. This unique stock photography enterprise includes numerous images of people shopping, cooking, and eating in healthy ways. Real Health Photos show diversity of gender, race, ethnicity, age, income level, and health condition.

Real Health Photos is a stock photography service owned and operated by Klein Buendel. It was developed with a research grant (MD003338, Mary Buller, Principal Investigator) from the National Institute of Minority Health and Health Disparities at the National Institutes of Health. Real Health Photos is designed to capture the diversity of health through photography and promote the inclusion of all populations in health promotion materials and media – and the effectiveness of the intended health message.

For more images, visit Real Health Photos.

Ms. Mary Buller, President and Owner of Klein Buendel, and her coauthors recently published a paper on their photographic research in the Journal of Health Communication.