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Using Targeted Photographs to Improve Health Messages for Stigmatized Populations

Using Targeted Photographs to Improve Health Messages for Stigmatized Populations

In a recent e-publication in the Journal of Health Communication, Mary Buller, President of Klein Buendel (KB), and her coauthors report results of an evaluation of using Real Health Photos in health communication messaging. 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 KB to portray the diversity of health through photography and promote the inclusion of all populations in health promotion materials and media.

Of particular concern is how to reach underserved populations with effective health messages. Underserved groups with particular health needs — including people with disabilities, the elderly, and the overweight or obese — are underrepresented in popular media images and are often stigmatized so that they have to deal with prejudice and ostracization.

This research project tested the prediction that photographs depicting people very similar to the target population of a health message would improve the health communication and increase the  target populations’ intentions to change behavior in a favorable, more healthful direction. The evaluation of using Real Health Photos in health communication messaging was guided by the homophily principle. The homophily principle — that perceived similarities among people produce positive reactions — is a cross-cultural, global phenomenon and is grounded in the power of identification. Specifically, the study tested two hypotheses: (1) whether a health communication message will be more effective (that is, create stronger behavioral intentions to increase physical activity and eat a healthy diet) when incorporating photographs that match the target population than photographs that do not match the population in disability, age, or weight; and (2) whether the effectiveness of photographs that match the population on disability, age, or weight will be mediated by identification with persons in the photographs (that is, matched photographs will increase identification relative to unmatched photographs and increased identification will be associated with greater behavioral intentions).

To test the hypotheses, three nationally-representative samples of adults (n=1,796) who were physically-disabled, elderly, or overweight/obese 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. Statistical analysis confirmed that Real Health Photos that matched the specific target population increased behavioral intentions mediated by identification in the physically-disabled and overweight/obese samples. Matched visual images improved health message effectiveness by capitalizing on the homophily and identification processes.

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, Dr. Kim Henry from Colorado State University, Lyndsay Fluharty from Telligen, Inc., and Dr. Erwin Bettinghaus, Xia (Lucia) Liu, Steve Fullmer, and Dr. David Buller from KB.

¡Caminemos Juntas!: A Smartphone App for Latinas to Connect with Walking Partners

¡Caminemos Juntas!: A Smartphone App for Latinas to Connect with Walking Partners

Dr. Valerie Myers, Klein Buendel (KB) Senior Scientist, is the Principal Investigator leading a new research project aimed at helping Latinas combat barriers to physical activity using smartphone technology and social networks.

Hispanic women are a growing and influential segment of the population, yet health disparities for Latinas remain high. Latinas are more likely than their non-Hispanic White counterparts to be overweight, diagnosed with diabetes, and physically inactive. Regular physical activity promotes physical and emotional well-being, such as lower risk of heart disease and diabetes, weight management, and improved quality of life, yet physical activity interventions for Latinas remain limited.

Community-focused walking interventions produce improvements in physical activity and are well-received by Latinas when they are socioculturally sensitive. New technology has the ability to provide Latinas with innovative ways to connect socially and increase PA. Location-based services (LBS) are a popular technology that uses geographical positioning to allow individuals to use their smartphones to connect to their surrounding environment.

¡Caminemos Juntas! is a physical activity walking app that uses location-based services to connect Latinas within nearby neighborhoods as a way to provide social support for increased walking behavior. A prototype of the ¡Caminemos Juntas! app was programmed for both iOS and Android smartphones in a previous Phase I project. Multi-method formative research was conducted to guide app design and content prior to conducting field usability testing. To guide prototype development, a national sample of Latinas (n=98; mean age 32.7 +/- 7.8 years; 45% primary Spanish speaking; 28.6% with annual income < $15,000) were surveyed to better understand their preferences, usage, needs, and obstacles of current apps in relation to health and physical activity. Latinas’ current physical activity behaviors and smartphone use, opinions on health-related apps using LBS, how often they access social networking sites on their mobile phone, and their likelihood of using a social networking app to connect to others with intentions to be physically active were also examined.

Phase I results revealed that 22.5% never or rarely exercised, 73.5% accessed social networking sites daily with an average of 8 times a day, and 43.9% used LBS every day. Ease of use (82%), informationally accurate (79.2%), and reliability (84.7%) were app features rated as highly important. Over 63% reported high likelihood of using a social networking app to connect to others with the intentions of being physically active, and 67.4% reported that this type of app would be very helpful. Focus groups showed that the app was appealing, also.

In the new Phase II project, the ¡Caminemos Juntas! app will be fully developed and evaluated in a randomized control trial with Latinas aged 18-45 in San Jose, CA and Denver, CO. Changes in physical activity, social support for exercise, and quality of life will be evaluated. New features to be explored include Fitbit® device integration, mapping of walks, and social media integration. The LBS features of the app will allow Latinas to determine a safe place to meet for a walk, connect with other users nearby, and be notified if there was an available walk in the user’s vicinity.

The research is funded by the National Institute on Minority Health and Health Disparities (MD009652) at the National Institutes of Health through the Small Business Innovation Research Program. Dr. Myers’ collaborators include Dr. Abby King from Stanford University, and Dr. Gary Cutter from Pythagorus, Inc. in Alabama.

Way to Serve Tops 75,000 Trainings

Way to Serve Tops 75,000 Trainings

WayToServe®an evidence-based online responsible alcohol server training program, has achieved a significant milestone by surpassing 75,000 completed trainings. The program, developed by scientists at Klein Buendel, Inc. (KB), the University of New Mexico (UNM), and the Pacific Institute for Research and Evaluation, was initially evaluated in a controlled randomized trial that resulted in increased refusal of sales to intoxicated patrons. WayToServe® was then transferred from its research phase to commercialization in 2012. It was licensed to Wedge Communications LLC for marketing and distribution initially in New Mexico for training of on- and off-site alcohol servers.

Additional state-specific versions of WayToServe® have been created that conform to the Responsible Beverage Service curriculum requirements of the State of California, the Texas Alcoholic Beverage Commission, Washington State Liquor Control Board, and Oregon Liquor Control Commission. WayToServe® is now sold in California, New Mexico, Texas, and Washington. The Spanish version, WayToServe Español, is scheduled to be tested in New Mexico and Texas later this year.

Commenting on the milestone achievement, Dr. David Buller, KB Director of Research and WayToServe® Co-Investigator, said “Plans are underway to refresh the entire online training for the next 75,000 servers to learn to sell alcohol responsibly and keep their customers and communities safe.”

The creation and evaluation of the original WayToServe® program was sponsored by two grants from National Institutes of Health to UNM (Dr. W. Gill Woodall, Principal Investigator). The WayToServe Español research project is being funded by a Small Business Innovative Research (SBIR) grant to KB from the National Institute of Minority Health and Health Disparities (R44MD010405; Dr. W. Gill Woodall, KB Senior Scientist, Principal Investigator).

Real Health Photos – Yoga Awareness Month

Real Health Photos – Yoga Awareness Month

September is National Yoga Awareness Month. Yoga is a mind and body practice with historical origins in ancient Indian philosophy. Like other meditative movement practices used for health purposes, various styles of yoga typically combine physical postures, breathing techniques, and meditation or relaxation.

According to the National Center for Complementary and Integrative Health at the National Institutes of Health, millions of Americans of all ages practice yoga each year. Many people who practice yoga do so to maintain their health and well-being, improve physical fitness, relieve stress, and enhance quality of life. They may also be addressing specific health conditions, such as back pain, neck pain, arthritis or anxiety.

KB’s Real Health Photos stock photography enterprise includes thousands of images to help organizations visually illustrate people being physically active for better health. Real Health Photos images show diversity of gender, race, ethnicity, age, income level, and health condition.

Use Real Health Photos for improving the impact of health campaigns for all kinds of people, including people practicing yoga.

Woman Sitting Doing YogaMan and Woman Standing On Rock Outstretching Arms Doing YogaTwo Women Holding Hands Standing On One Foot Each Doing YogaWoman Reaching for Sky Doing Yoga
For more images, visit Real Health Photos.

Real Health Photos is a stock photography service owned and operated by KB. It was created and evaluated with a research grant (R44MD003338, 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.

Collaborator Spotlight:
Dr. Victoria Sánchez

Collaborator Spotlight:
Dr. Victoria Sánchez

Dr. Victoria Sánchez is an Associate Professor in the College of Population Health at the University of New Mexico (UNM) in Albuquerque.  She earned her MPH at the University of California at Berkeley and her Doctorate in Public Health (DrPH) in Health Behavior and Health Education at the University of North Carolina at Chapel Hill.  She directs the MPH Community Health Concentration track at UNM and teaches social and behavioral sciences courses for the UNM College of Public Health.

Dr. Sánchez has a long-standing commitment to participatory planning and evaluation processes with communities and public health organizations. Over the last thirty years, she has integrated her expertise in public health practice and participatory and multidisciplinary research methodologies to plan and implement joint solutions for reducing health and social disparities in Latino and other vulnerable communities. As a member of multidisciplinary teams, she has applied social and cultural theories and models in the development, tailoring, testing, and evaluation of interventions to improve the health of Latinos/Hispanics in New Mexico, Texas, and California.

Currently, Dr. Sánchez is working with Klein Buendel as a collaborating scientist with Dr. Gill Woodall and Dr. David Buller on WayToServe Español: A Culturally-Appropriate Online Responsible Beverage Service Training for Spanish-Speaking Servers (R44MD010405; Dr. Gill Woodall, Principal Investigator). This research project is funded by the National Institute on Minority Health and Health Disparities. Dr. Sánchez collaborates on the creation and evaluation of culturally-appropriate content and the translation of the English WayToServe® online training program to Spanish. She helps ensure that the translation is compatible with the values and needs of servers in Spanish language-dominant bars and restaurants. The randomized control trial is being conducted at Spanish-dominant businesses in the Southwestern region of the United States.

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Real Health Photos – National Safety Month

Real Health Photos – National Safety Month

For 100 years, the National Safety Council has been the leading safety advocate preventing unintentional injuries and death in the United States. The Council’s National Safety Month, Observed annually in June, focuses on reducing leading causes of injury and death on the job, on the road, in the home, and in all communities. Specific areas they address include workplace violence prevention, safe driving, poisoning prevention, ergonomics, and fall prevention.

More than 33,000 people, for example, died in falls in 2015, according to the National Safety Council. “Falling is the third leading cause of unintentional injury-related deaths over all age groups, but it’s the #1 cause of death for those 65 and older” (Injury Facts 2017, National Safety Council). Strategies for preventing falls include securing carpets to the floor, wiping up spills immediately, installing grab bars in tubs, in showers, and near toilets, and if necessary, provide personal walking devices, such as canes or walkers, to aid in stability.

Klein Buendel’s Real Health Photos stock photography enterprise includes numerous images of older adults using personal walking devices. These unique photographs can be used in educational materials to show older adult populations how easy and typical it is for people to use devices for safe walking.

Real Health Photos images show a diversity of gender, race, ethnicity, age, income level, and health condition. Use Real Health Photos for improving the impact of health campaigns for people from all walks of life, including older adults.

Senior lady with caneSenior man with caneSenior lady with cane 2Senior man with cane 2
For more images, visit Real Health Photos.

Real Health Photos Logo

Real Health Photos is a stock photography service owned and operated by KB. It was created and evaluated with a research grant (R44MD003338, 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.

Real Health Photos® is a KB registered trademark.

Real Health Photos – International Women’s Day

Real Health Photos – International Women’s Day

March 8 is International Women’s Day (IWD) around the globe. This year’s theme is Press for Progress — a call to motivate and unite friends, colleagues, and whole communities to think, act, and be, gender inclusive.

Started by the Suffragettes in the early 1900’s, the first International Women’s Day was celebrated in 1911. According to the IWD website, “International Women’s Day belongs to all communities everywhere – governments, companies, charities, educational institutions, networks, associations, the media and more. Whether through a global conference, community gathering, classroom lesson or dinner table conversation – everyone can play a purposeful part in pressing for gender parity.”

Women of all ages, races, ethnicities, sizes, shapes, disabilities, and capabilities are often the focus of targeted health promotion campaigns. Matching photographic images to a target population can improve the effectiveness of a health message, according to KB research. The message is more effective because the photographs increase the audience member’s identification with the message in a very real and visual way.

KB’s Real Health Photos stock photography enterprise includes thousands of images to help improve the effectiveness of health promotion messages for targeted audiences. Real Health Photos images show diversity of gender, race, ethnicity, age, income level, and health condition or physical ability.

Use Real Health Photos for improving the impact of health campaigns for all kinds people, including women.

Two Hispanic Women Walking and Talking OutsideA white women and a black woman talking and laughing outsideTwo Young Female Friends Drinking WaterMother, Daughter and Woman Doctor

For more images, visit Real Health Photos.

Real Health Photos Logo

Real Health Photos is a stock photography service owned and operated by KB. It was created and evaluated with a research grant (R44MD003338, 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.

Real Health Photos® is a KB registered trademark.