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There are disturbing racial disparities in many health outcomes. However, do health communicators know how to do interventions that redress disadvantage? This article describes what communication campaigns do to address disparities, looks for evidence that segmented campaigns reduce disparities, and describes evidence that might support segmentation decisions (about behaviors, messages, channels, or message executions). The authors note arguments that segmentation can risk negative effects yet find no evidence about whether race- or ethnicity-conscious segmentation reduces disparities. Nonetheless, with evidence, some approaches to segmentation are justified on commonsense grounds and for their political legitimacy. Keywords: segmentation; communication campaigns; cost-effectiveness

This paper examines associations between symptoms, judgment of severity and treatments given for episodes of childhood diarrhea. Using data from ten large sample surveys conducted in six research sites in Asia and Africa, the paper addresses three main questions. One, to what extent are judgments of severity of diarrhea among young children a function of the symptoms observed during an episode of diarrhea? Two, what is the relative importance of symptoms observed vs judgments of severity in the treatments given for diarrhea? And three, what do the results imply for programs promoting the use of ORT for diarrhea? The study found that mothers; perception of severity of illness is linked most closely to three symptoms: vomiting, fever and lassitude. These symptoms are associated with (a) treating the child at all and (b) taking the child to a health facility. These conclusions take on particular significance since they are based on a comparison of ten data sets from six sites differing widely in population density, ecology, access to medical services, educational level and financial resources. Key words - diarrhea, ORT, treatment

Objectives. Adolescents are increasingly at risk for infection with human immunodeficiency virus (HIV) and other sexually transmitted diseases, especially in poor urban minority communities. To aid the design of interventions in these communities, this study investigated the role of knowledge, attitudes, perceived parental monitoring, and peer behavior in the onset and progression of sexual behavior in children at risk for exposure to HIV. Methods. A computerized personal interview was administered to 300 African-American 9- to 15-year-old children living in six public housing developments in a large US city. Results. Although children's knowledge about the hazards of sex increased with age, their sexual activity also increased (from 12% sexually experienced at 9 years of age to more than 80% experienced at 15 years of age). Parental monitoring appeared able to influence sexual activity. However, the perceived behavior of friends was associated with the rate at which sexual activity progressed with age and the degree to which condom use was maintained with age. Conclusions. The early onset and prevalence of sexual behavior and the importance of peer group influence call for early interventions that simultaneously influence the parents and peers in children's social networks, (Am J Public Health. 1994; 84:977-985), Urban, low-income black adolescents may experience early onset of sexual activity and peers seem to be the most influential factor on age of onset and use of condoms. Three hundred children ages nine through 15 living in housing projects were administered a computer interview on-site. As many as 12% of nine-year-olds reported having sex, and by age 15 almost all boys and 80% of girls reported sexual activity. Most had used condoms, and although many reported use of a condom at last intercourse, condom use declined with age and was associated with the perception that friends used condoms. Onset of sexual activity also correlated with the perception that friends were engaging in sexual activity. Condom use did not relate to knowledge about the hazards of unprotected intercourse. Parental monitoring correlated with less sexual activity but not condom use.

This study examined the volume of oral rehydration solutions given to children during diarrhea and the length of time the solutions are administered. It also attempted to test the importance of individual and contextual factors - especially mothers' knowledge - in explaining the administration of oral rehydration solutions. Data about the treatment of an episode of child diarrhea within the last three months were collected from large samples of mothers in seven sites in Africa, Asia, and Latin America. The results showed that oral rehydration solutions were given in smaller volumes and for shorter periods of time than recommended. The majority of children received at least a glass (200-250 ml) of solution on the first day, but few received more than that. Daily administration of packet-based solutions or of sugar-salt solutions (promoted in two of the countries) during diarrhea was generally quite low, ranging from 16 to 60% of cases given an oral rehydration solution. However, in four out of six sites, at least half of the children with diarrhea for more than one day were given an oral rehydration solution for more than one day. The majority of children were given some form of other fluids (e.g. more water, special teas, or continued breastfeeding), but their value in preventing dehydration was not clear because the volume of other fluids given could not be assessed. Few of the hypothesized predictors of administration explained the variation in volume or duration of ORS/SSS administration within any specific country or across sites. The research points to the need for more information on the decision process used by mothers when treating their children's diarrhea and on outside factors influencing this process.

Abstract Background In recent years, response rates to telephone surveys have declined. Online surveys may miss many older and poorer adults. Mailed surveys may have promise in securing higher response rates. Methods In a pilot study, 1200 breast, prostate and colon patients, randomly selected from the Pennsylvania Cancer Registry, were sent surveys in the mail. Incentive amount ($3 vs. $5) and length of the survey (10 pages vs. 16 pages) were randomly assigned. Results Overall, there was a high response rate (AAPOR RR4 = 64%). Neither the amount of the incentive, nor the length of the survey affected the response rate significantly. Colon cancer surveys were returned at a significantly lower rate (RR4 = 54%), than breast or prostate surveys (RR4 = 71%, and RR4 = 67%, respectively; p < .001 for both comparisons). There were no significant interactions among cancer type, length of survey and incentive amount in their effects on response likelihood. Conclusion Mailed surveys may provide a suitable alternative option for survey-based research with cancer patients.

Electronic cigarettes (e-cigarettes) are a controversial public health topic due to their increasing popularity among youth and the uncertainty about their risks and benefits. Researchers have started to assess the valence of media content about e-cigarette use, mostly using expert coding. The current study aims to offer a methodological framework and guideline when using crowdsourcing to rate the valence of e-cigarette media content. Specifically, we present (1) an experiment to determine rating instructions that would result in reliable valence ratings and (2) an analysis to identify the optimal number of raters needed to replicate these ratings. Specifically, we compared ratings produced by crowdsourced raters instructed to rate from several different perspectives (e.g., objective vs. subjective) and determined the instructions that led to reliable ratings. We then used bootstrapping methods and a set of criteria to identify the minimum number of raters needed to replicate these ratings. Results suggested that when rating e-cigarette valence, instructing raters to rate from their own subjective perspective produced reliable results, and nine raters were deemed the optimal number of raters. We expect these findings to inform future content analyses of e-cigarette valence. The study procedures can be applied to crowdsourced content analyses of other health-related media content to determine appropriate rating instructions and the number of raters. [ABSTRACT FROM AUTHOR]

Hornik and Woolf (1999) proposed using cross-sectional survey data to prioritize beliefs to address with communication campaign messages. The empirical component of the approach combines evidence of (1) association of beliefs with intentions and (2) current level of beliefs to calculate a "percentage to gain" as the potential promise of a belief. However, the method relies on cross-sectional data; its conclusions are open to challenge. Here, a panel study assesses whether the calculated promise of a belief actually predicts future behavior change. A nationally representative sample of 3,204 U.S. youth and young adults were interviewed twice, six months apart. Sixteen beliefs about the benefits and costs of smoking cigarettes are compared with regard to their percentage to gain (calculated from cross-sectional data) and their ability to account for subsequent cigarette use. A belief's cross-sectional percentage to gain is substantially associated with its ability to predict subsequent behavior change (r = .53, p < .05). [ABSTRACT FROM AUTHOR]