Creating a National Evidence Base for Health Communication

1
Creating a National Evidence Base for Health
Communication Informatics

• HINTS Data Users Meeting
• January 20-21, 2005

2
History and Vision
3
The Way it Has Often Been
4
But Stakes are High
5
The Cancer Process
Lethal Phenotype
Cancer Burden
Evolution/ Progression
Death Due to Cancer
Malignant Transformation
Susceptibility
Pre-initiation
Natural Death
Life Span
Birth
6
Opportunities for Intervention
Death Due to Cancer
2004
2015
Natural Death
Life Span
Birth
7
Opportunities for Communication

• Preventing Metastasis
• Maintenance (Chronic)
• Chemoprevention

• Early Detection
• Informational Control
• Informed Rx Decision
• Access to Treatment

• Diet/Exercise
• Risk Reduction
• Risk Identification

Control its Behavior
Detect and Eradicate its Presence
Avert or Delay its Onset
2004
2015
Natural Death
Life Span
Birth
8
Traditional Channels

• Diet/Exercise
• Risk Reduction
• Risk Identification

Avert or Delay its Onset
Mass Media Population Targeting Community
Intervention
Natural Death
Life Span
Birth
9
Amplifying Capacity

• Diet/Exercise
• Risk Reduction
• Risk Identification

• Psychographic push
• Message tailoring
• Personal health technologies
• Genomic risk assessment

Avert or Delay its Onset
Natural Death
Life Span
Birth
10
Traditional Channels

• Early Detection
• Informational Control
• Informed Rx Decision
• Access to Treatment

• Diet/Exercise
• Risk Reduction
• Risk Identification

Detect and Eradicate its Presence
Awareness Campaigns Patient Provider Interaction
Avert or Delay its Onset
Natural Death
Life Span
Birth
11
Amplifying Capacity

• Early Detection
• Informational Control
• Informed Rx Decision
• Access to Treatment

• Diet/Exercise
• Risk Reduction
• Risk Identification

Detect and Eradicate its Presence
Avert or Delay its Onset

• Online resources
• Personal health record
• Access to care

Natural Death
Life Span
Birth
12
Traditional Channels

• Preventing Metastasis
• Maintenance (Chronic)
• Chemoprevention

• Early Detection
• Informational Control
• Informed Rx Decision
• Access to Treatment

• Diet/Exercise
• Risk Reduction
• Risk Identification

Control its Behavior
Detect and Eradicate its Presence
Avert or Delay its Onset
Paper-Based Medical Records
Natural Death
Life Span
Birth
13
Amplifying Capacity

• Preventing Metastasis
• Maintenance (Chronic)
• Chemoprevention

• Early Detection
• Informational Control
• Informed Rx Decision
• Access to Treatment

• Diet/Exercise
• Risk Reduction
• Risk Identification

Control its Behavior
Detect and Eradicate its Presence
Avert or Delay its Onset

• Electronic Medical Records
• Personal Monitoring

Natural Death
Life Span
Birth
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Experts Recommend National Surveillance Program

• To monitor changes in health information
  environment over time
• To explore usage across channels and sources
  nationally
• To combine channel usage with knowledge,
  attitudes, behaviors
• To build an evidence base for planners,
  administrators, communicators, practitioners, and
  policy makers

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HINTS I Construction Operations
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Measure Knowledge, Attitudes, Behavior
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Measure Knowledge, Attitudes, Behavior
Marker Items From Other National Surveys
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Measure Attributes of New Media

• Demassified
• Decentralized
• Interactive
• Adaptable
• Connected

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Expand Framework to Accommodate New Media
Attributes
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Initial Set of Constructs
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Conducted Extensive Pre-testing
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Reduced, Reworked Structure

• Colon
• Prostate
• Skin

Men 45

• Prostate
• Skin

Men 35-44
Internet Users

• Skin

Men 18-34

• Cancer Related
• Behaviors
• Tobacco
• Alcohol
• Fruits/Veg.
• Exercise
• Height/Weight

Screener
Health Communication
Cancer Information Seekers

• Breast
• Cervical
• Skin

Women 35-44

• Cervical
• Skin

Women 18-34
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Streamlined Coverage 30 Minutes
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Data Sharing andDissemination
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Dissemination

• Data Users (Richard Moser)
• Clean, prepare data for dissemination
• Conduct internal research on NCI priorities
• Release data set to extramural community
• Support scientific publication research
• Results Users (Kelly Blake)
• Coordinate with NCI Office of Communication
• Conduct needs analysis (APHA)
• Produce information products
• Distribute to targeted audiences

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Data Sharing
http//cancer.gov/hints/

• Posted data for download, Feb. 2004

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Data Sharing
http//cancer.gov/hints/

• Posted data for download, Feb. 2004
• Posted technical documentation

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Data Sharing
http//cancer.gov/hints/

• Posted data for download, Feb. 2004
• Posted technical documentation
• Hosting data users conference, Jan. 2005

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Creating Informatics Support for Public
Researchers
HINTS Database SAS, SPSS
How many hours do Americans watch Television?
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Working with Results Users
How can I use findings to communicate to the
public better?
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HINTS II and Beyond
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NCI Strategic Framework
Source Hiatt Rimer (1999)
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Goal Retain 50 of Survey for
Surveillance Purposes
Source Hiatt Rimer (1999)
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Goal Dedicate Remaining Space to New
Research Ideas
Social Support, Health Disparities
Media Exposure, Seeking/Scanning
Lay Models of Cancer
35
Goal Offer Complement to Laboratory
Science
Source Hiatt Rimer (1999)
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Goal Monitor Effects of New
Communication Media

• Attributes
• Demassified
• Decentralized
• Interactive
• Adaptable
• Connected

Source Hiatt Rimer (1999)
37
Goal Advance Methods Science
Relevant to New Media

• Total Survey Error
• e ? coverage
• e ? sampling
• e ? response rates
• e ? measurement

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Goal Use Informatics Approach to Enable Big
Science
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Dates to Remember

• Feb. 14, 2005 H2 in field
• Sept. 30, 2005 Data delivered to NCI
• Oct. 1, 2005 H3 development begins
• March 30, 2006 Public release H2
• May 1, 2006 H3 frozen

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Have We Enabled Behavior?
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The NCI 2015 challenge goal eliminate death
and suffering due to cancer
When I look into the eyes of a patient losing
the battle with cancer, I say to myself, It
doesnt have to be this way.Dr. A.C. von
Eschenbach, M.D.Director, National Cancer
Institute The Nations Investment in Cancer
Research (2003)
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For More Information http//cancer.gov/hin
ts hesseb_at_mail.nih.gov