The Community Liaison Program: a health education pilot program to increase minority awareness of HIV and acceptance of HIV vaccine trials.

This paper describes a 16-month health education pilot program based on diffusion of innovation and social network theories. The program was implemented by volunteer community liaisons for the purposes of increasing awareness of and support for HIV vaccine research in minority populations. This theoretically driven pilot program allowed the liaisons to integrate delivery of the HIV vaccine research messages created for the program into their existing activities and routines. Through training in participatory engagement, volunteers were able to tailor and adapt an HIV prevention message for their communities. Process evaluation data showed that the acceptance of participatory engagement and HIV vaccine message dissemination far exceeded expectations. The anticipated number of community members to receive the message was estimated at 500 with 10 volunteer liaisons or 50 per person. However, the actual number of people reached was 644, with only 7 volunteer liaisons, or an average of 92 persons per liaison, almost double the original number. Further research is recommended to analyze the specific behavioral changes that can come from the use of social networks in HIV vaccine research awareness within minority populations.

Bioethics committees--a health communication approach.

The modern health care system is being transformed as a consequence of scarce resources and better informed consumers. In this transformed health care system human communication has become a crucially important process. This essay examines the health communication functions performed by bioethics committees in health care delivery and makes recommendations for promoting the effective use of these groups within the modern health care system. The essay describes how bioethics committee can help establish a climate in which physicians and other committee members can share relevant health information, learn about patient and family concerns, promote health education and informed consent, and facilitate effective decision making about complex health care practice issues. It is argued that clear recognition and attention to the central role of effective communication within the bioethics committee is essential for the survival of the modern health care system since ethics committees depend on sharing relevant information to diagnose health problems, provide health care, promote health education, help in the formulation of new health care policies, and provide much-needed decision-making support to health care providers and consumers. The role that health communication expertise can perform in the effective operation and utilization of bioethics committees is described. We conclude that in order to provide needed support in addressing the many complexities of modern health care, bioethics committees must develop clear communication processes, norms, and roles.

Communicating to promote justice in the modern health care system.

The systemic prejudices and biases that often limit the effectiveness of health care delivery are examined. How the inherent imbalance in control between consumers and providers of health care, based on the micropolitics of sharing relevant health information, perpetuates a system of marginalization and alienation within health care delivery systems is discussed. Communication barriers that often confront many stigmatized groups of health care consumers, such as the poor, people with AIDS, minorities, the ill elderly, and women, are identified. Such prejudicial treatment is framed within a cultural ideologies model, leading to identification of communication strategies for promoting justice in the modern health care system and enhancing the quality of health care delivery.

Promoting a consumer orientation to health care and health promotion.

There is a compelling need to establish a consumer orientation to health care to address the troubling imbalance of power between providers and consumers in the modem health-care system. This power imbalance has systematically disenfranchised and marginalized health-care consumers. Adoption of a consumer orientation that focuses institutional attention and resources specifically on fulfilling the physical and psychological needs of the consumer, equalizing influence and control between health-care providers and consumers, and empowering consumers to make informed decisions about their health care will help promote social justice within the modem health-care system. Strategies are suggested to help providers and consumers develop and promote a consumer orientation in modem health care.

Testing a Relational Model for Health Communication Competence among Caregivers for Individuals with Alzheimer's Disease.

The Relational Model of Health Communication Competence suggests that health-care participants' level of communication competence is positively related to their achieving desired physiological and psychological health outcomes. This article provides a partial test of the model by examining the relationships between communication competence, social support and cognitive depression among lay caregivers of patients with Alzheimer's disease. The study provides validation for the model by demonstrating that the communication competence of the caregivers is positively related to important psychological health outcomes, such as high levels of social support, and decreases in cognitive depression. Implications of these findings and directions for future inquiry are examined.

Survey of public knowledge about digestive health and diseases: implications for health education.

Increasing emphasis in recent years has been placed on health promotion, prevention, and the self-management of health care. These strategies presume the public has sufficient levels of relevant health information, as well as necessary attitudes and skills for the effective use of this information in the management of their own health care. This study tests this assumption as it relates to the level of public knowledge of digestive health and disease, a major health concern affecting an estimated 1 in 10 Americans. This paper reports results of a telephone survey of a representative national sample administered to 1,250 Americans in May 1983 that was designed to assess their level of information about digestive health and disease, comfort in communicating about digestive problems, and preference for health information sources. The results indicate that the American public is largely uninformed and misinformed about digestive health and disease, and they underscore the need for disseminating relevant health information about digestive health and disease to the public to facilitate prevention of digestive health problems and self-management of digestive health care. Health information dissemination is severely complicated by the widespread stigma associated with digestive topics, manifested in the American public's general discomfort in communicating with others about digestive health. These factors necessitate development of sensitive and pervasive digestive health promotion and education programs in the United States.