Please post your response to the readings here! I’d encourage you to, as much as possible, link your thoughts on the reading/s to your own personal/professional/classroom experiences.
Please post your response to the readings here! I’d encourage you to, as much as possible, link your thoughts on the reading/s to your own personal/professional/classroom experiences.
This week’s readings focused on critical and culture-centered approaches to health communication. The first reading defined the culture-centered approach as “understanding that communicating about health involves the negotiation of shared meanings embedded in socially constructed identities, relationships, social norms, and structures.†A key element to this approach is the active participation of community members. The author points out that with a culture-centered approach, the researcher shifts into the role of a listener and participant in the conversation rather than the expert/authority role they employ in more traditional methods. To me, this approach essentially focuses on a tactic that we talk about a lot in public health– involving stakeholders. Stakeholders and community members are experts on their experiences, while public health professionals can be seen more are people with the technical skills. This approach of working with the community is beneficial to everyone. The public health professionals can better understand the “problem†and how it is uniquely experienced in a particular community or by a particular demographic group of people. Moreover, the community can be empowered and take ownership over their health and health promotion as well as gain political agency (since public health is impacted by policy).
I feel, based my own experience at my practicum this summer, that public health professionals can often learn a lot more relevant and valuable knowledge by speaking with folks in the community than they can from books or academic articles. During my practicum I was able to perform stakeholder interviews and facilitate focus groups for a community health needs assessment. By speaking with diverse groups of people across the South Coast region I was able to learn about so many things, such as barriers to care that I didn’t know about previously or to their full extent. For example, while I was aware that transportation is a huge barrier in my home area of the state, I had not realized just how terrible the bus system was. It doesn’t run after 5 or 6 pm and on Sundays it doesn’t run at all. Another example that stuck out to me was learning that someone has to have a positive urine sample to be placed into a treatment facility for substance use disorder. That means that if someone has been briefly sober or just metabolized the substance out of their system, they can’t get the help they want unless they use a substance again. That is so problematic and dangerous. Without being able to speak to people about their experiences I wouldn’t have been able to gain such valuable knowledge that can help me be a better-informed public health practitioner.
The other readings focused more on critical approaches to health communication. The second reading focused on the ethical concerns of “disgust†based tactics and how this approach can perpetuate prejudice, bigotry, and further marginalize groups via dehumanization. The last reading analyzed skepticism of drug education amongst young men. These young men highlighted the need for relevant and relatable information and breaking the stereotype of someone who uses drugs. I found it interesting that the young men felt that the motivations behind the education were to “alleviate strain on the public health system†as well as to “produce fear and stigma.†This article showed that it is important to consider how health communication will be interpreted by the audience and if it will have unintended (perhaps counterproductive) effects.
The first reading, “The culture-centered approach to health communication†helped to define both culture and culture-centered approach. Culture, according to the author, is a “complex web of meanings intertwined with the shared values, beliefs, and practices that run through the strands of a community†(p. 46). The culture-centered approach aims to bring these cultural beliefs to the center of focus. However, there are many cultural biases in process-based or message-based health communication. Biases of domination, Western bias, cognitive bias, decontextualized bias, status quo bias, and control bias all ignore the contextual and structural aspects of culture while delivering health communication, instead focusing on the individual and attempting to streamline healthcare. The culture-centered approach, in contrast, aims to address these cultural differences by having people participate in their own healthcare.
The second reading “The pedagogy of disgust: the ethical, moral and political implications of using disgust in public health campaigns†addresses uses of disgust in healthcare campaigns. Disgust is often used in campaigns against issues like obesity or smoking. Fear and emotion are linked with health risk by said campaigns. Some research indicates that these campaigns can work, but not much evidence indicates how these types of campaigns work in the long time. According to the author, there is a moral aspect of disgust campaigns, because they vilify groups of people. These campaigns feed off of fear and negative emotions that exist in the public against marginalized groups, and these marginalized people, such as the obese, the elderly, or smokers, are aware that they are viewed by the public as “disgustingâ€.
This portion of the reading particularly resonated for me because I have myself been personally affected by disgust around obesity in particular. I have been overweight my entire life and have always been acutely aware that others viewed me and other fat people as disgusting. This has hurt my own self-image and has made me hyper-aware of my own body. Of course, obesity is a serious health issue, but stigmatizing and linking obesity with feelings of disgust really does hurt people who are part of that group.
The third reading, “Science and skepticism: Drug information, young men and counterpublic health†looked at a group of 25 young Australian men who use drugs and how they view anti-drug public health campaigns. Interestingly, the researchers determined that many of these young men were skeptical of the information they had been told in campaigns, instead believing their own experience. Others knew of the risks/adverse effects of drug usage, but believed the benefits outweighed these negative effects. Finally, others reported that is was the stigmatization of drug use that made them want to use drugs in the first place.
While reading, I was attempting to connect this reading with my own personal experience. I began to think about interactions that I have had with my father and brother regarding their hearing health. They both listen to music at dangerously loud levels, and I have repeatedly told them the risks and long-term effects of their listening behaviors. Their responses are not unlike those of the young men interviewed in the study about drugs. My father tends to be skeptical about this information, insisting that he has listened to music loudly his entire life and doesn’t have hearing loss, so the levels that he listens to can’t possibly be damaging. Because he personally has been able to listen to 85 dB music for long periods of time without noticing difficulty hearing, he denies that these levels can be damaging.
My brother admits that the levels he listens to are damaging, but that he enjoys it in the present moment, so he believes that it is worth the risk. It made me wonder how much skepticism permeates public views about hearing loss and hearing health, and how might hearing conservation campaigns address this skepticism.
The readings for this week all focus on being self-aware of your own inherent biases and privileges, as well as recognizing the dominant culture that shapes the systems we navigate. Going into the world as public health professionals, this is something we need to be aware of. The first reading reminded me of what we talked often talked about in community development (HPP 602). When we are working with a community, we are not the experts, they are. The community themselves is capable of creating change and we need to break away from the ‘savior’ mentality. This reading made me think of my ILE because I am unsure what exactly I want to do, but I was thinking about potentially doing something with immigrant health at the US/Mexican border. Keeping a culture centered approach will be critical to keep in mind for my ILE, as I am not a member of the community that I want to work with.
The next article we read was about the skeptical views on drug consumption that young men in Australia have. I think this article shows a great example of an instance where health officials are creating a health campaign without understanding truly why young men in Australia do drugs. The article mentioned how identity can be tied to drug use, can show status, and can be used in social contexts. Without looking at all of these factors, the campaign will likely not be taken seriously, as we see in the article. I think a common theme with drug campaigns is the use of fear to scare, especially when the campaign is focused towards adolescents. The campaigns often focus on why drugs are bad, how they can ruin your future, and include stories of overdose. When the campaign only focuses on fear and negative aspects, it will not get through to the target audience. One of the men mentioned this, saying the information they are receiving is coming from a biased view and really doesn’t take their experiences into account at all. This article reminded me of the DARE program I had in sixth grade. The only real focus was on scaring kids into not doing drugs, and only a couple of years later, kids were ironically wearing DARE shirts. I think when it comes to drugs, people are scared that if they stray from focusing on the negatives only, it will increase the chance of the audience doing drugs. As this article shows, the men really just wanted well rounded, scientific information so they could make their own informed decisions.
The final reading for this week was really interesting because fear and disgust are commonly used in health campaigns to try to create change. The first example they provided was shocking to me. Reading the example and the visuals they used in a campaign to prevent obesity, I just couldn’t believe that was something that they actually used. I understand that it draws attention, but as they discuss in the article, it can cause harm and further shame already marginalized groups of people. Before using these types of campaigns, I think we need to critically examine the effect they will have. Even certain language we use, without the use of visuals, I think can have this effect. For example, calling people who do not have an STI “clean”. What does that imply for those who do or have had an STI? These campaigns can be upsetting for a lot of people, and therefore, rather than listen to what they have to say, they will likely tune it out. Also, as we saw with the previous article, if the message comes across as patronizing or the audience feels they can’t relate to it, then why would they listen to it?
The section in the first reading about how the experiences of illness for a cancer patient are connected to their identity as a parent, partner and colleague made me think about last week’s reading. It also me think about the conversation we had in class about sharing a patient’s story. I think this reading, along with the discussion in class, really highlight how important sharing stories can be and emphasize how complex communication can be. Towards the beginning of the semester, I was worried that there would not be many connections between my field and public health. However, important aspects of communication like recognizing how much one individual can share about themselves and others when they communicate, is something that is extremely important to a wide range of fields, including mine.
The reading about the pedagogy of disgust made me think about my own experiences seeing campaigns and commercials that use guilt and disgust. In one way, they are much more memorable than some other commercials, but I would say they are memorable in a bad way. I find myself changing the channel or looking away when I know something extremely gross or sad is coming up. After seeing the material the first time, I will avoid it whenever I see or hear it again. I think this method does promote negative feelings towards whatever the cause is but it also encourages me to do other things to ignore the commercial, which means I am also ignoring the message it is trying to get across. I think it is tricky to use guilt and disgust because as we mentioned in class, there is often a group that sees the commercial that might feel helpless or targeted when they cannot change their behavior.
As I was reading the third reading, I remembered sitting in health classes and recognizing how much the material being presented was intended to scare us. I had no interest in participating in the activities being presented anyway, but I was very aware that the goal was to push us away from engaging in drugs and alcohol and how focused the class was on case studies of horrible situations. I feel like actually seeing someone have a negative outcome from using drugs or alcohol really scared me. Even just seeing news stories about horrible outcomes of kids my age using drugs made me not want to be anywhere near drugs. It might have been different because I did not want to engage in these activities anyway, but I think hearing real stories from people I knew about someone my age was very convincing and more convincing than just hearing about a hypothetical situation in a health class. This made me think about the exaggerated health promotions mentioned in the article. It made me realize how difficult it truly is to get a message like this across without being too exaggerated but also being powerful enough to get through to people.
This week’s readings focused on critical and culture-centered approaches to health communication. In the first reading, they introduced the culture-centered approach as a way of understanding that health communication involves discussions embedded in socially constructed identities, social norms and structures. I think this is an important concept to understand because individuals are complex and come with different roles and titles and that may impact how they identify as a person with a specific condition. The community’s voice is important and this approach allows for researchers to come into a community and listen and be a partner instead of intervening and dictating. This is important to me because with a mom who speaks limited English and is a refugee her voice and history/ culture is often diminished in the health setting. She has told me many times that she feels like they are just telling her what to do and it is not based on her individual case. If more places took the culture-centered approach, people from marginalized communities like my mother would have a say and be heard.
In the second reading, it talked about disgust in relation to fear/hatred embedded into responses surrounding racism, homophobia, sexism and discrimination to marginalized groups. In today’s society there is a lot of body shaming and “disgust†towards people who society considers fat. I think this is something that many public health campaigns needs to take into consideration because I feel like often people/media believes the best way to change behavior or change attitudes is through fear and shame. Instead of fat shaming or dehumanizing those individuals, we should be empowering people. People may think scaring someone to not wanting to be “a fat person†you should empower people to eat better so they can feel healthier and etc. instead of solely focusing on body image. Also, when you use disgust you potentially steering away from the targeted community because they feel ashamed, uninterested and like they cannot change how they are viewed.
I found this week’s readings on critical and culture-centered approaches to health communication to be particularly enlightening. In the first reading on the culture-centered approach to health communication, the topic of dominance in the health field was discussed. It was mentioned that many of the health communication programs and interventions that have existed are designed, conceptualized, and implemented by teams consisting of typically all white North American academics. This is even the case in programs that are specifically targeted to people of color. While it is a wonderful thing that such programs exist with POC in mind, dominant biases may naturally arise. This reminded me of our discussion in class a few weeks ago regarding the personal narrative intervention study that was conducted on African Americans. Many of the points that were brought up in class were also covered in this section of the reading in regards to the cultural considerations of a group of predominately white scholars targeting the stories of African Americans in a vulnerable state of health. In addition to all of these ideas, this further reminds me of the importance of being culturally competent and non-imposing in my future profession. I am reminded that when working with clients, it is so important to not act as a dominating figure and to adopt a culture-centered approach in which I attempt to understand them.
In regards to the second reading on the pedagogy of disgust, I was particularly interested in the ethical considerations there are in targeting disgust as a tactic in public health. The article stated, “An ethical critique, however, is not so much interested in the effectiveness of these tactics but rather in their implications for justice” (p. 9). I thought that this particular line hit the nail on the head. The effectiveness of a health campaign that demoralizes a large piece of the community might be capable of being effective in terms of the campaign’s goal, but I would argue that it is ineffective in another sense if its tactics in turn embarrass and weaken a substantial population. This is a dangerous ploy that has the opportunity for serious outcomes. Marking a group of people as “disgusting” will likely be effective in convincing people to not be that way, but what if that’s the way you are? It is quite alienating.
Lastly, the final reading on science and skepticism reminded me of the well-known D.A.R.E anti-drug campaign that exists years ago in the United States. This campaign utilized fear as a tactic in an attempt to convince children and teens to stay away from drugs, but much of material that was aggressively being delivered to these kids did not match with their reality and experiences with certain drugs. As a result, kids were skeptical and did not trust the information. For example, this article incorporate an image from an Australian drug campaign that attempts to convince the audience that marijuana ruins relationships and isolates its users. Included is a criticism from one of the participants of the study expressing his opinion that this is simply not true based on his experience. These are the same experiences that caused the D.A.R.E campaign to be not taken seriously and in turn, be less effective than it was probably expected.
Relating the first reading to a book I read called “The Spirit Catches You and You Fall Down” By Anne Faidman. The book chronicles multiple misunderstandings between an immigrant family from Houaysouy, Sainyabuli Province, Laos and the United States health care system. Their small daughter has severe epilepsy which in their culture is a holy phenomenon called The Spirit Catches You. The dominant paradigm of the US health care system left no understanding for the families cultural beliefs. Instead of integration between culture and healthcare there was pure conflict, distrust, and bitterness. The family did not believe in the treatments prescribed and eventually their child suffered severe brain damage from hypoxia at the age of four and never recovered brain function.
If there had been someone to listen, build trust, and take the time to value the culture that they brought with them this child would probably have been able to live a much longer and fulfilled life.
I agree that disgust used as a marketing strategy has some serious moral and ethical issues. In anti-drug and Tobacco campaigns they often use disgust which does nothing for those already addicted to either drugs or tobacco. Disgust campaigns may work for those not already participating in a particular behaviors but are obvious detrimental to those who already participate in that particular behavior. Our cultures general disgust with those who suffer from opioid use disorder is probably related to the many very popular anti-drug campaigns such as the “This is your brain on drugs.” . As the third article points to anti-substance campaigns really make no change on the individuals who are already using the substances.
This week’s readings on critical and culture-centered approaches to health communication were all about being aware of our own biases, involving those in the target audience when creating health communication, and being aware of how a health communication is received. The first reading, like many of our other readings, discussed how it is important to involve people from the culture when developing the health communication. The dominant paradigm of health communication deals with culture by suggesting the ways in which cultural concepts may be incorporated into health promotion interventions. There are many biases that come along with the dominant paradigm. If an upper-middle class white male from the United States is developing an intervention that will be implemented in a developing country- there will be bias from privilege. The interventions, while “designed†for a different culture, are going to be coming from a place of privilege and reflect the values of the people creating the intervention. Health communications also need to steer away from being focused on the individual. This often takes the people out of context and puts the responsibility of behavior change solely on them. Also, often trying to apply our theories of change to interventions intended for different cultures is not going to be effective. The theories developed in the West reflect Western values, which will often not be applicable to other places. I liked when the reading stated, “Culture-centered approaches suggest a shift in the tole of the researcher- from an interventionist who plans and executes campaigns to a listener and participant who engages in dialogue with the members of the community.†A more collaborative relationship will create better outcomes and will also give the people of that culture power over what types of health communication they are exposed to.
The second reading made me think about certain health campaigns in a different way. I had thought about fear/disgust-based approaches as sometimes crossing the line from persuasion to coercion but had not thought about the ethical implications. I never thought about how by using disgust in health communication, it is isolating the entire population that has that disease or struggles with that health behavior. Influencing people’s health behavior should not come at the expense of shaming an entire group of people. Also, these tactics are not only isolating the group that has the disease or engages in the unhealthy behavior, it is also making them less likely to change or take action due to the shame. Already vulnerable populations are going to be impacted the most from these types of campaigns and lead to feelings of even more disempowerment. In the third reading I thought it was interesting that their tactic was not to change the skepticism but rather use it to change how future drug education is conducted. Often health communication is aimed at “fixing†people, but people don’t need to be fixed they need to be educated and supported. I think that is the common theme throughout all the readings- work in collaboration with the people you are trying to help, aim to support, and always be conscious of the potential negative impacts of the communication strategy.
This week’s reading covered the culture-centered approach which is creating spaces for those voices in our work that have been systematically silenced with our expertise and elitism. The dominant paradigm is better known as the “status quo†is the way things are usually done. Within health communication, there are two streams of scholarship; process-based and message-based. Process-based is a variety of communication processes enacted in healthcare settings with an emphasis on the ways health messages are constructed, negotiated, resisted, and sustained. Message-based focuses on the development and evaluation of messages to achieve desired outcomes.
The pedagogy of disgust reading sheds light on how public health campaigns use elicit disgust to persuade their target audience to change behavior, however, this might create ethical, moral, and political issues. Just like with anything, there are boundaries on how far something can go before it becomes inappropriate or unacceptable. The reading also explained how health education literature supports the use of shock tactics, distressing, threatening, disturbing, and the use of graphic imagery. What is problematic with disgust is that it distinguishes self from others and reinforces prejudice and bigotry. In addition, it marginalizes outgroups and therefore challenges their human dignity.
The last reading was on a study done in Australia on young mean to gauge their skepticism with science and health education. Drug education comes in 2 forms; targeted and universal. 25 men young men age 16-20 years old in Melbourne, Australia who had experience using illicit drugs at least 3x in the last year were interviewed to understand their perception of health education and drug education. The 3 main areas of skepticism were; skepticism about drug risk, skepticism about the representation of drug consumers, and skepticism about the intended outcomes of drug education messages and drug policy. Skepticism about drug risk, some of the participants were not aware of the negative effects of drug use and some think health promotion initiatives exaggerate the negative risks, therefore, it is not believable. Skepticism about the representation of drug users and how they are represented in the mainstream. Many men associated themselves not fitting the stereotypical drug user since they go to school and have jobs. Lastly, skepticism about the intentions of drug education and policy is due to participants feeling like the government not actually caring about protecting health but more so for alleviating strain on the public health system. Many participants compared the effects of illicit drugs to alcohol and have done their own research showing how alcohol may be more harmful. The men felt that their local knowledge and experience using drugs were not valued.
The first reading this week was the “The Culture-Centered Approach to Health Communication.” This reading discussed how health communication has traditionally been rooted in white academia, and how this paradigm is not the most effective method of health communication. The culture-centered approach focuses on developing programs that are relevant and consistent with a group’s culture, and involves the researcher acting as a facilitator rather than an expert. This reading opened my eyes to a new method of health communication that I had not heard of before, but than made a great deal of sense given our commitments to providing culturally appropriate and community-driven interventions. However, my one concern is how an intervention can work when the dominant culture is part of the problem. For example, I wonder when domestic violence is an accepted part of a culture, how can we work within the culture while attempting to create this change.
The second reading discussed the pedagogy of disgust, which is a common method used in health communication campaigns. The authors argued that this method has serious political, moral, and ethical implications that must be acknowledged. This article reminded me of discussions about sexually transmitted infections that occurred in my high school health classes. These infections were always treated as more disgusting than other infections, such as the flu or the common cold. While this may have scared some students into using condoms or abstaining from sex, it could also have been isolating to individuals who have had STIs. I think that disgust may be an effective method to influence individuals who have not experienced a health behavior or condition themselves, but may not actually help improve the health of individuals who already have these conditions.
The final article was about how skepticism can influence how effective health communication campaigns can be. I found this article to be particularly useful, as a large part of my job is educating adolescents about alcohol and drug use. It seems like a common theme was that these campaigns were not trusted because they conflicted with the individual experiences of the men. Because they felt like the information was not relevant to them, they discounted the information entirely. Currently, I am working on developing a presentation/facilitated conversation for a fraternity about alcohol and drug use. This reading helped me to reflect on the generalizations and assumptions I am making in my presentation, and how I can improve the effectiveness by including the actual experiences of the members.
The second reading discussed the use of communication tactics that stimulate disgust as a way to try to promote behavior change. The people who advocate for “shock tactics†in health communication campaigns often emphasize the fact that it catches people’s attention. It usually is true that this type of campaign will provoke a strong emotional response and catch people’s attention. However, it might actually stimulate avoidance or denial instead of the desired behavior change. It’s important to discuss the ethics of this type of campaign, since disgust is usually linked to people’s fear and anxiety. This can easily contribute to stigma of certain social classes or groups of people. These people are usually underrepresented in the population or are disadvantaged in some way. Not only can the “pedagogy of disgust†contribute to stigma of certain people or health problems, but it can also contribute to poor mental health in people dealing with that health problem.
The third reading provided an interesting perspective on the problems of using the “pedagogy of disgust†or fear-based tactics to convince young people not to use drugs. I liked that they provided direct quotes from the participants and clear examples of how the participants reacted to drug education in schools and mass media campaigns. As I was reading, I kept being reminded of our previous readings about developing health communication campaigns and the importance of conducting research about the target audience. Throughout this article, the author emphasized how the young men would immediately dismiss any message that did not contain some element of their own experience with drugs. This highlights the importance of gathering local knowledge and perhaps using focus groups with drug users to craft messages that at least prompt the target audience to view the information as accurate. One of the young men referred to a report of someone jumping from a building while on drugs and mentioned the other factors that may have led to that act. It might help if the general public could see an analysis of the complex factors leading to these events rather than a simple message that only feeds in to the stigma surrounding drug use.
This week we learned about the cultured-centered approach, and about the use of disgust when creating and implementing health campaigns. Knowing about these two things are imperative to our work as public health professionals.
Something that really stood out to me was when the first reading talked about the biases of domination. In most cases, the people who get to research, create, and implement certain projects happen to fall under specific criteria: white, American, and college educated. It’s an unfortunate truth that the ones with the most power are seen as the most “experienced”, and that just isn’t true. The biases of domination makes people think that having a degree makes you smart. It’s important for us to be mindful of this when we do our work, as there may be times when we step into roles to work for or with certain groups that we don’t fully represent.
We also talked about the use of disgust in health communication. Disgust is used to grab the viewer’s attention by using shock value. Although they are shocking, they can be difficult to forget (ie. the anti-smoking commercials). One thing to keep in mind is our audience. The imagery and words that we use can have a significant effect on an audience, and if it is not done correctly, a person might end up offending or pushing away their target audience.