The role of electronic media in the rural-urban communities in relation to health information
Name
HINF 6100 - Introduction to Health Informatics
Walden University
2022
Introduction
During the last years of the 20th century health professionals developed a growing appreciation of the
critical role that communication plays in healthcare. The communication of information among the
various players in healthcare has always been taken as a given Eisenberg, D., & R. C. Kessler. (1993).
Like many common phenomenon, however, the nuances and unspoken interaction may have serious
implications for the communication process. Examples of the pivotal role of communication in
healthcare are everywhere communication between doctors (and other clinicians) and patients, between
health educators and their clients, between pharmaceutical companies and consumers, between parents
and children
Just as important as the positive contribution that communication can make to healthcare has been the
realization of the negative impact that ineffective communication can have within the healthcare arena.
We only have to note the contribution of poor communication to malpractice suits, misdiagnoses, and
failures in patient compliance, and cross cultural misunderstandings to see the role that communication
plays, Davis, T. C., Meldrum, H., Tippy, P. K. P., et al. (1996).
According to Clark, (1998) many of the challenges facing healthcare today, in fact, reflecting failures in
communication. The headlines are full of stories related to medical errors, patient confidentiality,
patient compliance, and other concerns related to the delivery of care. The common theme running
through these headline-grabbing issues is communication.
Given these circumstances, there has never been a better time to ad- dress the issue of health
communication. Baker, (1998), further asserts that It is a time when the importance of health
communication is being recognized, when the role of health communication is expanding, and when
the implications of effective (or ineffective) communication are becoming more significant.
According to Williams, (1999), health communication can contribute to all aspects of disease
prevention and health promotion. The most obvious application of health communication has been in
these areas of health promotion and disease prevention. Research has uncovered improvement of
interpersonal and group interactions in clinical situations (for example, between provider and patient,
provider and provider, and among members of a healthcare team) through the training of health
professionals and patients in effective communication skills. Atkin, (1990), further asserts that virtually
all Americans have been exposed to health messages through public education campaigns that seek to
change the social climate in order to encourage healthy behaviors, create awareness, change attitudes,
and motivate individuals to adopt recommended behaviors. Campaigns traditionally have relied on
mass communication (such as public service announcements on billboards, radio, and television) and
educational messages in printed materials (such as pamphlets) to deliver health messages. Other
campaigns have integrated mass media with community-based programs and/ or incorporated social
marketing techniques.
According to Wallack, et al (1990) increasingly, health improvement activities are taking advantage of
digital technologies, such as CD-ROM and the World Wide Web, that can target audiences, tailor
messages, and engage people in interactive, ongoing exchanges about health. As population-based
approaches to healthcare have become more common, the role of health communication has expanded.
Community-centered prevention shifts attention from the individual to group-level change and
emphasizes the empowerment of individuals and communities to effect change on multiple levels. As
mass media has became pervasive, an increasing proportion of the population has came to receive its
information—on healthcare and other topics from newspapers, magazines, radio and television. These
modes of information transfer are the hallmark of modern society, with the Internet now emerging as
the king of mass media. McGee, H. (2007) further asserts that the amount of space in both print and
electronic media devoted to healthcare has increased dramatically in recent years. It is important to
understand that how the audience perceives the mode of passing the information is an important factor
in determining if the messages being passed across will be received well. It is thus the task of the media
passing information to ensure that it is perceived well.
According to Royston, (2007), a main question that begs during this research is what role the channel
used to pass the health communication plays in passing the health related messages specifically on
cardiovascular risk health factors. Electronic media has moved from passing general health messages
to specific health messages. Examples in our current Kenyan media setup are the rapid campaigns by
Ministries of health and public health in collaboration with other stakeholders on water, Malaria and
Tuberculosis. This move to the media passing specific health factors should be formed on the premise
of understanding the intended audience. Intended audiences are often carved out of these broad
population groups and defined more narrowly based on characteristics such as attitudes,
Hickey, (2009) asserts that demographics, geographic region, or patterns of behavior. Once there is an
understanding of the audience then the messages to be passed across can be tailor made to capture and
suit their needs. Because the intended audience’s ability and willingness to make a behavior change
affects the extent to which communication objectives are reasonable and realistic, it is most efficient to
select intended audiences and develop communication objectives in tandem.
Galligan, (2007) using several different channels increases the likelihood of reaching more of the
intended audiences. It also can increase repetition of the message, improving the chance that intended
audiences will be exposed to it often enough to absorb and act upon it. For these reasons, a combination
of channels has been found most effective in producing desired results, including behavior change
(Center for Substance Abuse Prevention, 1996). Similar to the previous point, communication in
healthcare appears to be moving from an emphasis on knowledge transfer to one on behavior change.
Research has found that information by itself may not overcome attitudes, perceptions, lack of
motivation and other barriers to health-seeking behavior. McGee, H. (2008) thus said, effective
communication must motivate individuals to change their behaviors and provide the support necessary
for them to overcome the many barriers to effective management of their health. Most importantly,
electronic media has been known to have a wider coverage especially in Kenya. It will be interesting to
learn how and what contributions have been made in relation to building the knowledge of the people
in a position to access electronic media on cardiovascular diseases. A main focus would be the
audience at the rural urban centers who are no doubt the most at risk group in relation to cardiovascular
complications.
2.2 Common Cardiovascular Health Risk Factors in the Rural-Urban Communities
According to Pelle, (2008) Psychological Predictors of Prognosis in Chronic Heart Cardiovascular
diseases include conditions such as coronary heart disease and congestive cardiac failure (heart failure);
cerebral (brain) conditions such as stroke; and peripheral (limb) conditions such as peripheral vascular
disease. The main underlying cause of cardiovascular disease is atherosclerosis, a process where blood
vessels are narrowed or become completely blocked. It is most serious when it affects blood supply to
the heart, causing angina or heart attack, or to the brain, causing stroke.
According to Szabó, (2008) ‘Psychological Predictors of Prognosis in Chronic Heart Cardiovascular
disease remains the most common cause of death in Ireland, currently accounting for one-third of all
deaths and one in five premature deaths. However, there has been substantial progress. Age-
standardized death rates from cardiovascular disease have decreased by two-thirds over the past 30
years. Despite improvements, Ireland still ranks below the EU15 average for life expectancy for both
men and women. As mortality rates have reduced, demand on health services has intensified.
According to Gidron, (2008), risk factors are traits and life-style habits that increase a person's chances
of having coronary artery and vascular disease. Some risk factors cannot be changed or controlled,
while other risk factors are controllable. The most important risk factors are high blood pressure, high
blood cholesterol and cigarette smoking.
According to Denollet, J. (2006) other factors that may increase your risk for cardiovascular disease are
diabetes, being overweight (obesity), being inactive and having an unhealthy reaction to stress. Age,
sex, and heredity are risk factors that cannot be controlled. There may be a genetic code that raises the
likelihood of having heart and vascular disease. The older a person is, the more likely it is for the heart
and blood vessels to be damaged. Men are more likely to have heart and vascular disease at an early
age than women. Women do not usually have heart and vascular disease from atherosclerosis until after
menopause. The more risk factors that one has, the greater the chance for disease.
Stress is a normal part of our lives. Stress causes the release of adrenalin which speeds up your heart
rate, narrows your blood vessels and increases your blood pressure. Therefore, stress makes you heart
work harder. It is not the stressful situation, but your reaction to stress that is important.
People who feel time pressures and who are hard-driving are more prone to coronary artery disease.
Those who are calm, unhurried and easy-going are at less risk.
Some people inherit a tendency toward heart disease. Heredity becomes a risk factor for you if you
have blood relatives who have coronary artery disease (heart attack) before the age of 50. You cannot
control heredity, but you can help family members prevent a heart attack by reducing risk factors.
While the focus here is on cardiac-specific and stroke-specific aspects of acute care pathways, clinical
pathways also relate to how cardiovascular disease is prevented, its early detection, ongoing treatment
and rehabilitation, and palliative care. Within the current resource framework, there is much that can be
done to improve clinical care and outcomes, particularly for emergency patients, as well as to reduce
costs while maintaining quality. There is much that can be put in place to improve clinical effectiveness
and efficiency by way of organizational change, applying best practice procedures, developing new
cardiovascular models of care and the introduction of clinical pathways that highlight improvement of
clinical processes in cardiovascular care to enhance clinical effectiveness and efficiency. The
introduction of these clinical pathways and cardiovascular models of care will provide an effective
strategy to reduce clinical performance variations across the system.
The prevalence of heart failure is increasing in Ireland, as elsewhere around the world. This increase is
due to better survival following acute coronary events, longer survival after diagnosis of coronary heart
disease, continuing high prevalence of cardiovascular risk factors, and the ageing population.
Current data suggest a 2% prevalence of symptomatic heart failure in the general population in Ireland,
with a further 2% having left ventricular systolic dysfunction at risk of progressing to symptomatic
failure. It is estimated that 10% of the population over 75 years of age have heart failure and that over
10,000 new cases are diagnosed each year (Irish Heart Foundation, 2002). Heart failure is thus more
common than most cancers.
Heart failure is now the only major cardiovascular disease on the increase in Europe (Dickstein et al,
2008). It is predicted that by 2010 there will be a 70% increase from 2005 levels (Remme et al, 2005)
in the number of cases in Europe. The number of people living with heart failure in Ireland can be
estimated by applying prevalence rates to population projections from the Central Statistics Office
(CSO). A best case scenario of sustained prevalence of 2% would result in an increase of
approximately 8.5% in the number of people with heart failure over the next 10 years. A more likely
scenario of prevalence increasing by 1% to 3% would result in a 63% increase in heart failure by 2019.
If the number of people with asymptomatic (impending) heart failure is included, then the numbers are
much greater. The Irish Heart Foundation has predicted that by 2010, 300,000 people in Ireland will be
affected by heart failure (Irish Heart Foundation, 2002).
The personal burden of heart failure is great, with patients experiencing high levels of physical,
functional and emotional distress. Life expectancy for patients with chronic heart failure has also been
poorer than for most of the common cancers Stewart et al, (2001). However, advances in treatment
means that survival is improving and the disease can be controlled for many years in an increasing
number of patients Murphy et al, (2004).
In tandem with this anticipated population change, there are worrying international signals that the
pattern of reducing cardiovascular mortality is coming to an end, particularly in younger groups (Ford
and O’Flaherty et al, (2008). Cardiovascular profiles in mid-life are powerful predictors of mortality
and morbidity in early old age Clarke et al, (2009). The concern is that there will be a reversal of the
cardiovascular disease mortality patterns if current risk factor and health behaviour profiles (including
obesity, smoking and alcohol consumption) are not addressed across all ages in society.
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