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Informal knowledge transfer in the period before formal health education programmes: case studies of mass media coverage of HIV and SIDS in England and Wales.

Hilliard N, Jenkins R, Pashayan N, Powles J - BMC Public Health (2007)

Bottom Line: Only seven articles (14%) associated risk with promiscuity.Gay periodicals did not include specific advice on reducing the number of partners until early 1984.Advances in knowledge with the potential to prevent disease by behaviour change may thus yield substantial health benefits even without the mediation of formal education campaigns ('interventions').

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Affiliation: University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2SP, UK. njh56@cam.ac.uk

ABSTRACT

Background: How advances in knowledge lead via behaviour change to better health is not well understood. Here we report two case studies: a rapid reduction in HIV transmission in homosexual men and a decline in Sudden Infant Death Syndrome (SIDS) that took place in the period before the relevant national education programmes commenced, respectively, in 1986 and 1991. The role of newspapers in transferring knowledge relevant to reducing the risk of AIDS and SIDS is assessed.

Methods: HIV Searches were made of The Times (1981-1985), Gay News (1981-1984) and, for the key period of April to June 1983, of eight newspapers with the highest readership. Information on transmission route and educational messages were abstracted and analysed. SIDS Searches were made of The Times and the Guardian (1985-1991), The Sun (selected periods only, 1988-1991) and selected nursing journals published in England and Wales. Information on sleeping position and educational messages were abstracted and analysed.

Results: HIV Forty-five out of 50 articles identified in newspapers described homosexuals as an at risk group. Sexual transmission of AIDS was, however, covered poorly, with only 7 (14%) articles referring explicitly to sexual transmission. Only seven articles (14%) associated risk with promiscuity. None of the articles were specific about changes in behaviour that could be expected to reduce risk. Gay periodicals did not include specific advice on reducing the number of partners until early 1984. SIDS Out of 165 relevant articles in The Times and 84 in the Guardian, 7 were published before 1991 and associated risk with sleeping position. The reviewed nursing journals reflected a pervasive sense of uncertainty about the link between SIDS and sleeping position.

Conclusion: Presumptively receptive audiences responded rapidly to new knowledge on how changes in personal behaviour might reduce risk, even though the 'signals' were not strong and were transmitted, at least partly, through informal and 'horizontal' channels. Advances in knowledge with the potential to prevent disease by behaviour change may thus yield substantial health benefits even without the mediation of formal education campaigns ('interventions'). Formal campaigns, when they came, did make important additional contributions, especially in the case of SIDS.

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Articles mentioning SIDS with (darker colour) and without (lighter colour) mention of sleeping position, nursing journals, England and Wales, yearly counts for 1985 to 1992.
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Figure 3: Articles mentioning SIDS with (darker colour) and without (lighter colour) mention of sleeping position, nursing journals, England and Wales, yearly counts for 1985 to 1992.

Mentions: From January, 1985 to December 1992, we found 37 articles on SIDS published in 7 English nursing journals. We only found four articles published before 1992 that mentioned sleeping position (Figure 3). These four articles reflected not so much the strength of epidemiological evidence as a sense of uncertainty within the nursing profession about how such evidence was to be interpreted. "...although a few studies found that more babies were found lying in a prone position and this could be a contributory factor, this has not been statistically proven" [21]. In June 1989 a correspondent to the Midwives Chronicle drew the attention of her colleagues to "recent publications" and posed the question: "can we reduce numbers of SIDS by educating our clients? Should we recommend a non-prone sleeping position" [22]. In the Nursing Times, (April 1991), an author concedes that "advice given to parents is important. The evidence would suggest placing babies on their back or sides reduces their risk of SIDS" however they also note "Unless there is an obvious reason for the prone position no 'right' position emerges. There are conflicting opinions" [23].


Informal knowledge transfer in the period before formal health education programmes: case studies of mass media coverage of HIV and SIDS in England and Wales.

Hilliard N, Jenkins R, Pashayan N, Powles J - BMC Public Health (2007)

Articles mentioning SIDS with (darker colour) and without (lighter colour) mention of sleeping position, nursing journals, England and Wales, yearly counts for 1985 to 1992.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2194775&req=5

Figure 3: Articles mentioning SIDS with (darker colour) and without (lighter colour) mention of sleeping position, nursing journals, England and Wales, yearly counts for 1985 to 1992.
Mentions: From January, 1985 to December 1992, we found 37 articles on SIDS published in 7 English nursing journals. We only found four articles published before 1992 that mentioned sleeping position (Figure 3). These four articles reflected not so much the strength of epidemiological evidence as a sense of uncertainty within the nursing profession about how such evidence was to be interpreted. "...although a few studies found that more babies were found lying in a prone position and this could be a contributory factor, this has not been statistically proven" [21]. In June 1989 a correspondent to the Midwives Chronicle drew the attention of her colleagues to "recent publications" and posed the question: "can we reduce numbers of SIDS by educating our clients? Should we recommend a non-prone sleeping position" [22]. In the Nursing Times, (April 1991), an author concedes that "advice given to parents is important. The evidence would suggest placing babies on their back or sides reduces their risk of SIDS" however they also note "Unless there is an obvious reason for the prone position no 'right' position emerges. There are conflicting opinions" [23].

Bottom Line: Only seven articles (14%) associated risk with promiscuity.Gay periodicals did not include specific advice on reducing the number of partners until early 1984.Advances in knowledge with the potential to prevent disease by behaviour change may thus yield substantial health benefits even without the mediation of formal education campaigns ('interventions').

View Article: PubMed Central - HTML - PubMed

Affiliation: University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2SP, UK. njh56@cam.ac.uk

ABSTRACT

Background: How advances in knowledge lead via behaviour change to better health is not well understood. Here we report two case studies: a rapid reduction in HIV transmission in homosexual men and a decline in Sudden Infant Death Syndrome (SIDS) that took place in the period before the relevant national education programmes commenced, respectively, in 1986 and 1991. The role of newspapers in transferring knowledge relevant to reducing the risk of AIDS and SIDS is assessed.

Methods: HIV Searches were made of The Times (1981-1985), Gay News (1981-1984) and, for the key period of April to June 1983, of eight newspapers with the highest readership. Information on transmission route and educational messages were abstracted and analysed. SIDS Searches were made of The Times and the Guardian (1985-1991), The Sun (selected periods only, 1988-1991) and selected nursing journals published in England and Wales. Information on sleeping position and educational messages were abstracted and analysed.

Results: HIV Forty-five out of 50 articles identified in newspapers described homosexuals as an at risk group. Sexual transmission of AIDS was, however, covered poorly, with only 7 (14%) articles referring explicitly to sexual transmission. Only seven articles (14%) associated risk with promiscuity. None of the articles were specific about changes in behaviour that could be expected to reduce risk. Gay periodicals did not include specific advice on reducing the number of partners until early 1984. SIDS Out of 165 relevant articles in The Times and 84 in the Guardian, 7 were published before 1991 and associated risk with sleeping position. The reviewed nursing journals reflected a pervasive sense of uncertainty about the link between SIDS and sleeping position.

Conclusion: Presumptively receptive audiences responded rapidly to new knowledge on how changes in personal behaviour might reduce risk, even though the 'signals' were not strong and were transmitted, at least partly, through informal and 'horizontal' channels. Advances in knowledge with the potential to prevent disease by behaviour change may thus yield substantial health benefits even without the mediation of formal education campaigns ('interventions'). Formal campaigns, when they came, did make important additional contributions, especially in the case of SIDS.

Show MeSH
Related in: MedlinePlus