The objectives of this article are (1) review the contribution of traditional midwives to family planning communication in several Asian countries; (2) organize knowledge gathered from various studies into general guidelines for the most effective use of traditional midwives in family planning programs; and (3) present hypotheses for future research. In certain countries where pilot projects have tested the potential performance of traditional midwives in family planning programs, results have been encouraging. In other nations, more research is needed to determine the contribution traditional midwives can make to the family planning program.

Asia↗

PubMed1971

Incentives in the diffusion of family planning innovations.

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Animals↗

PubMed1965

The key to good patient relations.

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Nurse-Patient Relations↗

PubMedDate not supplied

Lowering the cost of lowering the cholesterol: a formulary policy for lovastatin.

OBJECTIVES: To describe a medical center policy designed to contain the cost of using the lipid-lowering drug lovastatin in a primary care setting, to examine the effect of the policy on cost containment, and to examine physician acceptance of the policy. SETTING: A Veterans Affairs medical center. INTERVENTIONS: The policy made lovastatin available to physicians when failure of therapy with diet and two first-line drugs was documented on an order form. The form also contained educational information including prices and recommended niacin as the drug treatment of first choice for most patients. DESIGN: To evaluate the effect of the policy, lipid-lowering drug use at the medical center was compared with that at a similar center that did not restrict lovastatin use, and with lipid-lowering drug use in the United States as a whole. A written questionnaire was used to survey physician reaction to the policy. RESULTS: The use of lovastatin as a percentage of total lipid-lowering drug use at the center with the lovastatin policy was one-fourth that at the other center or nationwide, and the use of niacin was four times greater (p less than 0.0001). The estimated savings in drug costs to the center with the lovastatin policy due to these differences was more than $30,000 per year. In the survey of physicians affected by the policy (n = 78, response rate = 100%), less than one-fourth viewed it unfavorably, and 90% favored this policy over restricting the drug to a subspecialty clinic. CONCLUSION: The authors' experience indicates that a formulary policy that permits limited use of an expensive drug in a primary care setting can contain costs in a way that is acceptable to physicians. A policy of this type could be useful to the increasing number of health care provider organizations that cover the cost of outpatient medications.

Ambulatory Care↗

PubMedDate not supplied

A staged model of communication effects: evidence from an entertainment-education radio soap opera in Tanzania.

The authors draw on (1) the hierarchy-of-effects (HOE) model, (2) the stages-of-change (SOC) model, (3) social learning theory (SLT), and (4) the diffusion of innovations (DOI) to synthesize a staged model through which communication messages have effects on individual behavior change by stimulating (1) involvement with media characters and role modeling of their actions, and (2) interpersonal communication. Data from a field experiment in Tanzania on the effects of an entertainment-education radio soap opera, Twende na Wakati (Let's Go With the Times), on the adoption of family planning, are analyzed in light of a six-staged model of communication effects. It is found that (1) the model provides a useful framework for understanding the effects of an entertainment-education program, and (2) the radio soap opera promoted progress through the stages for family planning adoption in the treatment area in three of the four years of broadcast, and in the comparison area after broadcasts of the radio program began there.

Adult↗

PubMedDate not supplied

Social marketing and diffusion-based strategies for communicating with unique populations: HIV prevention in San Francisco.

We conducted a 2-year investigation of the extent to which strategies based on social marketing and diffusion of innovations concepts are used in preventive health communication with unique (highly ostracized) populations. Of the 49 organizations in San Francisco that operate HIV prevention programs (N = 100), programs that most highly targeted unique populations were surveyed. Personal interviews were then conducted with 38 staff leaders who operated the most and least effective programs. Audiotapes and transcripts were content analyzed to identify the strategies used by program staff. Strategies based on social marketing concepts were more prevalent than strategies based on the diffusion of innovations: More effective programs were characterized by emphasis on homophily, audience segmentation, compatibility-based strategies, and interorganizational collaboration.

Adult↗

PubMedDate not supplied

The field of health communication today: an up-to-date report.

One important starting point for the field of health communication was the Stanford Heart Disease Prevention Program, a multiyear community intervention that began 25 years ago. Health communication is a specialty field of communication study that includes the media agenda-setting process for health issues; media advocacy for health; scientific communication among biomedical scientists; doctor-patient communication; and, particularly, the design and evaluation of preventive health communication campaigns, the focus of this article. Health communication study today is a well-established, expanding specialty in the United States and abroad.

Communication↗

PubMedDate not supplied

Diffusion of innovations theory and work-site AIDS programs.

Four case studies of the adoption of work-site AIDS programs are investigated, two of which were modifications of the Centers for Disease Control and Prevention's Business Responds to AIDS (BRTA) program. AIDS work-site programs were mainly initiated by the four study companies as a result of the efforts of a champion (defined as an individual who gains attention and resources for an issue in a system) or the occurrence of a tragic event, such as a company employee contracting AIDS. The BRTA program is an innovation that has not yet reached critical mass, which is the point after which further rates of adoption occur rapidly in a self-sustaining process.

Acquired Immunodeficiency Syndrome↗