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(Counseling Staff, 2018)<\/p>\nAuthor: Jessica Viola
\nHLTH 641: Health Communication, Spring 2021<\/p>\n
(C(Counseling Staff, 2018)<\/p>\n
Diversity and Inclusion are two buzz words in corporate America right now.\u00a0 I have been fortunate enough to work for large companies throughout my career, which has afforded me opportunities to educate myself and become a true advocate for diversity, equality, equity, and inclusion.\u00a0 There are many layers of diversity and equity in healthcare, but I am going to focus on only one.\u00a0 In 2019 I became pregnant and had a full-term pregnancy at 37 weeks and 2 days, to a healthy baby boy.\u00a0 Throughout my pregnancy, I did a lot of reading and internet searches to gain as much knowledge as I possibly could to not only stay healthy during pregnancy but learn how to advocate for myself and what to expect from my healthcare providers.\u00a0 This experience brought a rude awakening to the inequities that exist in the US healthcare system with pregnancy care.\u00a0 Some of the statistics on mortality rates and health complications for black women and infants during and after pregnancy in the United States are among the worse for developed countries.<\/p>\n
Healthcare disparities are preventable when looking at pregnancies.\u00a0 With access to education and prenatal care, there would be a direct decline in maternal and infant death rates.\u00a0 It is important to look at historical and cultural information to assess social status, occupations, education levels, and access to healthcare when evaluating prenatal and postnatal care in the United States (Arcaya et al., 2015).\u00a0 On average black women are paid 63 cents per dollar to every dollar a white man makes.\u00a0 The US average salary for black women is $36,227 per year, which causes limited access to healthcare (National Partnership for Women & Families, 2018).<\/p>\n
As a global leader with excess resources, the United States ranks among the lowest in regards to maternal mortality rates, with 17 maternal deaths per 100,000 live births.\u00a0 Countries such as the Netherlands, Norway, and New Zealand have three or fewer per 100,000 live births (Tikkanen et al., 2020).\u00a0 More than half of maternal deaths occur postpartum:<\/p>\n
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<\/p>\n
Digging in deeper to the above statistics, for black women this rate is 37.1 per 100,000 live births This is more than double the average rate.<\/p>\n
In addition, although infant mortality rates continue to decline, black infants are twice as likely to die within the first year of life than white infants (Alio et al., 2009).\u00a0 Statistics like these are unacceptable and trying to understand the reasoning of disparities between races is baffling.<\/p>\n
According to a 2014 study, ob-gyns are predominately females, representing 61.9% of the ob-gyn population.\u00a0 Also, ob-gyns had the highest diversity ratio of the studied physicians.\u00a0 When looking at the total physician workforce, 74.4% are white (Rayburn, 2016).\u00a0 For 2018 total physician race and ethnicity percentages click here: AAMC Percentage of all active physicians by race\/ethnicity, 2018<\/a>.\u00a0 Continued research needs to be conducted to uncover if there is a causal effect of care provided by a doctor of a different race than that of your own to determine if care is compromised.<\/p>\n I won\u2019t go into all the gory details, but my labor progressed quickly and I missed the window of opportunity to receive any pain medications or an epidural.\u00a0 The delivery of my son was an uneventful vaginal birth.\u00a0 However, the afterbirth (the placenta) did not come and the obstetrician had to manually extract it.\u00a0 There are risks with this, the first one is ensuring the whole placenta is removed and there are not pieces floating around in the uterus.\u00a0 If placental tissue is not completely removed, it can lead to a hemorrhage or infection.\u00a0 In extreme cases, a hysterectomy may need to be performed.\u00a0 Retained placentas occur in one to three percent of vaginal deliveries and are a common cause of maternal morbidity (Perlman & Carusi, 2019).\u00a0 The outcome could have been different, but I believe my doctor saved my life and followed up with all necessary procedures to ensure that the placenta was fully removed (internal ultrasound).\u00a0 \u00a0Fast-forward six weeks postpartum, I had an episode in the middle of the night where I fainted three times.\u00a0 I did not go to the hospital immediately, but then the next morning decided to go, knowing the risk factors of a potential blood clot.\u00a0 Women are at an increased risk of developing a life-threatening blood clot for up to three months postpartum (CDC, 2018).\u00a0 Know your risks: Learn about Blood Clots | CDC<\/a>.\u00a0 With my own experience, I cannot help but advocate for all women to receive the proper medical treatment and attention.\u00a0 In my case, it was my first pregnancy and an unknown.<\/p>\n Between 2005-2014 there were 40,922,512 live births and 7,031 maternal deaths in the US.\u00a0 The mortality ratio during this time frame was 15.6% for every 100,000 births.\u00a0 Of the data collected, there was an increase in mortality among black women.\u00a0 Also, there was a significant correlation to gestational diabetes, c-section deliveries, unplanned births, and four or fewer prenatal visits with an increase in mortality (Moaddab et al., 2018).<\/p>\n Cardiovascular-related pregnancy mortality rates are declining; however, other cardiovascular diseases and cardiomyopathy rates are increasing.\u00a0 There is not enough research explaining why cardiomyopathy rates are increasing among pregnant women, but \u201cblack women disproportionately experience higher pregnancy-related cardiovascular morbidity and mortality compared with white women.\u201d (Njoroge & Parikh, 2020).\u00a0 Continued research needs to be conducted to provide more insight as to why black women are at a higher risk of developing cardiovascular disease during pregnancy.\u00a0 Possible biological risk factors, age (being younger than 18 with multiple pregnancies or older than 30), education, income level and access to health coverage play a large role in the disparities seen in pregnancy outcomes in the US (Clay et al., 2019).\u00a0 It is important to note, that it is possible to be pregnant and deliver a baby in the US without having any healthcare coverage.<\/p>\n Black women are more likely to develop other conditions associated with pregnancy complications as well; increasing the risk associated with pregnancy at any age.\u00a0 These complications included fibroids, earlier signs of preeclampsia, and experiencing physical weathering (early health decline) (National Partnership for Women & Families, 2018).\u00a0 Black women tend to give birth at hospitals that predominantly serve black populations and these hospitals have higher rates of maternal complications compared to other hospitals (National Partnership for Women & Families, 2018).<\/p>\n One of the limitations on this topic is the available data, which right now seems to be from 2016 or prior.\u00a0 Looking at racial disparities on a national level shows government intervention needs to happen to create better education opportunities and access to healthcare.\u00a0 However, I did not find direct links to institutional racism tied to pregnancy outcomes.<\/p>\n The statistics are known, like black women experiencing preeclampsia earlier in pregnancy or an increase in cardiovascular complications.\u00a0 If these are known, there is no reason they cannot be assessed, treated, or managed.\u00a0 The healthcare system needs to update its practices to adapt to racial\/cultural needs.\u00a0 Each community has different needs and each pregnancy is not the same.\u00a0 The healthcare community treats each pregnancy the same (unless given a reason not to through prenatal visits).<\/p>\n One story from Harvard discusses issues of possible racism amongst the medical field, read it here: Racism and discrimination in health care<\/a>.\u00a0 If racism exists from a professional level with doctors, then medical schools have to change their curriculum to include diversity, inclusion, and sensitivity training.\u00a0 Healthcare professionals are supposed to be there to care for humans and ensure their well-being.\u00a0 If this is not the case, what are the consequences to those not acting ethically within the field?<\/p>\n We need to provide access to not only education but access to healthcare for everyone.\u00a0 This may look like recording phone numbers for people that purchase contraceptives as well as pregnancy tests and having the health department of each county follow up.\u00a0 This may feel like an invasion of privacy; however, we are doing contact tracing right now for the pandemic.\u00a0 If this could be one small step to providing early prenatal care that can positively affect pregnancy outcomes, why would we hesitate? Learn more about the disparities and donate to the cause here: Black Women\u2019s Maternal Health<\/a>.<\/p>\n Lastly, how do we have a conversation about maternal deaths without addressing government issues?\u00a0 Maternity leave is a glaring issue when looking at the United States.\u00a0 However, before even discussing maternity leave, what about lost wages during prenatal appointments?\u00a0 Salaries need to be looked at, there should be no gender pay gap.\u00a0 All pregnant women should be supported by employers to have appointments to ensure their health.\u00a0 If your employee is not healthy, the work will not be done anyway.\u00a0 Also, the government needs to do a better job ensuring that people understand how to access and use their benefits of the Affordable Care Act.\u00a0 US maternity leave is under the Family and Medical Leave Act (FMLA) that was established in 1993.\u00a0 FMLA provides certain employees up to 12 weeks of unpaid leave, which protects their job and any healthcare benefits provided by the company (US Department of Labor, 2021).\u00a0 Here is the fact sheet provided by the US government: FMLA Fact Sheet<\/a>. \u00a0The policies in place do not treat each person equally and does not take into account disparities, such as socioeconomic or relationship status to ensure all pregnant women have the resources to have not only a health pregnancy, but also a healthy delivery and postpartum journey.\u00a0 To recap, the US federal government only has a policy that provides unpaid leave<\/u><\/strong>.\u00a0 It is up to 12 weeks, at the discretion of a potentially biased person(s), and only available to certain employees. \u00a0This is beyond inhumane and applies directly to me. \u00a0I want to start a charity lobbying for policy changes.<\/p>\n In January 2019 I was laid off from a company that I was with for almost seven years.\u00a0 I continued to receive severance pay through August of 2019.\u00a0 I started with my current employer in June 2019, the baby came early.\u00a0 I was only with my employer for 19 weeks by the time he arrived.\u00a0 To qualify for employer maternity benefits, which was up to 16 weeks leave, I had to be employed by them for 26 weeks.\u00a0 Living in NYS provided some coverage, but since I wasn’t with my current employer for 26 weeks, I hadn’t paid into the system long enough.\u00a0 Again, I was receiving and paying into the system through my severance, but NYS does not look at past employment for qualification.\u00a0 I was entitled to six weeks, below my cost-of-living state-paid benefits.\u00a0 My benefits were extended due to some postpartum issues.\u00a0 Being married provided a privilege<\/u> of being able to figure it out financially.\u00a0 Six weeks is not long enough.\u00a0 Not everyone can make those adjustments.\u00a0 Preventable added stressors should not be a concern.\u00a0 Stress causes major health consequences.\u00a0 The US claims to support families and wants new births, but their actions (inactions) clearly state they do not.<\/p>\n *Additional Resource: CDC Hear Her Campaign: CDC Resources<\/a><\/p>\n Keywords: pregnancy, mortality rates, health coverage, inequity, disparity, retained placenta, maternity leave<\/p>\n AAMC. (2018). Percentage of all active physicians by race\/ethnicity, 2018. Retrieved from: https:\/\/www.aamc.org\/data-reports\/workforce\/interactive-data\/figure-18-percentage-all-active-physicians-race\/ethnicity-2018<\/a><\/p>\n Alio, A.P., Richman, A.R., Clayton, H.B., Jeffers, D.F., Wathington, D.J. and Salihu, H.M. (2009). An ecological approach to understanding black-white disparities in perinatal mortality. Maternal and Child Health Journal, 14<\/em>. doi: 10.1007\/s10995-009-0495-9<\/p>\n Arcaya, M.C., Arcaya, A.L. and Subramanian, S.V. (2015). Inequalities in health: definitions, concepts, and theories. Global Health Action, 8<\/em>(1). doi: 10.3402\/gha.v8.27106<\/p>\n Counseling Staff. (2018). [Pregnancy-related mortality rates] [Photograph]. Northwestern: The Family Institute. https:\/\/counseling.northwestern.edu\/blog\/mental-health-counseling-black-women-pregnancy\/<\/a><\/p>\n Clay, S.L., Griffin, M. and Averhart, W. (2019). Black\/white disparities in pregnant women in the United States: An examination of risk factors associated with black\/white racial identity. Health and Social Care in the community, 26(5). doi: 10.1111\/hsc.12565<\/p>\n Expecting or recently had a baby? (2018). Centers for Disease Control and Prevention. Retrieved from: Expecting or Recently had a Baby? Learn about Blood Clots | CDC<\/a><\/p>\n Institute for Urban Policy Research & Analysis. (2018) [Disparate rates of black women dying: At birth and postpartum period] [Photograph]. The University of Texas at Austin. Retrieved from https:\/\/liberalarts.utexas.edu\/iupra\/news\/new-policy-brief-on-maternal-health-disparities-for-black-women<\/a><\/p>\n Moaddab, A., Dildy, G.A., Brown, H.L. Bateni, Z., Belfort, M., Sangi-Haghpeykar, H. and Clark, S. (2018). Health care disparity and pregnancy-related mortality in the United States, 2005-2014. Obstetrics & Gynecology, 131<\/em>(4). doi: 10.1097\/AOG.0000000000002534<\/p>\n National Partnership for Women & Families. (2018). Black women\u2019s health maternal health: A multifaceted approach to addressing persistent and dire health disparities<\/em>. National Partnership. https:\/\/www.nationalpartnership.org\/our-work\/health\/reports\/black-womens-maternal-health.html<\/a><\/p>\n Njoroge, J.N. and Parikh, N.I. (2020). Understanding health disparities in cardiovascular diseases in pregnancy among black women: Prevalence, preventive care, and peripartum support networks. Current Cardiovascular Risk Reports, 14<\/em>(8). doi: 10.1007\/s12170-020-00641-9<\/p>\n Perlman, N.C. and Carusi, D.A. (2019). Retained placenta after vaginal delivery: Risk factors and management. International Journal of Women\u2019s Health, 11<\/em>. doi: 10.2147\/IJWH.S218933<\/p>\n Rayburn, W.F., Xierali, I.M., Castillo-Page, L. and Nivet, M.A. (2016). Racial and ethnic differences between obstetrician-gynecologists and other adult medical specialists. Obstetrics & Gynecology, 127(1). doi: 10.1097\/AOG.0000000000001184<\/p>\n Tello, M. (2020). Racism and discrimination in health care: Providers and patients. Harvard Health Publishing Harvard Medical School<\/em>. Retrieved from https:\/\/www.health.harvard.edu\/blog\/racism-discrimination-health-care-providers-patients-2017011611015<\/a><\/p>\n Tikkanen, R., Gunja, M.Z., FitzGerald, M. and Zephyrin, L. (2020). Maternal mortality and maternity care in the United States compared to 10 other developed countries. The Commonwealth Fund. Retrieved from https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2020\/nov\/maternal-mortality-maternity-care-us-compared-10-countries<\/a><\/p>\n Tikkanen, R., Gunja, M.Z., FitzGerald, M. and Zephyrin, L. (2020). [Timeline of pregnancy related death rates] [Photograph]. The Commonwealth Fund. Retrieved from https:\/\/www.commonwealthfund.org\/publications\/issue-briefs\/2020\/nov\/maternal-mortality-maternity-care-us-compared-10-countries<\/a><\/p>\n U.S. Department of Health & Human Services. (2021). Addressing health inequities among pregnant women<\/em>. Centers for Disease Control and Prevention. Retrieved from: https:\/\/www.cdc.gov\/hearher\/resources\/news-media\/addressing-health-inequities.html<\/a><\/p>\n U.S. Department of Health & Human Services. (2021). Expecting or recently had a baby? Learn about blood clots. Centers for Disease Control and Prevention. Retrieved from: https:\/\/www.cdc.gov\/ncbddd\/dvt\/infographics\/blood-clot-pregnancy-info.html<\/a><\/p>\n U.S. Department of Labor. (2021). Family and Medical Leave (FMLA). Retrieved from: https:\/\/www.dol.gov\/general\/topic\/benefits-leave\/fmla<\/a><\/p>\n","protected":false},"excerpt":{"rendered":" Author: Jessica Viola<\/p>\n There are many layers of diversity and equity in healthcare, but I am going to focus on only one.\u00a0 In 2019 I became pregnant and had a full-term pregnancy at 37 weeks and 2 days, to a healthy baby boy.\u00a0 Throughout my pregnancy, I did a lot of reading and internet searches to gain as much knowledge as I possibly could to not only stay healthy during pregnancy but learn how to advocate for myself and what to expect from my healthcare providers.\u00a0 This experience brought a rude awakening to the inequities that exist in the US healthcare system with pregnancy care.\u00a0<\/p>\n","protected":false},"author":3228,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-115","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/posts\/115","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/users\/3228"}],"replies":[{"embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/comments?post=115"}],"version-history":[{"count":0,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/posts\/115\/revisions"}],"wp:attachment":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/media?parent=115"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/categories?post=115"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/tags?post=115"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}},{"id":111,"date":"2021-06-09T13:51:46","date_gmt":"2021-06-09T13:51:46","guid":{"rendered":"https:\/\/edspace.american.edu\/nutritioneducation\/?p=111"},"modified":"2021-06-09T13:55:14","modified_gmt":"2021-06-09T13:55:14","slug":"most-memorable-campaign-of-the-early-2000s","status":"publish","type":"post","link":"https:\/\/edspace.american.edu\/nutritioneducation\/2021\/06\/09\/most-memorable-campaign-of-the-early-2000s\/","title":{"rendered":"Most Memorable Campaign of the Early 2000’s"},"content":{"rendered":" Author: Jessica Boileau \u201cVERB, it\u2019s what you do\u201d. Feeling nostalgic? If you were watching television as a child in the early 2000s, you may recognize this phrase. VERB was a media campaign to promote physical activity to combat childhood obesity. The campaign ran from 2002 to 2006 and was targeted towards the 9 to 13-year-old age group. With the short amount of airtime, was this campaign truly successful? This media campaign was very successful because it reached out to so many young people and was memorable, enough to where even I recognize the phase almost 20 years later.<\/p>\n Childhood obesity has significantly increased over the past three decades (Han et al, 2010). Obesity in youth is a major concern because it can lead to obesity in adulthood. Therefore the individual would be predisposed to medical complications and diseases in the future. Some examples are diabetes, metabolic syndrome, hyperandrogenism, cardiovascular complications, respiratory complications, and many other issues. All of these increase the individual\u2019s mortality rate (Speiser et al., 2005). The prevalence of childhood obesity is due to the current lifestyle children part-take in, which is a sedentary lifestyle (Han et al, 2010). Television and video games have created a new lifestyle for children because it promotes a sedentary life (Speiser et al., 2005). Only 25% of children in the United States reported regular physical activity, and 14% said they do not participate in regular activity at all. In a study that compared weight gain in youth ages from the years 1980 to 1999, the number of overweight individuals doubled in children ages 6 to 11 and tripled in the ages 12 to 17. Particularly, African-Americans, Hispanics, Pima Indians, and Native Americans have a high rate of obesity (Speiser et al., 2005).<\/p>\n One of the ideas to combat childhood obesity is to promote physical activity. Lack of physical activity is not subject to one social class but is prevalent among all children despite socioeconomic status, gender, and race (Speiser et al., 2005). The most effective treatment for childhood obesity is to decrease sedentary activity and increased physical activity. Sixty minutes of daily moderate to vigorous physical activity, and less than two hours a day doing a sedentary activity are recommended for the best results (Raj & Kumar, 2010). Ways to encourage physical activity are to make it fun and not a requirement and make it accessible to all youth (Speiser et al., 2005). Recommendations to parents are to make physical activity a positive experience. They should start early with their child and make physical activity part of the family\u2019s daily routine. This can be done by taking a walk every day or playing games. The parent can also discourage television at times and encourage their child to participate in sports or recreational activities that they enjoy (CDC<\/a>, 2020). This is why a campaign like VERB was so successful because it portrayed physical activity as fun and enjoyable to youth.<\/p>\n VERB was a multicultural campaign created by the U.S. Department of Health and Human Services\u2019 Center for Disease Control and Presentation when childhood obesity was recognized as a major concern (DC Health Matters, 2021). The VERB campaign used a combination of paid advertising, marketing strategies, and partnership efforts. The most common platform was presented on television as a commercial on media channels like Nickelodeon, Cartoon Network<\/a>, and Disney Channel<\/a>. The campaign worked with the 9 to 13 age group to develop ideas, thus making the campaign \u201cfor-kids-by-kids\u201d (DC Health Matters, 2021). This marketed physical activity as cool, fun, and a way to have a good time with friends (NSMC, 2021). Using a \u201cfor-kids-by-kids\u201d method, they were very successful by increasing awareness by 74% in the 9 to 13-year-old Americans. 90% of those demonstrated that they also understood the messages portrayed (DC Health Matters, 2021).<\/p>\n The primary goal of the VERB campaign was to increase and maintain physical activity in youth ages 9 to 13 (NSMC, 2021). The U.S. Congress was concerned over the rise of obesity and believed it was important to change lifestyle habits and promote health messages early in life. Secondary goals were to increase knowledge, attitudes, and beliefs of regular physical activity, increase parental and influencer support, make aware of options and opportunities for physical activity, and create opportunities for youth to participate in regular physical activity (NSMC, 2021). The campaign recommended at least 60 minutes of moderate to vigorous activity five days a week. The campaign not only wanted to encourage physical activity but also get youth involved with family and positive groups, like teams and clubs (Dobbs, 2003). Check out (Figure 1) to see more detail on strategy and goals.<\/p>\n The 9 to 13 age group is a delicate age to market towards, because they cannot say \u201cyou have to do this\u201d. The campaign had to keep up with the trends and interests of youth by associating the message with music, clothing, electronics, or enjoyment of life (Wong et al., 2004). They used popular brands, athletes, celebrities, and activities or products that were considered cool, fun, and motivating. The parent or influencers role is to praise the youth when they participate in physical activity (Wong et al., 2004).<\/p>\n As a multicultural campaign, VERB reached many backgrounds. However, the CDC wanted to specifically reach out to African Americans, Hispanics, Asian Americans and American Indians (NSMC, 2021). Culture influences an individual\u2019s perceptions and experiences of life events, so it is a huge factor in how one views health (Wright et al., 2013). Children in these cultures have the tendency to be less physically active due to their culture. VERB was created to be unique because this group would not be reached easily by a general campaign (NSMC, 2021). The specific age group was targeted because the 9 to 13-year-old age group is when the child is less dependent on their parents for their decision-making process. A secondary target in order to help the child more is teachers, youth leaders, physical education, healthcare professionals, pediatricians, and coaches. This group would help encourage the child to be active and give praise where it is due (NSMC, 2021).<\/p>\n There is a three-step process when it comes to targeting an audience. This involves segmentation, evaluation, and selection. Segmentation looks at the larger population and divides it into a smaller group. In order to do so, the group should have something in common. Examples would be needs, wants, barriers, motivations, values, behaviors, and lifestyles. Once the common background has been identified, the campaign must create unique strategies to persuade the group to change (Lee & Kotler, 2016). In the case of the VERB campaign, the group has a couple of barriers in common. The children who are not physically active have fear of failure, lack of time, family responsibilities, and competing interests (NSMC, 2021). This is why the campaign promotes physical activity as fun, to decrease the pressure of failure. Also having parents and educators promote physical activity helps cut the barriers of lack of time and other responsibilities.<\/p>\n The next step is evaluation. This is the stage where the segments will be prioritized to narrow down the groups even more. Here is when the campaign should consider their ability to reach the target and how receptive they will be (Lee & Kotler, 2016). Children will not be as receptive if they are told to do the physical activity by their parents or educators. This would portray physical activity as a chore, which is going to decrease their willingness to participate. Creating commercials with celebrities playing games with the iconic yellow kickball (pictured to the right) makes physical activity look fun and cool.<\/p>\n Lastly, the selection is when the campaign characterizes groups by meaningful predictors of market behavior. There are a couple of variables involved in this stage including demographic segmentation, geographic segmentation, psychographic segmentation, and behavior segmentation. The demographic variable considers age, gender, race, religion and etc. This campaign segments age-specific to 9 to 13-year-olds. Race is targeted, however, they would like all cultures to be involved. Geographic segmentation is according to geographic areas or regions. This campaign was specific to the United States, so all American children were targeted. Psychographic divides based on social class, lifestyle, values, or personality characteristics. The VERB campaign considers that the group they want to influence is sensitive, and needs to see physical activity in a specific way. They could view physical activity as a chore, or they may not even think about it at all, so they use the values of the children and market towards it. Behavior divides based on knowledge, attitudes, and behaviors related to the \u201cproduct\u201d. VERB considers that there is low knowledge on physical exercise, so they market towards parents and educators as well in order to get the child educated. Using all the variables of selection then creates a campaign that would be more likely to have the group respond similarly to the product, price, place, and promotion (Lee & Kotler, 2016).<\/p>\n After the target audience has been decided, the next step is to influence the group through the four \u201cP\u2019s\u201d. The first is product. Product is the desired behavior of the target audience (Lee & Kotler, 2016). The VERB campaign\u2019s product is voluntary physical activity (Wong et al., 2004). The second \u201cP\u201d is price, which is the cost the target audience associates with adopting the behavior. Physical activity can be free or could be pricy depending on the chosen activity. \u00a0Another part could be the \u201ccost\u201d of timing for physical activity programs for the parent and child. The third is place, which is where and when the behavior would take place (Lee & Kotler, 2016). VERB wants physical activity to be done in a safe place. So it is encouraged to take place in parks, schools, and youth organizations (Wong et al., 2004.). Lastly, promotion, which is the communication to inspire the target audience (Lee & Kotler, 2016). Through the advertising on television, they marketed physical activity as fun and cool in order to get the message across successfully.<\/p>\n Even though VERB did not run for many years, it did have a lasting impact on the children in my generation. As soon as I saw the slogan for VERB, I was immediately flooded with memories of the campaign. VERB became a huge success not only because it helped children get active in the early 2000s, but its message was also memorable. This is what then helps to provide a long-term behavior change.<\/p>\n Communicating VERB keeping it fun for children (cdc.gov)<\/a><\/p>\n VERB – Materials (cdc.gov)<\/a><\/p>\n Figure 1: Describes the marketing strategy and the short, mid, and long term goals of the campaign team. Retrieved from: Preventing Chronic Disease (thensmc.com)<\/a><\/p>\n CDC: Centers for Disease Control and Prevention. (2020). Making Physical Activity a Part of a Child\u2019s Life. Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion.<\/em> https:\/\/www.cdc.gov\/physicalactivity\/basics\/adding-pa\/activities-children.html.<\/p>\n DC Health Matters. (2021). VERB: it\u2019s what you do. DC Health Matters<\/em>. https:\/\/www.dchealthmatters.org\/promisepractice\/index\/view?pid=3663.<\/p>\n Dobbs, K. (2003). VERB: It\u2019s what you do. CDC: Centers for Disease Control and Prevention.<\/em> https:\/\/www.cdc.gov\/pcd\/issues\/2004\/jul\/pdf\/04_0043_02.pdf.<\/p>\n Han, J.C. et al. (2010). Childhood Obesity. The Lancet<\/em>. https:\/\/doi.org\/10.1016\/S0140-6736(10)60171-7<\/a><\/p>\n Huhman, M. et al. (2004). The VERB\u2122 Campaign Logic Model: A Tool for Planning and Evaluation. Preventing Chronic Disease: Public Health Research, Practice, and Policy<\/em>. 1(3): 1-6.<\/p>\n Lee, N.R. & Kotler, P. (2016). Social Marketing: Changing Behaviors for Good<\/em>, Fifth Edition. SAGE Publications, Inc.<\/p>\n NSMC: Leading Behavior Change. VERB. NSMC: Leading Behavior Change<\/em>. https:\/\/thensmc.com\/resources\/showcase\/verb%E2%84%A2.<\/p>\n Raj, M. & Kumar, R.K. (2010). Obesity in children & adolescents. Indian Journal of Medical Research<\/em>. 132(5): 598-607.<\/p>\n Speiser, P.W. (2005). Childhood Obesity. The Journal of Clinical Endocrinology & Metabolism<\/em>. (90) 3:1871\u20131887,\u00a0https:\/\/doi.org\/10.1210\/jc.2004-1389<\/a><\/p>\n Wong et al., (2004). VERB\u2014A Social Marketing Campaign to Increase Physical Activity Among Youth. Preventing Chronic Disease<\/em>. 1(3): A10.<\/p>\n Wright, K. B., Sparks, L., & O\u2019Hair, D. H. (2013). Health Communication in the 21st Century<\/em> (2nd ed.). Wiley-Blackwell.<\/p>\n","protected":false},"excerpt":{"rendered":" Author: Jessica Boileau<\/p>\n \u201cVERB, it\u2019s what you do\u201d. Feeling nostalgic? If you were watching television as a child in the early 2000s, you may recognize this phrase. VERB was a media campaign to promote physical activity to combat childhood obesity. The campaign ran from 2002 to 2006 and was targeted towards the 9 to 13-year-old age group. With the short amount of airtime, was this campaign truly successful?<\/p>\n","protected":false},"author":3228,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[11,12,13,10],"class_list":["post-111","post","type-post","status-publish","format-standard","hentry","category-uncategorized","tag-activity","tag-child","tag-fun","tag-obesity"],"_links":{"self":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/posts\/111","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/users\/3228"}],"replies":[{"embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/comments?post=111"}],"version-history":[{"count":0,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/posts\/111\/revisions"}],"wp:attachment":[{"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/media?parent=111"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/categories?post=111"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/edspace.american.edu\/nutritioneducation\/wp-json\/wp\/v2\/tags?post=111"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}},{"id":103,"date":"2020-08-05T19:23:49","date_gmt":"2020-08-05T19:23:49","guid":{"rendered":"http:\/\/edspace.american.edu\/nutritioneducation\/?p=103"},"modified":"2021-06-09T13:56:23","modified_gmt":"2021-06-09T13:56:23","slug":"should-you-opt-out-of-vaccines","status":"publish","type":"post","link":"https:\/\/edspace.american.edu\/nutritioneducation\/2020\/08\/05\/should-you-opt-out-of-vaccines\/","title":{"rendered":"Should you opt-out of vaccines?"},"content":{"rendered":" Author<\/strong>: Deborah Carnahan Vaccines did not become a matter of interest until my son was born, and he started receiving vaccinations. After each trip to the pediatrician, my son developed a fever and cried for days, which was scary for a new mom. The pediatrician identified the probable cause of the reaction, removed pertussis from his vaccines, and he was able to tolerate future vaccinations. From that point, I was skeptical about the process of vaccinations, and my concern recycled when my dogs started getting shots, and a dog died after a rabies vaccination. Even though situations occurred that caused a bit of hesitancy, there is a case for vaccinations in preventing the spread of disease, and for the pharmaceutical and biotech industries to continue the ongoing research and development of vaccines to prevent and combat the spread of infectious diseases.<\/span><\/p>\n The theory of immunization dates back thousands of years and originated in the ancient Indian peninsula (Northern and Eastern India) as a practice of variolation\/inoculation, with the immunization of individuals from a product taken from an infected person (Vijay, 2019). The first major breakthrough in immunizations later occurred on May 14, 1796, by Edward Jenner, who was prompted by Lady Montagu\u2019s \u201cvariolation\u201d concept and inoculated eight-year-old James Phipps with cowpox pus to prove that the less virulent cowpox would protect against smallpox. It was the first time it was possible to prevent infection in a healthy person medically, but then it took 180 years after that breakthrough to make the six essential vaccines available around the world (Naran et al., 2018).<\/p>\n Interestingly, vaccines are recommended to everyone at some point in their life. Vaccines are products, comprised of sub-components, killed or inactivated organisms, or live-attenuated (reduced) viruses, that work by stimulating the immune system to fight an infection or disease. Together, the immune system and vaccines can help fight disease and infection (See Piot et al., 2019 and Naran et al., 2018).<\/p>\n Also, immunizations are an enormous part of the reason for the decrease in the rates of vaccine-preventable diseases, and advancement in the health of children. Vaccination against infectious diseases changed history by preventing millions of deaths each year from disease (Edwards, & Hackell, 2016). Though, there are some parents and individuals that feel there is reason for concern over the safety<\/a> of vaccines, referred to as vaccine hesitancy.<\/p>\n Vaccine hesitancy is a term used to explain the varying degrees to which people feel about vaccines, and to remove the pro- and anti-vaccination labels (Edwards, & Hackell, 2016). Vaccine hesitancy has been around from the beginning since the first smallpox vaccine. Most often, people who are vaccine-hesitant are not part of any organized group but are individuals who lack of trust in the safety or efficacy of vaccines or believe the risk of vaccination is higher than the risk of the infectious disease. There is also some that believe that because certain infectious diseases are no longer a threat, they do not need vaccines (Picard, 2017).<\/p>\n Because most individuals have been vaccinated, the vaccine-preventable disease levels are at a low. However in 2014, America had over 600 cases of measles, the highest number in 20 years, linked to a trip to Disneyland. Another reason for the spike in measles during 2014 is that more people are opting not to vaccinate their children, and cited one reason is a discredited study linking vaccination to autism (Wang et al., 2016). There are also theories that doctors and pharmaceutical companies profit from vaccinations, and for that reason, push vaccinations onto the public. That is not the case, and pediatricians and doctors do not profit but lose money on vaccine administration (Lam, 2015).<\/p>\n Health care professionals and the public health system make efforts to reverse vaccine hesitancy, including The World Health Organization (WHO) which works at addressing vaccine hesitancy by looking at the factors, motivations, or barriers causing vaccine hesitancy. Some of the barriers that have been identified that have prevented individuals from getting vaccines include perceptions about vaccines, social norms, availability, affordability, and access, and the WHO is continuing the work of developing an approach to increase participation in vaccinations (\u201cImproving vaccination demand and addressing hesitancy,\u201d n.d.).<\/p>\n Currently, there are 18 vaccines<\/a> available to fight serious diseases. These vaccines have helped save millions of lives of infants, children, adolescents, teens, and adults, and given based on age, physical location, health condition, and sometimes as a necessity for travel. Some of those vaccines are for chickenpox, diphtheria, flu, mumps, polio, and measles. There are also vaccines available to prevent diseases that are no longer present in the United States, such as cholera, smallpox, and tuberculosis, but continue to exist in other parts of the world (Centers for Disease Control and Prevention, 2020).<\/em><\/p>\n The states have vaccination laws, which include vaccination requirements for children in public and private schools, daycare settings, college\/university students, healthcare workers, and patients in certain facilities. Children need to be vaccinated against certain contagious diseases as a condition for school and childcare attendance. Most laws apply to public and private schools with similar immunization and exemption provisions. Each state has immunization information and exemptions specifically for that state in the State School Immunization Requirements and Vaccine Exemption Laws<\/a> (Centers for Disease Control and Prevention, 2020).<\/em> There is a comprehensive schedule of recommended immunizations for children and adolescents under 18 years of age on the CDC website (Centers for Disease Control and Prevention, 2020).<\/em><\/p>\n Vaccines not only protect the individual against disease, but they can also protect the unvaccinated individuals by reducing transmission from person to person and limiting the risk of infection throughout a population. This type of protection is called herd protection or immunity, yet requires a large percentage of the people to be vaccinated, around 75-95%, to be effective (Iftikhar, n.d.).<\/p>\n Herd immunity<\/a> is essential in the prevention and spread of diseases like measles. An individual\u2019s natural immunity, which happens after a person gets a disease and their body creates the antibodies to fight that disease, works along with herd immunity to interrupt the spread of disease. For natural immunity to be effective against diseases, everyone would have had to contract the disease. Since that is not the case, vaccines help stop the spread of infectious diseases (Iftikhar, n.d.).<\/p>\n When parents have concerns about vaccines, they may refuse a dose of a vaccine, or a specific series of vaccines, or possibly all vaccines, and have some level of vaccine hesitancy. However, the odds of a parent refusing all vaccines, based on the information from the Centers for Disease Control and Prevention (CDC), is rare. There are cases that exist where children, or adults, should avoid vaccines because of age, allergies, pregnancy, or other health issues, and guidelines<\/a> per vaccine regarding who or who should not get a particular vaccine (Centers for Disease Control and Prevention, 2020).<\/em><\/p>\n For school children, some states allow exemptions from the requirements for vaccines for schools in certain cases. A medical exemption is one case that is permitted and occurs when a child has a medical reason not to get a vaccine. Also, some states allow non-medical reasons, such as for religious or philosophical reasons. There are requirements regarding the application process and requirements if an outbreak of disease happens, which in case a student\u2019s exemption may not be allowed, or the child may be excluded from school. Also, recertification for a medical exemption may be classified as temporary or permanent and may need to be recertified by a doctor (Centers for Disease Control and Prevention, 2020).<\/em><\/p>\n It has been over one hundred years since the first recorded influenza pandemic, the 1918 Spanish flu, caused by an A(H1N1) virus. Before this recent coronavirus, there were three other pandemics that occurred since the Spanish flu, Asian flu in 1957, the Hong Kong flu in 1968, and the 2009 swine-origin flu. (Yamayoshi & Kawaoka, 2019).<\/p>\n Each year, seasonal cases of the flu cause 3 \u2013 5 million deaths, and a significant number of deaths. Symptoms of flu may include can a cough, fever, sore throat, runny nose, body or headaches, and some vomiting or diarrhea. There are vaccines that have been developed to combat seasonal influenza<\/a>, which differ from new viruses, or pandemics (\u201cSeasonal flu vs. pandemic flu infographic,\u201d 2019).<\/p>\n There is a push in the scientific community to speed up the process of vaccines, especially because of the urgent need to address epidemics like the H1N1 influenza, Ebola, Zika, and SARS-CoV-2. There is new vaccine technology that allows a quicker response as in the H1N1 influenza vaccine, and some vaccines are in the experimental phase, like Ebola vaccines, or a malaria vaccine, and this research should continue (Lurie et al., 2020). Yet, vaccine development requires financial resources, a development and testing phase, manufacturing capabilities, and some type of fair allocation to needed areas, even though a pandemic crisis may subside, before a vaccine is available (Lurie et al., 2020).<\/p>\n Scientific advancements may bring new vaccines, but the road from discovery to the marketplace can be lengthy because of financing, development, trials to determine efficacy, licensing, and public approval. Despite the hurdles, immunization should remain at the forefront of research and health for humans and society.<\/p>\n Vaccine hesitancy will most likely continue to be an issue though the development process for vaccines has, in the past, been long, with testing and regulation for safety and efficacy (Edwards & Hackell, 2016). With a push to develop vaccines faster in consideration of new infectious diseases, vaccine hesitancy may increase, but individuals should consider looking at the positives of vaccines, before opting out of vaccines.<\/p>\n When it came to administering the core vaccines for my dog, now six years old, I requested an alternative vaccination schedule. The veterinarian administered the vaccines one at a time and spread out the vaccinations over an extended period, and there were no side effects encountered. Individuals can also request alternative vaccination schedules or postpone vaccines, instead of declining them altogether (Edwards, & Hackell, 2016). Again, each individual must research vaccines, and choose the best course for themselves, their families, and their communities.<\/p>\n Edwards,\u00a0K.\u00a0M., & Hackell,\u00a0J.\u00a0M. (2016). Countering vaccine hesitancy. PEDIATRICS<\/em>, 138<\/em>(3), e20162146-e20162146. https:\/\/doi.org\/10.1542\/peds.2016-2146<\/a><\/p>\n Iftikhar,\u00a0N. (n.d.). Herd immunity: What it means for COVID-19<\/em>. Healthline. https:\/\/www.healthline.com\/health\/herd-immunity<\/a><\/p>\n Improving vaccination demand and addressing hesitancy<\/em>. (n.d.). World Health Organization. https:\/\/www.who.int\/immunization\/programmes_systems\/vaccine_hesitancy\/en\/<\/a><\/p>\n Kaslow,\u00a0D.\u00a0C. (2020). Certainty of success: Three critical parameters in coronavirus vaccine development. npj Vaccines<\/em>, 5<\/em>(1). https:\/\/doi.org\/10.1038\/s41541-020-0193-6<\/a><\/p>\n Lam,\u00a0B. (2015, February 10). Vaccines are profitable, so what?<\/em> The Atlantic. https:\/\/www.theatlantic.com\/business\/archive\/2015\/02\/vaccines-are-profitable-so-what\/385214\/<\/a><\/p>\n Lurie,\u00a0N., Saville,\u00a0M., Hatchett,\u00a0R., & Halton,\u00a0J. (2020). Developing COVID-19 vaccines at pandemic speed. New England Journal of Medicine<\/em>, 382<\/em>(21), 1969-1973. https:\/\/doi.org\/10.1056\/nejmp2005630<\/a><\/p>\n Naran,\u00a0K., Nundalall,\u00a0T., Chetty,\u00a0S., & Barth,\u00a0S. (2018). Principles of immunotherapy: Implications for treatment strategies in cancer and infectious diseases. Frontiers in Microbiology<\/em>, 9<\/em>. https:\/\/doi.org\/10.3389\/fmicb.2018.03158<\/a><\/p>\n Picard,\u00a0A. (2017). 12. The roots of vaccine hesitancy. Public Health in the Age of Anxiety<\/em>, 342-347. https:\/\/doi.org\/10.3138\/9781487510404-014<\/a><\/p>\n Piot,\u00a0P., Larson,\u00a0H.\u00a0J., O\u2019Brien,\u00a0K.\u00a0L., N\u2019kengasong,\u00a0J., Ng,\u00a0E., Sow,\u00a0S., &<\/p>\n Kampmann,\u00a0B. (2019). Immunization: Vital progress, unfinished agenda. Nature<\/em>, 575<\/em>(7781), 119-129. https:\/\/doi.org\/10.1038\/s41586-019-1656-7<\/a><\/p>\n Seasonal flu vs. pandemic flu infographic<\/em>. (2019, July 17). Centers for Disease Control and Prevention. https:\/\/www.cdc.gov\/flu\/resource-center\/freeresources\/graphics\/seasonal-vs-pandemic-flu-infographic.htm<\/a><\/p>\n Unsplash. (n.d.). Beautiful Free Images & Pictures | Unsplash. https:\/\/unsplash.com<\/a><\/p>\n Vetter,\u00a0V., Denizer,\u00a0G., Friedland,\u00a0L.\u00a0R., Krishnan,\u00a0J., & Shapiro,\u00a0M. (2017). Understanding modern-day vaccines: What you need to know. Annals of Medicine<\/em>, 50<\/em>(2), 110-120. https:\/\/doi.org\/10.1080\/07853890.2017.1407035<\/a><\/p>\n Vijay,\u00a0K. (2019). Introductory chapter: The journey of vaccines – The past and the present. Vaccines – the History and Future<\/em>. https:\/\/doi.org\/10.5772\/intechopen.86274<\/a><\/p>\n Vaccines and immunizations | Home | CDC<\/em>. (2020, June 9). Centers for Disease Control and Prevention. https:\/\/www.cdc.gov\/vaccines\/<\/a><\/p>\nWhat is the difference?
\n<\/strong>Health, age, an uncontrollable, socio-economic status? <\/strong><\/h3>\nPrevention <\/strong><\/h2>\n
Policy Changes<\/strong><\/h2>\n
References<\/strong><\/h2>\n
\nHLTH 641: Health Communication, Spring 2021<\/p>\nChildhood Obesity<\/strong><\/h2>\n
What was the VERB Campaign?\u00a0 <\/strong><\/h2>\n
Market Strategy<\/strong><\/h2>\n
Lasting Impact of the Campaign <\/strong><\/h2>\n
Additional Links to VERB Brochures <\/strong><\/h2>\n
Figures <\/strong><\/h2>\n
References<\/strong><\/h2>\n
\nHLTH 641: Health Communication, Summer 2020<\/p>\n\n\n\n\n\n\nBackground of vaccines<\/strong><\/h2>\n
Types of vaccines<\/strong><\/h2>\n
![\"Mom](\"http:\/\/edspace.american.edu\/nutritioneducation\/wp-content\/uploads\/sites\/1614\/2020\/08\/Screen-Shot-2020-08-05-at-3.14.51-PM.png\")
<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n\n\n\n\n\n\nWho needs vaccines?<\/strong><\/h2>\n
Why are vaccines important?<\/strong><\/h2>\n
![\"3](\"http:\/\/edspace.american.edu\/nutritioneducation\/wp-content\/uploads\/sites\/1614\/2020\/08\/Screen-Shot-2020-08-05-at-3.18.17-PM.png\")
<\/p>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n\n\n\n\n\n\n\n\n\nWhat exemptions exist for vaccines?<\/strong><\/h2>\n
Could a policy about vaccines change?<\/strong><\/h2>\n
![\"older](\"http:\/\/edspace.american.edu\/nutritioneducation\/wp-content\/uploads\/sites\/1614\/2020\/08\/Screen-Shot-2020-08-05-at-3.20.15-PM.png\")
<\/p>\nWhat is the future of vaccines?<\/strong><\/h2>\n
References:<\/h2>\n