Talking About Childhood Obesity

While discussing obesity with pediatric patients and their families can be difficult, it is an essential step toward appropriate weight management. There is paucity of data regarding language preferences when discussing obesity in this population. In this pilot qualitative study, we interviewed 8 parents of patients diagnosed with obesity to identify language and communication preferences for discussing their child’s weight. Interviews were analyzed for emerging themes. Important trends appeared revealing that parents prefer neutral, medical terms discussed at well-child checks or obesity-specific visits. Providers should frame lifestyle changes as positive for all patients and set achievable goals with the help of visual aids. Our analysis uncovered several important communication strategies that can better equip providers to discuss obesity with their pediatric patients. This research may serve as a foundation for larger studies into the topic.

Advance Care Planning Preferences for Adolescents With Cardiac Disease

BACKGROUND AND OBJECTIVES: Adolescents with cardiac disease are at risk for life-changing complications and premature death. The importance of advance care planning (ACP) in adults with congenital heart disease and in pediatric patients with HIV and cancer has been demonstrated. ACP preferences of adolescents with heart disease have not been evaluated. We describe ACP preferences of adolescents with heart disease and compare with those of their caregivers. METHODS: Outpatient adolescents aged 12 to 18 years with heart failure, cardiomyopathy, heart transplantation, or who were at risk for cardiomyopathy, as well as their caregivers, completed self-administered questionnaires which evaluated participants’ opinions regarding content and timing of ACP discussions, preferences for end-of-life communication, and emotional responses to ACP. RESULTS: Seventy-eight adolescents and 69 caregivers participated, forming 62 adolescent-caregiver dyads. Adolescents and caregivers reported that adolescent ACP discussions should occur early in the disease course (75% and 61%, respectively). Adolescents (92%) wanted to be told about terminal prognosis, whereas only 43% of caregivers wanted the doctor to tell their child this information. Most adolescents (72%) and caregivers (67%) anticipated that discussing ACP would make the adolescent feel relieved the medical team knew their wishes. Most caregivers (61%) believed that adolescents would feel stress associated with ACP discussions, whereas only 31% of adolescents anticipated this. CONCLUSIONS: Adolescents and their caregivers agree that ACP should occur early in disease course. There are discrepancies regarding communication of prognosis and perceived adolescent stress related to ACP discussions. Facilitated conversations between patient, caregiver, and providers may align goals of care and communication preferences.

Communicating Uncertainty in National Security Intelligence: Expert and Non-expert Interpretations of and Preferences for Verbal and Numeric Formats

Organizations in several domains including national security intelligence communicate judgments under uncertainty using verbal probabilities (e.g., likely) instead of numeric probabilities (e.g., 75% chance), despite research indicating that the former have variable meanings across individuals. In the intelligence domain, uncertainty is also communicated using terms such as low, moderate, or high to describe the analyst’s confidence level. However, little research has examined how intelligence professionals interpret these terms and whether they prefer them to numeric uncertainty quantifiers. In two experiments (N = 481 and 624, respectively), uncertainty communication preferences of expert (n = 41 intelligence analysts inExperiment 1) and non-expert intelligence consumers were elicited. We examined which format participants judged to be more informative and simpler to process. We further tested whether participants treated probability and confidence as independent constructs and whether participants provided coherent numeric probability translations of verbal probabilities. Results showed that whereas most non-experts favored the numeric format, experts were about equally split, and most participants in both samples regarded the numeric format as more informative.Experts and non-experts consistently conflated probability and confidence. For instance, confidence intervals inferred from verbal confidence terms had a greater effect on the location of the estimate than the width of the estimate, contrary to normative expectation. Approximately ¼ of experts and over ½ of non-experts provided incoherent numeric probability translations of best estimates and lower and upper bounds when elicitations were spaced by intervening tasks.

Impact of Patient Communication Preferences on the Patient Trust in Physicians: A Cross-Sectional Study in Iranian Outpatient's Clinics

There are widely emerging concerns that patient confidence in physicians is diminishing as physician–patient communication is threatened globally. This study aimed to assess patient communication preferences and their impact on patient trust in physicians. A cross-sectional study was conducted among outpatient clinics of 2 public and private hospitals in Tabriz, Iran. A total of 704 patients were selected conveniently. Of the 704 patients, 6.39% had low trust, 36.79% moderate trust, 35.37% had a high trust, and 21.45% had blind trust in physicians. Overall patient communication preference score was more in a private clinic rather than a public one ( P = .008). Patients of private hospitals and those who were living in rural areas have been shown to have more trust in physicians. Patients’ trust in physicians showed a significant association with patient communication preference ( B = 0.58; 95% CI: 0.53-0.63, P < .001).

Social Networking in Adolescents: Time, Type and Motives of Using, Social Desirability and Communication Choices

The evolution of digital media in adolescents has changed the patterns and motives of use and the impact on their communication choices in their social and family networks. The objectives of this study are to understand how peers communicate adopting a social network (SN) or by voice and their social desirability. After the informant consent signature, the adolescents completed a series of self-report questionnaires on the use of SN, on communication preferences, and on social desirability through online. Most of the adolescents belonged to the 17-19 age group (83.6%) and were female (68.9%). Adolescents spent more than 3 hours/day on Whatsapp and more than 2 hours/day on Instagram, while the use of Facebook was on average only 35 minutes/day. Females used digital media for longer than males. Adolescents aged 17-19 years choose more Facebook and voice modes compared to adolescents aged 14 and 16 years. The alternative modes of Whatsapp and voice were chosen more than the social networks in their communication strategies, especially for negative topics. Motives for use were, in addition to boredom, related to maintaining one's social sphere with peers. Some educative considerations were made based on these results.

Psychographic Segmentation: Another Lever for Precision Population Brain Health

Dementia prevention interventions that address modifiable risk factors for dementia require extensive lifestyle and behavior changes. Strategies are needed to enhance engagement and personalization of the experience at a population level. Precision Population Brain Health aims to improve brain health across the lifespan at a population level. Psychographic segmentation is a core component of Precision Population Brain Health with untapped potential. Psychographic segmentation applies behavioral and social sciences to understanding people’s motivations, values, priorities, decision making, lifestyles, personalities, communication preferences, attitudes, and beliefs. Integrating psychographic segmentation into dementia care could provide a more personalized care experience and increased patient engagement, leading to improved health outcomes and reduced costs. Psychographic segmentation can enhance patient engagement for dementia and shift the clinical paradigm from “What is the matter?” to “What matters to you?” Similar benefits of psychographic segmentation can be provided for dementia caregivers. Developing dementia prevention programs that integrate psychographic segmentation could become the basis for creating a shared framework for prevention of non-communicable diseases and brain health disorders at a population level. Integrating psychographic segmentation into digital health tools for dementia prevention programs is especially critical to overcome current suboptimal approaches. Applying psychographic segmentation to dementia prevention has the potential to help people feel a sense of empowerment over their health and improve satisfaction with their health experience—creating a culture shift in the way brain health is approached and paving the way toward Precision Population Brain Health.

The COPE-Trial—Communicating prognosis to parents in the neonatal ICU: Optimistic vs. PEssimistic: study protocol for a randomized controlled crossover trial using two different scripted video vignettes to explore communication preferences of parents of preterm infants

Background One of the numerous challenges preterm birth poses for parents and physicians is prognostic disclosure. Prognoses are based on scientific evidence and medical experience. They are subject to individual assessment and will generally remain uncertain with regard to the individual. This can result in differences in prognostic framing and thus affect the recipients’ perception. In neonatology, data on the effects of prognostic framing are scarce. In particular, it is unclear whether parents prefer a more optimistic or a more pessimistic prognostic framing. Objective To explore parents’ preferences concerning prognostic framing and its effects on parent-reported outcomes and experiences. To identify predictors (demographic, psychological) of parents’ communication preferences. Design, setting, participants Unblinded, randomized controlled crossover trial (RCT) at the Division of Neonatology of the University Medical Center Mainz, Germany, including German-speaking parents or guardians of infants born preterm between 2010 and 2019 with a birth weight < 1500 g. Inclusion of up to 204 families is planned, with possible revision according to a blinded sample size reassessment. Intervention Embedded in an online survey and in pre-specified order, participants will watch two video vignettes depicting a more optimistic vs. a more pessimistic framing in prognostic disclosure to parents of a preterm infant. Apart from prognostic framing, all other aspects of physician-parent communication are standardized in both videos. Main outcomes and measures At baseline and after each video, participants complete a two-part online questionnaire (baseline and post-intervention). Primary outcome is the preference for either a more optimistic or a more pessimistic prognostic framing. Secondary outcomes include changes in state-anxiety (STAI-SKD), satisfaction with prognostic framing, evaluation of prognosis, future optimism and hope, preparedness for shared decision-making (each assessed using customized questions), and general impression (customized question), professionalism (adapted from GMC Patient Questionnaire) and compassion (Physician Compassion Questionnaire) of the consulting physician. Discussion This RCT will explore parents’ preferences concerning prognostic framing and its effects on physician-parent communication. Results may contribute to a better understanding of parental needs in prognostic disclosure and will be instrumental for a broad audience of clinicians, scientists, and ethicists. Trial registration German Clinical Trials Register DRKS00024466. Registered on April 16, 2021.

A makeover for Dudley’s Q+

Theoretical basis The Dudley Beauty case illustrates a contemporary branding, management and marketing challenge facing many companies that are 50 plus years old. Movahhed (2016) highlights the six elements to consider during brand strategy: the target audience, the brand promise, brand perception (past, current and future), brand values, brand voice and brand positioning. The times have changed with changing macroenvironmental factors including political, economic, sociological, technological, legal and other environmental (PESTLE) changes that affect a business but which the business does not directly control. Research methodology The case is based upon an interview with Dudley Beauty CEO and President Ursula Dudley Oglesby and secondary sources. Case overview/synopsis The “A Makeover for Dudley’s Q+” case explores the challenges of a second-generation textured hair care and personal care company in the direct selling channel as it faces an aging market and changing business and economic environment. A Black-owned company, begun in 1967 by her parents, Dudley Beauty is led by the founders’ daughter, Harvard College and Harvard Law School-educated, Ursula Dudley Oglesby. At over 50 years old, the company has continually created new textured hair products and has high brand awareness among older Black consumers but has not adequately addressed changing hair trends and shifting communication preferences of younger consumers. The company is at a critical point needing to reach a younger, larger market to survive. The business situation supports marketing, management, strategy, and/or entrepreneurship undergraduate students in understanding how macroenvironmental forces and internal structures affect businesses. Complexity academic level This case is intended primarily for use by undergraduates in a variety of courses. It is suitable for courses in Principles of Marketing, Entrepreneurial Marketing, general Entrepreneurship and Marketing Strategy courses covering topics such as direct selling, the role of environmental factors in business, rebranding efforts using digital and social media marketing and women/minority business owners.

Pet Owners and Antibiotics: Knowledge, Opinions, Expectations, and Communication Preferences

Despite the important role of antimicrobial use in companion animals in the global challenge presented by antimicrobial resistance (AMR), very few studies have quantified pet owner factors that can contribute to suboptimal veterinary antimicrobial use. We conducted an online survey of pet owners, asking about their experiences with veterinarians, their opinions on antibiotic use and knowledge of antibiotics, and their communication preferences regarding judicious prescribing. Just over half (54%) of the 558 pet owners had received antibiotics for their pet at their last non-routine veterinary consultation and most owners were happy (83%) with the antibiotic prescribing decision of their veterinarian. A quarter (25%) indicated that they had been surprised, disappointed or frustrated when a veterinarian had not given their pet antibiotics; 15% had explicitly requested them. Owners placed a higher priority on their pet receiving the most effective treatment than on treatment being cheap or convenient. Most respondents recognized the limitations of antibiotic therapy and the risks associated with antibiotic use, but 50% believed the risks were confined to the treated animal; only a minority was aware of inter-species transfer of bacteria. Pet owners indicated that they would find judicious prescribing messages focused on the direct risks of antibiotics to their pet more compelling than those about public health. Our findings suggest that veterinary communications about responsible antibiotic use should focus on pet owners’ priorities and address or bypass their gaps in understanding regarding antibiotic resistance.