Public health communication campaigns have been credited with helping raise awareness of risk from chronic illness and new infectious diseases and with helping promote the adoption of recommended treatment regimens. Yet many aspects of public health communication interventions have escaped the scrutiny of ethical discussions. With the transference of successful commercial marketing communication tactics to the realm of public health, consideration of ethical issues becomes an essential component in the development and application of public health strategies. Ethical issues in public health communication are explored as they relate to eight topics: 'targeting' and 'tailoring' public health messages to particular population segments; obtaining the equivalence of informed consent; the use of persuasive communication tactics; messages on responsibility and culpability; messages that apply to harm reduction; and three types of unintended adverse effects associated with public health communication activities that may label and stigmatise, expand social gaps, and promote health as a value. We suggest that an ethical analysis should be applied to each phase of the public health communication process in order to identify ethical dilemmas that may appear subtle, yet reflect important concerns regarding potential effects of public health communication interventions on individuals and society as a whole.
Health communication campaigns, as an outcome of and an input into the social process, can create unintended as well as intended effects. The present paper represents an initial conceptual treatment of the unintended effects, the less studied of the two. It suggests that unintended effects can manifest in multiple dimensions, including those of time lapse, levels of analysis, audience types, content specificity, and valence. On these dimensions, a typology organizes available evidence to offer an outlook on 11 types of unintended effects, including obfuscation, dissonance, boomerang, epidemic of apprehension, desensitization, culpability, opportunity cost, social reproduction, social norming, enabling, and system activation. Implications for theory, research, and practice are discussed.
RECENT and numerous additions to the survey methodology literature, especially in the area of random-digit-dialing, have helped researchers to generate samples of household units for telephone surveys. However, the literature on selecting survey respondents within those household units has not kept pace. In fact, after searching through the standard texts on telephone surveys (see for example, Blankenship, 1977, or Dillman, 1978 researchers might conclude that there is only one method of respondent selection-the Troldahl-Carter (1964) method.In the Troldahl-Carter method, one of four selection matrices which list various combinations of age and sex of household members is assigned randomly to telephone numbers in the sample. Thus, by asking only two questions (How many people 18 years or older live in your household, and how many of them are men?), the interviewer has enough information to select the respondent who is designated at the intersection point on the matrix. This method, which is less cumbersome and more appropriate to telephone interviews than the complete enumeration of the household proposed by Kish (1949), still requires the interviewer to ask potentially sensitive questions early in the interview. For example, two elderly women who live together Abstract Four procedures for selecting telephone survey respondents within a household unit-Troldahl-Carter, male/female alternation, next-birthday, and no-selection methods-were compared in a small-sample survey. The data indicate that the nextbirthday method is a relatively efficient procedure for selecting a sample that is representative of all household members.Charles T.
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