African Americans have higher colorectal cancer (CRC) mortality than White Americans and yet have lower rates of CRC screening. Increased screening aids in early detection and higher survival rates. Coupled with low literacy rates, the burden of CRC morbidity and mortality is exacerbated in this population, making it important to develop culturally and literacy appropriate aids to help low-literacy African Americans make informed decisions about CRC screening. This article outlines the development of a low-literacy computer touch-screen colonoscopy decision aid using an innovative marketing method called perceptual mapping and message vector modeling. This method was used to mathematically model key messages for the decision aid, which were then used to modify an existing CRC screening tutorial with different messages. The final tutorial was delivered through computer touch-screen technology to increase access and ease of use for participants. Testing showed users were not only more comfortable with the touch-screen technology but were also significantly more willing to have a colonoscopy compared with a “usual care group.” Results confirm the importance of including participants in planning and that the use of these innovative mapping and message design methods can lead to significant CRC screening attitude change.

Objectives Radiological terror presents a real threat, but little is known about how low-income, urban African Americans may respond to such threats. The aim of this study was to understand the unique challenges of this group and to explore their knowledge of what a “dirty bomb” is, their intended behaviors should one occur, and their barriers to complying with “shelter in place” recommendations. Methods Thirty-seven 18–65-year-olds who were users of community centers in disadvantaged areas participated in 3 focus groups in Philadelphia. Results were analyzed by using the Krueger method of analyzing narrative text. Results The responses highlighted little knowledge or concern about a dirty bomb. Lack of trust in local authorities was expressed, with participants indicating that they did not feel their needs were addressed. While shelter in place was understood, most said they would still check on family or talk with others to get the “whole truth” because the most trusted information sources were neighbors and community leaders. Conclusion Our results indicate that a risk communication intervention for urban minorities may support desirable behaviors in the event of a dirty bomb, but successful communication will require establishing a local leader as a spokesperson to convince people of the importance of sheltering in place.

Potential terror events such as "dirty bombs" could have significant public health effects, but little is known about how low-literacy populations perceive dirty bombs, their trust in public health or government officials to provide credible information, and their willingness to comply with recommended actions. We surveyed 50 low-literacy adults from a large urban center; they were mostly members of ethnic minority groups. We used unique social marketing methods-perceptual mapping and vector message modeling-to create 3-dimensional models that reflected respondents' knowledge of what a dirty bomb is, their intended behaviors should one occur, and their concerns about complying with "shelter in place" recommendations. To further understand individual variations in this at-risk group, a k-means cluster analysis was used to identify 3 distinct segments, differing on trust of local authorities and their emergency response, willingness to comply with emergency directives, and trust of information sources. Message strategies targeting each segment were developed to focus on concepts important to moving the groups toward a "shelter in place" behavior, revealing key differences in how best to communicate with risk communication. We discuss how these methods helped elucidate specific differences in each segment's understanding of and likely response during the event of a "dirty bomb" and how these techniques can be used to create more effective message strategies targeted to these groups.

The objective of this study is to use a qualitative approach to prioritise road traffic injury (RTI) interventions for the city of Cuernavaca in Mexico. Seven focus group discussions and two nominal groups were held with participants representing different road users and social groups. All the focus group sessions were recorded and video filmed. Processing and analysis of the information gathered was done using qualitative methods. The problem of RTIs was well recognised by members of the local community, represented by participants in this study. The participants showed knowledge of the causes and related urban development dynamics. Participants identified possible interventions, and even rated them. The participatory approach utilised generated helpful insights and it enabled the researchers to identify key local actors and issues, for example, concerns of different road users, perception of certain factors and actors as causes of RTIs, and attitudes and behaviour within a specific physical environment. A prioritised list for 18 different interventions was developed. The first one will be implemented to prevent RTIs in the youth population. Understanding the social context to analyse the problem and possible solutions as seen by the community is important when analysing public health problems because it informs decision making when developing and implementing interventions.