Evolving research in epigenetics and the developmental origins of health and disease offers tremendous promise in explaining how the social environment, place, and resources available to us have enduring effects on our health. Troubling from a communications perspective, however, is the tendency in framing the science to hold mothers almost uniquely culpable for their offspring's later disease risk. The purpose of this article is to add to the conversation about avoiding this unintended outcome by (1) discussing the importance of cognitive processing and issue frames, (2) describing framing challenges associated with communicating about developmental origins of health and disease and offering principles to address them, and (3) providing examples of conceptual metaphors that may be helpful in telling this complex and contextual story for public health.

Findings from the field of Developmental Origins of Health and Disease (DOHaD) suggest that some of the most pressing public health problems facing communities today may begin much earlier than previously understood. In particular, this body of work provides evidence that social, physical, chemical, environmental, and behavioral influences in early life play a significant role in establishing vulnerabilities for chronic disease later in life. Further, because this work points to the importance of adverse environmental exposures that cluster in population groups, it suggests that existing opportunities to intervene at a population level may need to refocus their efforts “upstream” to sufficiently combat the fundamental causes of disease. To translate these findings into improved public health, however, the distance between scientific discovery and population application will need to be bridged by conversations across a breadth of disciplines and social roles. And importantly, those involved will likely begin without a shared vocabulary or conceptual starting point. The purpose of this paper is to support and inform the translation of DOHaD findings from the bench to population-level health promotion and disease prevention, by: 1) Discussing the unique communication challenges inherent to translation of DOHaD for broad audiences, 2) Introducing the First-hit/Second-hit Framework with an epidemiologic planning matrix as a model for conceptualizing and structuring communication around DOHaD, and 3) Discussing the ways in which patterns of communicating DOHaD findings can expand the range of solutions considered, and encourage discussion of population-level solutions in relation to one another, rather than in isolation.

Growing concern over failure to detect early stage breast cancer has led communities across the United States to participate in the Breast Cancer Awareness Month program. This program mobilizes local public and private institutions, particularly the media, to reach a large audience each October with information on salutary behaviors, including screening, and on resources that can assist newly motivated audiences to adopt the behaviors. Although the scholarly literature includes no assessments of the effect of the program on the actual detection of early stage breast tumors, similar programs targeting other illnesses (e.g., AIDS) are quickly emerging. We attempt such an assessment by applying time-series designs to 92 quarters (beginning January, 1975) of data obtained from cancer registries in the Atlanta and Detroit metropolitan areas as well as in the San Francisco Bay Area. We find that the detection of in situ and local breast tumors increased in all three communities during the quarters that included Breast Cancer Awareness Month. We conclude that community mobilization may have its intended benefit but suggest that community organizers not ignore unintended costs including the emotional and physical sequelae of false positives.

This study explored how migration-related socio-cultural and environmental factors interact to render immigrant Latino men residing in rural Oregon at increased risk for HIV/STI. More specifically, the paper describes the socio-demographic characteristics and sexual risk profile of immigrant Latino men and characterises the physical and socio-cultural contexts in which they reside. In-depth interviews were conducted with 49 men who newly immigrated to the USA and had recently engaged in sexual intercourse with women. Content analysis indicated that job instability and seasonal/industry restrictions resulted in frequent changes in employment and living situations, and one-third of respondents reported having no one to turn to when in need. Over two-fifths had ever had sex with a sex worker, with almost a quarter reporting sex with a sex worker in the past three months. In addition, over half of the men reported that they never, or inconsistently, used condoms. Although respect for wives/girlfriends was valued, loneliness, sexual experimentation and inherent sexual needs were cited as reasons that men have sex outside their primary relationships. Our data support the convergence of risky environments and migration-driven factors in exacerbating STI prevalence and the HIV epidemic among Latino immigrant men residing in the Northwest.

Moral foundations theory (MFT) has been a useful framework for understanding moral judgment and its relationship to political leaning. However, some have argued that MFT omits key domains of moral reasoning. We explored the utility of two candidate foundations (Proportionality and Equity) with a national sample of U.S. adults recruited through Nielsen’s Harris Panel, randomly split into calibration ( n = 1,499) and replication samples ( n = 1,499). We find that Proportionality and Equity are conceptually distinct from the original foundations (as measured in the Moral Foundations Questionnaire [MFQ]) but relate to them in predictable ways. Equity consistently predicted political leaning above and beyond covariates and the original foundations, but Proportionality only distinguished conservatives from liberals in the calibration sample, which suggests Proportionality may be highly relevant to moral judgments regardless of political ideology. Our findings also indicate potential bias when using one of the MFQ’s screener items to filter out unengaged participants.

A core principle of policy advocacy is that to engage decision makers in the urgency, complexity, and controversy of problems, advocates must effectively tell the story of those issues. Policy stories, or narratives, paint mental pictures of what a problem is, who is affected, and how it came to be. Yet, the persuasive effects of narratives on one key group, state legislators, remain understudied. Drawing from the Narrative Policy Framework (NPF), media advocacy, and public interest communications, we sought to inform advocacy strategy by illuminating state legislators’ responses to messages about public investments in quality childcare for all. Contrary to expectations, we found that narratives can have unintended effects challenging or even diminishing legislator support. We discuss implications for advocacy strategy.

Investments in early childhood education can have long‐lasting influence on health and well‐being at later stages of the life course.  Widespread public support and strategies to counter opposition will be critical to the future political feasibility of enhancing early childhood policies and programs.  Simple advocacy messages emphasizing the need for affordable, accessible, high‐quality childcare for all can increase public support for state investments in these policies.  Policy narratives (short stories with a setting, characters, and a plot that unfolds over time and offers a policy solution to a social problem) that describe structural barriers to childcare and policy solutions to address these barriers may be particularly effective to persuade individuals inclined to oppose such policies to become supportive.  Inoculation messages (messages designed to prepare audiences for encountering and building resistance to opposing messages) may protect favorable childcare policy attitudes in the face of oppositional messaging. Context Early childhood education (ECE) programs enhance the health and social well‐being of children and families. This preregistered, randomized, controlled study tested the effectiveness of communication strategies to increase public support for state investments in affordable, accessible, and high‐quality childcare for all. Methods At time 1 (August‐September 2019), we randomly assigned members of an online research panel (n  =  4,363) to read one of four messages promoting state investment in childcare policies and programs, or to a no‐exposure control group. Messages included an argument‐based message (“simple pro‐policy”), a message preparing audiences for encountering and building resistance to opposing messages (“inoculation”), a story illustrating the structural nature of the problem and solution (“narrative”), and both inoculation and narrative messages (“combined”). At time 2 (two weeks later) a subset of respondents (n  =  1,436) read an oppositional anti‐policy message and, in two conditions, another narrative or inoculation message. Ordinary least squares regression compared groups’ levels of support for state investment in childcare policies and programs. Findings As hypothesized, respondents who read the narrative message had higher support for state investment in childcare policies than those who read the inoculation message or those in the no‐exposure control group at time 1. Among respondents who were initially opposed to such investments, those who read the narrative had greater support than respondents who read the simple pro‐policy message. Those who received the inoculation message at time 2 were more resistant to the anti‐policy message than respondents who did not receive such a message, but effects from exposures to strategic messages at time 1 did not persist at follow‐up. Conclusions Results offer guidance for policy advocates seeking to increase public support for early childhood policies and programs and could inform broader efforts to promote high‐value poli...

The 2001 anthrax attacks brought public health into the media spotlight in away unmatched since the AIDS epidemic of the 1980s. This moment presented Americans with opportunities to better understand the strengths and weaknesses of the nation’s public health infrastructure, as well as to better understand the political and policy backgrounds against which this infrastructure operates. The authors systematically examined how thoroughly this underlying political context was covered by two major U.S. news papers: the New York Times, widely considered the nation’s paper of record; and the Atlanta Journal-Constitution, the home newspaper of the Centers for Disease Control and Prevention (CDC).In particular, the authors explored whether and how these news sources drew connections between political decision making and functioning of the CDC. They conducted quantitative and qualitative analysis of 157 news articles, supplemented by interviews with four reporters and one editor close to the story. Political context was included inconsistently and in sometimes strikingly different ways by the two newspapers, and lines of accountability extending beyond the CDC itself were not clearly traced. The authors theorize that these patterns in coverage of political context reflect the nature of reporting on public health issues; the different relationships of the two papers to the CDC; and the unwillingness of key public health sources to articulate certain claims in the heat of the crisis.