Health Promotion Communication Technologies And Their Associated Risks

Abstract

The occurrence and cure of the major life-threatening and disabling illnesses today are greatly dependent upon the decisions and behaviors that individuals adopt over time in their own homes, schools, workplaces, and recreational mas. This is also true of the most prevalent minor illnesses, and almost all prevention and health promobion strategies. The American public is beginning to obtain direct aiccess to and is becoming increasingly motivated to use health information, decision-support tools, and reliable mechanisms for improving self-efficacy and realizing specific behavior change objectives. If this trend continues, a substantial impact will be made on the health and self-esteem of the American public. However, with these new opportunities come new responsibilities to guard against both errors of commission and omission as a result of the introduction of new health promotion communications technologies (HPCTs). The central focus of health promotion communications technologies as a field is the utilization of new electronic technologies to give people direct access to information and decision-making tools which will help them prevent illness, improve their state of well-being, and build their productive capacities as individuals. The present state-ofthe-art of HPCTs is still nascent relative to its potential. However, systems which offer comprehensive health information 24 hours a day, 7 days a week will soon be available to an ever widening spectrum of the American public. The liabilities, regulations, and guidelines directing the evolution of HPCTs need to be carefully thought through to ensure both the safety and potential contribution of these technologies. This paper focuses on: 1) the factors behind the emergence of communications and computer applications used by the general public to improve their own health; 2) the recent history of the public's involvement in influencing their own health; 3) the nature and genmtions of health promotion communications technologies; and 4) the risks unique to having the general public using communications and computer applications to influence their own health. The United States, and other nations in the developed world, are shifting From an industrial to an information-based society. (1) The majority of American workers are now employed within the information sector. The single largest non-sleeping activity outside the workplace is the consumption of information (albeit not necessarily wisdom) through television viewing. Two characteristics of the transition to an infomtion society of particular importance to the health system, are shifts from: 1) institutional help to self-help, and 2) folrced technologies to "high techhigh touch (or in other words, user-friendly technologies that are intrinsically democratizing and humanizing). The heakth system, influenced by the larger societal shift, is undergoing a major revolution. (2) The first phase of this health revolutioa is being driven by measures to stop medicine's unmanageable cost inflation and by the increasing corporatization of health care. The result is the replacement of "fee for service" medicine with ]HMOs, PPOs, DRGs and other prospective reimbursiement schemes. While funds for health care are being held relatively constant, health care needs (based upon changing demogralphics, technology, and perception of need) continue to grow, leaving a gap between health needs and the traditional services intended to meet those nmds. This "health giip" beckons a more profound change in the nature of the health system, one that will go beyond cutting costs to also improve quality of care, deal with the maldistribution of services, and meet the demand for more protection, prevention, and health promotion. A more substantial transformation of the heal ih system is emerging, along with the financial restructuring of health services, in the form of wellness. The wellness approach promises not only to cut the cost of health sarvices, but also to greatly improve the health of Americans by influencing Lifestyle and enviroimental factors not effectively addressed within the biomedical paradigm. The wellness paradigm is able to accomplish so much more than biomedical approaches alonc:, because lit draws upon the relatively untapped resources of individuals and their communities to influence health. Many underlying trends, such as shifts in the nature of prevalent disease, social arid cultural shifts, the new financial imperative (due to the rising costs of medicine), technological catalysts, and changes in the concepts of health anid disease, axe reinforcing the growth of wellness and self-care. The "health gap" (the growing schism between health needs and available resources to meet those needs) can be bridged by the wellness paradigm, if the above mentioned trends continue to favor its growth. The potential impact of this new model of health care can, however, only be reali2,ed if the General E'ublic//Health Information Interface is understood and developed effectively. J B E GENERAL PUIBLIC//HEALTH JWORMATIOa