Asbestos disease risk communication conducted by the New Jersey Department of Health

Our plain-English summary of Asbestos disease risk communication conducted by the New Jersey Department of Health, by M. Stanbury, G. Solice-Sample, J. Pescatore (American Journal of Industrial Medicine, 1993).

The study

• Authors: M. Stanbury, G. Solice-Sample, J. Pescatore
• Journal: American Journal of Industrial Medicine
• Published: 1993;23(1):97-104
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Since October 1985, the New Jersey Department of Health (NJDOH) has required hospitals to report all patients with a discharge diagnosis of asbestosis. As follow-up to a needs assessment survey of these patients, the NJDOH developed an educational packet including an information bulletin titled "Asbestos Disease: Medical and Legal Facts for Employees" and a pre-stamped postcard evaluation survey. The packet was sent to 1,418 patients reported by hospitals; 433 patients returned the evaluation questionnaire. The survey assessed attitudinal responses (were the materials helpful and easy to understand?) and behavioral responses (did the respondent plan on discussing the materials with a doctor or lawyer?) to the information in the packet. Of the postcard respondents, 85% found the materials helpful, and approximately half indicated that they would discuss the materials with a doctor or lawyer. Of the 33% who were proxy respondents, half appeared not to have understood that the materials had relevance to them as family members. Modifications to the protocol for the asbestos disease educational packet were made based on the evaluation data. Limitations of the evaluation survey and the value of process evaluations in risk communication projects are discussed.

In plain English

This article described and evaluated a mailed education project by the New Jersey Department of Health, which has required hospitals to report patients discharged with an asbestosis diagnosis since 1985. In 1990 the department mailed 1,418 reported patients a six-page bulletin, "Asbestos Disease: Medical and Legal Facts for Employees," with a prestamped evaluation postcard. Of 1,282 delivered letters, 433 (34%) postcards were returned. Among respondents, 366 (85%) found the material helpful and 369 (85%) found it easy to understand. In all, 223 (52%) said they would discuss it with a physician and 207 (48%) with a lawyer; many others said they already had one. Relatives or friends completed 145 postcards (33%), and the authors judged that as many as 77 (54%) of these proxies did not understand the bulletin was relevant to them. Afterward, the department highlighted family members in the bulletin and began writing to patients' physicians before mailing. The authors concluded the mailings should continue. They noted that nonrespondents were not assessed and that the survey was not designed to measure cause and effect.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Program (process) evaluation of a mailed risk communication packet, using a postpaid return postcard survey of recipients
• Who was studied: 1,418 patients reported by New Jersey hospitals with a discharge diagnosis of asbestosis. The first group was 298 patients who had asked for information in an earlier needs assessment survey and were mailed in September 1990. The second group was 1,120 newly reported patients, mailed in December 1990. 136 letters were undeliverable. Respondents averaged 68 years old, 93% white, 94% male.
• Exposure: No asbestos exposure was measured; no fiber types, products or doses are given. Recipients were patients reported with asbestosis. What was studied was a mailed packet: a cover letter, a six-page bulletin on medical and legal facts about asbestos disease, and an evaluation postcard.
• Main results:
  • 433 (34%) of 1,282 delivered letters were returned as completed postcards. This was 129 of 286 (45%) in the first group and 304 of 996 (31%) in the second group.
  • Of the 433 postcard respondents, 366 (85%) found the material helpful and 369 (85%) found it easy to understand. 12% left these questions blank.
  • Of 433 respondents, 223 (52%) said they would discuss the bulletin with a physician. Of the 210 who said no or left it blank, 95 (45%) said they already had a doctor.
  • Of 433 respondents, 207 (48%) said they would discuss the materials with a lawyer. Of the remaining 226, 103 (46%) said they already had a lawyer.
  • 145 (33%) of the 433 postcards were completed by a relative or friend.
  • Among the 145 proxy respondents, the authors judged that as many as 77 (54%) did not understand the bulletin was potentially relevant to them.
  • 39 (3%) of the 1,282 recipients, or their physicians or lawyers, telephoned. Several callers were worried that people were notified without the diagnosis being confirmed.
  • After the evaluation, the bulletin was revised to highlight family members.
  • After the evaluation, the mailing protocol was changed to write first to the patient's discharging physician before mailing the bulletin to the patient.
• The authors' conclusion: The authors concluded that, given patients' positive reactions, the mailings to persons with hospital discharge reports of asbestosis should continue. They also concluded that the postcard evaluation was a useful tool for monitoring how the program was carried out.
• Limitations the authors state:
  • Nonrespondents were not assessed, so it is not known how they differed from respondents.
  • The findings may not apply to other high-risk groups, because these recipients already had an occupational disease linked to a widely publicized hazard.
  • The postcard survey was meant for program improvement and was not designed to measure whether the bulletin caused the desired health behaviors.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis.

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