The semantic differential for health. A technique for measuring. Beliefs about diseases.

Abstract

W HAT the public thinks and feels about any disease is a strong determinant of its response to preventive, casefinding, and therapeutic programs. In order to make health programs more effective in reaching the public, health agencies need to plan their educational and promotional efforts and the style of their services to take account of the conscious and unconscious meanings various high-risk subgroups in the community have applied to the disease being attacked. It is generally acknowledged that diseases are perceived as different in many respects. It is also apparent that various diseases arouse feelings having different qualities and intensities (gnawing worry, sudden panic, embarrassment, guilt, distaste). What is needed, then, is an interviewing and rating technique that will capture these ideas and feelings and represent them objectively. Past approaches to this research problem have been largely of two general types: survey-type, multiple-choice questions and projective techniques. The multiple-choice questions have often produced results that were highly influencedby what the respondents believed were the socially desirable answers rather than what they truly believed about the subject. The use of projective techniques overcomes this objection, but this is an expensive procedure whose reliability is greatly influenced by the level of skill and the uniformity of approach of the field interviewers. A newer method for the situdy of beliefs and feelings is the semantic differential developed by Osgood and associates (1). To date, this technique has been used most conspicuously in studies of linguistics, communication, and personality. The semantic differential aims at elucidating the connotations and latent meanings of words and concepts by mathematical measurement of their correlations with networks of other concepts and dimensions of meaning (la). The semantic differential does not prestructure a subject's response to the same degree as a multiple-choice question in that the subject is not limited to a few categories of response but may place his response anywhere along a broad continuum. The Osgood method was altered slightly by Maclay and Ware in their study of three American Indian tribes (2). Their modified semantic Dr. Jenkins is associate professor of epidemiology and clinical associate professor of psychology, University of North Carolina, Chapel Hill. This study was supported in part by research contract PH 8663-207 with the Behavioral Science Section, Division of Community Health Services, Public Health Service. Dr. Travis J. Northcutt, formerly of the Florida State Board of Health, supervised the field interviewers. Dr. John S. Neill, director of the Hillsborough County (Florida) Health Department, and Dr. James 0. Bond, formerly assistant State health officer in charge of research, Florida State Board of Health, were administrative officers of the larger program of which this study was a part.