Health Communications
in the Community
Peter D. Rumm MD, MPH
Associate Professor, CHMP, DSPH
215.7621652 pdr26@drexel.edu
An example of the growing
emphasis on communication
The Centers for Disease Control and Prevention (CDC)
announced the award of a seven-year, $73 million contract to
provide a single point of contact for consumers and health
professionals to access comprehensive, timely, and credible
health information. “Communicating directly with the American
public has become a vital part of CDC’s role in protecting the
nation’s health and safety,” said CDC Director Dr. Julie
Gerberding.
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“With this unified approach, we will attempt to get the right
health information to the right people at the right time.”
We are very excited about this new opportunity to improve
CDC’s service to the public and health professionals,” said Jim
Seligman, CDC Chief Information Officer. “Accurate health
information is vitally important for people to make good health
choices
Case Study - Promoting an
Asthma Program
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Why? The growing incidence of asthma is
a medical mystery.
Excellent guidelines and treatments
available but often not followed by
patients or practitioners.
Problem is especially prevalent in inner
city African American children 3 to 4 x
mortality rate as suburban white children.
Define a goal then act
For example – more publicity about
the problem, i.e. awareness.
First step = planning
Second step = implementation
Third step = evaluation
Develop in this case a Media
Plan
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Identify goals. What are the best strategies for reaching people?
What do you want them to know? What actions do you want them
to take? Identify audiences you want to reach. What media do
they use?
Develop appropriate messages for each target audience. What are
the actions you want people to take? What are the benefits of
taking these actions?
Compile a media list, using a media directory available at most
public libraries.
Produce materials for a press kit. Include how asthma affects the
local community, how many have asthma, who the local experts
are.
Write a media advisory (one page describing the event and inviting
the media) and a press release (a mini news story).
Construct a timetable of outreach events and activities. How far in
advance do you need to prepare? What are local media deadlines?
Add an evaluation component. How will you determine whether
you have been successful?
Recommendations on
implementation
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Become familiar with local news media. Pay specific attention to
reporters who have covered stories related to asthma or other
health issues..
Call local media outlets and ask who covers health. Find out who
does local cable programming and contact their news and public
affairs programs. Invite reporters to cover events. List events in
community calendars in local media. Special events, such as World
Asthma Day or town meetings, are opportunities to make news
and can provide a visual context for a TV interview.
Partner with other organizations, such as a local sports team or
local chapters of the American Lung Association, Asthma and
Allergy Foundation of America.
Identify a local respiratory specialist willing to talk to the media.
Place the spokesperson on talk shows.
Recommendations on an
evaluation
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Establish baseline measurements.
Ask whether the objectives and/or
audiences were reached.
Track phone calls and other
responses, the number of mentions
in the news, the number of
impressions (people reached).
http://nhlbi.nih.gov/health/prof/lung
/asthma/am_sp01/tips.htm
What is health communication
anyway?
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“The study and use of
communication strategies to inform
and influence individual and
community decisions that enhance
health.”
Definition of CDC and the NCI/NIH.
Some things it can do
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Increase knowledge of
intended audience
Influence perceptions and
beliefs that could shape
norms/policy
Reinforce healthy behavior
Increase demand for
services
Refute myths
Advocate a position
Increase surveillance and
disease awareness
Distribute emergency
messages in a real time
manner increasingly
through the HAN and other
techniques
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Strengthen organizational
relationships
Show the benefit of
behavior change
Prompt action
Done properly clarify the
true risk (and/or benefit)
of a disease or behavior
change
With other strategies can
begin to tackle difficult
problems such as access
With varying success,
cause sustained individual
behavior change
What it cannot do
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Compensate for inadequate care or access
Produce sustained change in behaviors at
the individual/population level unless part
of a sustained/comprehensive program
Always be effective – many barriers to
effective communication.
Please suggest some of these!
Characteristics of effective health
communication campaigns
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Some examples – VERB, Red Dress, and
Pink Ribbon
Campaign goal is defined and part of
larger goal.
Messages created effectively.
Ability to pre-test, retest, and update.
Implement effectively
& Most importantly – evaluate and
improve
The planning process
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Usually best campaigns have planning done in
teams with necessary expertise from broad
disciplines.
Set defined objectives:
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By 2005 increases the number of women 40 or
above, in Washington DC who are getting annual
mammogram from 60% to 70% through a media
campaign highlighting currently available
programs.
80% of the women in the campaign catchment
area will on a community survey state they had
awareness of the campaign.
At least 25% of the women surveyed will state
they got the mammogram due to the campaign.
Chose the media
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What is meant by the term channel of
communication?
In targeting low income/low educational
level females - what might be effective
channels of communication to get a
message promoting breast cancer
screening across?
Would these channels be the same in all
cultures?
Choosing the appeal
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Consider emotional, humorous,
serious, scientific – the list is
endless.
Threat appeals are not usually
effective for most audiences
(especially youth – why do think this
is so?).
Testing a concept message
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Want to find out through testing on
small groups of the intended
audience such things as:
• Is the appeal strategy effective?
• Are terms confusing or culturally biased
(polyp man line up example)?
• Any language barriers?
• Could the message actually change
behavior or attitudes
Deciding materials/honing the
message
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Print – format, distribution, media
Audio
TV, video, film
Web based (how appropriate is it for
general audiences currently?)
“Alternative” or targeted campaigns
might require special material
selection – churches, fairs, work,
schools.
Rules to go by
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Don’t stray too far known scientific
knowledge.
Be consistent in message.
Be clear. Kiss Principle
Be credible
Understand there is a risk benefit of
using celebrities
Hone materials to be culturally
sensitive and specific
Launching the program
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See publicity if possible through news outlets,
free sources, professional and community
contacts.
Consider a press release and formal media kit if
it is an innovative or controversial campaign or
you are trying to change policy or build
awareness.
Build evaluation of initial launch into the
campaign – be ready to modify if not the right
message.
Science and an art on how much of media and
expense are used in the initial blast of media
vs. what can be sustained.
Consider the ethical dilemma of not having
enough funds to sustain an effective campaign.
Evaluation
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Qualitative is truly important in media – helps understand
why, helps tailor the message, and some messaging and
evaluation is hard to capture through statistical analysis.
Classic technique is the focus group.
Quantative – increasingly CDC and other agencies want
demonstratable results very quickly. Important to measure
earl shifts in attitudes, penetrance of message, and any
potential steps toward behavior change.
Should also measure reliability and validity of the message if
it is being altered in differing formats.
Build the cost of evaluation into the program/campaign =
biggest common mistake.
Most often argue the point to get resources to do evaluation.
Fortunately skills learned in epid, stat, and CHP are very
transferable.
One can quickly pick up terms like media share, markets
etc. what MPH trained professionals (my view) strongly bring
to the table is credibility often missing in media campaigns.
Design a campaign
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Background:
Men are much less likely to access medical care than
females.
PSA test for prostate now a grade C recommendation by
the USTFPS. Many agencies including NCI, ACS
believe in informed consent and that most men should
be tested by age 50 (still somewhat controversial).
Concerns about treatment are abating somewhat as new
less invasive procedures being developed.
African American men though have dramatically higher
rates (about 30%) of prostate cancer than white men
– even among educated men with good health care.
Design a campaign for Pittsburg
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That:
Promotes all men discussing with their health care
provider the pros and cons of PSA.
Promotes that AA men may be of higher risk.
Through a tie in with other current men’s health issue
(guess what this is) men are coming in more regularly
for checkups.
Several drug companies agree to underwrite screening
costs and initial consultation for men without
insurance coverage.
Stresses that PDOH working with the CDC can test out a
program similar to that of breast and cervical cancer,
whereby a man diagnosed goes on Medicaid for up to
5 years for treatment if unable to pay.
Three classroom groups
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I. Design an overall campaign for the city.
II. Design a campaign specifically geared
just to AA men.
IIII. Design a campaign to reach all
health providers in the city area.
Each group has $200,000 budget x 3 yrs.
Groups one and two can get some free
radio time on stations that might be
appropriate to their targeted audiences.
The CMOs of the health plans offer to a
media spokesman from group III present
at grand rounds in four of six hospitals
that see about 75% of the pop ululation
but few outpatients – is this a good idea?
Focus group results
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Campaign materials for group I and II are too
complicated and not culturally sensitive.
Were written at a 12th grade level.
Conversely, the health professionals thought materials
too simplistic and therefore, might not change the
screening counseling and/or behavior.
Also, health professionals skeptical about a new
payment program being sustainable past a one year
pilot and are concerned about the ethics. As a group
you negotiate with the PDOH and the CDC and get 5
years promised.
Several doctors want their information in a web based
format and suggest this should be also done for their
patients – discuss the pros and cons.
Define by next class
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Social marketing
Market share
Market penetration
Efficacy vs. efficiency of
communication
What is the hardest skill for any
communicator to know?