Health Communication
Dr. Jones
University of Arkansas
Communication
• The exchange of meanings between individuals
or groups through a common system of
symbols.
• Communication takes place when one’s mind so
acts upon its environment that another mind is
influenced, and in that other mind an
experience occurs which is like the experience
in the first mind, and is caused in part by that
experience.
Communication Types
• Nonvocal
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signals
signs
symbols
icons
gestures
proxemics
• Vocal
• Mass media
– public opinion
– attitudes
– persuasion
Communication Process
• Who says what to
whom with what
effect?
• Linear model
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•
source – person on phone
encoder – mouthpiece on phone
message – words the person speaks
channel – phone lines
decoder – earpiece, other end
receiver – person listening on
phone
Communication Process – cont’d
• Issues
– entropy – static in
transmission of message;
not understandable
– redundancy – repetition of
elements within a message
that prevent communication
of message
• Solution
– feedback – helps to
avoid entropy or
redundancy
Communication Process – cont’d
• Psychological effects
– Perceptions
– Attitudes and behaviors
– Cognitive dissonance
Inoculation Theory
• Theory built around the premise that
inoculating or immunizing individuals to
future persuasive communication will provide
recipients with enhanced resistance to verbal
appeals of persuaders (McGuire, 1961)
Inoculation – four strategies
• Direct refutation
– negate its content validity
– show message to be irrelevant
– point out covert strategy
– point out long-term consequences
• Sever the association between the persuader
and the message
• Authenticity of source
• Concept or attitude boosting
Constants
Transients
Threat
susceptibility
severity
Efficacy
response efficacy
self-efficacy
Cues
message
source
Audience
demographics
customs
values
social/psychological
Message goals
Salient beliefs
Salient referents
Arguments
Culture
Environment
Preferences
Persuasive Message
Health Communication – Its intent,
what it can do
• The intent of health communications is:
– To inform, influence, and motivate individuals and
organizations to take action toward health
• Health communications can:
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increase awareness of a health issue;
demonstrate or illustrate skills;
demonstrate a demand for health services; and
remind of, or reinforce, knowledge, attitudes, or
behavior
Health Communication – What it can’t
do
• Health communications can’t:
– compensate for lack of health care;
– produce behavior change without supportive
program components;
– be equally effective in addressing all issues or
relaying all messages
Health Communications Models,
Theories, and Practices
• Social Marketing
• Health Education
– PRECEDE-PROCEED model
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Mass Communication
Persuasive Models
Ethical Communication
Behavior Models
Diffusion of Innovations
Research shows . . .
People get health information from:
•TV
•Doctor or other health professional
•Newspaper
•Family or friends
•Magazines
•Medical or health books
•Health plan or health insurance company
•Health newsletters
•Radio
•Internet
39%
37%
28%
24%
23%
23%
21%
15%
14%
13%
NOTE: 35% spoke with a doctor about a medical condition as a result of a media
report. And 54% said they changed a health-related behavior as a result of a media
report!!
Audiences for Health
Communication
Individual
Group/Public/Co
mmunity
Health
Professionals
Gov’t/Policymakers
Media
Source
Health Messages for Young Audiences
1. Begin prevention early
a. prevention
b. moderation
c. intervention
2. Microtarget to age/
environmental differences
•
Age groups
a.
b.
c.
d.
e.
preschoolers (0-5)
Early school (5-7)
Middle childhood (7-10)
early adolescence (10-13)
Mid/late adolescence (13-16, 16+)
3. Use consistent messages,
variety of sources, long
time period
a. stars/celebrities
b. peers
c. family
4. give children control of
their own destinies
Communication in the Future
• Effects of mass
communication on
audiences
• dynamics of nonverbal &
verbal communication
between individuals
• persuasive communication
and the use of technology
to influence dispositions
• perceptions of different types
of communication
• processes of interpersonal
communication as mediator
of information
• effects of various forms of
communication technology
Audience Attention
Mindless/Passive
Mindful/Active
Information Processing
Passive/Peripheral
Active/Central
Information Processing
Passive/Peripheral
Active/Central
Bottom-up
Novelty
Unexpected
Immediate language
Top-Down
Information Processing
Passive/Peripheral
Active/Central
Bottom-up
Novelty
by information
mode of delivery
situation
Top-Down
Information Processing
Passive/Peripheral
Active/Central
Bottom-up
Unexpected
By information
Mode of Delivery
Situation
Top-Down
Information Processing
Passive/Peripheral
Active/Central
Bottom-up
Immediate language
denotatively specific
spatially immediate
temporally immediate
no qualifiers
Top-Down
How to motivate individuals to attend
to health messages
1. Use novel messages, settings, and media;
2. consider discrepant and unexpected messages,
settings, and media;
3. instruct the audience to pay attention to the
message;
4. construct messages in a denotatively specific
manner;
5. choose spatially immediate demonstratives;
6. use temporally immediate speech;
7. avoid qualifiers; use probabilities associated with
specific outcomes of certain behaviors
What activities or technologies do you think are the
greatest risks to human health?
• Public
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nuclear power
motor vehicles
handguns
smoking
motorcycles
alcoholic beverages
private aviation
police work
pesticides
surgery
• Experts
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motor vehicles
smoking
alcoholic beverages
handguns
surgery
motorcycles
x-rays
pesticides
electric power
swimming
Behavioral Decision-making (BDM)
Consideration in Message Design
• Pre-contemplationcontemplation
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risk perceptions
risk comparisons
probability judgments
cumulative/”one shot”
qualitative/quantitative
probability terms
– framing effect
• Contemplationpreparation
– decision-making
perspective
– time horizon
– importance assessment of
decision-making factors
Using Fear Appeals
• Drive explanation
• parallel response
• subjective expected
utility
• Components
– threat
– action
• Fear appeal should
contain:
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severity of threat
target’s vulnerability
personal efficacy
response efficacy
• other considerations:
– target age
– trait anxiety
– response costs
Mass Communication – steps needed for
individual to be persuaded to follow a
behavior
• exposure to the message
• attention to the message
• interest in/personal
relevance of message
• understanding the
message
• personalizing the behavior
to fit one’s life
• accepting the change
• remembering the message
and continuing to agree with
it
• being able to think of it
• making decisions based on
bringing the message to
mind
• behaving as decided
• receiving + reinforcement for
behavior
Successful communication of message
depends on 5 components:
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credibility of message source
message design
delivery channel
target audience
targeted behavior
Social Marketing THEORY
Dr. Jones
University of Arkansas
What is it?
• Social Marketing Theory– Applies the concept of traditional marketing to the
“sale” or promotion of healthy behaviors.
– Elements
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market plan
carefully designed messages
employment of mass media
consensus building
appropriate packaging
SMT continued
• SMT emphasizes the importance of specific
target audiences and segmentation of the
population when designing programs.
– Gender, race, age, religion, education, etc.
Components
• The eight components include but are not
limited to:
– consumer orientation
– exchange theory
– audience analysis and segmentation
– formative research
– channel analysis
– marketing mix
– process tracking
– marketing management
1) Consumer orientation
• This component consists of familiarizing the
health educators and marketers to the needs
of the consumers to better market towards
them.
– To discover the needs and wants of the
consumers, focus groups can be formed to
represent the demographic being served.
2) The Exchange Theory
• Tangible and non-tangible items that are given
up to achieve health behavior goal.
• To achieve a lower triglyceride level and decrease your
total cholesterol you might have to give up eating at
McDonalds five times a week in exchange for two times
a week.
3) Audience Analysis and Segmentation
• Audience analyses, knowing your target
populations.
– what population you are working with
– who is at risk
• Segmentation, describes breaking down
populations into more specific groups. This
makes groups readily available for analysis,
diagnosis, and treatment with new
implementation of programs.
4) Formative Research
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Documentation of development
Extensive note taking
Existing materials
Materials that need to be made
Continuous Evaluation
5) Channel Analysis
• Channels refer to the lines of communication through which
an individual is reached.
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Billboards
TV
Internet
Print Media
Novelty Items
Radio
News Outlets
• When trying to promote the Gardasil vaccination, concentrate
on channels of media that young women are exposed to, such
as teen magazine, MTV.
6) Marketing Mix
• Based on the 4P’s:
– product
– price
– place
– Promotion
• And sometimes PARTNER
6) Marketing Mix cont.
• Product– What we are trying to “sell”?
– May be a tangible product or in our case an
intangible product, the idea of health.
– Can be used to explore the consumer’s perception
of the problem or product and how to remedy it.
6) Marketing Mix cont.
• Price– Price describes what the consumer has to “pay”
for the product.
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Monetary
Time
Effort
Remembering to do it
– Behaviors will more likely be adopted if the
benefits outweigh the costs.
6) Marketing Mix cont.
• Place– Where will you promote?
– Where will product be sold?
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shopping malls
mass media
fliers
brochures
6) Marketing Mix cont.
• Promotion– Integrates the advertisements, public relations,
promotion, media, personal testimonials, and
entertainment sources.
– The rationale for promotion is to create and
sustain the product.
• a PSA may be used to increase awareness of breast
cancer and give tips on self examination.
7) Process Tracking
• Evaluations
– surveys
– Letters to the editors
– Press release
• process (what you are doing right now)
• impact (directly after the fact), and
• outcome (after the program, ie. 6 months) evaluations.
Partner
• Teaming up with other organizations to better
market to the desired consumer
• Collaboration of time, resources, people,
money, etc.
8) Marketing Management
• Involves the specific aspects of the program
you are trying to manage
– Budget
– Administration issues
– Team building
– Leadership
Media Advocacy
In our “mass mediated” democracy, public
health battles are fought not only in the clinics
and the courts, but also on the 10pm news, the
front pages, financial section, and even on 24hour talk radio.
– Jeffrey Chester, Center for Health Education
Media Advocacy’s Questions
Will improved health status come about
primarily as a result of:
people gaining more knowledge about personal
health behaviors?
OR
groups gaining power to change social and economic
conditions?
Media Advocacy
Definition
• The strategic use of media as a resource for
advancing a social or public policy initiative
Media advocates ask this question: How can a
media opportunity best advance policy goals
and shift the debate from individuals to the
collective decisions of policies and norms?
Media Advocacy
Media
Advocacy
Set Public
Agenda
Public
Advocacy
Influence
Legislation
Set Policy
Media Advocacy vs. Health Education
Media Advocacy
Health Education
Political science
Behavioral science
Individual as advocate
Individual as audience
Advances healthy public policies
Develop health messages
Decentralized and opportunistic
Problem & approach fixed
Changes in environment
Changes in individual
News and paid ads
Public service bulletins
Target is person with power
Target is person with problem
Power gap
Information gap
Media Advocacy vs. Social Marketing
Media Advocacy
Social Marketing
Political science
Behavioral science
Agenda setting and framing
Observational Learning
Individual as advocate
Individual as audience
Develops healthy public policies
Develops health messages
Changes in environment
Changes in individual
News and paid ads
Public service bulletins
Media Advocacy Strategies
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Cultivating relationships
Research (monitoring)
Creative epidemiology
Creating news
Link with other news
Issue framing (access, content)
Gain access to media
Use paid advertising
Face of victim
Media Advocacy
Framing for Access
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Controversy
Milestone
Anniversary
Irony
Celebrity
Breakthrough
Localize
Personalize
Injustice
Media Advocacy
Framing for Content
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Translate individual problem to social issue
Assign primary responsibility
Present solution
Make practical/policy appeal
Develop pictures and images
Tailor to audience
Media Advocacy
Planning
GOTME
Goals
Objectives
Target
Message
Evaluation
Media Advocacy
Limitations
• Lack of guidelines
• Complex skills
• Time requirements
• Movement away from behavior
• Controversial and confrontative
Media Advocacy
Earned Media
• Utilizing print, broadcast, and interactive media
to elevate the level of public awareness. NOT
posters, brochures, or other print materials.
• Core principles:
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Messages
Target
Testing
Follow-up
Media Advocacy
Earned Media - Messaging
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Relevant – news
Appropriate
Concise (10 to 15 seconds, soundbites)
Memorable
Actionable
Media Advocacy
Earned Media - Targeting
• Focus to get most for money
• Maximize efficiency
• Reach those who need message
• Example: drinking and driving
– Underage drinkers
– 21 to 34 year olds
– Hard core drinkers and repeat offenders
Media Advocacy
Earned Media – No Free Media
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Focus on issue
Local relevance
Timeliness (Today!!)
Problem – Solution
Call to action – call to advocacy
Media Advocacy
Earned Media –Hooks that work
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Crisis – you have a solution
Controversy
Innovation/Creation (visual)
Research/Studies
– Does not need to be ALL original
Media Advocacy
Earned Media – Tactics/Strategies
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Proclamation
Community event
Press conference (few)
Ribbon-cutting /Ground breaking
Speaking engagements
Media Advocacy
Earned Media - Vehicles
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Media advisories
Calendar of events
Press release
Letter to the editor
PSA
Op-Eds
• Talk Radio
• News media
• Internet/new media (used
by 35% of reporters)
• Cable television
• Community bulletin boards
Media Advocacy
Earned Media – Successful programs
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Remain focused
Effective materials and messages
Generate awareness
Foster strategic alliances
Provide ease of action
Sustain effort
Media Advocacy
Earned Media – Partners in programs
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Research
Training
Branding
Development
Marketing
Media
Tracking
Reporting
Some Examples
 http://www.thetruth.com/
 http://www.publicstrategies.org/ma_6_30_99.htm
 http://www.ama-assn.org/ama/pub/category/18311.html
 http://blogs.usatoday.com/oped/2008/03/shortage-of-pri.html
 https://secure.consumersunion.org/site/Advocacy?JServSessionIdr009=24
oyqrpzp2.app46a&cmd=display&page=UserAction&id=1732
 http://usccb.org/cchd/povertyusa/tour2.htm
 http://www.marininstitute.org/
Some Tips
 Remember – it’s important for community health
professionals to talk with the media!
 You can reach opinion leaders
 You can change policy
 You can make a difference
 Why we don’t do it
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Resistance
Bad experience
“I’m not an advocate”
Think data speak for themselves
Don’t have time
Some Tips
 Before the interview
 Have a reason for it
 Review your research
 Prepare media bites, social math
 Examples:
 In 1969, for many students, walking to school was as easy as walking
down the street because their school was right in their neighborhood. By
2001, lots of schools were farther away from their students, and walking
or biking to school was the equivalent of doing a 5K race or more – twice
a day. (http://ola.wkkf.org/faf/frameworks_socialmath_issue40.pdf)
 The alcohol industry spends more than $2 billion every year to advertise
and promote consumption. This amounts to approximately $225,000
every hour of every day. (http://www.chipolicy.org/pdf/TA5.pdf)
 Anticipate tough questions
 Have some safety/transition phrases
Possible Problems
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Saying too much
Straying from expertise
Relaxing too much
You filling the gap
Getting mad/impatient
After the Interview
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Review main points
Follow up with information
Seek feedback
Write 3 suggestions to yourself
Concluding
• Remember
– Reporting is professional.
– Interviews are not conversations.
– Consider EVERYTHING as on the record.
– Know the other side’s arguments.
– Maintain your credibility! Do not compromise it
for any reason.
Framing for Legislators
• not data-driven;
• personal stories supported by data make
strong points;
• takes a long time;
• timing is everything!
Legislators
• Limited time
• One page bulleted
• Simple charts
Effective
• Develop relationships
• Use credible
data/sources
• Know the position of
the person you are
trying to influence
• Compromises
• Absolutes
• Keep it simple
• Negotiables
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Willingness to hear other side
Coalitions
Agreement on issues
Individual agendas
Contributing to greater good
Assumptions
• Everybody understands how good/bad this is
for public health
• It’s obvious this is an important issue
• There is no WAY this can fail
• There’s no point in raising this issue
What to Expect
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Introduction to the legislator
Co-sponsor
Support
Yes or No vote
Know the Other Side
• Find conflicting data
• Know your stuff
• Know who you’re stuffing