Course Notes

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HLSC 6803 Class One Notes I. Introduction II. Health Communication 1. Definition individuals and organization to take action toward health. 2. Health Communications can: i. ii. —Intention-to inform, influence, and motivate Increase awareness Demonstrate skills iii. iv. Demonstrate a demand for health services Remind or reinforce knowledge 3. Health Communications can’t: i. Compensate for lack of health care ii. iii. Produce behavior change Be equally effective with all messages 4. Types of Health Communication Theories 5. Top sources of health information 6. Audiences for Health Communication 7. Communication Definition —the exchange of meanings between individuals or groups through a common system of symbols. Communication that takes place when one’s mind so acts upon it’s 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. 8. Communication Types Non-vocal Signal Signs Symbols Icons Gestures Proxemics Vocal Mass Media Public Opinion Attitudes 9. Communication Process-who says what to whom with what effect? i. Persuasion Linear model

ii. Psychological effects a. Perceptions b. Attitudes and Behaviors c. Cognitive Dissonance

HLSC 6803 Health Communication Class Two Notes I. Motivation to Attend to Messages 1. Audience Attention 2. Information Processing a. Passive/Peripheral b. Active/Central c. Top-Down d. Bottom-Up e. Novelty f. Unexpected g. Immediate language h. Novelty 1. By information 2. Mode of delivery 3. Situation i. Unexpected 1. By information 2. Mode of delivery 3. Situation j. Immediate language 1. Denotatively specific 2. Spatially immediate 3. Temporally immediate 4. No qualifiers II. 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 the use of qualifiers III. Behavior Decision Making Consideration in Message Design 1. Precontemplation-Contemplation a. Risk Perceptions b. Risk Comparisons c. Probability Judgments d. Qualitative/Quantitative e. Framing Effect 2. Contemplation-Preparation a. Decision-Making perspective

b. Time horizon c. Importance assessment

HLSC 6803 Health Communications Class Three Notes I. II. Short Review of Health Behavior Theories a. Stages of Change b. Social Cognitive Theory (aka Social Learning Theory) c. Self-Efficacy d. Health Belief Model Staged social Cognitive Approach a. Role of personal factors in behavior change i. Knowledge ii. Skills iii. Self Efficacy iv. Outcome Expectations v. Personal goals b. Behavior change occurs in stages i. Messages need to be developed with stage in mind ii. Messages need to consider outcome expectations at each level of change c. From Precontemplation to contemplation i. Encourage reevaluation of current behavior ii. Preliminary consideration of alternative behavior d. From contemplation to preparation i. Encourage trying the alternative behavior ii. Examine risk behavior and its benefits/disadvantages e. From preparation to action i. Encourage the restructuring of environment/social setting ii. Plan for obstacles that will hinder behavior change process iii. Promote enhancement of self-efficacy iv. Model social reinforcement of appropriate behavior f. From action to maintenance i. Encouragement refinement of skills ii. Booster self-efficacy to deal with new obstacles iii. Encourage people to feel satisfied with obtaining goals in face of temptation. III. Fear Appeals a. Effects of Fear Appeals i. Drive ii. Parallel Response iii. Subjective Expective Utility Models b. Components of Fear Appeal i. Threat component 1. Severe threat 2. Vulnerability to threat ii. Action component

1. Personal efficacy 2. Response efficacy c. Organizing appeal i. Problem-solution ii. Topical organization iii. Cause-effect d. Vividness of appeal e. Framing the Appeal i. Loss Frame (more effective) ii. Gain Frame f. Use of Fear Appeals i. Volunteers/Nonvolunteers ii. Age of target audience iii. Anxiety of target audience iv. Response costs

HLSC 6803 Health Communications Class Four Notes I. Individual/Group Theory Differences a. Independent target persons behavior —more individual b. Group theories target mass behavior —more economical II. III. Types of Group Theories a. Diffusion Theory b. COAST c. Social-Ecology Theory d. Social Marketing Diffusion Theory a. Diffusion-definition The spread of cultural elements from one area or group of people to others by contact. b. Diffusion Theory-definition The spread of ideas, innovations, products, health action communicated through certain channels over time among members of a social system. i. Four components a. Idea/Innovation b. Communication Channels c. Time d. Social System c. Principles of diffusion theory i. categories of adopters a. Innovators b. Early adopters c. Majority adopters d. Late adopters e. Laggards ii. rate of diffusion iii. decision-making process a. knowledge b. persuasion c. decision d. implementation e. confirmation iv. types of innovations decisions a.optional (individual choice) b. collective (group) c.authority (powerful group) d. contingent (combination) v. characteristics of diffusion a. relative advantage

b. compatibiltiy c. complexity d. trialability e. observability vi. consequences of diffusion a. desirable vs. undesirable b. direct vs. indirect c. anticipated vs. unanticipated vii. criticism of the diffusion theory

HLSC 6803 Health Communication Class Five Notes IV. Inoculation and Persuasion Message Theories a. Inoculation Theory Definition- McGuire’s inoculation theory (1961, 1964): a small dose of the opposing position can increase resistance to subsequent influence attempts. i. Inoculation versus Social inoculation 1. inoculation seeks to strengthen existing attitudes to make them less susceptible to future threats and change. 2. social inoculation seeks to develop individuals ability to refute attacks by learning from other peers. Strategies such as peer modeling and peer –led discussion are used. ii. Threat is the key to how inoculation works 1. Threat motivates receivers to recognize the vulnerability of their attitudes and beliefs to potential challenges 2. Threat motivates people to bolster their attitudes and beliefs. iii. Steps of an effective inoculation message 1. Warn the receiver of the impending attack. 2. Make a weak attack. 3. Get the receiver to actively defend the attitude. V. Persuasive Health Message framework i. Is an integrated approach to message design 1. theory of reasoned action 2. protection motivation theory 3. elaboration likely model ii. Messages need to be 1. culturally appropriate 2. geographically appropriate 3. demographically appropriate iii. Two factors need to be addressed prior to message development 1. constant factors 2. transient factors iv. constant factors 1. threats 2. efficacy 3. cues

VI. 4. audience profiles v. transient factors 1. message goals 2. salient beliefs (moving by leaps, bounds) 3. salient referants 4. culture 5. environment 6. preferences Health messages for young audiences a. Four Principles i. Begin prevention early ii. Microtarget to age group iii. Use consistent messages from a variety of sources over a long period of time. iv. Give children ownership and control of own destiny. b. Begin prevention early i. Prevention ii. Moderation iii. Intervention c. Microtarget to age and environmental differences i. Age groups 1. Preschoolers (0-5) 2. Early School (5-7) 3. Middle Childhood (7-10) 4. Early Adolescence (10-13) 5. Mid- to Late Adolescence (13-16+) d. Use Consistent Messages from a Variety of Sources over a Long Period of Time. i. Stars/Celebrities ii. Peers iii. Family e. Give Children Control of Their Own Destinies.

HLSC 6803 Health Communications Class Seven Notes I. Social marketing theory a. Definition: Applies concept of traditional marketing to the "sale" of promotion of healthy behaviors. Elements include market plan, carefully designed message, employment of mass media, consensus building, and appropriate packaging. b. Social marketing stresses the importance of understanding the target audience and designing strategies based on their wants and needs rather than what good health practice directs that they should do. c. 8 major components i. consumer orientation ii. exchange theory iii. audience analysis and segmentation iv. formative research v. channel analysis vi. marketing mix 1. product 2. price 3. place 4. promotion vii. process tracking viii. marketing management II. Other Theories a. Persuasion in communication (Mass Communication) i. Definition-- Individuals pass through a series of steps to assimilate a desired behavior. 1. exposure to the message 2. attention to the message 3. interest in or personal relevance of the message 4. understanding 5. personalizing behavior to fit life 6. accepting change 7. remembering the message and continuing to agree 11. with it 8. making decisions based on bringing the message to mind 9. behaving as decided 10. receiving (positive) reinforcement accepting the behavior into one’s life ii. 5 things must work correctly 1. the credibility of the message source

2. the message design 3. the delivery channel 4. the target audience 5. the targeted behavior b. SMCR Theory (Source, Message, Channel, Receiver Communications Model) i. Characteristics of source-credibility, likability, similarity ii. Characteristics of Message-order, one-side or two-side, fear, visuals, amount of evidence iii. Characteristics of Channel-one medium vs. other, combinations, keep message simple, noise or distraction iv. Characteristics of Receiver-personality variables (self esteem, efficacy, anxiety, ego-defensiveness), ego involvement (emotional commitment) HLSC 6803 Health Communication

Class Eight Notes III. Health Communication Process (Health communication wheel0 a. Stages of the health communication process i. Planning and Strategy Selection ii. Selecting Channels and Materials iii. Developing Materials and Pretesting (First three stages) iv. Implementation v. Assessing Effectiveness vi. Feedback to Refine Program b. Planning and Strategy Selection i. Review available data ii. Identify existing activities and gaps iii. Write goals and objectives iv. Gather new data v. Determine target audience vi. Establish audience tracking system vii. Assess resources viii. Draft communication strategies ix. Write Program Plan and Timetable c. Selecting Channels and Materials i. Identify messages and materials ii. Decide whether to produce new materials iii. Choose channels 1. face to face 2. group delivery 3. organizational 4. mass media 5. community 6. combination of the above iv. Public Service media Campaigns 1. Key elements iii. Pretesting a. Understandable b. Relevant c. Attention-getting and memorable d. Attractive e. Credible f. Acceptable to the target audience d. Developing Materials and Pretesting i. Develop and Test Message Concept ii. Develop Draft materials 1. Self-administered surveys 2. Interviews 3. Focus group interviews 4. Readability testing

5. Gatekeeper review 6. Combination of above iv. Plan and Conduct Pretest 1. Design survey 2. Recruit respondents 3. Identify interviewers 4. Facilities 5. Gatekeeper review e. Implentation i. Prepare to introduce program ii. Tracking progress iii. Establish process evaluation f. Assessing effectiveness i. Types of evaluation 1. Formative 2. Process 3. Impact 4. Outcome 5. Cost effectiveness 6. Cost benefit ii. Elements of evaluation design 1. Statement of objectives 2. Case definition of data 3. Methodology 4. Data collection 5. Data processing/analysis 6. Reporting g. Feedback to refine program i. Apply what has been learned ii. Revise program iii. Disseminate findings to others HLSC 6803 Health Communications

Class Nine Notes Media Advocacy and Earned Media I. II. III. What is media advocacy? a. The strategic use of media as a resource for advancing a social or public policy initiative. b. How can a media opportunity best advance policy goals and shift the debate from individuals to the collective decisions of policies and norms? c. Steps in Media Advocacy i. Media Advocacy ii. Set Public Agenda iii. Public Advocacy iv. Influence legislation v. Set Policy How is media advocacy different from health education? a. Political vs Behavioral science b. Individual as advocate vs. individual as audience c. Advance healthy public policy vs. develop health messages d. Decentralized and opportunistic vs. Problem and approach e. Changes in environment vs. changes in individual f. Uses news and paid ads vs. public service bulletins g. Target is person power vs person with problem h. Power gap vs. information gap Media Advocacy Strategies a. Cultivating relationships b. Research (monitoring) c. Creative epidemiology d. Creating news e. Link with outher news f. Issue framing (access, content) i. Access 1. Controversy 2. Milestone 3. Anniversary 4. Irony 5. Celebrity 6. Breakthrough 7. Localize 8. Personalize 9. Injustice ii. Content 1. Translate individual problem to social issue 2. Assign primary responsibility 3. Present solution

IV. V. VI. 4. Make practical/policy appeal 5. Develop pictures and images 6. Tailor to audience g. Gain access to media h. Use paid advertising Limitations a. Lack of guidelines b. Complex skills c. Time requirements d. Movement away from behavior e. Controversial and confrontive Media Advocacy Planning a. GOTME i. G-goals ii. O-objectives iii. T-target iv. M-Message v. E-evaluation Earned Media a. Utilizing print, broadcast, and interactive media to elevate the level of public awareness. Not posters brochures, or other print materials. b. Core Principles i. Messages ii. Target iii. Testing iv. Follow-up c. Messaging i. Relevant-news ii. Appropriate iii. Concise (10-15 seconds) iv. Memorable v. Actionable d. Target i. Focus to get most for money ii. Maximize efficiency iii. Reach those who need message iv. Example: Drinking and driving 1. Under-age drinkers 2. 21-34 year olds 3. Hard core drinkers and repeat offenders e. No Free Media-Earned! i. Focus on issue ii. Local relevance iii. Timeliness-today!!

iv. Problem-solution v. Call to action —call to advocacy f. Hooks that work i. Crisis-you have a solution ii. Controversy iii. Innovation/creation (visual) iv. Research/Studies v. Note: does not need to be all original g. Tactics/Strategies i. Proclamation ii. Community event iii. Press conference (few) iv. Ribbon-cutting/ground breaking v. Speaking engagements h. Vehicles i. Media advisories ii. Calendar of events iii. Press release iv. Letter to the editor v. PSA vi. Op-Eds vii. Talk radio viii. News media ix. Intenet/new media (used by most of reporters) x. Cable television xi. Community-bulletin boards i. Partners in programs i. Research ii. Training iii. Branding iv. Development v. Marketing vi. Media vii. Tracking viii. Reporting j. Successful programs i. Remain focused ii. Effective materials and messages iii. Generate awareness iv. Foster strategic alliances v. Provide ease of action vi. Sustain effort HLSC 6803 Health Communication

Class Ten Notes Interviewing Tips for Researchers I. II. III. IV. Research can have a profound impact on health education, public health and health promotion Why talk to the media? a. Important b. Reach opinion leaders c. Change policy d. Make a difference Why not? a. Bad experience b. Resistance c. e. I’m not an advocate d. Data speak for itself Don’t have the time Before the interview a. Have a reason for interview b. Review your research c. Prepare media bites, social math d. Anticipate tough questions e. Safety/transition phrases V. VI. VII. VIII. IX. Problems during the interview a. Say too much b. Stray from the expertise c. Relax too much d. You fill the gap e. You get mad/impatient After interview a. Review main points b. Follow up with information c. Seek feedback d. Write 3 suggestions to self Concluding a. Reporting is professional b. Interview is not conversation c. Consider everything said is on the record d. Know oppositions arguments e. Never compromise credibility Framing data for legislators a. Not data driven b. Personal stories supported by data make strong points c. Takes much time d. Timing is everything Talking to legislators

X. XI. XII. a. Have limited time b. Provide one page bulleted lists c. Simple charts Most effective strategies with legislators a. Develop relationships b. Use credible data sources c. Know the position of the member you are trying to influence d. Compromises e. Absolutes Negotiables a. Willingness to hear the other side b. Coalitions c. Agreement on issues d. Individual agendas e. Contributes to greater good Assumptions a. Everybody understands how good/bad this is for public health b. It’s obvious this is an important issue c. There is no way that this can fail d. There is no point in raising this issue XIII. What to expect? a. Introduction legislator b. Co-sponsor c. Support d. Yes or no XIV. Know the other side. a. Find conflicting data b. Know your stuff c. Know who your are stuffing

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