Heather Pierce, MPH
May 9, 2012
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Describe characteristics of effective health
messages.
Learn cost-effective ways to create clear and
compelling health communications
materials.
Learn how technology and social media can
help increase your audience reach and
engagement.
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Communication can:
◦ Increase knowledge and awareness of problems.
◦ Influence and reinforce perceptions, beliefs,
attitudes and norms.
◦ Prompt action.
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Communication cannot:
◦ Compensate for inadequate or inaccessible
services.
◦ Produce sustained change in absence of parallel
changes in services, technology, and policy.
Source: Making health communication programs work, 2nd ed., NCI, 2002.
Use audience research and
theory to design effective
messages and create
dissemination strategies that
move audiences to action or
link them to available services.
Inform
Inspire
Action
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Use Microsoft templates and SmartArt
◦ Define and understand your target audience.
◦ Consider race, ethnicity, age, location, other
demographics.
◦ Recognize barriers and challenges to reaching your
audience, getting their attention, and ensuring their
understanding.
◦ Telephone
◦ Emails or letters
◦ Online forums or
discussion groups
◦ An intermediary to ask
users on your behalf
◦ Online surveys
◦ Small focus groups with
selected user types
◦ Postage-paid input or
feedback cards
◦ Conferences, meetings, or
chance encounters
◦ “Eavesdropping” on online
gathering-spots
◦ Subscribing to users’
newsletters
◦ Holding an online chat
with users
◦ User needs assessments
conducted by others
◦ Public polling data or
marketing profiles
◦ Social networking sites
such as Facebook or
Twitter
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http://www.cdc.gov/healthcommunication/Audience/
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Moms
Tweens
Teens
Internists
Responsible generation
Boomers
Family physicians
Hispanics
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Accessible to your target audience, given
their use of technology or their disabilityrelated needs
Useful to your audience
Relevant to their needs and concerns
Easy to understand, given your target users’
reading ability, dominant language, and prior
knowledge of your topic
Sensitive to cultural issues, beliefs, and
backgrounds
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Can the people who are the audience for
the material quickly and easily:
◦ Find what they need?
◦ Understand what they find?
◦ Act appropriately on that understanding?
Source: Center for Plain Language. (n.d.). About plain language. Retrieved August
11, 2009 from http://www.centerforplainlanguage.org/aboutpl/index.html
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Write for the average reader.
Organize to serve the reader’s needs.
Use helpful headings.
Use “you” to speak to your reader.
Use active voice.
Use short sentences and short sections.
Use concrete familiar words.
Omit excess words.
Place words carefully.
Use no more than 2 or 3 levels.
Excess words
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As a means of
As prescribed by in
At a later date
At the present time
Constitutes
For the purpose of
Heretofore
In order to
On a monthly basis
Pertaining to
Related to
So as to
Should it appear that
With regard to
Plain alternatives
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`
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To
Under
Later
Now, currently
Forms, makes up
To, for
Until now
To
Monthly
About
Of
To
If
About
Instead of…
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a and/or b
accomplish carry out
accorded
accordingly
addressees
advantageous
afford an opportunity
apparent clear
assist, assistance aid
commence
comply with
Implement
in order that
in the amount of
in the event of
utilize, utilization
Try…
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a or b or both
do
given
so
you
helpful
allow, let
plain
help
begin, start
by, per
start
so
for
if
use
Before
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The Dietary Guidelines
for Americans
recommends a half hour
or more of moderate
physical activity on most
days, preferably every
day. The activity can
include brisk walking,
calisthenics, home care,
gardening, moderate
sports exercise, and
dancing.
After
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Do at least 30 minutes of
exercise, like brisk
walking, 5 or more days
a week.
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Use “chance” or “more likely” or “less likely”
instead of “risk.”
Talk about weight loss in pounds instead of
percentage of body weight.
Use “9 out of 10 people” instead of 90%.
Use visuals to help explain numeric concepts.
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Attractive
Relevant
Supports the messages and purpose of the
content
Includes white space
Uses images that demonstrate desired
behaviors
Creates good contrast between printed text
and paper color; makes limited use of reverse
text
Shows consistency in font size and style
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Awareness of one’s own cultural worldview
Attitude toward cultural differences
Knowledge of different cultural practices and
worldviews
Cross-cultural skills
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Cultural competence is achieved by identifying
and understanding the needs and help-seeking
behaviors of individuals and families.
Culturally competent organizations design and
implement services that are tailored or matched
to the unique needs of individuals, children,
families, organizations, and communities served.
Practice is driven in service delivery systems by
client-preferred choices, not by culturally blind
or culturally free interventions.
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Communication styles (e.g., language use, non-verbal
expression, sense of time, personal distance)
Attitudes toward conflict (e.g., Is it OK to be direct in a
conflict?)
Approaches to completing tasks (e.g., How important is it
to establish the personal relationship early in a
collaboration?)
Decision-making styles (e.g., Is authority delegated or
kept to one’s self? Are decisions reached by majority rule
or by consensus building?)
Attitudes toward disclosure (e.g., Is it appropriate to be
frank about emotions or ask about personal matters)
Approaches to knowing (e.g., analytic, scientific method,
or affective, intuitive)
Source: DuPraw, M.E., and Axner, M. (n.d.). Working on common cross-cultural communication
challenges. Retrieved from the PBS website: http://www.pbs.org/ampu/crosscult.html
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Whether the individual or community is of primary importance
Accepted roles of men, women, and children
Preferred family structure
Relative importance of folk wisdom, life experience, value of
common sense compared with formal education and advanced
degrees
Ways that wealth is measured (material goods, personal
relationships)
Relative value placed on different age groups
Whether people are more comfortable with traditions or open to
new ways
Favorite and forbidden foods
Manner of dress and adornment
Body language, particularly whether touching or proximity is
permitted in specific situations
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50 million
adults can’t
read as well as
a 4th or 5th
grader.
42 million
can’t read at
all.
Prose Literacy Levels in the U.S.
Sources: Grim illiteracy statistics indicate Americans have a reading problem. (2007). Retrieved July
23, 2008, from the Education Portal Web site: http://educationportal.com/articles/Grim_Illiteracy_Statistics_Indicate_Americans_Have_a_Reading_Problem.html
National Assessment of Adult Literacy, U.S. Department of Education.
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Reading grade levels are helpful, but not an
absolute.
◦ Fry and/or SMOG
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Readability formulas do not measure:
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Cultural appeal.
Audience response to layout and graphics.
Concept density.
Familiarity of medical and scientific information.
Clarity of writing.
Reader’s motivation or readiness to learn.
Preference for
homepage that
showed a human face;
mixed reactions to
this image
Strong
engagement with
images of people
Misinterpretation of
arrows
Misinterpretation of
numbers
Sample design guidelines
Sample writing guidelines
Select a large default font size.
Avoid charts and tables. They are often
difficult for people to understand.
Create a very simple, clean design.
Nothing that distracts.
Use plain language.
Use black text on a white background.
Employ subheads and bullets wherever
possible.
Avoid pictures that could serve as
“triggers” to someone in recovery.
Place the most important information at
the top of the page.
Choose images that communicate
concepts literally rather than
figuratively.
Avoid long pages that require scrolling.
NIDA low-literacy website on neuroscience, drug abuse prevention, and treatment
Plain language,
scannable text
Definitions of
medical terms
Illustrations that
literally depict the
content
Guided path
NIDA low-literacy website on neuroscience, drug abuse prevention, and treatment
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What do you want your audience to do?
Use action statements.
Use interactive formats where appropriate.
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Make the content meaningful and appealing
to the reader.
Suggest clear, specific behaviors that are
doable by the target audience.
Ask readers to ask questions, take action
steps, or write down action they will try to do.
Use testimonials and short stories.
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Many people base their decisions on emotion
rather than logic.
Most health risk messages are based on fear
appeals
◦ Afraid of getting hurt, getting a disease, or dying
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Use of theory saves time and money because
there is less trial and error.
Theoretically based campaigns are more
likely to succeed than those developed from
inspiration alone.
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Fear appeals:
◦ Have been used since
antiquity.
◦ Tend to be more
effective with “copers”
and “sensation
seekers.”
◦ Seem to be persuasive
when accompanied by
“high-efficacy”
messages.
Source: A meta-analysis of fear appeals: Implications for effective public health
campaigns. Health Education & Behavior, Vol. 27 (5): 59–615, October 2000.
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The use of positive emotions including humor
and joy are effective in gaining attention and,
in particular, the attention of individuals who
may have considered themselves overly
familiar with a campaign.
Positive emotions including empathy and
compassion may help individuals to reframe
and reconsider issues that they may have
considered not particularly relevant to their
lives.
Source: Lewis, IM. and Watson, BC, White, KM, and Tay, RST. Promoting public health
messages: Should we move beyond fear-evoking appeals in road safety? Qualitative
Health Research 17(1):pp. 61–74, 2007.
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Positive content is more viral than negative—
but it’s more complex than that.
Strong emotions such as awe, anger, and
anxiety lead to viral content.
Content that is weaker emotionally or even
deactivating, such as sadness, is less viral.
This holds true regardless of how surprising,
interesting, or useful content is.
Source: Berger, J, Milkman, K, What makes online content viral? Journal of Marketing Research,
2011.
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Can you understand everything easily?
Can you find what you are looking for?
Does it provide the information you need?
Do you find it so interesting and informative
that you want to learn more?
How could it be improved?
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Meet your audience where they are.
◦ For example, sample dissemination strategies by
age:
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18–34: Digital, social media
35–49: Worksite campaigns
50–64: Reach spouses as influencers
65+: Doctors’ offices, faith-based campaigns
Match your message to the medium—and
vice versa.
Consider how to best use your resources.
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Push, not pull.
Craft your message so that it’s portable.
See knowledge sharing as part of an ongoing
conversation.
Reach the right people—not the most people.
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Does your
audience use it?
Does it align with
the rest of your
communications
plan?
Who will maintain
it?
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Growth. More than 300 million users, and
there are now more than million Tweets per
day.
Trends. Facilitates viral information sharing,
especially about emerging news and trends.
Reach. Has a high percentage of use among
young people and various demographic
groups.
Source: Twitter, August 2011
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Blogs
Chatrooms, forums, or
online discussions
Poll and survey
mechanisms
Communities of practice
RSS feeds—make it easy
for others to pick up our
news without lifting a
finger
Web analytics
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Not everyone uses the web.
Factors include age, income, education,
ethnicity, and access.
Household income is the greatest predictor of
Internet use for Americans.
“…mobile is playing a key role in bridging
those gaps between people who have that
broadband connection at home and people
that don’t. It really gives people an
economically viable opportunity to tap into
the online world that they wouldn’t normally
have.”
—Aaron Smith, PEW Internet and American Life Project
Source: Mobile access helps agencies break past digital divide | Interview with Aaron
Smith. (2010, July 8). Retrieved January 13, 2011, from the Pew Internet & American
Life Project Web site: http://www.pewinternet.org/Media-Mentions/2010/Mobileaccess-helps-agencies-break-past-digital-divide.aspx
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Some 83% of American adults own cell phones and
three-quarters of them (73%) send and receive text
messages.
Young adults are the most avid texters by a wide
margin.
Cell owners between the ages of 18 and 24 exchange
an average of 109.5 messages on a normal day.
African American and Hispanic cell users are more
intense and frequent users of all of the phone’s
capabilities than whites.
Minorities send more text messages and make more
calls on average than their white counterparts.
Source: Pew Research Center’s Internet & American Life Project
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Teens and texting:
◦ 75% of teens between 12 and 17 own a mobile
phone
◦ 1 in 3 teens send 3,000 texts per month
Text messaging program designed as a smoking
cessation intervention for teens ready to quit
smoking
Messages sent for up to 4 weeks pre‐quit and up to 6
weeks post-quit date
Free with unlimited texting plan
Information collected from user at sign‐up: mobile #,
age, gender, quit date, and smoking frequency
Data: PEW “Teens and Mobile Phones”; Lenhart, Ling, Campbell, & Purcell, 2010
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Free cell phone text messaging service for
pregnant women and new moms from National
Healthy Mothers, Healthy Babies Coalition
Text messages sent 3 times per week; available
in English and Spanish
Negotiated free messages with CTIA, the Wireless
Foundation, so that all messages are free—even
without a text messaging plan or with limited
texting plan (participating carriers)
Messages are timed to the pregnant woman’s
due date or the baby’s date of birth
Launched in February 2010
More than 281,000 enrollees by
January 2012
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Users are more likely to receive and use
information that comes from a source they
trust or see as credible.
Hard-to-reach audiences are exactly that:
hard to reach.
Your dissemination source can help you tailor
your message so that it resonates with
recipients.
Your message is carried into the networks of
others, not just your own.
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Curate
Crowdsource
Consider new partners
Heather Pierce
hpierce@palladianpartners.com