health communication: “this is our time” cartagena, spain 7june 2013 franklin apfel md, mhs –...
TRANSCRIPT
Health Communication:
“This is our time”
Cartagena , Spain7June 2013
Franklin Apfel MD, MHS – Managing Director,World Health Communication Associates (WHCA)
www.whcaonline.org
Aim
To have a conversation with you about :
• Why communication is an increasingly important determinant of health
• Why “this is our time” – how public health can use “new “ and old communication tools and platforms to make healthier choices easier
What is health communication?
• A multifaceted and multidisciplinary approach to reach different audiences and share health-related information with the goal of influencing, engaging, and supporting individuals, communities, health professionals, special groups, policymakers and the public to champion, introduce, adopt, or sustain a behavior, practice, or policy that will ultimately improve health outcomes (Schiavo, 2007, p.7)
Conversation- dialogue
Communication is a 2-way
reality
Audience centred or insight based approach
starting with ‘the audience ’
Two-way thinkingTraditional information communications & ‘message based’ approach
OUR mission & crafting
‘our messages’
communicating the information & messages
‘the audience’
understanding 1: the audieence
& 2: the behaviour
everyday lives hopes hopes & fears / values &
beliefs behaviours infuences
what really ‘moves & motivates’
generating ‘insight’
The behavioural challenge
Car seats = self evidently safer! Directly reducing injury & deaths
Priests blessthe car seats
How to create a valued product or service?
Child care seats & Hispanic mums
AED
CORE INSIGHTS‘My child is safest in my arms’
‘God will decide when to take my baby’
“Its very important to get drunk.
I’m spending money and I want to get
drunk,
and if I don’t it’s just a waste of
money!” Quoted in Alcohol Harm Reduction Strategy for England,
Cabinet Office 2004
‘HAVING A GOOD TIME
‘INSIGHT’ is the key
Supply Side logic
Socio political logic
Binge drinkers consider it their right. It’s a release for the working class to forget their lives (Youth worker)
What causes binge drinking ? You only have to look at the price list (Bar manager)
Why (1) is
Health communication is an
determinant of health
Determinants of health
Dahlgren and Whitehead’s Rainbow Model
Dahlgren and Whitehead, 1993
Health literacy is the key mediating factor
and metric
Dahlgren and Whitehead, 1993
Health literacy friendliness
Social norms
Hazard Marketing
Health Literacy
The capacity to obtain, interpret, understand
and use health information and services
to enhance health.
HLS-EU Definition
Measuring health literacy- the questions
Country scores
( HLS-EU consortium,2012)
Inadequate and problematic
health literacy – inequities
Health outcomes of “
inadequate and
problematic” health
Literacy• Poorer health choices• Riskier behaviours• Less use of preventive services • More delayed diagnoses • Poorer understanding of medical conditions• Less adherence to medical instructions • Poorer self-management skills • Increased risk of hospitalization • Poorer physical and mental health • Increased mortality risk• Higher health costs
Health Literacy for all and by all
• People- risk assessment, disease prevention, health care seeking, disease management
• Providers- social determinants of health, patient centered care
• Policy Makers- Health in all policies
THE INTERACTIVE NATURE OF HEALTH
LITERACY • Health literacy is a dynamic reality. It
occurs when skills and abilities to get and use information are aligned with the complexity/clarity of demands/tasks required for health.
Many sectors and settings
• Health Systems
• Education
• Media health information marketplaces
• Home Community
• Workplace
• Policy Making Arenas
Why (2) is
“This is our time”
• How can we use our new knowledge, tools and platforms to reach individuals and mass audiences and strengthen health literacy and make healthier choices easier
Are you part of the “we” ?
When you think of a health communicator- what is your image
?
Many have this image
The “spokesperson”
At the bedside
In the clinic
Workplace
In the community
Public health is all about communication
We are all communicators!
In fact 60- 80% of most public health workers time relates to
communication
Provider-patient, emails ,social media, conferences, report writing, telephoning,
intelligence/insight gathering , publishing ,reading, advocating, talking to
ourselves and others
Making health systems
more health literacy
friendly
Adopting “universal precautions”
(re)Design systems around access
• Provides easy access to health information and services and navigation assistance
• Redesigns systems and physical space
• Make signage and instructional materails understandable
• Provides “navigator” assistance where needed
Strengthen our communication skills • Use health literacy strategies in interpersonal
communication and confirm understanding at all points of contact
• Confirm understanding (such as using the teach-back, show-me or chunk-and-check methods)
• Secure language assistance for speakers of languages other than the dominant language
• Limit to two to three messages at a time
• Use easily understood symbols in way-finding signage
Engage with audience
• Design and distribute print, audiovisual and social media content that is easy to understand and act on .
• Involve diverse audiences, including those with limited health literacy, in development and rigorous user testing
• Use a quality translation process to produce materials in languages other than the dominant language
Use new and old tools to
enhance our impact and
reach Tools • Framing
• Formative research
• Social Marketing
• Media Advocacy
• Advocacy communication
• Lobbying
• Internet based advocacy
• Networking
Platforms • Print media
• Television
• Radio
• Internet
• Social media
• M-Health
• Community –based
• Personal
Framing is key
Framing is “selecting some aspects of a perceived reality and making them more salient …in such a way as to promote a particular problem definition, causal interpretation, moral evaluation and/or treatment recommendation” (Entman, cited in Chapman 2004, p.362).
Frames create the context within which policy debate takes place
Learning from the Hazard
merchants
Big TobaccoFraming Reframing
Reframing Alcohol AdsLess is better
• Linking alcohol and abuse
Reframe investment decisions
Value not cost
Use new platforms – to
enhance our skills
To empower
To gather intelligence (Citizen Science)
To interact- social media sites
Why social media is critical
To connect
More mobile phones than
toilets• Out of the world’s estimated 7 billion
people, 6 billion have access to mobile phones. Far fewer — only 4.5 billion people — have access to working toilets. ( and toothbrushes) .
Implications for health communications
• Unprecedented access to information
• Monologue- dialogue• Rapid• Anywhere, anytime
m-Health• Patient diagnostic and treatment
support- Identifying patient symptoms
correctly
• Healthcare provider training & communications support- Expediting the delivery of medical
treatment• Remote patient data collection
- Monitoring effectiveness of treatment options
m-Health cont
• Remote patient monitoring- Increasing patient compliance with prescribed treatment
• Education and awareness
- Empowering patients to make better
informed decisions• Citizen science
Collecting data, surveys • Disease and epidemic outbreak tracking
- Providing decision makers with timely, location-
related information
Example : Digital Health
Scorecard
Seven Risk factors
A single number score
To entertain- edutainment
• Educational soaps
To inform- work with journalists
as key health information
intermediaries
And much much more …
Just a taste…
•Lets make some healthy “noise” together
