Health Communication: “This is our time” Cartagena, Spain 7June 2013 Franklin Apfel MD, MHS –...

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

Thank You

www.whcaonline.org

Contact franklin@whcaonline.org