Health

Communication:
This is our time

Cartagena , Spain
7June 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
 Two-way thinking
Traditional information communications &
message
OUR mission based approach
communicatin
& crafting g the
our information
messages the
& messages audience

Audience centred or insight based

approach
understandin
generating
g 1: the
insight
audieence &
2: the
behaviour
everyday lives hopes what really
starting with hopes moves &
the & fears / values & motivates
audience beliefs behaviours
 The behavioural
challenge

Car seats = self evidently safer!

Directly reducing injury & deaths
Child care seats & Hispanic
mums CORE INSIGHTS
My child is safest in my
arms
God will decide
when to take my baby

How to create a
valued product or
service?
Priests bless
the car seats
AED
 HAVING A GOOD
TIME
Its very important
to get drunk.
Im spending money
and I want to get
drunk,
and if I dont
its just a waste of
money!
Quoted in Alcohol Harm Reduction Strategy for England,
Cabinet Office 2004
 INSIGHT is the key
What causes binge
drinking ?
You only have to look at
the price list
(Bar manager)
Supply Side logic
Binge drinkers consider it
their right. Its a release
for the working class to
forget their lives
(Youth worker)

Socio political
logic
 Why (1) is

Health communication is
an
determinant of health
Determinants of
health
Dahlgren and Whiteheads Rainbow
Model

Dahlgren and Whitehead, 1993

 Health literacy is the
key mediating factor
and metric
Health literacy friendliness

Social nor

Hazard Marketing
Dahlgren and Whitehead, 1993
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
Poorer health choices health
Riskier behaviours
Literacy
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 Platforms
Framing Print media

Formative research Television

Social Marketing Radio

Media Advocacy Internet

Advocacy communication Social media

Lobbying M-Health

Internet based advocacy Community based

Networking 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 Tobacco
Framing Reframing
 Reframing Alcohol Ads
Less 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 worlds 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