Welcome to the Webinar

Health Communication Matters! Applying Health Literate Communications:

Examples from a Nasty Flu Season

We will begin shortly…

Today you’ll be hearing from. . .

Nancy Murphy, MSHC,

Metropolitan Group,

Moderator

Michael Villaire, MSLM, Institute for

Healthcare Advancement

Yvonne Garcia, Centers for Disease Control & Prevention

Agenda

1. Review of session objectives2. Introduction of today’s speakers3. Does your public health message work?4. Questions & Answers5. CDC Influenza Communication Campaign: “Examples from an

Eventful Flu Season” 6. Questions & Answers7. Specific actions and resources 8. Next steps & conclusion

Objectives

• Explain definitions of health literacy and plain language, statistics, prevalence, and costs associated with limited health literacy

• Describe the role of health professionals as change agents for effective communications with diverse audiences

• List strategies to develop health materials for readability/usability

• Explain how CDC communicators apply fundamentals of risk communication and plain language to reach a diverse audience

Health Literacy: Undervalued by Public Health?A tool for public health professionals. Prepared for the American Public Health Association Community Health Planning & Policy Development Section

Tammy Pilisuk, MPH AUG 2011

Who is in our audience

Aca-demic

City/Co Health dept.

Fed govt Hospital Private industry

CBO State Health

Other0

5

10

15

20

25

30

35

Employer/Organization

Who is in our audience

Geography

CaliforniaOther states

25 states represented

Who is in our audience Profession

Mostly Health Promotion/Health Education professionals . . . And good representation from administrators, nutritionists, nurses, data analysts, policy specialists & faculty

What do you want to learn from this webinar?

• About 1/3 said specifics around flu messaging

• About 2/3 said health literacy or effective health communication tools and tactics

• Plus. . . Practical examples, tips, tools, trends and models

How to Participate

• Phone line is automatically on mute

• Send facilitator a question or comment using Ready Talk’s chat function

• Click “raise hand” button to be taken off mute and ask a question verbally

• Slides and resources will be posted online following webinar – link will be shared via email with all participants

Who is speaking today: Michael Villaire

Michael Villaire, MSLMChief Operating Officer, Institute for Healthcare Advancement

Email: mvillaire@iha4health.org

Website: www.iha4health.org

Who is speaking today: Yvonne Garcia

Yvonne Garcia, Influenza Communication Lead, Health Communications Specialist, CDC/NCIRD

Email: ybg2@cdc.gov

Website: www.cdc.gov  

Who is moderating our discussion today:

Nancy Murphy, MSHC

Nancy Murphy, MSHCExecutive Vice President, Metropolitan Group

Email: nmurphy@metgroup.com

Website: www.metgroup.com

Questions welcomed

• Submit a question at any time during this Webinar using the chat function OR clicking the “raise hand” button to be taken off mute.

• We will consolidate questions and pose them to the speakers throughout the Webinar and during the Q&A session at the end.

• We also may host additional webinars on related health communication topics depending on the results of the evaluation, so please tell us if you want more!

Before we launch into our presentations, here is a question for you:

What drew you to this webinar?

A. Learn more about health literacy for myself

B. To help colleagues apply health literacy

C. I am interested in flu messaging

Introducing Michael Villaire

Michael Villaire, MSLMChief Operating Officer, Institute for Healthcare Advancement

Health Literacy 101: Does Your Public Health Message

Work?

Public Health Matters Webinar

March 27, 2013

Michael Villaire, MSLM

Chief Operating Officer

Institute for Healthcare Advancement

www.iha4health.org

mvillaire@iha4health.org

(800) 434-4633 x202

• “Using printed and written information to function in society, to achieve one’s goals, and to develop one’s knowledge and potential” (Kirsch et al, 1993)

DefinitionsLiteracy

• “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Ratzan and Parker, 2000)

• “Health literacy allows the public and personnel working in all health-related contexts to find, understand, evaluate, communicate, and use information. Health literacy is the use of a wide range of skills that … include reading, writing, listening, speaking, numeracy, and critical analysis, as well as communication and interaction skills.” (Calgary Charter on Health Literacy, 2008)

DefinitionsHealth Literacy

Definitions

Why Does Health Literacy Matter?Those with limited literacy skills:

• Report poorer overall health• Have poorer ability to manage chronic diseases• Have poorer outcomes• Less likely to understand their diagnosis• Less likely to have screening / preventive care• Present in later stages of disease• Are more likely to be hospitalized / rehospitalized

Cost of Poor Health Literacy• $73 billion in unnecessary costs annually

(Friedland, Georgetown University, 2003)

• $106-$238 billion in unnecessary costs annually (Vernon, University of Connecticut, 2007)

Cost of Chronic Disease• $1.7 trillion (75% of HC expenditures)• Nearly 1 in 2 Americans live with a chronic disease• 90% >65 have a chronic disease;

77% have 2+• 70% of annual US deaths (CDC 2008)

Why Does Health Literacy Matter?

NAAL Health Literacy Findings• 36% have limited health literacy skills

(22% Basic, 14% Below Basic)

• About 12% considered Proficient

• Women’s avg. HL score 6 pts. higher (4% more men in Below Basic)

You know what you mean…

But does he?

A question for Michael

So we can see that we clearly have a problem!

What are some specific ways that we can increase the likelihood of the public understanding our public health messages?

7 Points to Ensure Your Materials are On Target

• Audience• Message• Readability• Design• Culturally Appropriate• Learnable• Field-test

Audience

• Who is your audience? • What are their needs? • What are they interested in? • What is their ability? • What are their barriers?

Message

• What do you want them to do? • Limit to no more than 3 concepts. • What do they need to do the behavior?

Readability

• Grade reading level• Active voice• Short sentences (10-15 words max)• Short, simple words (no jargon)• Use examples• Define unfamiliar / technical words

• Readability measures– SMOG (Simple Measure of Gobbledygook)– Count words with more than 3 syllables in 30

sentences– Use conversion table to obtain grade reading

level

http://www.harrymclaughlin.com/SMOG.htm

Readability

http://www.harrymclaughlin.com/SMOG.htm

Design

• White space • Large type size (12-14 point) and double-

spaced• Standard font (no italics or ALL CAPS)• Two type faces (Arial-headings; Times

New Roman-body)• Simple headings. . .

More Design

• Usable, appropriate, explanatory graphics (no abstract graphics)

• Use columns • Bulleted lists (keep to 7-8 max)• Color / Navigation

A question for Michael

Do you have a sample document that we might engage our participants in evaluating based on the tips you have shared with us so far?

Design critique • What’s good?• What’s not so good?

Real-life Examples

From “What To Do When Your Child Gets Sick” Institute for Healthcare Advancement www.iha4health.org

Real-life Examples

From “Living With Diabetes: An Everyday Guide for You and Your Family” American College of Physicians Foundation foundation.acponline.org/hl/hlresources.htm

Real-life Examples:Photonovela

From “From Junk Food to Healthy Eating: Tanya's Journey to a Better Life” Inter-Cultural Association of Greater Victoria www.photonovel.ca/photonovels.htm

“The Bible”

Available from:

• http://www.hsph.harvard.edu/healthliteracy/resources/doak-book/

• IHA Health Literacy Conference

Key takeaways• Only about 12% of American adults are

estimated to have the level of skill necessary to understand health information. That leaves 88% of us with some serious challenges!

• Failure to address health literacy challenges effectively has real and significant costs.

• There are simple tools that can make a real difference – focus on white space, short words and sentences, limited number of concepts – readability and design matter.

Join the Conversation!

Questions or comments for Michael?

Please submit questions by using the chat function OR clicking the “raise hand” button to be taken off mute

We have our first question for Michael. . .

Discussion/Q&A

Ask Michael! Share with Michael!

Poll Question

To check the reading level on a document, I:

a. Use the grade level scoring on MSWord

b. Use another readability calculator

c. Is that the same as “spell check?”

d. I need to check the reading level???!!

Introducing Yvonne Garcia

Yvonne Garcia Influenza Communication Lead Health Communications Specialist CDC/NCIRD Atlanta, Georgia

CDC Influenza Communication Campaign“Examples from an Eventful Flu Season”

Yvonne Garcia

March 27, 2013

Centers for Disease Control and PreventionNational Center for Immunization and Respiratory Diseases

Objectives

Provide CDC communication strategies designed to address different types of challenges, such as flu vaccine hesitancy

Describe effective health communication strategies with disparate populations that may be vaccine hesitant

Explain how CDC communicators apply fundamentals of risk communication and plain language in materials to reach a broad and diverse audience

CDC Communication Goals

Consistent messages about importance of universal flu vaccination and benefits: Keep top of mind.

Steady increases in flu vaccination coverage over time.

Foster knowledge and favorable beliefs regarding influenza vaccine and vaccination recommendations.

Maintain and extend confidence in flu vaccine safety.

Address disparities in vaccination coverage.

Special focus on people at high-risk for complications from flu.

Communication Challenges Vast number of messages and misinformation out there Vaccine safety and efficacy Many vaccine formulations for different groups of

individuals Misconceptions: flu is a bad cold; flu vaccine will give you

the flu; flu vaccine in not effective Audiences: similarities and differences Adult vaccination disparity and health disparate

population reach Shrinking budgets

Target Audiences Everyone 6 months of age and older Special Focus Parents of young children Older adults (65+) People with chronic medical conditions Pregnant women People who live with or care for those at

high risk for complications from flu, including:• Health care workers • Household contacts and caregivers of

children less than 5 years of age, especially children less than 6 months of age

Minority/ethnic populations

A question for Yvonne

Wow! So you have many challenges in messaging AND you’re trying to reach broad and diverse audiences. What are some specific ways you addressed those challenges and reached those audiences effectively in the 2012-2013 flu season?

Campaign Elements

General Audience: national, multi-sector partners representing business, health, retail, national organizations, sports organizations, universities, multi-media, etc.

Minority Populations: grassroots stakeholder engagement and cross collaboration with health departments/organizations, CBOs, faith-based, pharmacies and other vaccinators, ethnic media outlets, business, etc.

CDC Partners in Actionfrom Times Square to small town USA

Campaign Elements CDC Support Mechanisms:

Digital and social media Materials and Tools Flu Partner Portal Capacity Building Plans (Webinars, Flu 101, Social Media)

Traditional Media: television/radio/print PSAs, interviews

Education and outreach to health care professionals

New and Digital Media• Publisher Outreach• Content syndication• CDC email alerts• Mobile messaging• Smart phone/iPad

apps

Social Media• Twitter chats• Blogs

Digital and Social Media Tools

Digital and Social Media Tools

Content Syndication: http://tools.cdc.gov/syndication/

RSS Feeds: http://www2c.cdc.gov/podcasts/rss.asp

CDC Flu Twitter: http://twitter.com/CDCFlu

CDC Facebook: http://www.facebook.com/CDC

Receive notices as CDC posts updates to specific flu web pages: http://www.cdc.gov/Other/emailupdates/

Flu Vaccine Hesitancy

“The flu vaccine will give you the flu…I got sick with the flu after I got a flu shot ”

“I’m healthy and don’t need a flu shot”

“I’ve never had the flu so why get a flu shot”

“ I’m afraid of needles.”

A question for Yvonne?

And so in spite of all those great outreach strategies, some people still hesitate to get vaccinated. What additional messages did you use in educating the public?

Educating the public about influenza

Influenza (the flu) is a contagious respiratory illness caused by influenza viruses.

Influenza (the flu) can be a serious disease that can lead to

hospitalization and sometimes even death. Anyone can get sick from the flu.

Some people, such as older people, young children, and people with certain health conditions, are at high risk for serious flu complications.

Educating the public about influenza It takes about two weeks after vaccination for the body’s

immune response to fully respond and for you to be protected.

“It’s not too late to get vaccinated.” National Influenza

Vaccination Week (NIVW)

People have several options in terms of where they can get vaccinated and the type of influenza vaccine to choose. http://flushot.healthmap.org/

The best way to protect against the flu is by getting vaccinated each year.

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• Matte articles• PSA’s• Print Materials• Web Buttons,

Banners, and Widgets

Resources

Cold vs flu

Influenza Symptoms: can be mild to severe

The flu usually comes on suddenly. People who have the flu often feel some or all of these symptoms:• Fever or feeling feverish/chills• Cough• Sore throat• Runny or stuffy nose• Muscle or body aches• Headaches• Fatigue (tiredness)• Some people may have vomiting and diarrhea, though this is more

common in children than adults.

Educating the public about flu vaccine There are two reasons for getting a yearly flu vaccine:

1. Flu viruses are constantly changing, flu vaccines may be updated to protect against the viruses predicted to circulate the most during the coming flu season.

2. A person’s immune protection from vaccination declines over time and annual vaccination is needed for optimal protection.

Each season many flu viruses spread but most of these viruses fall into four main categorized groups: two influenza A and 2 influenza B viruses.

The 2012-2013 flu vaccine protects against the three influenza viruses that research indicates will be most common during the season. This includes an influenza A (H1N1) virus, an influenza A (H3N2) virus, and an influenza B virus.

The timing of influenza outbreaks is unpredictable. They have occurred as early as October and as late as May.

Flu Season Communication Tactics Provide media, the public, clinicians, public health and other partners with

rapid, accurate, transparent, clear, and actionable information on influenza disease activity, prevention, and treatment

National press briefings: Flu season kick-off, NIVW

Radio media tours with national, local and ethnic media outlets

CDC Website traffic tripled in page views this flu season

Maintain weekly e-mail distribution of updates, resources, key messages to public health providers, organizations, private sector partners and other stakeholders

Web and social media activities

Materials distribution and partner driven flu promotion activities

US Emergency Rooms

Inundated With Flu Patients

http://www.cdc.gov/flu/freeresources/index.htm

Resources

2013-2014 Flu Season

Goals: Focus groups to test new logo and theme, quadrivalent vaccine message testing and fact sheets.

Continue messaging that conveys importance of universal

vaccination with a focus on people with high risk health conditions and health disparities.

New materials to reach African American, Hispanics and American Indian/Alaska Native populations.

National Influenza Vacccination Week- December 8-14, 2013

Thank you!Contact: fluinbox@cdc.gov

For more information please contact Centers for Disease Control and Prevention

1600 Clifton Road NE, Atlanta, GA 30333 Telephone: 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348 E-mail: cdcinfo@cdc.gov Web: http://www.cdc.gov/flu

Key takeaways• Understanding perceived benefits

and barriers to vaccination among target audiences is key in designing an effective campaign.

• Partnerships and collaboration strategies can increase visibility and target audience reach.

• Clear messages and materials + community engagement can build awareness about the importance and benefits of universal flu vaccination.

Poll Question

If I were trying to persuade someone to get a flu shot, I would:

a) Tell them how many people die from flu every year

b) Tell them about someone you know who got the flu

c) Ask them if they know the difference between the cold and the flu

Join the Conversation!

Questions or comments for Yvonne?

Please submit questions by using the chat function OR clicking the “raise hand” button to be taken off mute

We have our first question for Yvonne. . .

Discussion/Q&A

Ask Yvonne! Share with Yvonne!

Join the Conversation!

Questions or comments for either panelist?

Please submit questions by using the chat function OR clicking the “raise hand” button to be taken off mute

Questions for our speakers

Michael Villaire, MSLM

Chief Operating Officer, Institute for Healthcare Advancement

Yvonne GarciaCenters for Disease Control & Prevention (CDC)

Health Literacy: Undervalued by Public Health?A tool for public health professionals. Prepared for the American Public Health Association Community Health Planning & Policy Development Section

Tammy Pilisuk, MPH AUG 2011

Learning more. . .

• Following today’s webinar, you will receive an email with a link to

• A recording of today’s webinar, which will be archived for future access

• Presenters’ slides

• List of resources related to today’s topic

Evaluation & Questions

• An evaluation will pop up on your screen immediately following the conclusion of today’s webinar ─ please share your feedback that will help us improve future webinars

• Please let us know if you would like to follow-up on anything we touched on today

• Have additional questions? Contact our presenters or moderator

Resources• CDC: Health Literacy

http://www.cdc.gov/healthliteracy/index.html

• National Institute For Literacy (NIFL) health literacy listserve: http://www.nifl.gov/lincs/discussions/subscribe_all.html

• American Medical Association’s health literacy site: http://www.ama-assn.org/ama/pub/about-ama/our-people/affiliated-groups/ama-foundation/our-programs/public-health/health-literacy-program.shtml

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Additional Resources• www.nlm.nih.gov/medlineplus/etr.html

• www.coveringkidsandfamilies.org/resources/docs/stylemanual.pdf

• www.health.gov/healthliteracyonline

• www.cdc.gov/healthmarketing/pdf/Simply_Put_082010.pdf

• www.hsph.harvard.edu/healthliteracy/resources/doak-book

• www.hsph.harvard.edu/healthliteracy/practice/additional-resources-for-creating-and-assessing-materials

• www.healthcommunications.org/resources/Improving%20Readability%20with%20Appropriate%20Design.pdf

• www.slideshare.net/SPHCalpact/plain-writing-training-tool

Speaker Contact Information

Michael Villaire, MSLM, Chief Operating OfficerInstitute for Healthcare Advancement mvillaire@iha4health.org(800) 434-4633 x202

Yvonne Garcia, Influenza Communication Lead Health Communications Specialist CDC/NCIRDybg2@cdc.gov

Thank you to our Sponsors

Community Health Planning and Policy Development Section, APHA

Thank you to our planning committee

• Tammy Pilisuk, MPH, APHA-CHPPD

• Erin Brigham, MPH, CareSource, APHA-CHPPD

• Amanda Crowe, MA, MPH, Impact Health Communications, LLC

• Meghan Bridgid Moran, PhD, San Diego State University, School of Communications

• Nancy Murphy, MSHC, Metropolitan Group

Thank you to our speakers!

Michael Villaire, MSLM, Institute for Healthcare Advancement

Yvonne GarciaCenters for Disease Control & Prevention (CDC)

About This Series • The Health Communication Matters series will help participants in all

walks of public health to apply health literacy principles to their everyday communications.

• What audiences do you communicate with—consumers, health professionals, disenfranchised communities, your public health peers? Whatever your role in public health, it’s likely that you need to communicate effectively. But how do you know your communication is effective?

• Only about 10 percent of the general population is considered “health literate.” That leaves the vast majority of us with barriers to understanding the health-related information we read.

Conclusion

Thank you!

www.calpact.org