Communication in Health

EducationDr. A.O Aremu

community Medicine Dept.

Bowen University

PUH 222 Psychological Foundations of Health Behaviour and change Process

Lecture Outline• Definitions

• Channels of Communication

• Types of communication

• The communication Process

• Approaches/ Methods

• Communication tools and rules

• Barriers to effective communication

• Overcoming barriers to effective communication

• Health Education Definition

• Process of providing information and advice related to healthy lifestyle and

encouraging the development of knowledge, attitudes and skills aimed at

behaviour change of individuals or communities. - WHO

Enables and influences control over own´s health, leading to optimalization

of attitudes and habits related to lifestyle and increasing quality of life.

What Is Communication?

• Reflection on the literal meaning of the word communication

• 1. Exchange of information, between Individuals

• 2. Message—a spoken or written message

• 3. Act of communicating

• 4. Rapport—a sense of mutual understanding and sympathy

• 5. Access—a means of access or communication, for example,

a connecting door

• Process of transferring information from a sender to a receiver with

the use of a medium in which the communicated information is

understood by both sender and receiver.

• Can be regarded as a two-way process of exchanging or shaping

ideas, feelings and information.

Broadly it refers "to the countless ways that humans have of

keeping in touch with one another"

• Communication is more than mere exchange of

information. It is a process necessary to pave way for

desired changes in human behaviour, and informed

individual and community participation to achieve

predetermined goals.

Purpose of Communication

Health Communication• Communication and education are interwoven.

• Communication strategies can enhance learning.

• The ultimate goal of all communication is to bring about a change in the

desired direction of the person who receives the communication. These

desired directions may be:

1. At the cognitive level (in terms of increase in knowledge)

2. It may be affective (in terms of changing existing patterns of behaviour and

attitudes)

3. It may be psychomotor (in terms of acquiring new Skills)

These are all referred to as learning objectives of communication

Health Communication Defined

• Several definitions have been suggested in the past:

• It has been defined as “the study and use of communication

strategies to inform and influence individual and community

decisions that enhance health” CDC 2001

• Also as “the art and technique of informing, influencing,

• and motivating individual, institutional, and public audiences

about important health issues”

The following definitions have emerged:• Health communication is 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.

• Te science and art of using communication to advance the health and wellbeing of people

and populations ….. Society for Health Communication

Key Characteristics of Health Communication

• Audience-centered

• Research-based

• Multidisciplinary

• Strategic : All activities need to be well planned and respond to a specific

audience-related need.

• Process oriented: Influencing people is a long-term process

• Cost-effective:

• Creative in support of strategy:Allows consideration of multiple options,

formats, and channels to reach target audiences.

• Audience and media specific: Messages need to be audience

specific and tailored to channels allowing the most effective reach

to target audiences

• Relationship building:Establishing and preserving good

relationships is critical to the success of health communication

interventions

• Aimed at behavioral or social change:

Channels of communication

• Channel refers to the "physical bridges" or the media of communication

between the sender and the receiver.

• Media systems

• The total communication effort is based on three media systems:

a. Interpersonal communication

b. Mass media

c. Traditional or folk media

Interpersonal communication

• Also refered to as face-to-face communication

• It is the most common channel of communication

• It is more persuasive and effective than any other form of

communication

• It is particularly important in influencing the decisions of the

undecided persons

The Mass media

• The channel is one or more of the following "mass media",

• TV,

• Radio,

• Print media,

• Features of the Mass Media

The Mass media have the advantage of reaching a relatively larger population

in a shorter time than is possible with other means.

Being one-way channels of communication, mass media carry messages only

from the centre to the periphery

Feedback mechanisms are poorly organized

Usually not effective in changing established modes of behaviour

The Folk media

Every community has its own network of traditional or folk media

such as folk dances, singing, dramas.

These are important channels of communication close to the cultural

values of the rural population.

These have been the principal instruments of preserving the cultural

heritage. Health messages may be communicated through these

traditional media.

Feedback• It is the flow of information from the audience to the sender

• It is the reaction of the audience to the message

• The feedback provides an opportunity to the sender to modify his

message

• In interpersonal communication the feedback is immediate. In mass

communication it takes some time.

• Feedback is generally obtained through opinion polls, attitude

surveys and interviews

TYPES OF COMMUNICATION

• One-way communication (Didactic Method)

• Two-way communication (Socratic method)

• Verbal communication

• Non verbal communication

• Formal and informal communication

• Visual communication

• Telecommunication and internet

One-way communication (Didactic Method)

• The flow of communication is "one-way" from the communicator to the

audience. The familiar example is the lecture method in class rooms. • Quick if the message is simple and needs quicker communication e.g. date & time of

meeting

• The drawbacks of the didactic method are :

• 1. knowledge is imposed

• 2. Learning is authoritative

• 3. Little audience participation

• 4. No feedback

• 5. Does not influence human behaviour

Two-way communication (Socratic method)

• Here both the communicator and the audience take part

• The process of learning is active and "democratic".

• It is more likely to influence behavior

• Can be adapted to suit the receiver’s needs

• Suitable for more complex messages

Disadvantage:

• It is time consuming

Verbal communication

• This is the traditional way of communication by word of mouth.

• Direct verbal communication may be loaded with hidden meanings.

• It is persuasive.

Non verbal communication

• This is Communication occurring without words.

• Sometimes-called Silent Signals

• It includes a whole range of bodily movements, postures, gestures,

facial expressions (e.g., smile, raised eye brows, frown, staring,

gazing etc.). These are known as dy language

• Silence is non-verbal communication. It can speak louder than

words!

Types of non verbal communication

Kinesics: Has to do with body position and motion

- Body orientation, posture, gesture (Kinesics)

-Facial expressions and eye movements (oculesics)

Eye contact

Paralanguage (voice)( Tone, pitch, Rhythm, Timbre, loudness)

Touch (Haptics)

Physical appearance and clothing

Proxemics and Territoriality( Personal space and territory)

*Kinesics *Some Facial Expressions

*Hand Gestures

Formal and informal communication• Communication classified into

• Formal (follows lines of authority) and

• Informal (grape-vine) communication.

• Informal network (e.g., gossip circles) exists in all organizations.

• The informal channels may be more active, if the formal channels do

not cater to the information needs.

• Visual communication

• The visual forms of communication comprise :

• charts and graphs,

• pictograms,

• tables, maps,

• posters etc ..

Telecommunication and the internet

• The is the process of communicating over distance using

electromagnetic instruments designed for the purpose.

• Radio, TV and internet etc are mass communication media

• The telephone and telegraph are known as point-to-point

telecommunication systems

The Communication Process

• Communication is a dynamic process that begins with the

conceptualizing of ideas by the sender who then transmits the

message through a channel to the receiver, who in turn gives the

feedback in the form of some message or signal within the given

time frame.

THE COMMUNICATION PROCESS• The communication process is the series of steps taken in order to successfully

communicate.

COMPONENTS OF COMMUNICATION

Elements/Components of Communication

• It has the following main components:

1. Sender (source / WHO )

2. Message (content / WHAT )

3. Channel(s) (medium / HOW )

4. Receiver (audience / TO WHOM )

5. Feedback ( EFFECT )

THE COMMUNICATION PROCESS

The Sender

• He is the originator of the message:

His objectives should be clearly defined.

He should know the interests and needs of his audience.

He should know the message.

He should know the channels of communication.

He should know his abilities and limitation

• The impact of the message will depend on his own social

status (authority), knowledge and prestige in the community.

The Receiver/ Audience

• This may be a single person or a group of people

Two types of audience are:

• Controlled :It is held together by a common interest. It is a

homogenous group.

• Uncontrolled (Free audience) :It is a group which has gathered

together out of curiosity

The more homogeneous the audience is, the greater are the chances

of an effective communication

The Message• A message is the information (or "technical know-how") which the

communicator transmits to his audience to receive, understand, accept

and act upon

• Health communication may fail in many cases, if its message is not

adequate

• A good message must be :

• 1. In line with the objective{s)

• 2. Meaningful

• 3.Based on felt needs

• 4.Clear and understandable

The Message

5. Specific and accurate

6. Timely and adequate

7. Fitting the audience

8. Interesting

9. Culturally and socially appropriate

The Communication process

The Communication Process

• Communications is a continuous process which mainly

involves three elements viz. sender, message, and receiver.

• 1. Sender

• The sender or the communicator generates the message and

conveys it to the receiver. He is the source and the one who

starts the communication

2. Message

• It is the idea, information, view, fact, feeling, etc. that is

generated by the sender and is then intended to be

communicated further.

3. Encoding

• The message generated by the sender is encoded

symbolically such as in the form of words, pictures,

gestures, etc. before it is being conveyed.

Encoding process

• The communicator arranges the thoughts and ideas appropriately in

the message for the benefit of receiver. This process of arranging

ideas and preparing the message is called ‘encoding’.

• Encoding is the transmission of ideas into a message by the source.

4. Media

• It is the manner in which the encoded message is

transmitted. The message may be transmitted orally or in

writing. The medium of communication includes

telephone, internet, post, fax, e-mail, etc. The choice of

medium is decided by the sender.

5. Decoding

• It is the process of converting the symbols encoded by the

sender. After decoding the message is received by the

receiver.

Decoding

• During decoding, the receiver interprets the sender’s message and

• tries to understand it in the best possible manner.

• Effective communication occurs only if the receiver understands the

• message in exactly the same way as it was intended by the sender.

The degree to which the receiver decodes the message depends on

• His knowledge of the subject matter,

• Experience,

• Trust and relationship with the sender.

6. Receiver

• This is the last person in the chain for whom the

message was intended.

• Once the message is received and understood in its

proper perspective and acted upon according to its

intent, the purpose of communication is said to have

been accomplished.

7. Feedback

• Once the receiver confirms to the sender that he has

received the message and it is understood, the process of

communication is complete.

• It increases the effectiveness of the communication as it

permits the sender to know the efficacy of his message.

• The response of the receiver may be verbal or non-verbal.

• 8. Noise

• Refers to any obstruction that is caused by the sender,

message or receiver during the process of communication.

Examples

• Bad telephone connection,

• Faulty encoding,

• Faulty decoding,

• Inattentive receiver,

• Poor understanding of message due to prejudice or

inappropriate gestures, etc.

Rules for effective communication7c’s of effective communication

1. Command Attention

2. Cater for the Head and the Heart - messagemust catch people’s emotion

3. Clarify the message – make it simple

4. Convey a benefit

5. Create trust

6. Convey consistent message/theme – throughdifferent media

7. Call for action45

Approaches/Methods of health

communication

• Individual approach/face to face

• Group approach

• Mass approach

Methods of health communication

• Panel discussion Role play(Socio drama)

Health exhibition

Individual approach

Advantages

• Educator gets acquainted with individuals to deal more effectively with health problems

• More opportunity to deliberate with the individual thus affording more opportunity for

behavioural change

• It provides opportunity to ask questions in terms of specific interests

• Immediate feedback

Disadvantages

• Educator can given it only to those who come in contact

• The reach is only to a small number of people at a time.

• Message spreads slowly

Group Approach

Advantages

• Large number of people can be reached

• People of all socio-economic status have access to H/E

• Disadvantage

• Communication is one way, no feedback immediately

Features of mass media and personal communication

Mass Media Personal communication( interpersonal

Methods)

1. Reaches the widest Population 1.Capitalizes on warmth and understanding and

knowledge of communication

2. Gets public attention 2.Provides opportunity for involvement, for

asking questions, expressing fears and learning

more

3. Gives greater support for concentrated

programmes e.g those lasting for a week

or month

3. Can get people tomake changesin personal

habits more readily when discussion presents

reasonable explanaqtions for these changes.

4. More effective among those with above

average educational level

4. More influential with average and below

average educational level

Communication channels and toolsRecall

• The various types of communication channels:

• Interpersonal Channels, which include one-to-one communication, such as provider to

client, spouse to spouse, or peer to peer.

• Community-Based Channels, which reach a community (a group of people within a

distinct geographic area, such as a village or neighborhood, or a group based on common

interests or characteristics, such as ethnicity or occupational status). Forms of community

communication are:

— Community-based media, such as local newspapers, local radio stations,

bulletin boards, and posters.

— Community-based activities, such as health fairs, folk dramas, concerts, rallies, and

parades.

— Community mobilization, a participatory process of communities identifying and taking

action on shared concerns.

• Mass Media Channels, which reach a large audience in a short period of

time and include:

• — Television

• — Radio

• — Newspapers

• — Magazines

• — Outdoor/Transit Advertising

• — Direct Mail

• — The Internet

• CHANNELS enable you to reach the audience

• TOOLS are the tactics used to send messages through the channels

Tools include:

*Advocacy

*Advertising

*Promotion

*Interpersonal communication

*Event creation and sponsorship

*Publicity

*Entertainment vehicles (mobile)

Barriers to effective communication

*Barriers to communication can be defined as the aspects or *conditions that interfere with effective exchange of ideas or *thoughts.

Classification of Barriers to effective Communication

Can be classified in terms of the stage of the communication

process during which the problem(s) arise(s):

• Sender/ Encoding Barriers

• Transmission/ Channel Barriers

• Receiver/ Decoding Barriers

• Feedback Barriers

Barriers to effective CommunicationEncoding Barriers

• Lack of sensitivity to receiver

• Lack of basic communication skills

• Insufficient knowledge on subject matter

• Emotional interference

• Lack of confidence

• Filtering

• Language/improper choice of words

• Projection

Transmission barriers

• Physical distraction

• Channel barriers/wrong medium selection

• Long communication chain

• Distance and time

• Noise

Decoding

Barriers

• Poor listening skills

• Lack of interest

• Lack of knowledge

• Emotional distractions

• Information overload

• Conflicting messages

• Selective perception

Responding/Feedback

barriers

• No Provision for feed back

• Inadequate feed back

Filtering:

• Filtering implies willful distortion of information.

Language:

• Words mean different things to different people. Age, education and cultural

background are three of the more obvious variables that influence the

language a person uses and the definitions he or she gives to words.

Projection:

• Projecting one's own motives into others behavior. This may affect the

expectations from the audience.

Selective Perception:

• Receivers in the communication process selectively see or

hear based on their needs, motivation, experience,

background and other personal characteristics. They also

project their interests and expectations onto the

communications as they decode them.

Information Overload:

• Individuals have a finite or limited capacity for processing

data and any information passed on beyond this capacity

results in lost information and less effective communication

Types of Barriers to Effective communication

Health education may often fail due to communication

barriers between the educator and the community –

these maybe:

1. Physiological - difficulties in hearing, expression

2. Psychological - emotional disturbances, neurosis,

levels of intelligence, language or comprehension

difficulties.

3. Environmental - Noise, invisibility, congestion

• 4. Cultural

• Illiteracy, levels of knowledge and understanding, customs, beliefs,

religion, attitudes, economic and social class differences, language

variations, cultural difficulties between foreigners and nationals,

between urban education and the rural population.

Even when health services are readily available, the social and

cultural barriers can present serious problems to the achievement of

health behaviour change. These barriers should be identified and

removed

• 5. Semantics/ Language barrier• The most common semantic barriers are listed as follows:

a. Misinterpretation of Words

b. Use of Technical Language

c. Ambiguity

• •A sender often assumes that his audience would perceive the situation as he

does or have the same opinion about an issue or understand the message as he

understands it

d. Different Languages

Overcoming barriers to effective health Communication

SENDER BARRIERS

• Clarify ideas before communicating them/the need to make consultations

• Communicate according to need of the receiver

• Use simple language,(avoid jargons) appropriate tones and gestures

• Avoid information overload

• Proper/appropriate media selection

• Ensure proper feedback

PHYSICAL BARRIERS

• Appropriate Sitting Arrangement

• Ensure Visibility & Audibility

• Environmental Comfort

• Minimize Visual/Oral Distractions

Overcoming Communication Barriers