The right information for the right people

at the right timefor the intended

effect.

Communication for the public good

How do we currently communicate health

scientifically?

•Public health usual ideas:

• The data speak for themselves• Surveillance sets the agenda• Indicators set policy objectives

Is there a better way???

….

Current Use of Communication Tactics

Posters to PSAsSchool programsPeer OutreachMedical ProgramsMedia BriefingsCollaborativesTrainingNews ProgramsPaid advertisingPamphlets Billboards

Direct Mailings

CelebritiesEntertainment Media

etc.........

How do we best use communication?Hot Lines

Web Sites

Current Understanding of Communication Tactics

PSAsSchool programsPeer OutreachMedical ProgramsMedia BriefingsCollaborativesTrainingNews BriefingsPaid advertisingPamphlets Billboards

Direct Mailings

CelebritiesEntertainment Media

etc.........

No tactic aloneaccounts for very much change in behavior! Hot Lines

Web Site

The path to ideal health

GoalGoal StrategiesStrategies

Public Relations

Advocacy/’negotiation

Social Marketing

Health Literacy

Improve health decision making and behaviors

PR/Marketing Communication

• Influence the environment to help determine the agenda

• Use “earned” news media and paid advertising to gain exposure for health literacy

• Create exposure and repetition of the message

Ask your Doctor, RJ Reynolds, 1947

Social Marketing

• Use a scientifically based strategy to influence the target (intended) audience.

•Create an optimum blend of the 4P’s of marketing (product, price, promotion, place) to reduce the target audience’s perceived barriers to accepting the product.

Proactive Dissemination Communication with Sociometric science

1

23

4

5

6

7

8

9

10

11

12

1314

15

28

29

30

31

3233

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

28

29

30

31

32

33

Usual community with mavens, persuaders and connectors

The Maven/Champion/Opinion leader has his/her own networks

Persuader

Connector

Maven

Maven

Champion

Opinion leader

Negotiation

• Identify partners with an open communication process for the best decision; (collaborative consultation)

Strategic Strategic PartnershipsPartnerships

Stakeholders

NGOs; PVOs, Govt. agencies

Consumers

Explore options and Seek Alternatives

• Develop capitalwith trust andrelationships

Integrate Strategic Communication for programs:

ProgramsPrograms

PublicityPublicityPublicityPublicityPolicies Policies & & ResultsResults

Policies Policies & & ResultsResults

Technology Transfer

Develop individual norms with a baseline Health Literacy

Health Literacy is the capacity of individualsto obtain, interpret, and understand basic health information and services necessary for

appropriate health decision-making.

S. Ratzan, R. Parker , Editors, Complete Bibliography of Medicine,National Library of Medicine, National Institutes for Health 2000

Diffusion of Knowledge, Attitudes and Practices (KAP)

0

20

40

60

80

100

1 3 5 7 9 11 13 15 17 19

Time

Per

cen

t

KnowledgeAttitudePractice

Diffusion of Knowledge, Attitudes and Practices (KAP)

0

20

40

60

80

100

1 3 5 7 9 11 13 15 17 19

Time

Perc

en

t

KnowledgeAttitudePractice

Public Relations Advocacy (Social and Policy)

Social MarketingNegotiation

Create a New Social Norm

Source: http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm

Smoking Prevalence Among U.S. Adults

05

1015202530354045

Adu

lts

Smok

ing

Source: http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm

Smoking Prevalence Among U.S. Adults

05

1015202530354045

Adu

lts

Smok

ing

P RAdvocacy/Negotiation

Social Marketing

Health Literacy

Communication

Communication

Are we using communication effectively?

How much do we really know? Are we examining/measuring the

right indicators for impact and success? Or “behavioral change?”

Should there be quality standards for methodology and reporting?

Services/Policy Provider behavior

Behavior vs. Social Change:Where does communication influence?

Media

CLIENTClient

Social Change

Communication

Communication

Developing Health Competence

Public Relations

Advocacy/Negotiation

Social Marketing

Health Literacy

Communication

Communication for Health Competence

Develop health competence indicators to create dialogue and health “thinking” on the agenda

Think big with determinants and outcomes Develop intermediate goals for the three

areas:1. SYSTEM with quality 2. ENVIRONMENT with supportive activities3. INDIVIDUAL with health literacy

Create long-term outcome of health competent world

“Man’s stock of tools marks out the stages of civilization, the Stone Age, the Bronze Age, the Iron Age. Tools are a result of successive improvement: the effort of all generations is embodied in them…The tool is the direct and immediate expression of progress.

We throw out the out-of-date tool.

Final Thoughts

This action is a manifestation of health, of moral health, of morale also; it is not right that we should produce bad things because of a bad tool; nor is it right that we should waste our energy, our health, and our courage because of a bad tool, it must be thrown away and replaced

Le Corbusier, Toward a new Architecture, 1927

Final Thoughts

Pathways to a Health Competent Society Conceptual Framework -- At a glance

Domains ofCommunication

Initial OutcomesBehavioralOutcomes

SustainableHealth Outcomes

Social PoliticalEnvironment

Service DeliverySystem

Community/Individual

SupportiveEnvironment

Service Performance

Client Behaviors:

Community

Individual

Environment

Service Systems

Community

Individual

UnderlyingConditions

Context

Resources

Reduction in:

Unintended/mistimed

pregnancies

Morbidity/mortalityfrom pregnancy/

childbirth

Infant/child morbidity/mortality

HIV transmission

Threat of infectious diseases

UnderlyingConditions

Domains ofCommunication

HealthCompetence

Outcomes

En

vir

on

me

nt

Ser

vic

e S

ys

tem

sC

om

mu

nit

yIn

div

idu

al

BehavioralOutcomes

SustainableHealth Outcomes

Context

Disease Burden

Social

Cultural

Economic

Communication

Technology

Political

Legal

Reduction in:

Unintended/mistimed

pregnancies

Morbidity/mortalityfrom pregnancy/

childbirth

Infant/child morbidity/mortality

HIV transmission

Threat of infectious diseases

Resources

Human and Financial

Resources

Strategic Plan/Health

Priorities

Other Development

Programs

Policies

SupportiveEnvironment

•Multi-sectoralpartnerships

•Public opinion•Institutionalperformance

•Resource access•Media support•Activity level

Service Performance

•Access•Quality•Client volume•Client satisfaction

Client Behaviors

Community•Sanitation•Hospice/PLWA•Other actions

Individual•Timely service use•Contraception•Abstinence/partner reduction

•Condom use•Safe delivery•BF/nutrition•Child care/immuniz.•Bednet use

•Political will•Resource allocation•Policy changes•Institutional capacitybuilding

•National coalition•National comm strategy

•Availability•Technical competence•Information to client•Interpersonalcommunication

•Follow-up of clients•Integration of services

•Leadership•Participation equity•Information equity•Priority consensus•Network cohesion•Ownership•Social norms•Collective efficacy•Social capital

•Message recall•Perceived socialsupport/stigma

•Emotion and values•Beliefs and attitudes•Perceived risk•Self-efficacy•Health literacy

Pathways to a Health Competent Society

Social PoliticalEnvironment

•Community action groups•Media advocacy•Opinion leader advocacy•Organizational development•Coalition building

Service DeliverySystem

• Norms & standards• Rewards & incentives• Job/peer feedback• Job aides• Training in CPI• Supportive settings• Community outreach• Internet portals• Distance learning

Community &Individual

• Participation in social change efforts

• Strengthening social networks

• Peer support groups• Multimedia programs• Enter-education• Social marketing• Household care• Interactive media & internet