Cartagena Spain 7June 2013 Franklin Apfel MD MHS Managing Director World Health Communication Associates WHCA wwwwhcaonlineorg Aim To have a conversation with you about ID: 932528
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Health Communication: “This is our time”
Cartagena , Spain7June 2013
Franklin Apfel MD, MHS – Managing Director,World Health Communication Associates (WHCA) www.whcaonline.org
Slide2Aim
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
Slide3What 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)
Slide4Conversation- dialogue Communication is a 2-way reality
Slide5Audience 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’
Slide6The 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
AEDCORE INSIGHTS
‘My child is safest in my arms’
‘God will decide
when to take my baby’
Slide8Slide9Slide10Slide11“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
Slide12‘INSIGHT’ is the key
Supply Side logicSocio political logicBinge 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)
Slide13Why (1) is Health communication is andeterminant of health
Slide14Determinants of health Dahlgren and Whitehead’s Rainbow Model
Dahlgren and Whitehead, 1993
Slide15Slide16Health literacy is the key mediating factor and metric
Dahlgren and Whitehead, 1993
Health literacy friendlinessSocial norms
Hazard Marketing
Slide17Health Literacy
The capacity to obtain, interpret, understand and use health information and services to enhance health.
Slide18HLS-EU Definition
Slide19Measuring health literacy- the questions
Slide20Country scores( HLS-EU consortium,2012)
Slide21Inadequate and problematic health literacy – inequities
Slide22Health outcomes of “ inadequate and problematic” health Literacy
Poorer health choicesRiskier behavioursLess use of preventive services More delayed diagnoses Poorer understanding of medical conditionsLess adherence to medical instructions Poorer self-management skills Increased risk of hospitalization
Poorer physical and mental health Increased mortality riskHigher health costs
Slide23Health Literacy for all and by all People- risk assessment, disease prevention, health care seeking, disease managementProviders- social determinants of health, patient centered care Policy Makers- Health in all policies
Slide24THE 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.
Slide25Many sectors and settings Health SystemsEducationMedia health information marketplaces
Home CommunityWorkplacePolicy Making Arenas
Slide26Why (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
Slide27Are you part of the “we” ?When you think of a health communicator- what is your image ?
Slide28Many have this imageThe “spokesperson”
Slide29At the bedside
Slide30In the clinic
Slide31Workplace
Slide32In the community
Slide33Public 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
Slide34Making health systems more health literacy friendly
Adopting “universal precautions”
Slide35(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 understandableProvides “navigator” assistance where needed
Slide36Strengthen 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 languageLimit to two to three messages at a timeUse easily understood symbols in way-finding signage
Slide37Engage 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 testingUse a quality translation process to produce materials in languages other than the dominant language
Slide38Use new and old tools to enhance our impact and reach Tools Framing Formative researchSocial MarketingMedia Advocacy Advocacy communication
Lobbying Internet based advocacyNetworkingPlatforms Print mediaTelevisionRadioInternetSocial media M-HealthCommunity –basedPersonal
Slide39Framing 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
Slide40Learning from the Hazard merchants
Slide41Big TobaccoFraming Reframing
Reframing Alcohol AdsLess is better Linking alcohol and abuse
Slide43Reframe investment decisions Value not cost
Slide44Use new platforms – to enhance our skills
Slide45To empower
Slide46To gather intelligence (Citizen Science)
Slide47To interact- social media sites
Slide48Why social media is critical
Slide49To connectMore mobile phones than toiletsOut 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) .
Slide50Implications for health communicationsUnprecedented access to informationMonologue- dialogueRapidAnywhere, anytime
Slide51m-HealthPatient diagnostic and treatment supportIdentifying patient symptoms correctly Healthcare provider training & communications supportExpediting the delivery of medical treatmentRemote patient data collectionMonitoring effectiveness of treatment options
Slide52m-Health contRemote patient monitoringIncreasing patient compliance with prescribed treatmentEducation and awarenessEmpowering patients to make better
informed decisionsCitizen science Collecting data, surveys Disease and epidemic outbreak trackingProviding decision makers with timely, location-related information
Slide53Example : Digital Health Scorecard
Slide54Seven Risk factors
Slide55A single number score
Slide56To entertain- edutainment Educational soaps
Slide57To inform- work with journalists as key health information intermediaries
Slide58And much much more …Just a taste…Lets make some healthy “noise” together
Slide59Thank You www.whcaonline.org
Contact franklin@whcaonline.org