Heather Pierce, MPH May 9, 2012

1.

2.

3.

Describe characteristics of effective health messages.

Learn cost-effective ways to create clear and compelling health communications materials. Learn how technology and social media can help increase your audience reach and engagement.

  ◦ ◦ ◦ ◦ Communication can: Increase knowledge and awareness of problems.

Influence and reinforce perceptions, beliefs, attitudes and norms.

◦ Prompt action.

Communication cannot: Compensate for inadequate or inaccessible services.

Produce sustained change in absence of parallel changes in services, technology, and policy.

Source: Making health communication programs work, 2 nd ed., NCI, 2002.

Use audience research and theory to design effective messages and create dissemination strategies that move audiences to action or link them to available services.

Inform Inspire Action

 Use Microsoft templates and SmartArt

◦ ◦ ◦ Define and understand your target audience.

Consider race, ethnicity, age, location, other demographics.

Recognize barriers and challenges to reaching your audience, getting their attention, and ensuring their understanding.

◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Telephone Emails or letters Online forums or discussion groups An intermediary to ask users on your behalf Online surveys Small focus groups with selected user types Postage-paid input or feedback cards Conferences, meetings, or chance encounters ◦ ◦ ◦ ◦ ◦ ◦ “Eavesdropping” on online gathering-spots Subscribing to users’ newsletters Holding an online chat with users User needs assessments conducted by others Public polling data or marketing profiles Social networking sites such as Facebook or Twitter

 http://www.cdc.gov/healthcommunication/Audience/ ◦ Moms ◦ ◦ ◦ ◦ Tweens Teens Internists Responsible generation ◦ ◦ Boomers Family physicians ◦ Hispanics

     Accessible to your target audience, given their use of technology or their disability related needs Useful to your audience Relevant to their needs and concerns Easy to understand, given your target users’ reading ability, dominant language, and prior knowledge of your topic Sensitive to cultural issues, beliefs, and backgrounds

 ◦ ◦ ◦ Can the people who are the audience for the material quickly and easily: Find what they need?

Understand what they find?

Act appropriately on that understanding?

Source: Center for Plain Language. (n.d.). About plain language. Retrieved August 11, 2009 from http://www.centerforplainlanguage.org/aboutpl/index.html

          Write for the average reader.

Organize to serve the reader’s needs.

Use helpful headings. Use “you” to speak to your reader. Use active voice.

Use short sentences and short sections. Use concrete familiar words.

Omit excess words.

Place words carefully. Use no more than 2 or 3 levels.

Excess words               As a means of As prescribed by in At a later date At the present time Constitutes For the purpose of Heretofore In order to On a monthly basis Pertaining to Related to So as to Should it appear that With regard to ` Plain alternatives               To Under Later Now, currently Forms, makes up To, for Until now To Monthly About Of To If About

Instead of…                 a and/or b accomplish carry out accorded accordingly addressees advantageous afford an opportunity apparent clear assist, assistance aid commence comply with Implement in order that in the amount of in the event of utilize, utilization Try…                 a or b or both do given so you helpful allow, let plain help begin, start by, per start so for if use

Before  The Dietary Guidelines for Americans recommends a half hour or more of moderate physical activity on most days, preferably every day. The activity can include brisk walking, calisthenics, home care, gardening, moderate sports exercise, and dancing.

After  Do at least 30 minutes of exercise, like brisk walking, 5 or more days a week.

    Use “chance” or “more likely” or “less likely” instead of “risk.” Talk about weight loss in pounds instead of percentage of body weight. Use “9 out of 10 people” instead of 90%. Use visuals to help explain numeric concepts.

       Attractive Relevant Supports the messages and purpose of the content Includes white space Uses images that demonstrate desired behaviors Creates good contrast between printed text and paper color; makes limited use of reverse text Shows consistency in font size and style

1.

2.

3.

4.

Awareness of one’s own cultural worldview Attitude toward cultural differences Knowledge of different cultural practices and worldviews Cross-cultural skills

   Cultural competence is achieved by identifying and understanding the needs and help-seeking behaviors of individuals and families.

Culturally competent organizations design and implement services that are tailored or matched to the unique needs of individuals, children, families, organizations, and communities served.

Practice is driven in service delivery systems by client-preferred choices, not by culturally blind or culturally free interventions.

      Communication styles (e.g., language use, non-verbal expression, sense of time, personal distance) Attitudes toward conflict (e.g., Is it OK to be direct in a conflict?) Approaches to completing tasks (e.g., How important is it to establish the personal relationship early in a collaboration?) Decision-making styles (e.g., Is authority delegated or kept to one’s self? Are decisions reached by majority rule or by consensus building?) Attitudes toward disclosure (e.g., Is it appropriate to be frank about emotions or ask about personal matters) Approaches to knowing (e.g., analytic, scientific method, or affective, intuitive) Source: DuPraw, M.E., and Axner, M. (n.d.).

challenges . Retrieved from the PBS website: Working on common cross-cultural communication http://www.pbs.org/ampu/crosscult.html

          Whether the individual or community is of primary importance Accepted roles of men, women, and children Preferred family structure Relative importance of folk wisdom, life experience, value of common sense compared with formal education and advanced degrees Ways that wealth is measured (material goods, personal relationships) Relative value placed on different age groups Whether people are more comfortable with traditions or open to new ways Favorite and forbidden foods Manner of dress and adornment Body language, particularly whether touching or proximity is permitted in specific situations

  50 million adults can’t read as well as a 4th or 5th grader.

42 million can’t read at all.

Prose Literacy Levels in the U.S.

Sources: Grim illiteracy statistics indicate Americans have a reading problem. (2007). Retrieved July 23, 2008, from the Education Portal Web site: http://education portal.com/articles/Grim_Illiteracy_Statistics_Indicate_Americans_Have_a_Reading_Problem.html

National Assessment of Adult Literacy, U.S. Department of Education.

  ◦ Reading grade levels are helpful, but not an absolute. Fry and/or SMOG ◦ ◦ ◦ ◦ ◦ ◦ Readability formulas do not measure: Cultural appeal.

Audience response to layout and graphics.

Concept density.

Familiarity of medical and scientific information.

Clarity of writing.

Reader’s motivation or readiness to learn.

Preference for homepage that showed a human face; mixed reactions to this image Strong engagement with images of people Misinterpretation of arrows Misinterpretation of numbers

Sample design guidelines Select a large default font size. Sample writing guidelines Avoid charts and tables. They are often difficult for people to understand. Create a very simple, clean design. Nothing that distracts. Use black text on a white background.

Avoid pictures that could serve as “triggers” to someone in recovery.

Use plain language.

Employ subheads and bullets wherever possible.

Place the most important information at the top of the page.

Choose images that communicate concepts literally rather than figuratively.

Avoid long pages that require scrolling.

NIDA low-literacy website on neuroscience, drug abuse prevention, and treatment

Plain language, scannable text Definitions of medical terms Illustrations that literally depict the content Guided path NIDA low-literacy website on neuroscience, drug abuse prevention, and treatment

   What do you want your audience to do?

Use action statements.

Use interactive formats where appropriate.

    Make the content meaningful and appealing to the reader.

Suggest clear, specific behaviors that are doable by the target audience. Ask readers to ask questions, take action steps, or write down action they will try to do. Use testimonials and short stories.

    Many people base their decisions on emotion rather than logic.

Most health risk messages are based on fear appeals ◦ Afraid of getting hurt, getting a disease, or dying Use of theory saves time and money because there is less trial and error. Theoretically based campaigns are more likely to succeed than those developed from inspiration alone.

 ◦ ◦ ◦ Fear appeals: Have been used since antiquity. Tend to be more effective with “copers” and “sensation seekers.” Seem to be persuasive when accompanied by “high-efficacy” messages.

Source: A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Education & Behavior , Vol. 27 (5): 59–615, October 2000.

  The use of positive emotions including humor and joy are effective in gaining attention and, in particular, the attention of individuals who may have considered themselves overly familiar with a campaign. Positive emotions including empathy and compassion may help individuals to reframe and reconsider issues that they may have considered not particularly relevant to their lives. Source: Lewis, IM. and Watson, BC, White, KM, and Tay, RST. Promoting public health messages: Should we move beyond fear-evoking appeals in road safety? Qualitative Health Research 17(1):pp. 61–74, 2007.

    Positive content is more viral than negative— but it’s more complex than that. Strong emotions such as awe, anger, and anxiety lead to viral content. Content that is weaker emotionally or even deactivating, such as sadness, is less viral. This holds true regardless of how surprising, interesting, or useful content is. Source: Berger, J, Milkman, K, 2011.

What makes online content viral? Journal of Marketing Research,

     Can you understand everything easily?

Can you find what you are looking for? Does it provide the information you need? Do you find it so interesting and informative that you want to learn more?

How could it be improved?

   ◦

Meet your audience where they are.

For example, sample dissemination strategies by age:   18–34: Digital, social media 35–49: Worksite campaigns  50–64: Reach spouses as influencers  65+: Doctors’ offices, faith-based campaigns

Match your message to the medium—and vice versa. Consider how to best use your resources.

    Push, not pull.

Craft your message so that it’s portable.

See knowledge sharing as part of an ongoing conversation.

Reach the right people—not the most people.

  

Does your audience use it?

Does it align with the rest of your communications plan?

Who will maintain it?

   Growth. More than 300 million users, and there are now more than million Tweets per day.

Trends. Facilitates viral information sharing, especially about emerging news and trends.

Reach. Has a high percentage of use among young people and various demographic groups. Source: Twitter, August 2011

      Blogs Chatrooms, forums, or online discussions Poll and survey mechanisms Communities of practice RSS feeds—make it easy for others to pick up our news without lifting a finger Web analytics

   Not everyone uses the web. Factors include age, income, education, ethnicity, and access.

Household income is the greatest predictor of Internet use for Americans.

“…mobile is playing a key role in bridging those gaps between people who have that broadband connection at home and people that don’t. It really gives people an economically viable opportunity to tap into the online world that they wouldn’t normally have.” —Aaron Smith, PEW Internet and American Life Project Source: Smith.

Mobile access helps agencies break past digital divide | Interview with Aaron (2010, July 8). Retrieved January 13, 2011, from the Pew Internet & American Life Project Web site: http://www.pewinternet.org/Media-Mentions/2010/Mobile access-helps-agencies-break-past-digital-divide.aspx

     Some 83% of American adults own cell phones and three-quarters of them (73%) send and receive text messages.

Young adults are the most avid texters by a wide margin. Cell owners between the ages of 18 and 24 exchange an average of 109.5 messages on a normal day. African American and Hispanic cell users are more intense and frequent users of all of the phone’s capabilities than whites. Minorities send more text messages and make more calls on average than their white counterparts.

Source: Pew Research Center’s Internet & American Life Project

     Teens and texting: ◦ ◦ 75% of teens between 12 and 17 own a mobile phone 1 in 3 teens send 3,000 texts per month Text messaging program designed as a smoking cessation intervention for teens ready to quit smoking Messages sent for up to 4 weeks pre‐quit and up to 6 weeks post-quit date Free with unlimited texting plan Information collected from user at sign‐up: mobile #, age, gender, quit date, and smoking frequency Data: PEW “Teens and Mobile Phones”; Lenhart, Ling, Campbell, & Purcell, 2010

      Free cell phone text messaging service for pregnant women and new moms from National Healthy Mothers, Healthy Babies Coalition Text messages sent 3 times per week; available in English and Spanish Negotiated free messages with CTIA, the Wireless Foundation, so that all messages are free—even without a text messaging plan or with limited texting plan (participating carriers) Messages are timed to the pregnant woman’s due date or the baby’s date of birth Launched in February 2010 More than 281,000 enrollees by January 2012

    Users are more likely to receive and use information that comes from a source they trust or see as credible. Hard-to-reach audiences are exactly that: hard to reach. Your dissemination source can help you tailor your message so that it resonates with recipients.

Your message is carried into the networks of others, not just your own.

1.

2.

3.

Curate Crowdsource Consider new partners

Heather Pierce [email protected]