What Works in Health Communications?

1. What Works in Health Communications? A Prevention Works!Resource Kit for the National Prevention Network

2. Diffusion of Innovation “Diffusion is the process by which an innovation is communicated through certain channels over time among the members of a social system.” —Everett M. Rogers, Diffusion of Innovations, 1983, p. 3

3. What Is Health Communications? “The art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues. The scope of health communication includes disease prevention, health promotion, health care policy, and the business of health care as well as enhancement of the quality of life and health of individuals within the community.” Source: Healthy People 2010

4. What Is Health Communications? “The study and use of communication strategies to inform and influence individual and community decisions that enhance health.” Source: Making Health Communication Programs Work, Rev. September 2002, National Institutes of Health/National Cancer Institute

5. What Is Social Marketing? “The application of marketing principles and techniques to program development, implementation, and evaluation to promote healthy behaviors or reduce risky ones.” Source: Social Marketing Institute, www.social-marketing.org

6. What Is Social Marketing? “Social marketing is...the design, implementation, and control of programs developed to influence the social acceptability of a social idea or cause by a group. It has its roots in both commercial marketing and social reform campaigns, such as the abolition of slavery and campaigns for government regulation of the quality of food and drugs.” Source: CSAP’s Prevention Primer, http://ncadi.samhsa.gov/govpubs/phd627/smarket.aspx

7. What’s the Difference? • Social marketing typically encompasses more extensive consumer market research, with behavior change as the goal.* • Communication can promote improved health. But by itself it cannot cause sustained behavior change.* *Source: Making Health Communication Programs Work, Rev. September 2002, National Institutes of Health/National Cancer Institute

8. Social Marketing and Prevention “Prevention practitioners working to communicate messages to reduce alcohol, tobacco, and drug problems have embraced techniques of social marketing as well as media advocacy as part of an overall environmental approach to problem reduction. In a society with heavy reliance on mass media and a crowded message environment, the art of social marketing can make a valuable contribution to prevention efforts.” Source: CSAP’s Prevention Primer, http://ncadi.samhsa.gov/govpubs/phd627/smarket.aspx

9. Importance of Health Communications “Health communication can contribute to all aspects of disease prevention and control, health promotion, and medical…care. “Communication is critical to the work of health professionals and their interactions with each other, their patients, and the information they create and use.” Source:Communicating Health: Priorities and Strategies for Progress, Office of Disease Prevention and Health Promotion, DHHS, July 2003

10. Importance of Working With Media “The media’s powerful influence and ‘reach’ are indispensable for raising awareness, altering beliefs and behavior, changing community ‘norms,’ and affecting policy decisions.” Source: Strategizer 42, Building Public Support Through Media Relations, Community Anti-Drug Coalitions of America, (undated)

11. The Bad News: What Communications Cannot Do • Make up for inadequate health care services or access to services • Produce sustained behavior change without the support of other programs for change • Be equally effective in addressing all issues or relaying all messages. Source: Making Health Communication Programs Work, Rev. September 2002, National Institutes of Health/National Cancer Institute

12. Why Communications Cannot Be Equally Effective With All Issues... Some topics or proposed behavior change may be complex (e.g., use of disulfaram/antabuse); the intended audience may have preconceptions about the topic (e.g., “alcoholic”) or the messenger (e.g., Women’s Christian Temperance Union); the topic may be controversial (e.g., methadone maintenance). Source: Making Health Communication Programs Work, Rev. September 2002, National Institutes of Health/National Cancer Institute

13. What Communications Can Do • Increase audience knowledge, awareness • Influence perceptions, beliefs, attitudes • Prompt action • Demonstrate/illustrate healthy skills • Reinforce knowledge, attitudes, behavior • Show benefits of behavior change.

14. What Communications Can Do • Advocate a position on an issue/policy • Increase demand or support for services • Refute myths, misconceptions • Strengthen organizational relationships.

15. Communications Combined With Other Strategies Can… • Cause sustained change in individual behavior, organizational policy • Overcome barriers/systemic problems, such as insufficient access to care. Source: Making Health Communication Programs Work, Rev. September 2002, National Institutes of Health/National Cancer Institute

16. Communications Can Affect Multiple Types of Change • Individuals • Groups • Organizations • Communities • Society.

17. Communications Can Include Multiple Methods of Influence • Media literacy • Media advocacy • Public relations • Advertising • Educational entertainment • Individual/group instruction • Partnership development. Source: Making Health Communication Programs Work, Rev. September 2002, National Institutes of Health/National Cancer Institute

18. “The Four Ps”of Social Marketing • Product: Create an enticing product (the package of benefits associated with the desired action) • Price: Minimize the price the target audience believes it must pay in the exchange • Placement: Make the exchange and its opportunities available in placesthat reach the audience and fit its lifestyles • Promotion: Promote the exchange opportunity with creativity and through channels and tactics that maximize desired responses. Source: Social Marketing Institute, www.social-marketing.org

19. Four More “Ps” for Social Marketing in Prevention • Partnerships: Teaming up with other community organizations that have similar goals • Public relations: Fostering a public image that increases public recognition of an agency, organization, or program • Policy: Creating an environment that supports change over the long term • Politics: Building support within all sectors of the community.

20. CSAP’s Communications Programs and Initiatives CSAP’s communications programs and initiatives have both strong communications and social marketing underpinnings. CSAP follows the four-stage communications planning process.

21. 6 5 4 3 2 1 Rogers’s “Diffusion of Innovation” Theory 1. Creating awareness. 2. Getting the facts. 3. Thinking about changing the behavior. 4. Examining the social consequences. 5. Changing the behavior. 6. Making a lifetime commitment to behavior change.

22. Some Audience Members Adopt Change Sooner Than Others

23. Another Way To Visualize the Rate of Change Among Audience Members

24. Four-Step Planning Process 1. Planning and Strategy Development 2. Developing and Pretesting Concepts, Messages, and Materials 3. Implementing the Program • Assessing Effectiveness and Making Refinements

25. Four-Step Planning Process Wheel

26. #1 Priority for Communications:Make a Plan “Alice came to a fork in the road. ‘Which road do I take?’ she asked. ‘Where do you want to go?’ responded the Cheshire cat. ‘I don’t know,’ Alice answered. ‘Then,’ said the cat, ‘It doesn’t much matter. If you don’t know where you are going, any road will get you there.’” —Lewis Carroll, Alice in Wonderland, 1865

27. Put it in Writing! A written plan helps identify and resolve gaps, identifies available and needed resources, and provides a roadmap to help you see where and when to adjust your strategy over time.

28. Questions the Plan Should Answer • What is the communications goal? • Who is the target audience? • What is the message for this audience? • Does the message/material work? • How will this plan be implemented? • How will you know if it works? (evaluation)

29. Communications Successes in Prevention “Nearly half of all living adults who ever smoked have quit. The anti-smoking campaign has been a major public health success…. This achievement has few parallels in the history of public health. It was accomplished despite the addictive nature of tobacco and the powerful economic forces promoting its use.” Source:“History of the 1964 Surgeon General’s Report on Smoking and Health,” CDC, 2004, http://www.cdc.gov/tobacco/30yrsgen.htm

30. Communications Successes in Prevention The National Youth Anti-Drug Media Campaign: • The percentage of teens seeing/hearing messages rose from 32 percent in 1998 to 52 percent in 2003. • The number of teens who “learned a lot” from anti-drug ads increased 65 percent, from one in five to one in three, between 1998 and 2003. Source: Partnership Attitude Tracking Study: Teens 2003, Partnership for a Drug-Free America, http://www.drugfreeamerica.org/acrobat/Full_Report_PATS_Teens_2003.pdf

31. Communications Successes in Prevention In 1997, the Massachusetts Bureau of Substance Abuse Services sponsored a paid radio public service announcement to encourage parent-child communication about alcohol use. In a followup study, respondents who recalled the spot were much more likely to have three or more discussions about alcohol with their children. Source: Surkan, P.J.; DeJong, W.; Herr-Zaya, K.M.; Rodriguez-Howard, M.; Fay, K. A paid radio advertising campaign to promote parent-child communication about alcohol, Journal of Health Communication, Volume 8: 489-495, 2003

32. Communications Successes in Prevention The Washington State Division of Alcohol and Substance Abuse targeted parents of kids ages 3–10 with a 1994–1995 media campaign. The results include the following: • Nearly three in four parents recalled seeing or hearing one of the three campaign ads. • Parents who recalled the ads reported more frequent discussions with their kids about alcohol than non-recallers. • Source: GMA Research Corporation, Talking to Your Kids About Alcohol Ad Tracking Study, Wave 2, Final Report, February 1995

33. Key Resources for PlanningHealth Communications “The Pink Book” Making Health Communication Programs Work, National Institutes of Health, National Cancer Institute, Office of Cancer Communications (2001) http://cancer.gov/pinkbook

34. Key Resources for PlanningHealth Communications “Social Marketing Skills Training” CSAP’s Central Center for the Application of Prevention Technologies (CAPT)—offered as an online training at: www.ccapt.org/sm_skills.html or on a CD-ROM: www.ccapt.org/products.html

35. Key Resources for PlanningHealth Communications CDCynergy—an interactive training and decision-support tool (CD-ROM format) Centers for Disease Control and Prevention (CDC), Office of Communication: www.cdc.gov/communication/cdcynergy.htm

36. Key Resources for PlanningHealth Communications The Community Toolbox Web site created and maintained by the Work Group on Health Promotion and Community Development at the University of Kansas in Lawrence, KS, in collaboration with AHEC/Community Partners in Amherst, MA, at: http://ctb.ku.edu/