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Health Communication: “This is our time” Cartagena, Spain 7June 2013 Franklin Apfel MD, MHS – Managing Director, World Health Communication Associates.

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Presentation on theme: "Health Communication: “This is our time” Cartagena, Spain 7June 2013 Franklin Apfel MD, MHS – Managing Director, World Health Communication Associates."— Presentation transcript:

1 Health Communication: “This is our time” Cartagena, Spain 7June 2013 Franklin Apfel MD, MHS – Managing Director, World Health Communication Associates (WHCA)

2 Aim 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

3 What 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)

4 Conversation- dialogue Communication is a 2-way reality

5 Audience centred or insight based approach starting with ‘the audience ’ Two-way thinking Traditional 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’

6 The behavioural challenge Car seats = self evidently safer! Directly reducing injury & deaths Car seats = self evidently safer! Directly reducing injury & deaths

7 Priests bless the car seats Priests bless the car seats How to create a valued product or service? Child care seats & Hispanic mums AED CORE INSIGHTS ‘My child is safest in my arms’ ‘God will decide when to take my baby’ ‘God will decide when to take my baby’

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11 “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

12 ‘ INSIGHT’ is the key Supply Side logic Socio political logic Binge 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)

13 Why (1) is Health communication is an determinant of health

14 Determinants of health Dahlgren and Whitehead’s Rainbow Model Dahlgren and Whitehead, 1993

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16 Health literacy is the key mediating factor and metric Dahlgren and Whitehead, 1993 Health literacy friendliness Social norms Hazard Marketing

17 Health Literacy The capacity to obtain, interpret, understand and use health information and services to enhance health.

18 HLS-EU Definition

19 Measuring health literacy- the questions

20 Country scores ( HLS-EU consortium,2012)

21 Inadequate and problematic health literacy – inequities

22 Health outcomes of “ inadequate and problematic” health Literacy Poorer health choices Riskier behaviours Less use of preventive services More delayed diagnoses Poorer understanding of medical conditions Less adherence to medical instructions Poorer self-management skills Increased risk of hospitalization Poorer physical and mental health Increased mortality risk Higher health costs

23 Health Literacy for all and by all People- risk assessment, disease prevention, health care seeking, disease management Providers- social determinants of health, patient centered care Policy Makers- Health in all policies

24 THE 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.

25 Many sectors and settings Health Systems Education Media health information marketplaces Home Community Workplace Policy Making Arenas

26 Why (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

27 Are you part of the “we” ? When you think of a health communicator- what is your image ?

28 Many have this image The “spokesperson”

29 At the bedside

30 In the clinic

31 Workplace

32 In the community

33 Public health is all about communication We are all communicators! In fact % of most public health workers time relates to communication Provider-patient, s,social media, conferences, report writing, telephoning, intelligence/insight gathering, publishing,reading, advocating, talking to ourselves and others

34 Making health systems more health literacy friendly Adopting “universal precautions”

35 (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 understandable Provides “navigator” assistance where needed

36 Strengthen our communication skills Use health literacy strategies in interpersonal communication and confirm understanding at all points of contact teach-back, show-me or chunk-and-checkConfirm 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 language Limit to two to three messages at a time Use easily understood symbols in way-finding signage

37 Engage 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 testing Use a quality translation process to produce materials in languages other than the dominant language

38 Use new and old tools to enhance our impact and reach Tools Framing Formative research Social Marketing Media Advocacy Advocacy communication Lobbying Internet based advocacy Networking Platforms Print media Television Radio Internet Social media M-Health Community –based Personal

39 Framing 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

40 Learning from the Hazard merchants

41 Big Tobacco Framing Reframing

42 Reframing Alcohol Ads Less is better Linking alcohol and abuse

43 Reframe investment decisions Value not cost

44 Use new platforms – to enhance our skills

45 To empower

46 To gather intelligence (Citizen Science)

47 To interact- social media sites

48 Why social media is critical

49 To connect More mobile phones than toilets Out 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).

50 Implications for health communications Unprecedented access to information Monologue- dialogue Rapid Anywhere, anytime

51 m-Health Patient diagnostic and treatment support - Identifying patient symptoms correctly Healthcare provider training & communications support - Expediting the delivery of medical treatment Remote patient data collection - Monitoring effectiveness of treatment options

52 m-Health cont Remote patient monitoring - Increasing patient compliance with prescribed treatment Education and awareness - Empowering patients to make better informed decisions Citizen science Collecting data, surveys Disease and epidemic outbreak tracking - Providing decision makers with timely, location- related information

53 Example : Digital Health Scorecard

54 Seven Risk factors

55 A single number score

56 To entertain- edutainment Educational soaps

57 To inform- work with journalists as key health information intermediaries

58 And much much more … Just a taste… Lets make some healthy “noise” together

59 Thank You Contact


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