1. The right information for the right people at the right time for the intended effect. Communication for the public good

2. 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??? ….

3. Current Use of Communication Tactics Posters to PSAs School programs Peer Outreach Medical Programs Media Briefings Collaboratives Training News Programs Paid advertising Pamphlets Billboards Direct Mailings Celebrities Entertainment Media etc......... How do we best use communication? Hot Lines Web Sites

4. Current Understanding of Communication Tactics PSAs School programs Peer Outreach Medical Programs Media Briefings Collaboratives Training News Briefings Paid advertising Pamphlets Billboards Direct Mailings Celebrities Entertainment Media etc......... No tactic alone accounts for very much change in behavior! Hot Lines Web Site

5. The path to ideal healthGoal Strategies Public Relations Advocacy/’negotiation Social Marketing Health Literacy Improve health decision making and behaviors

6. 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

7. 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.

8. Proactive Dissemination Communication with Sociometric science Usual community with mavens, persuaders and connectors The Maven/Champion/Opinion leader has his/her own networks Persuader Connector Maven Champion Opinion leader

9. Negotiation Identify partners with an open communication process for the best decision; (collaborative consultation) Strategic Partnerships Stakeholders NGOs; PVOs, Govt. agencies Consumers Explore options and Seek Alternatives Develop capital with trust and relationships

10. Integrate Strategic Communication for programs: Programs PublicityPublicity Policies & Results Technology Transfer

11. Develop individual norms with a baseline Health Literacy Health Literacy is the capacity of individuals to 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

12. Diffusion of Knowledge, Attitudes and Practices (KAP)

13. Public Relations Advocacy (Social and Policy) Social Marketing Negotiation Create a New Social Norm

14. Source: http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm Smoking Prevalence Among U.S. Adults

15. Source: http://www.cdc.gov/tobacco/research_data/adults_prev/prevali.htm Smoking Prevalence Among U.S. Adults P R Advocacy/Negotiation Social Marketing Health LiteracyCommunication

16. Are we using communication effectively? l How much do we really know? l Are we examining/measuring the right indicators for impact and success? Or “behavioral change?” l Should there be quality standards for methodology and reporting?

17. Services/Policy Provider behavior Behavior vs. Social Change: Where does communication influence? Media CLIENT Client Social Change Communication

18. Developing Health Competence Public Relations Advocacy/Negotiation Social Marketing Health Literacy Communication

19. Communication for Health Competence l Develop health competence indicators to create dialogue and health “thinking” on the agenda l Think big with determinants and outcomes l Develop intermediate goals for the three areas: 1. SYSTEM with quality 2. ENVIRONMENT with supportive activities 3. INDIVIDUAL with health literacy l Create long-term outcome of health competent world

20. “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

21. 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

22. Pathways to a Health Competent Society Conceptual Framework -- At a glance Domains of Communication Initial Outcomes Behavioral Outcomes Sustainable Health Outcomes Social Political Environment Service Delivery System Community/ Individual Supportive Environment Service Performance Client Behaviors: Community Individual Environment Service Systems Community Individual Underlying Conditions Context Resources Reduction in: Unintended/ mistimed pregnancies Morbidity/mortality from pregnancy/ childbirth Infant/child morbidity/mortality HIV transmission Threat of infectious diseases

23. Underlying Conditions Domains of Communication Health Competence Outcomes Environment Service Systems Community Individual Behavioral Outcomes Sustainable Health Outcomes Context Disease Burden Social Cultural Economic Communication Technology Political Legal Reduction in: Unintended/ mistimed pregnancies Morbidity/mortality from 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 Supportive Environment Multi-sectoral partnerships Public opinion Institutional performance 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 capacity building National coalition National comm strategy Availability Technical competence Information to client Interpersonal communication 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 social support/stigma Emotion and values Beliefs and attitudes Perceived risk Self-efficacy Health literacy Pathways to a Health Competent Society Social Political Environment Community action groups Media advocacy Opinion leader advocacy Organizational development Coalition building Service Delivery System 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