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Ten Distinguishing Ideas for Health Communication in the 21st Century

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This presentation draws upon my book, Health Communication: From Theory to Practice, Second Edition, San Francisco: Jossey-Bass, an imprint of Wiley, 2013. It was given as part of a Sept. 10, 2014 Author's Night at the New York Academy of Medicine.

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Ten Distinguishing Ideas for Health Communication in the 21st Century

  1. 1. Copyrights © Renata Schiavo, 2013, 2014
  2. 2. Renata Schiavo/About Me Founding President, Health Equity Initiative Senior Lecturer, Columbia University Mailman School of Public Health Editor-in-Chief, Journal of Communication in Healthcare: Strategies, Media and Engagement in Global Health Founder and Principal, Strategic Communication ResourcesSM Author, Health Communication: From Theory to Practice Proud NYAM Fellow 
  3. 3.  Making a difference in people’s health and lives  Tackling health disparities/helping promote health equity  Fostering conversations and interventions that help put the public back in public health  Commitment to social innovation  Developing global strategies that support local solutions  Encouraging participation and people’s ownership of health and social issues/ solutions
  4. 4.  Health Communication: A Few Definitions  Ten Distinguishing Ideas for Health Communication in the 21st Century  Health Communication in the 21st century: Why should you care?
  5. 5. “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” – Healthy People, 2010 p. 11–20; Ratzan,1994
  6. 6. Health communication is the scientific development, strategic dissemination, and critical evaluation of relevant, accurate, accessible, and understandable health information communicated to and from intended audiences to advance the health of the public. – J.M. Bernhardt , Journal of Public Health, 2004
  7. 7. “The process of understanding and sharing [health related] meanings.” – J. Pearson and P. Nelson (1991) “Health communication and other disciplines ‘may have some differences, but they share a common goal: creating social change by changing people’s attitudes, external structures, and/or modify or eliminate certain behaviors’” -- Centers for Disease Control and Prevention (2011)
  8. 8. “Health communication is a multifaceted and multidisciplinary field of research, theory, and practice. It is concerned with reaching different populations and groups to exchange health-related information, ideas, and methods in order to influence, engage, empower, and support individuals, communities, health care professionals, patients, policymakers, organizations, special groups and the public, so that they will champion, introduce, adopt, or sustain a health or social behavior, practice, or policy that will ultimately improve individual, community, and public health outcomes.” – R.Schiavo (2013)
  9. 9.  Interpersonal Communication › Provider–patient communication › Personal selling and counseling › Community dialogue (interpersonal communication at scale)  Mass Media and New Media Communication, and Public Relations  Community Mobilization and Citizen Engagement  Professional Medical Communications  Constituency Relations which lead to Strategic Partnerships in Health Communication  Policy Communication and Public Advocacy Schiavo, R. Health Communication: From Theory to Practice, San Francisco: Jossey-Bass, Second Edition, 2013. All rights reserved.
  10. 10. © Charlieaja | Dreamstime.com - Why? Photo
  11. 11.  Mirror how people talk about health and illness in real life settings  Resonance effect – “I heard it from many places”  Multiple groups and stakeholders are engaged in the same health issue = multiple group-specific approaches to communication that may rely on different areas/media  Cost-effectiveness  Increased reach among key groups and stakeholders  Increased ability to recruit and engage multiple partners  Only comprehensive programs can achieve sustainable results
  12. 12. Communication operates in a complex environment, so integration of multiple areas and media is key to effectiveness Source: Schiavo, R. Health Communication from Theory to Practice. Second Edition. San Francisco: Jossey-Bass, 2013. Figure 1.1. All rights reserved. Used by permission.
  13. 13. Multimedia communication (e.g., a combination of interpersonal, community, new media, mass media, professional clinical communication, etc) results in 35% percent increase in attention and public engagement
  14. 14. Looking at key features that may help increase communication effectiveness in the 21st century © Boyande1971 | Dreamstime.com
  15. 15.  Beyond: › Just participatory audience research, focus groups, etc. › Providing information › Sender-receiver or top down approaches  Effectively fostering ownership of health and social issues among communities, key groups and populations  Participatory planning/community engagement in all phases of health communication planning, implementation and evaluation  Key to sustainability of all interventions and related behavioral, social and organizational results
  16. 16.  Communication for Development (C4D) http://www.unicef.org/cbsc/  Communication for Behavioral Impact (COMBI) http://www.who.int/ihr/publications/combi_toolkit_outbrea ks/en/ http://www.comminit.com/combi/category/sites/global/c ombi/  Other experiences and resources on The Communication Initiative (CI) Network http://www.comminit.com/global/search/apachesolr_sear ch/community%20health%20workers?filters=tid:36
  17. 17.  Research and evaluation as an integral process of the health communication cycle › Focus on people, needs, situations, socio- political environment › In-depth understanding of key social determinants of health › In-depth situation and audience analysis › Rigorous monitoring and evaluation process › Participatory research methods › Mixed methods (online/offline, quant/qual)
  18. 18. Source: Schiavo, R. 2013, Figure 14.3 - Flu Vaccine Campaign in Whyville @ 2009 Numedeon, Inc. Used by permission.
  19. 19. Source: Schiavo, R. Health Communication: From Theory to Practice. Second Edition. Figure 10.1. San Francisco, Jossey-Bass/Wiley. All rights reserved. Used by permission.
  20. 20. Source: Schiavo, R. Health Communication from Theory to Practice. Second Edition. Figure 2.1. San Francisco: Jossey-Bass, 2013. All rights reserved. Used by permission.
  21. 21.  Don’t produce any workshop, video, brochure, or social media site before establishing a sound communication strategy  Strategy = the “how” we achieve outcomes and communication objectives  Long-term process for partnership and participation based on two-way dialogue within all phases  Beyond messages and media channels
  22. 22. “Communication goes beyond the delivery of a simple message or slogan to encompass the full range of ways in which people individually and collectively convey meaning. Among the powerful tools employed by SBCC [Social and Behavioral Change Communication] programs are mass media, community-level activities, interpersonal communication, information and communication technologies, and new media.” ~ Health Communication Capacity Collaborative (HC3), a USAID-funded project based at the John Hopkins Bloomberg School of Public Health, Center for Communication Programs Schiavo, R. Health Communication: From Theory to Practice, San Francisco: Jossey-Bass, Second Edition, 2013. © Copyright, 2013. All rights reserved.
  23. 23. Photo Credits: Courtesy of Health Equity Initiative. www.healthequityinitiative.org Used by permission. Source: Schiavo, R. Health Communication from Theory to Practice. Second Edition. San Francisco: Jossey-Bass, 2013. All rights reserved. Used by permission.
  24. 24.  A concept health communication borrows from commercial and social marketing  Inform policies/budget allocations for health communication interventions  Strongly connected to rigorous program evaluation  Need to strengthen cost-effectiveness research  Cost-benefit research can also support the importance of communication interventions  Capacity building key to all efforts
  25. 25.  The fun part!!!  Creativity is great but needs to address specific strategic needs  Refrain from creating a mix of communications vs. a communication mix
  26. 26.  Moving away from the one-message = one behavior approach to Multiple audience- and media-specific messages = multiple audience-specific health and social behaviors  Messages and activities tied together with culturally-friendly channels with highest reach
  27. 27. Mike Keefe, Intoon.com - Used by permission
  28. 28. People continue to talk about health and illness in a variety of settings, venues, and across different media Schiavo, R. Figure 14.2, 2013. All rights reserved. Used by permission
  29. 29. •“Showing instead of telling” is an old key mantra of health communication •Start your story thinking of “once upon a time…” Make it personal and relevant to others! Lynette Webb © Ilianamihaleva | Dreamstime.com © Deepta | Dreamstime.com
  30. 30. The human brain processes visual information 60,000 faster than other types of information Ref: Parkinson, M. 2012
  31. 31.  Communication as a relationship business  Good relationships = Shared meanings  Strategies to develop and manage successful multisectoral partnerships = an essential communication competency  Start early to involve potential partners/key stakeholders/communities
  32. 32.  What do you want people to do?  What happens between communication and health or social behavior?  e.g., awareness, attention, perceived risk/relevance, knowledge, dealing with and addressing multiple obstacles/existing social norms, behavior intention, perceived social support by multiple groups /levels of society, behavior readiness and adoption, behavior maintenance (in one’s lifestyle), wanting to become an ambassador/engage others, etc. SUSTAINABLE BEHAVIORAL AND SOCIAL RESULTS  Many social, economic and environmental determinants of health affect intermediate steps and behavior among key groups and stakeholders We are in the new era of BEHAVIORAL AND SOCIAL IMPACT COMMUNICATION
  33. 33. Still don’t understand health systems and its many complementary elements and participant groups?  Watch what it takes to make Maya cry in a World Bank video, Health Systems Creates Healthy Futures  Systems are made of people who can influence social determinants of health https://www.youtube.com/watch?v =PFVCNUOM5Us Source: World Bank, Sept. 2011 and 2013
  34. 34.  Did these populations participate in the health communication process?  Did we engage them via community dialogue, interpersonal communication, participatory planning, interactive media, or other community and social engagement processes?  Did the intervention had an impact among vulnerable and underserved groups? Did it help advance health equity?
  35. 35. Health communication theory and practice influences and is influenced by the key issues of our times
  36. 36.  Health disparities  Patient and community empowerment  The rise of chronic diseases  Limits of preventive medicine and behavior  A mobile, on-demand, and audience- driven communication environment  Low health literacy  Impact of managed care and other cost – cutting interventions
  37. 37.  Reemergence of communicable diseases  Worldwide urbanization  The threat of bioterrorism  International access to essential drugs  Global health workers brain drain and other capacity-building needs in developing countries
  38. 38.  Global demographic landscape reveals myriad of cities and towns  World urban population is expected nearly to double by 2050 › 6.4 billion people expected to live in cities in 2050  Long list of potential urban hazards  Disproportionate inequalities among large groups of city dwellers › Within and between urban areas › Significant numbers of early death and debilitating diseases › Health inequalities reflect larger social inequalities
  39. 39. Multisectoral partnerships and multidisciplinary health communication teams are needed in order to address urban health issues (and similar issues in other settings) Schiavo, R., 2013. Figure 8.7. Health outcomes as a complex construct. All rights reserved. Used by permission.
  40. 40. Reference: Schiavo, R. In Okigbo, 2013. Table 1 Source: Unpublished table from Schiavo, R. and Ramesh, R. Strategic Communication in Urban Health Settings: Taking the Pulse of Emerging Needs and Trends. Online report, May 4, 2010. Strategic Communication Resources, New York, NY. NY http://www.renataschiavo.com/surveyresultsnew.html. All rights reserved. Copyrights  2010 by Renata Schiavo/Strategic Communication Resources. Used by permission.
  41. 41. Ebola crisis and other outbreaks demonstrate that we need to move from the disaster “rut” to a systematic approach to risk communication in outbreak prevention and control settings Schiavo, R. Figure 6.5., 2013. All rights reserved. Used by permission.
  42. 42.  Focus on: › Prevention › Community mobilization and community health workers strategies › Helping remove barriers to healthy behaviors and access to services and information › Being inclusive of vulnerable and underserved populations – we cannot afford otherwise › Key role of constituency relations and multi- sectoral partnerships
  43. 43.  Experiencing a recent “renaissance”  Critical to: › Promoting health equity/eliminating disparities › Increasing access to health services › Engaging and empowering communities and key groups to address key social determinants of health  Considered one of the most important disciplines in public health and healthcare › Anthrax crisis propelled communication to forefront of public health › Healthy People 2010 helped set guidance for increased visibility/integration of health communication in public health › Several international initiatives galvanizing field (e.g., communication for development, C4D, COMBI, HC3, centers of excellence,, etc. ) Schiavo, R. Health Communication: From Theory to Practice, San Francisco: Jossey-Bass, Second Edition, 2013. All rights reserved.
  44. 44.  Significant advances of health communication theory and practice across different fields and sectors, including public health, healthcare and community/social development  Health Communication Working Group (HCWG), part of American Public Health Association (APHA) Public Health Education and Health Promotion (PHEHP) section, founded in1998  Strong presence at APHA annual meetings  Multiple sessions, annual film festival, business meetings and social event Schiavo, R. Health Communication: From Theory to Practice, San Francisco: Jossey-Bass, Second Edition, 2013. All rights reserved.
  45. 45.  A main focus of Healthy People 2020 and several current and upcoming international agendas, models, and organizations › UNICEF – Communication for Development › WHO – Communication for Behavioral Impact › CDC – CDCynergy – Health Communication and Public Health Emergency Communication modules › Dedicated health communication divisions of the National Communication Association (NCA) and International Communication Association (ICA)  Several new positions started in past few years › Includes academia, governments, non-profit organizations, corporations, hospitals, foundations, etc. › Increasingly the focus is on the complex and multifaceted role of health communication Schiavo, R. Health Communication: From Theory to Practice, San Francisco: Jossey-Bass, Second Edition, 2013. All rights reserved.
  46. 46. To help SAVE LIVES! © Elya1000 | Dreamstime.com - People Having Fun Photo © Xidong Luo | Dreamstime.com
  47. 47. Renata Schiavo, PhD, MA www.renataschiavo.com This presentation draws upon Schiavo, R. Health Communication: From Theory to Practice, San Francisco: Jossey-Bass, Second Edition, 2013. All rights reserved. http://www.wiley.com/WileyCDA/WileyTitle/productCd-1118122194.html

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