This document summarizes a 3-year project funded by the European Centre for Disease Prevention and Control to build capacity for health communication regarding communicable diseases in Europe. The project involved gathering information from stakeholders, conducting literature reviews, and developing recommendations. Key findings include limited evidence and variability in health communication approaches across countries in Europe. Recommendations focus on developing organizational structures, partnerships, dedicated funding, leadership, and workforce training to strengthen health communication capacity.

1. Translating Health Communication Programme:
Implications for Capacity Development
Establishing a programme for dissemination of evidence based health
communication activities and innovations on communicable diseases
for country support in the EU and EEA/EFTA 2009-12
Professor Margaret Barry
Health Promotion Research Centre
National University of Ireland Galway
Ollscoil na hÉireann, Gaillimh

2. Project Funding
This research project was commissioned by the
European Centre for Disease Prevention and Control (ECDC)
http://www.ecdc.europa.eu/en/Pages/home.aspx
Duration of Project: 3 years
Start Date: December 2009

3. Project Consortium
Co-ordinating centre:
Health Promotion Research Centre, NUI Galway, Ireland
Consortium partners:
Institute for Social Marketing, University of Stirling, Scotland
University of Navarra Clinic, Pamplona, Spain.
Consortium members:
Health Promotion Research Centre, NUI Galway, Ireland
Professor M. Barry, Dr J. Sixsmith, Ms P. Doyle, Ms. M. D’Eath, Dr S. Mahmood, Ms M. O’Sullivan and
Dr C. Domegan, Discipline of Marketing.
Institute for Social Marketing & Centre for Tobacco Control Research,
University of Stirling, Scotland
Professor G. Hastings, Ms G. Cairns, Ms L. McDonald, Ms K. Angus,
University of Navarra Clinic, Pamplona, Spain.
Dr F. Guillen-Grima, Dr C. Oroviogoichoechea, Dr J. Nunez-Cordoba

4. Overall Programme Aim (2009-2012)
To build capacity and support the optimal use and
development of health communication activities for
communicable diseases in EU and EEA countries.

5. Methodology
• Knowledge Inquiry:
– Primary information gathering - e-survey and telephone interviews with 109 key
stakeholders across the 30 EU and EEA countries
– Synthesis of evidence - series of nine reviews (literature reviews, rapid evidence
reviews, systematic reviews)
• Knowledge Consolidation – SWOC analysis to consolidate the project outputs
– Strengths and weaknesses of the evidence base for health communication in
Europe
– Opportunities and challenges for strategic development - an online expert
consultation process
• Knowledge Translation - project findings used to inform capacity development
for policy and practice (Knowledge to Action Processes Framework)

6. Methodology
Knowledge to Action
Processes Framework
(KTA)
Knowledge is distilled as it is
funnelled through these
phases:
1. Knowledge Inquiry -
through primary
information gathering
activities
2. Knowledge Synthesis - a
series of reviews
synthesising
current knowledge
3. Knowledge Consolidation
- SWOC analysis
4. Knowledge Translation -
capacity development
for policy and practice
SWOC Analysis
Online
Consultation
Public Health
Capacity
Development
Primary
Information
Gathering
Synthesis of
Evidence

7. Results – Current Evidence
The synthesis of evidence highlighted some key strengths
and gaps in the European evidence base currently available
for health communication and communicable diseases
Strengths
• An emerging body of knowledge concerning core concepts and
• theoretical models - health literacy, health advocacy, promotion of
• immunisation uptake and behaviour change
• Resources exist in the form of toolkits and
guides for developing, implementing and evaluating health
communication activities

8. Results – Current Evidence
Weaknesses
• Limited evidence base on intervention research for communicable
• diseases in a European context
• Methodological variability – lack of rigorous evaluation,
standardised measures, and inconsistent reporting
• Limited consensus about the concepts relating to: social
marketing, health information-seeking, risk communication,
campaign evaluation, trust and reputation management
• Limited inclusion of disadvantaged and hard-to-reach
populations in current research

9. Results – Current Practice
Opportunities
• Greater coordination, collaboration and the development of strong
partnerships
• Explore the transferability of knowledge from noncommunicable to
communicable diseases
• Establish a common, consistent and shared glossary
• Develop the use and application of new media
• Enhance education and training in health communication
• Conduct research on the systematic use of evidence and evaluation
• Invest in formative research and audience segmentation

10. Results – Current Practice
Challenges
• The political, administrative, linguistic and cultural diversity of countries
• Great variability between countries in terms of range and level of
activities undertaken
• Lack of dedicated national budgets and plans
• Lack of clarity regarding responsibility for health communication
activities at country level
• Communicating effectively with stakeholders
• Lack of knowledge regarding the use of new technologies
• Limited knowledge and application of evaluation methods
• Lack of education and training opportunities

11. Example of Health Literacy
Barry, D’Eath & Sixsmith (2013) Interventions for Improving Population Health Literacy: Insights
from a rapid review of the evidence. Journal of Health Communication
• Paucity of intervention studies relating to population health literacy with
regard to the prevention and control of communicable diseases
– 5 reviews covering 83 studies –only 3 studies related to communicable disease (medication
adherence)
• Majority of published research is produced in the US and concerns
functional health literacy
• Greater clarity around the concept of health literacy and its measurement –
wider dimensions (e.g. HLS-EU-Q - Sørenson et al., 2012)
• Strategies for enhancing population health literacy – promotion, prevention
and healthcare; access, appraise and apply information
• Small number of studies on the use of online technologies
• Little evidence of inclusion of disadvantaged and hard-to-reach groups in
reviews
• Strategic action at the European level on the effective development,
implementation and evaluation of health literacy interventions

12. Future Developments
Organisational Structures
• Health communication should be incorporated into planning and
implementation of all public health policies
• Capacity would be improved by enhanced collaborative working and
greater coordination
Partnerships
• Could potentially limit costs, facilitate transnational approaches and
ensure a commonality of health messages
• Utilise a citizen-centred approach – social dialogue, build public trust
Financial resources
• Dedicated budgets - greater use of evaluation, including cost-
effectiveness, will equip policymakers with the relevant evidence

13. Future Developments
Leadership and Governance
• Development of formal structures within Public Health Authorities or
Ministries of Health – clear lines of responsibility
• Future communication needs to be inclusive and focus on reducing
disparities and inequalities
Knowledge Development
• Development of systematic evaluation - identifying indicators of success
• Explore the transferability of knowledge and resources from
noncommunicable diseases to communicable diseases
Workforce
• More structured education and training for health communication

14. Acknowledgements
• We acknowledge the support of ECDC Competent Bodies, public health
practitioners and experts that participated in this project
• We would also like to acknowledge the support of ECDC and the Research
Consortium Partners
References:
• Sixsmith, Doyle, D’Eath and Barry (2013) Translating Health Communication for
the Prevention and Control of Communicable Diseases in Europe: Current
Evidence, Practice and Future Developments. Stockholm: ECDC
• Special Issue of the Journal of Health Communication, 2013 (in press)
• Further project details and outputs are available at: www.ecdc.europa.eu