Health Communication Dr. Ume Sughra

Objectives Students shall be able to comprehend and apply: Health Communication 7 C’s of effective communication “P” process

Communication It is a requirement for life in any society. It is the process in which feelings or ideas are expressed as messages: sent, received and comprehended. The process of communication is dynamic, continuous, irreversible and transactional.

Human Communication Human communication is the process of creating meaning between two or more people. It is to transfer Ideas, Information, Norms, Values, Attitudes through message to another party so that it can be understood and acted upon.

Why do we communicate ? The importance of communication: To make people understand us and to understand others. To make us accepted. To undertake something. To strengthen the human relationships and social links. To spread the human spirit of friendship and cooperation.

Benefits in the Medical Field To improve patient compliance To improve patient satisfaction To improve health outcomes for patients To improve the accuracy and efficiency of the consultation and hence is more rewarding for the doctor

Elements Of Communication

What can hinder communication? 1- At the source or sender level Does not know or convinced with others cannot communicate the message. Does not formulate clearly the objectives or the message. Does not choose the suitable language of the receptor. Does not change the tone. The communicator must be CLEAR: C: Clarify L: Listen E: Encourage A: Appreciate R: Reassure Do not give orders. Do not attack. Do not be aggressive or ridiculous.

2- At the message level Difficult words. Is not of interest to the receiver. Is not related to the stated objectives. Unclear, confusing. 3- At the channel level Noise. Not adapted to the message transmission. Not accessible to the receptor.

4- At the receptor level Indifferent to the message. Could not decode (understand) the message. Cannot receive the message. Poor listening conditions. 5- At the feedback level Feedback not well prepared. Limited time. Selection of those who respond. Question poorly formulated.

Examples of communication skills used in the medical field: (1) Skills of history taking Welcome the patient, stand up, shack hands. Call him/her with his/her name Asking in voice tone showing your care Asking one question every time. Giving open questions. During the client's answer, help him/her to continue. Asking the question in different ways to be sure that the client is understanding.

(2) Skills of communication in Counseling Counseling is not guiding, recommending, persuading, instructing and advising. Counseling is helping one person at one time or several together in a group or family to live in more satisfying and resourceful way i.e. counseling is helping a person (or a group) to develop self-help and self-care abilities.

Importance of Counseling Counseling is valuable at any age, in health and in illness, whenever adaptation to physical psychological changes is required. It is helpful to the elderly and their care giver, as well as to children and their parents, to women at all their life stages, e.g. puberty and child bearing, motherhood and menopause. It is also helpful for women undergoing hysterectomy, mastectomy, or seeking treatment for infertility.

Communication for Health Communication and education are interwoven. Communication is more than mere exchange of information. Communication is a two-way process of exchanging or shaping ideas, feelings and information. The ultimate goal of all communication is to bring about a change in the desired direction of the person who receives the communication.

Communication Communicator: the person or the team give the message (Educator). Message: the contents (materials) of health education Channel: method of carrying the message Audience: the receivers (users or targets) of the message

Communication Process Sender Message Channel Receiver FEED BACK

Good Communication Technique Source credibility. Clear message. Good channel: individual, group & mass education. Receiver: ready, interested, not occupied. Feed back. Observe non-verbal indications(hints) Active listing. Establishing good relationship.

Counselling Face to face communication “GATHER” APPROACH G  Greet the client A  ask needs T  tell client about merit , demerit, logistics & costs of different methods H  help client in decision making E  explain & educate about chosen decision R  return for follow-up visits

Counselling

Educator Personnel of health services. Medical students, nursing & social work. School personnel. Community leaders & influentials. Requirements: Personality: popular, influential and interested in work. Efficiency trained and prepared for the job. Must show good examples.

Message What information to be communicated. Simple, at the level of understanding. Culturally accepted. Interested. Meet a felt need. Avoid technical jargon. Use audiovisual aids.

Communication Types

Communication Types ONE WAY: TWO WAY: no feed back, imposed information, passive learning, less influence TWO WAY: “Socratic method”, Q&A, feed back, democratic, discussions, more influence

Communication Types Verbal communication  only talk Non-verbal communication body movements, postures, facial expressions, touch etc. Formal communication forms e.g. toys, songs, games etc Informal communication rigid courses Visual charts, posters, maps, graphs, pictures, tables Telecommunication electro-magnetic instruments, over distance e.g. satellite, radio,TV, telephone, telegraph, telex ….“point-to-point” Internet HTTP, protocols, wireless, fiber optic

Practice 1-Individual Face to face Education through spoken word A- Occasions of health appraisal. B- Home visits Nurses Health visitors Social workers

2-Group a. Lessons and lectures in schools. Lectures in work places e.g. factories. Demonstration and training 3- Mass media. Broadcasting: radio & TV. Written word: newspapers, posters, booklets. Others e.g. theaters

Communication Barriers Physiological Difficulties in hearing, expression Psychological Emotional disturbance Environmental Noise, invisibility Cultural Knowledge, custom, believe, religion

Communication Barriers Social and cultural gap between the sender and the receiver Limited receptiveness of receiver Negative attitude (BIAS)of the sender Limited understanding and memory Insufficient emphasis by the sender (health professional) Contradictory messages Health education without identifying the “needs "of the community

7 C’s of Effective Communication

7 C’s of Effective Communication

1. Completeness The message must be complete. It should convey all the facts required by the audience. The sender of the message must take into consideration the receiver and should communicate all the facts and figures related to the message.

2. Conciseness Conciseness means communicating what you want to convey in least possible words. Conciseness is a necessity for effective communication. Concise communication has following features: It is both time-saving as well as cost-saving. It underlines and highlights the main message. Concise communication provides short and essential message in limited words to the audience. Concise message is more appealing and comprehensible to the audience.

3. Consideration Consideration implies “stepping into the shoes of others”. Effective communication must take the audience into consideration, i.e, the audience’s view points, background, mind-set, education level, etc. Make an attempt to envisage your audience, their requirements, emotions as well as problems. Ensure that the self-respect of the audience is maintained and their emotions are not at harm.

4. Clarity Clarity implies emphasizing on a specific message or goal at a time, rather than trying to achieve too much at once. Clarity in communication has following features: It makes understanding easier. Complete clarity of thoughts and ideas enhances the meaning of message. Clear message makes use of exact, appropriate and concrete words

5. Concreteness Concrete communication implies being particular and clear rather than fuzzy and general. Concreteness strengthens the confidence. Concrete message has following features: It is supported with specific facts and figures. It makes use of words that are clear and that build the reputation. Concrete messages are not misinterpreted

6. Courtesy Courtesy in message implies the message should show the sender’s expression as well as should respect the receiver. The sender of the message should be sincerely polite, judicious, reflective and enthusiastic. Courteous message has following features: Courtesy implies taking into consideration both viewpoints as well as feelings of the receiver of the message. Courteous message is positive and focused at the audience. It makes use of terms showing respect for the receiver of message. It is not at all biased

7. Correctness The message is exact, correct and well- timed. Correctness in communication implies that there are no grammatical errors in communication. Correct communication has following features: The message is exact, correct and well- timed. If the communication is correct, it boosts up the confidence level. Correct message has greater impact on the audience/ readers. It checks for the precision and accurateness of facts and figures used in the message. It makes use of appropriate and correct language in the message.

‘P’ Process

P Process It is a strategic communication process Step-by-step framework Road map leading to strategic and participatory programs

‘P’ Process

The P - Process Step 1 Analysis Step 2 Strategic Design Step 3 Development & Testing Step 4 Implementation & Monitoring Step 5 Evaluation & Replanning

Cross-Cutting: Participation & Capacity Strengthening A strong communication program should fully engage multiple stakeholders at the national, district, and community level. Capacity Strengthening: A successful plan always considers ways to build capacity at the institutional and community level.

Step 1: Analysis Where are we now? Using a tobacco control lens Health priorities Culture-social norms People Policies Existing programs Local organizations Communication channels

What Is Analysis? Analysis is a process to: Three areas of analysis Examine the environment in which you will operate Determine the problems, their severity, and causes Identify factors inhibiting or facilitating desired changes Three areas of analysis Context Programs Audience

1. Context Country-level trends and demographics Smoking prevalence and habits Tobacco influence (economics, politics) Legal framework (FCTC-ratified?—etc.)

2. Programs Existing tobacco control programs Partners or potential partners Gaps in current program environment that need to be filled Funding

3. Audience Knowledge, attitudes, and behaviors of key audiences Policymakers, smokers Men/women/youth, nonsmokers exposed to environmental smoke, youth Determine states of readiness Not thinking of it Thinking but not acting Taking smoking outside Actively trying to quit Advocating for others to quit

Step 2: Strategic Design What do we want to do? Guides objectives, concepts, audiences, execution, evaluation

Strategic Design Strategic design is a process to determine: Where are we now (analysis) Where we want to be (objectives) How we’ll get there (strategies) What we’ll do (tactics) Resources to employ (budgets, people, partners) Output is a plan to guide implementation

Objectives Objectives should be SMART Specific Measurable Appropriate Realistic Time bound A SMART objective: to increase the percentage of Jordanian homes that are smoke-free by 10 percentage points by 2009

Strategies What steps will you take to accomplish your objectives? Identify audiences Develop a strategy brief detailing campaigns (tactics) Draw up an implementation plan Develop a monitoring and evaluation plan

Identify Audiences Legislators, policy makers, political leaders Smokers (men, women, youth) Non-smokers Health professionals, teachers, intermediaries Media professionals, journalists

Identify Audiences Determine objectives for each audience segment Determine the “overall strategic approach” for achieving objectives with each segment Determine relationships across audience segments and how approaches are best aligned

Draw up an Implementation Plan The implementation plan details how the work will get done and may include: Specific details on what will be done, when, by whom Gantt charts, which illustrate both phasing of campaign elements and key stages/milestones in development and implementation Individual “strategy briefs” for specific communication campaign elements

Develop a Strategy Brief You can develop: A strategy brief for the larger campaign A separate strategy brief for each element of the larger campaign A strategy brief is brief! Develop an outline using short statements

Develop a Strategy Brief The strategy brief for each campaign component outlines: The specific campaign element (TV ad, billboard, formal presentation) Primary audience Communication objective Key promise and benefit (main message) Supporting statements (reinforcing copy points) Desired action response Additional requirements Executional considerations

Develop a Strategy Brief Activities and channels to consider Advocacy Advertising Entertainment-education programs Community mobilization Interpersonal communication/counseling

Develop a Monitoring and Evaluation Plan Budget, people, partners Be sure to include resources for analysis, testing of materials, and evaluation Be aware that partnerships with media and others can help reduce some costs

The Communication Strategy Plan The communication strategy plan should be: Formal—but not final Reviewed and used—all the time Flexible—for change due to: Budgets, environment, audiences, opportunities, and counter-moves by the tobacco industry

Strategic Design: Recap A good communication strategy includes: Understanding the problem (analysis) Communication objectives Target audiences and audience segmentation Objectives for each audience/segment Overarching strategies and why they’ll work Campaign elements and how they fit together

Strategic Design: Recap A good communication strategy includes: Implementation plan How will the campaign work What will be done When will it be done Who will do it How will it be phased, placed, orchestrated, and managed Monitoring and evaluation How to measure impact (process/outcome) Budget Less is more

Social Marketing

Social Marketing Social marketing is the systematic application of marketing, along with other concepts and techniques, to achieve specific behavioral goals for a social good

Social Marketing Social marketing is the use of marketing principles & techniques to develop & promote socially beneficial programs, behaviors, & other products. In public health, social marketing has shown great promise as a strategic planning process for developing behavior change interventions and improving service delivery.

Distinctive Features Data-driven strategic planning process Relience on marketing’s conceptual framework  Voluntary Behavior Change Commitment to create satisfying exchanges Use of marketing mix to design interventions Segmentation of the target populations Data-based consumer orientation

The primary aim of 'social marketing' is 'social good', while in 'commercial marketing' the aim is primarily 'financial'. This does not mean that commercial marketers can not contribute to achievement of social good. Increasingly, social marketing is being described as having 'two parents' - a 'social parent' = social sciences and social policy, and a 'marketing parent' = commercial and public sector marketing approaches

“If we want things to stay as they are, things will have to change” Guiseppe di Lampedusa (1957)

Health Social marketing must not be confused with Social media marketing

Steps In The Social Marketing Process Audience analysis: Cause s & audience affected, formative research  to understand issue from the consumers’ viewpoint Strategy development: Research findings  marketing decision, blueprint, plan to guide program development, identifies target audience, partners to support, core product to offer, strategies to lower costs Program development: Interventions are developed, prototype materials, training & promotional activities Program implementation Program monitoring and evaluation: All aspects of program interventions are monitored to identify unforeseen problems that may require midcourse revisions to improve their effectiveness.

Applications Family planning Breastfeeding Increase fruit and vegetable consumption Physical activity Immunization Environmental protection Variety of safety practices & healthy behaviors

Applications SMART (Social Marketing and Assessment Response Tool). Health promotion campaigns in the late 1980s began applying social marketing in practice AIDS controlling programmes are largely using social marketing and social workers are largely working for it. Most of the social workers are professionally trained for this particular task SMARTER OBJECTIVES: Specific, Measurable, Attainable, Relevant and Time-sensitive with the addition of the words Evaluate and Reevaluate 

SMART & SMARTER SMART (Social Marketing and Assessment Response Tool). SMARTER OBJECTIVES: Specific, Measurable, Attainable, Relevan t and Time-sensitive with the addition of the words Evaluate and Reevaluate 

The planning process takes this consumer focus into account by addressing the elements of the "marketing mix.“ As an example, the marketing mix strategy for a breast cancer screening campaign for older women might include the following elements: The product could be any of these three behaviors: getting an annual mammogram, seeing a physician each year for a breast exam and performing monthly breast self-exams. The price of engaging in these behaviors includes the monetary costs of the mammogram and exam, potential discomfort and/or embarrassment, time and even the possibility of actually finding a lump.

Eight Essential Components Of Social Marketing A consumer orientation to realize organizational (social) goals An emphasis on the voluntary exchanges of goods and services between providers and consumers Research in audience analysis and segmentation strategies The use of formative research in product and message design and the pretesting of these materials

Eight Essential Components Of Social Marketing An analysis of distribution (or communication) channels Use of the marketing mix - utilizing and blending product, price, place and promotion characteristics in intervention planning and implementation A process tracking system with both integrative and control functions A management process that involves problem analysis, planning, implementation and feedback functions

THINK POSITIVE

THINK BIG

THINK DIFFERENT