1. 1 Does Your Message Have the Same Old Frame? Message Framing and Health Disparities NPHIC Annual Conference September 2007 Susan D. Kirby, Dr.P.H. susan@kirbyms.com Sponsored by the Southern Center for Communication, Health & Poverty A CDC-Designated Center for Excellence in Health Communication and Marketing www.southerncenter.uga.edu

2. 2 Message Framing Gain vs. loss framing Usually aimed at direct health behavior audience Strategic frame analysis Used for policy and societal mobilization audiences

3. 3 Gain versus Loss Framing Gain = Lives saved Loss = Lives lost Gain promotes risk aversion Prefer small certain gains to large possible gains Best for prevention behaviors Loss promotes risk seeking Prefer possible large/small loss to any certain loss Best for detection or screening behaviors

4. 4 Gain versus Loss Framing If ‘certain’ of screening outcome Gain framing is more effective If ‘uncertain’ of screening outcome Loss framing is more effective Pointing out health disparities Creates negative reaction Cultural targeting Enhances effectiveness with “right” frame Not more effective if combined with ‘wrong’ frame More disparity research needed

5. 5 CVD versus Diabetes 35 Overweight AA Male ‘Certain’ CVD You can add years to your life if you get tested and treated for CVD today ‘Uncertain’ Diabetes You can prevent losing a leg, foot, or toe by getting tested and treated for diabetes today

6. 6 Strategic Frame Analysis

7. 7 How We Process Information Mental shortcuts help us make sense Communication has cues about where to fit information into existing knowledge Helps us connect to shortcuts or “dominant frames” New information seen through dominant frames Our understanding is frame-based Not fact-based

8. 8 Strategic Frame Research Identifies deep values, beliefs, and assumptions Studies their impact on policy preferences Uncovers ways to change how issues are framed Communication shift attitudes and behaviors

9. 9 Why It Matters … Perceptions shaped by core beliefs New thinking challenges core beliefs If challenged we revert to familiar Makes it hard for people to hear new messages We have to connect people to a different frame

10. 10 By connecting an issue to an existing valued high-level frame, we can reframe how people think and feel about an issue.

11. 11 ‘Estate tax’ is one way to frame tax debate

12. 12 ‘Death tax’ reframed this tax debate

13. 13 Framing Strategy Includes Connecting issue w/ valued frame Thematic not episodic context Simplifying model or metaphor Social math Messengers Visuals Tone

14. 14 Framing Levels Level One Big ideas, like freedom, justice, community, success, responsibility Level Two Issue types, like the environment or child care Level Three Specific issues, like rainforests or earned income tax credits

15. 15 Level One Examples We want to live in a society that is … Authentic Caring Committed Community focused Competitive Connected to others Increasing Knowledge Nurturing Positive in Outlook Responsible Safe/ Secure

16. 16 Level Two Level 2 frames can focus on issues like children, elderly, education, friendship, or corporate America Level 2 can also be a new or novel way of grouping issues together Prisons and education Children and corporate America

17. 17 Building a Framing Story Connect your issue to a Level 1 value Ask what kind of world people want to live in Ask what would that world look like? Level 2 connected to level 1 Many issues can fit into Level 2 for different purposes Level 3 specifies how Level 2 is achieved Tell a story linking levels 1 to 2 to 3

18. 18 Linking Levels Together Tobacco Level 1 - We want to live in a truthful society Level 2 - Companies are honest about their products Level 3 – Policies that require disclosure of product contents Cancer Level 1 - We want to live in a hopeful society Level 2 - Diseases like cancer can be cured Level 3 – Program to identify cancer cures

19. 19 Context Families should handle their own stuff, We should stay out of it. The family bubble. Andy needed the support of others, and a solid town like Mayberry to avoid abusive situations as a single parent

20. 20 Numbers – Social Math GOOD - In the 60s, about 11 of 25 kids walked or biked to school. By 2001, only 4 of them were getting exercise that way. BETTER – Today lots of schools are ere farther away from their students. Now walking or biking to school is the equivalent of doing a 5K race or more - twice a day.

21. 21 Messengers HIV and Hispanic Communities

22. 22 Visuals What are youth doing today?

23. 23 Metaphor or Model Brain Foundation = Architecture Early experiences affect the architecture of the maturing brain. The quality of that architecture establishes either a sturdy or a fragile foundation for all following development Getting things right the first time is easier and less costly than trying to fix them later. =

24. 24 Disparity-related Framing The Dominant Frames We Know Individual responsibility People are the ones who decide if they smoke! In-Community responsibility It’s that community’s fault! Poverty isn’t the problem Education is problem with poor health choices!

25. 25 Disparity Framing Research Disparity focus increases stereotyping Stimulates negative reactions in all parties ‘Quality of Life’ resonates ‘Community conditions’ also Civic wellbeing resonates Cost prevention resonates

26. 26 Disparity Framing Research Physical and org structures are useful terms Include ‘elderly as examples’ Stay solutions focused Community needs to involved Use close to home examples ‘Patchwork with gaps” metaphor Does not trigger stereotypes

27. 27 Focus messages on solutions not the problem - early in the message Avoid negative stereotypes Do not repeat the current ineffective frames Repetition, repetition, repetition More Framing Advice

28. 28 Resources Getting the Biggest Bang for Your Health Education Buck: Message Framing and Reducing Health Disparities. Schneider American Behavioral Scientist. 2006; 49: 812-822 FrameWorks Institute Report http://www.frameworksinstitute.org/clients/commhealth_civ icwellbeing.pdf http://www.frameworksinstitute.org/clients/commhealth_civ icwellbeing.pdf Berkley Media Studies Group Kirby Marketing Solutions at www.kirbyms.comwww.kirbyms.com Southern Center for Communication, Health & Poverty at www.southerncenter.uga.edu

29. 29 Question and Answer Small Group Activity