1. Communicating Health Disparities: Health Communication with Special Populations Presented by C. Ashani Turbes, Ph.D. Southern Center for Communication, Health & Poverty Macro International, Inc. June 5, 2007

2. Presentation Objectives Framing: To identify issues to consider in identifying how strategies to address public health issues, particularly related to STDs, should be framed for Black audiences Communication: To discuss strategies to communicate public health issues, particularly related to STDs, for Black audiences Public Participation: To discuss participatory engagement of the public in issue framing and grappling and identifying communication strategies

3. Diversity in African American Communities Multiple audience segments in the “African American community” Framing and communication should be attentive to: Age, Sex, Socioeconomic status, Sexual orientation, sexual risk, geographic region (rural vs. urban), etc. Framing must take into account the “culture of the African American communities” (values, aspirations)

4. Feature Studies Multiple Risk Factors (Southern Center) Preconception Health (Southern Center) Black Women & Mass Media (Macro) STD & HPV Focus Groups Study (Macro)

5. Feature studies continued… Multiple Risk Factors Focus groups with adults in rural and urban settings Concern about HIV/STDs Desire to hear messages from “people like us.” Belief in racism, but trust of doctors Government mistrust Using the Internet Preconception Health Focus groups with adult women in rural and urban settings Concern about HIV/STDs Shame about STDs Trust in doctors Reliance on family for health information Using the Internet

6. Feature studies continued… Black Women & Mass Media Focus groups with women in small urban settings Concern about HIV/STDs Trusted sources Using Black Radio Hearing from person “like us” - Use of spokesperson (with the disease) STD/HPV Focus Groups Focus groups with adults in rural and urban settings Stigma of STDs Shame about STDs Desire for spokesperson “like us” Trusted information sources

7. Issue Framing How an issue is defined (or how the story is told) What in the issue is considered most important (Reich 1989; Best 1989) What the public thinks about the issue (how the public structures that issue in the world)

8. Issues for Framing Trust (a barrier) Stigma/Shame Personal Responsibility

9. Issues continued… Consider STDs together Can’t compartmentalize diseases Deep Structure Culture (versus Surface structure of a culture) History of racism and its relationship to trust, power, and control Value systems (Faith in God) Desire for community respect Attitudes about sex

10. Communication Strategies Reaching out to salient referents Role of family/friends Engaging trusted sources Faith community, leaders, celebrities, People “like us”

11. Strategies continued… Using the Internet The shrinking digital divide The radio as communication tool Using “Black” radio to reach African American audiences

12. Other communication strategies Entertainment-Education Interactive Health Communication Interpersonal Communication

13. Public/Community Engagement It is essential to understand and work within an audience’s value system in order to reach them in ways that are relevant to them, not only personally but relevant to their broader community. To this end “it is important to engage all sectors of society” (Bernhardt 2006; Maibach 2006).

14. Public/Community Engagement Public engagement is an effort to involve all sectors of a community in ongoing public deliberation about an issue; this effort should allow participants to collaborate, strengthen citizen ties, and build common ground to make decisions about issues affecting a community.

15. Engaging the public… Why? To gain deep knowledge of culture To better understand value systems To empower individuals and a community to become engaged in health issues affecting their community To hold government and public health officials accountable

16. Why engage continued… To create an environment of social learning in a community To respect need for issue “grappling” To recognize the value of public “experiential knowledge” as “expertise” necessary to address public health issues To obtain information on viable communication/ dissemination strategies for a community

17. “We must work collaboratively with communities experiencing disparities to overcome the historical context of distrust and create meaningful, effective health communication interventions.” Friemuth & Quinn, 2004

18. Discussion Questions What issues have you considered to identify how specific strategies should be framed with your audiences, in their communities? What communication strategies have you used with diverse audiences? Have they been successful? Why or why not? How have you engaged the public in making decisions about STD risk reduction for Black audiences?

19. Questions & Comments

20. For more information contact C. Ashani Turbes, Ph.D. Project Manager Macro International Inc. 3 Corporate Square, Suite 370 Atlanta, Georgia 30329