Vocabulary

• Diffusion

The process by which ideas, innovations, or information spreads from one place or group to another over time.

• Institutional

Relating to institutions, organizations, or established systems, particularly within a society or community.

• Multilevel

Involving or occurring at multiple levels or stages; having different layers or tiers.

• Sustain

To support, maintain, or uphold over time; to ensure the continuation or durability of something.

• Viral

Pertaining to the rapid and widespread circulation of content on social media. (Elsewhere, may refer to viruses and their spread.)

• Policymaking

The process of creating and implementing policies, typically by government officials or other decision-makers.

• Lawmakers

Individuals, such as legislators or elected officials, who are responsible for creating and passing laws.

• Emphasize

To give special importance or prominence to a particular point, idea, or aspect.

• Disseminate

To spread or distribute information, knowledge, or ideas widely to the public or a specific audience.

• Debunk

To expose or discredit false or misleading information; to reveal the falseness or hollowness of a claim or belief.

Health Literacy

What is health literacy? Health literacy refers to an individual's ability to obtain, understand, and apply health information effectively to make informed decisions about their health and healthcare. It encompasses skills such as reading and comprehending health-related materials, interpreting medical instructions, and critically evaluating health information from various sources.

Why is health literacy important? Health literacy is crucial because it empowers individuals to:

• Make Informed Decisions: It allows people to make informed choices about their health, healthcare options, and preventive measures.

• Promote Disease Prevention: It supports public health initiatives by helping people understand and follow guidelines for disease prevention and healthy behaviors.

• Access Healthcare: It enables individuals to navigate the healthcare system, understand insurance, and access appropriate healthcare services.

• Manage Medications: Health literacy aids in understanding prescription instructions, potential side effects, and the importance of medication adherence.

What factors affect health literacy? Several factors can influence an individual's health literacy:

• Education Level: Higher education levels often correlate with higher health literacy levels.

• Language Proficiency: Proficiency in the primary language is crucial for understanding health information.

• Cultural Background: Cultural beliefs and norms can affect how individuals perceive and respond to health information.

• Access to Resources: Limited access to healthcare facilities, internet, or educational materials can hinder health literacy.

• Healthcare System Complexity: The complexity of the healthcare system and medical terminology can pose challenges for individuals with lower health literacy.

What are some common barriers to health literacy? Barriers to health literacy include:

• Complex Language: Medical jargon and complex language in healthcare materials can make it difficult for individuals to understand information.

• Limited Health Education: Inadequate health education and lack of exposure to health-related topics can impede health literacy.

• Low Literacy Skills: Limited reading and numeracy skills can hinder the ability to process health information.

• Cultural and Linguistic Differences: Cultural and linguistic diversity can lead to misunderstandings and misinterpretations of health information.

• Limited Access to Healthcare: Disparities in healthcare access can limit opportunities for individuals to learn about and manage their health.

• Digital Divide: Lack of access to digital resources or low digital literacy can prevent individuals from accessing online health information.

• Stigma and Shame: Stigmatized health conditions may discourage individuals from seeking information or help due to fear or shame.

Understanding health literacy and addressing these barriers is essential for improving healthcare outcomes, reducing disparities, and promoting a healthier and more informed population.

Shannon Weaver Communication Model

(U.S. Department of Health & Human Services et al., 2005)

Communication theory investigates how messages are created, transmitted, received, and assimilated. When applied to public health problems, theories tell us how communication processes affect behavior change. The field of public health communications works on sending understandable health information to advance the public’s health.

With an ecological perspective, public health communications uses the following multilevel strategies:

• Tailored messages at the individual level
• Targeted messages at the group level
• Social marketing at the community level
• Media advocacy at the policy level
• Mass media campaigns at the population level

Public health communications can do the following:

• Increase knowledge and awareness of a health issue
• Influence perceptions, beliefs, and attitudes that factor into social norms
• Prompt action
• Demonstrate or illustrate healthy skills
• Increase support for services
• Debunk misconceptions
• Strengthen organizational relations

However, communication has some of the following limitations:

• alone it may not be enough to sustain individual-level behavior changes.
• may not be effective for relaying complex health messages.
• cannot compensate for lack of access to health care or healthy environments.

The various media outlets influence almost every aspect of human life: economic, political, social, and behavioral.

Media Effects

Media effects are the outcomes of all the images and stories that are sent. Researchers study not only how the media influence the audience, but also how the audience affects the media. Media content reflects the audience’s preferences.

Most critical questions to know:

1. What factors affect the likelihood that a person will receive a given message?
2. How do media effects vary with the amount of exposure to that message?

Funding largely determines whether or not someone will receive a message through the mass media. Most public health programs do not have large budgets, so they rely on strategies for free distribution, such as:

• Public service announcements
• Embedding health messages in entertainment, such as soap operas
• Promoting news coverage of public health topics
• Messages sent by community institutions
• Trends on social networks

How often people need to hear a message before it influences their behavior depends on several factors:

• Readiness of the audience to change
• The complexity of the health issue,
• The presence of competing messages,
• Repeated exposure to a message,
• Delivery through multiple channels.

A health message can influence someone’s behaviors through many different routes such as:

• Immediate learning (people learn directly from the message)
• Delayed learning (the impact hits some time after it has been conveyed)
• Generalized learning (persuaded about the message concepts)
• Social diffusion (when a message goes viral)
• Institutional diffusion (a response from public agencies reinforces the message’s impact).

Agenda Setting

The mass media can focus attention on issues to generate public awareness and momentum for change. Major research has focused on how the mass media influence public opinion, especially about politics and policies.

Agenda setting involves all of these:

• Media agenda (what they decide to cover)
• The public agenda (what people think about)
• The policy agenda (legislative actions on issues).

Research has shown that the amount of media coverage an issue receives correlates strongly with the public’s opinion of how important that issue is.

Although mass media may not tell us what to think, they are surprisingly effective in telling us what to think about. Framing the message tells the audience what is important. The media often tells the audience not only what to think about, but how to think about it. The way facts are packaged to tell a story creates the frame. By framing stories to emphasize social and environmental factors that affect health, advocates can use the media to pressure decision makers to develop and support healthy policies. See Table 9.

SBAR Communication Framework

(Institute for Healthcare Improvement, n.d.)

This is a technique to improve brief or urgent health communications by framing the conversation with the following elements:

S = Situation, a concise statement of the problem.

B = Background, pertinent and brief information about the situation.

A = Assessment, analysis and considerations of options.

R = Recommendation, action requested

Best Fit for Health Interventions

• Health communication strategies

• • Description: presenting health messages, ranging from advertising for public awareness to complex social marketing.

  • Examples

• • • Public service announcements about where to obtain COVID-19 vaccine.

    • Billboards reminding people to wear seatbelts.

    • Campaigns to prevent drug overdose deaths with Naloxone.

• Health education strategies

• • Description: nearly all health interventions include education, but education may not be enough to create behavior change. For a person who already has motivation to change, simply providing information can help improve health.

  • Examples

• • • Telling mothers the benefits of breastfeeding.

    • Explaining the causes of diarrhea and how to avoid it.

    • Showing how to apply first-aid after an injury.

References

Institute for Healthcare Improvement. (n.d.). SBAR Tool: Situation-Background-Assessment-Recommendation. Institute for Healthcare Improvement. https://www.ihi.org/resources/Pages/Tools/sbartoolkit.aspx

U.S. Department of Health & Human Services, National Institutes of Health, & National Cancer Institute. (2005). Theory at a Glance: A guide for health promotion practice (2nd ed.). https://cancercontrol.cancer.gov/sites/default/files/2020-06/theory.pdf