chapter 7; Planning Health Communication Intervention Flashcards
the key to effective interventions is the involvement of the [..] community
target
if you let your target audience that you are listening to them and understand what they ned, they will be more receptive to your message
yes
stakeholders have something “at stake” (their lives, health, reputation, funding, etc.) that depends on the [..] of a project
success
stakeholders in a health communication intervention might include;
- primary audience, secondary audience, tertiary audience
- primary audience: the target audience of behavioral change, the people you are hoping to influence with your intervention
- secondary audience; the gatekeepers to your target audience - they control access to communicating with your target audience (e.g. , parents, religious leaders, block captions, community service groups, commercial establishments)
- tertiary audience; the finlcuers who have earned the respect and admiration of your target audience (e.g., health care professionals, local personalities such as local news anchors, respected politicians, other opinion leaders, national figures such s health authorities or celebrities), it they have a reason to be concerned
in stake holders, you should think of them as actual “players” in your intervention. this means that they not only passively provide input on the intervention but also are actively involved in its development and implementation
yes
stakeholder led interventions tend to work best when the group has been functioning for some time in various [..] roles, so that much of the initial “forming, storming, and Norman” has taken place and the group can “perform” at its [..]
partnership
peak
you should have a clear idea of your comparative advantage (i.e. where your group shines) and where you need to fill in the gaps , after organization has assessed your strengths, weaknesses, opportunities, and threats
yes
having defined your own strengths and weaknesses you would be well served in selecting partners who have knowledge, skills, resources, or connections to a target audience that you [..]
lack
why is it good to gather your stakeholders together before conducting your initial planning;
- you partners may have already collected some of this information and would be willing to share it for a common cause
- they may be able to facilitate recruiting participants for focus groups and other formative research tasks
- they may be able to share some of the costs, particularly through in kind donations of time, effort, or meeting space
- if everyone shares in the formative research, they are more invested in the results and seeing them translated into an effective program
the primary reason to not engage stakeholders early in planning is if you believe the target audience or communication goals are likely to [..] based on data that you do not yet have
(gather data first in that case, and then move to partner identification)
change
the health communication phases of planning, implementation, and evaluation are often depicted as a well to emphasize the cyclical nature of data collection and program improvement
yes
the planning cycle; steps 1-3
- form your macro plan, which includes analysis of the problem the ecological setting, the core intervention strategy, and the affected populations
(this state of planning normally occurs after data demonstrate the presence of a problem affecting specific groups of people. if there is evidence that a specific intervention has worked to reduce this problem elsewhere, feasibility testing might be conducted to adapt the intervention to the new population. the less we know about the problem, potential solution, or intended audience, the more formative research must be done before taking the next planning steps)
the planning cycle; steps 4-6
- the strategic health communication plan, which focuses on specific change objectives, audiences, messages, and media
(concepts, messages, materials, and media strategies are tested at this stage of planning. this “pretesting” is sometimes referred to as formative research , and at times it is considered “process” research. it should replaced finalization of the implementation plan that comes next)
the planning cycle; steps 7-8
- the implementation (or tactical) plan, which says what will be done, when , where, how , with what money, and who is responsible for every piece
process research is often conducted shortly after the launch of a program to make sure all operations are running smoothly and that messages are getting out and being interpreted as planned. corrections can be made if this assessment is done early enough
the planning cycle; steps 9
- evaluation plan, which says what aspects of the intervention will be monitored or evaluated to determine the interventions worth to key stake holders. most programs want to achieve measurable objectives, so baseline data often need to be collected before a program is launched. evaluation planning must begin in the first days or program development
yes
the planning cycle; steps 10
- continuation (or expansion) plans to ensure a broader reach, diffuse expenses, and provide continuity of leadership and ownership. you might look for ways to terminate your activities
yes
the precede-precede model works [..] from a desired state of health and asks what environment, genetics, behavior, individual motivation, or administrative policy is necessary to create the healthy state. it assesses the [..] factors that shape health status and allows the planner to focus on those factors that are best targeted for intervention
backwards
multiple
precede-proceed; as the name implies precede proceed lays out an [..] phase and an [..] phase. in the first phase, the model asks the planner to conduct a [..] assessment, such as understanding a groups quality of life by assessing not only objective data, but also subjective data collected by working with the community to identify problems and priorities.
assessment
implementation
social
precede-proceed pt 2; next is the epidemiology assessment, where the planner must understand the [..] of the health issue in the group, and then assess the genetics, behaviors, and possible environmental causes of the [..] issue.
extent
environmental
precede-proceed pt 3; once the background assessment is complete, the planner can think about the predisposing, reinforcing, and enabling factors associated with the health issue. this is called the educational and ecological assessment. predisposing factors are those that exist [..] the individuals, such as their knowledge, attitudes, beliefs, and life experiences, that might influence [..]. reinforcing factors are those that are [..] of the individual, usually in a peer group or interpersonal sphere, that they may provide rewards or punishments for a behavior. often takes the form of peer pressure or influences, or social support (or lack of thereof)
within, behavior
outside
the last step of precede aligns the results from the educational assessment with what might be required on a policy of programmatic level to move into implementation
yes
precede-proceed; part 4
finally enabling factors are those that may allow the behavior to occur at a [..] or [..] level; often these can be societal beliefs or norms, or environmental or public policy
community
societal
formative research refers to the information gathering activities you conduct [..] to developing a health communication strategy . the BEHAVE framework provides four simple questions to be answered.
prior
the four questions to be answered from BEHAVE framework are;
- who are you trying to reach
- what do you want them to do
- what factors influence their behavior
- which actions will most effectively address these factors
yes
BEHAVE is basically;
to [..] a specific target audience to perform a specific [..], we will focus on an important [..] (something the target audience values). our approach will address specific issues (e.g. self efficacy, lowered barriers, enhanced health literacy) and use specific means of reaching the audience (media channels)
(if you cannot answer these questions then you must do formative research)
persuade
behavior, benefit
formative research is done to develop an intervention. includes three different activities;
1. using quantitative and qualitative methods to develop intervention/message concepts, devise an audience segmentation strategy and research appropriate communication channels
2. testing your concepts/messages with your audience
3. pretesting your initial materials with your intended users. in the case of mHealth or other types of interactive media, user testing may also be conducted to assess whether the mechanics of the tool are easy to use and accessible to your audience
yes
the main point in formative researches that your audience is integrally involved in the development process. making sure you are creating health communication that is acceptable to your audience and addresses their risk perceptions, barriers, and other factors that may impede them from healthy behavior
to address the first step-developing and understanding who is your audience- you can collect both primary data and secondary data
primary data- data you collect yourself, through methods such as surveys, interviews, focus groups, or observation
secondary data - data you get from existing sources, such as the local health department, the CDC, or a local hospital
quantity is secondary data
qualitative is primary data
yes
basic quantitive data collection can also be done to understand the unique needs of your target audience
yes
[..] are the most common type of quantitive primary data that are collected
surveys
another application of the standard survey is a commercial marketing technique called perceptual mapping. relies on survey data in which participants respond to questions use a Likert-type scale
(1-10 e.g.)
you may also use qualitative methods to understand how best to select an audience segment and communication channels
e.g. focus groups with children or interviews with key informations (such as parents) from your target audience - primary data - can help you decide if different messages and different channels are needed for different groups
common qualitative methods used in formative research;
- in depth interview
- focus groups
- observation
- intercept interviews
- photo voice
- in-depth; used to discuss highly personal topics, usually at a stage of research where the program does not yet feel sufficiently informed to use a group format
- focus; 8-10 ppl, give feeling for what people think , feel , and say they do. to develop hypothesis, explore broad topics, and generate ideas
- observation; directly observe ongoing behavior or an environment. “naturalistic” observation or “participant” observer where insert yourself to observe
- intercept; go to location where the intended audience would encounter information about a behavior or acquire a product and then invite them to participate in an interview
- communities are given the tools to document their own lives, problems, and possible solutions through photography
cognitive mapping is used to describe the maps of geographic areas that people carry in their heads
perceptual mapping is hone using multidimensional scaling to model fundamental social-psychological processes
yes
market research online communities (MROCs) can be used to listen to specific audience segments and explore topics in depth , as one would with a live focus group
advantages; convenience for the participants, engagement with participants over an extended period of time, and greater anonymity for participants (when only audio or text responses are used)
qualitative data provide the backstory for the quantitative data and may point to the need for more quantitative data and may point to the need for more quantitative studies
the combination of quantitative and qualitative research methods is referred to as a mixed methods approach.
having completed your formative research, the next step of the process is to bring everything you have learned to bear on planning the actual messages, communication tools, and health communication intervention
the term creative brief comes from the advertising business, where a short document is prepared that gives details of what should be considered when something is being designed or advertised
it is a clear and concise way to present the overall thinking behind a communication intervention and the issues that are most important to keep in mind during design and implementation
elements of a creative brief;
(overview of project, target audience segment), objectives obstacles, benefit/key promise, support statements/reasons, tone, distribution opportunities, creative considerations, other elements
- overview; short summary of the overall goals of the project and its importance to the organization(s) involved
- audience; carefully defined, unique segment with specific characteristics, such as demographic description, behavioral readiness stage, literacy level, lifestyle information, and role in overall communication strategy (primary audience, secondary , etc). when multiple audience segments are targeted, a different creative brief should be developed for each
elements of a creative brief;
overview of project, target audience segment, (objective, obstacles), benefit/key promise, support statements/reasons, tone, distribution opportunities, creative considerations, other elements
- objective; what specific behavior do you want the communication to produce in the target audience ? this is often phrased as what you want them to think, feel, or do, and it may be referred to as “call to action”
- obstacles; what structural barriers beliefs, cultural practices, social pressure, or misinformation are obstacles to your audience taking this step? is there an audience that must be approached first in order to free your intended audience to act as desired?
elements of a creative brief;
overview of project, target audience segment, objective, obstacles, (benefit/key promise, support statements/reasons), tone, distribution opportunities, creative considerations, other elements
- benefit/key promise; what is the single most important reward (from audience’s point of view) that will result from doing the desired behavior? is there a secondary reward? which is more immediate, and which will take longer to achieve? from the audience perspective, “what’s in it for me?’
- support statements/reasons; these statements explain why the target audience should believe the promise of the key benefit. this may be scientific data, emotional data, or data drawn fro the experience of others who the target audience admires or can relate to . support statements should also provide solutions to the obstacles raised earlier
elements of a creative brief;
overview of project, target audience segment, objective, obstacles, benefit/key promise, support statements/reasons,( tone, distribution opportunities,) creative considerations, other elements
- tone; what feeling or personality should you message or have? the tone set by the communication materials will influence how the target audience feels after interacting with the communications. examples of tones including authoritative, family oriented, funny, loving, modern, preachy, rural , scary, sad and so on
- distribution; what venues, seasons, or events increase the likelihood of reaching your audience? in what other ways might this material be used? do you need different versions to reach audiences in different settings?
elements of a creative brief;
overview of project, target audience segment, objective, obstacles, benefit/key promise, support statements/reasons, tone, distribution opportunities, (creative considerations, other elements)
- creative; what else should the writers and designers keep in mind during development? what is the intended medium and channel for this product? will a certain style of presentation resonate more with the selected target audiences: conversational, testimonial, informational, emotional, or instructional? will the material need to be prepared in more than one language? will well known spokespersons be involved (e.g. political figures or entertainers)? are there special words or phrases to use or avoid?
- other elements: some briefs include approval routing, timelines, and just about anything else that is needed to reach management consensus before beginning creative development
it is essential to keep the artists “on message” and “on strategy” . it is extremely easy to let a creative idea steal the show. but this is where the creative brief helps you to ensure quality
yes
working through the creative brief, you can describe the projects overall purpose and provide all the information you have available about the intended audiences
yes
the concepts of a health communication intervention are often large, overarching ideas of what it is you are hoping to get your audience to do or know
the concept must appeal to both the head and the heart, and must communicate how this idea fits into the lives of the target audience
only the audience can answer if the concept and messages you created are right (for the audience)
yes
audiences and gatekeepers need to be invited to pretest concepts before moving on to final messages and materials for final production.
in addition to gatekeepers, it is often important to consider who else might be sensitive to the ideas being put forward
when we think about how many things we try to “prevent”, we should be mindful of the people who already suffer from these conditions.
must consider how these people, or their loved ones, will feel if their condition is portrayed as something to avoid at all costs
having tested our concepts, you will now build on that foundation to create messages and communication materials - patient - provider communication guidelines, posters, pamphlets, ads, radio scripts, social media posts- that carry your ideas to the hearts and minds of your intended audience
the channels and activities that will use your material determine the format for production, not vice versa
creative content is ideally tested in the format in which it will be used. e.g if an individual is meant to see a commercial spot on the television, it should be tested as if it were being shown on TV
important factors to pretest are attractiveness, understandability, and believability
do the messages and material engage the audience? do they feel they would act in the intended manner after getting this information
all material intended for use in the health communication intervention should be tested with the intended recipients and with the gatekeepers prior to distribution. no excuses
yes
in message testing, participants often are provided a list of messages and the context of those messages
yes
user testing has your audience examine both the messages and the material
usually this is done with “talk alouds” in which a small group is exposed to the material or tool and each person is asked to verbalize their reactions aloud
yes
usability testing refers to studying how people use a finished product such as a website, mobile app, electronic game, or mHealth tool, but it can also be done with pamphlets and posters. in this type of testing, you are measuring how well an intended user can learn and use the product, as well as their satisfaction with the process
usability testing should measure the following;
- ease of learning
- efficiency of use
- memorability
- error frequency and severity
- subjective satisfaction
- ease of learning; how fast can a user who has never sen the user interface before learn it sufficiently well to accomplish basic tasks?
- efficiency of use; once an experienced has learned to use the system, how fast can they accomplish tasks?
- memorability; of a user has used the system before, can they remember enough to use it effectively the next time, or must the user relearn everything
- error frequency and severity; how fate do users make errors while using the system, how serious are those error, and how do users recover from these errors?
- subjective satisfaction; how much does the user like using the system ?
there are a number of techniques that could be used to assess the actual physical response people have to health communication materials. these strategies can show whether the person is responding in the ways you would expect and use measures like skin temperature, eye pupil dilation, and brain waves
galvanic skin response (GSR) is a measure of the electrical current that passes along the surface of the skin. because perspiration conducts electricity much better than dry skin, a minute increase in perspiration resulting from an emotional response can be detected as an increase in electrical conductance
GSR is painless and can be measured easily using uncomplicated devices and a computer display
pupil dilation and eye tracking technology. eye tracking is a measure of where and how long we gaze at an image (moving or still) or text. we also have an innate response of the automatic nervous system to imminent danger or arousal that causes our pupils to dilate.
together with our blink rate (which also speeds up when we are aroused or experience fear), pupil dilation can be measured by photographic or video processes.
eye movement tracking devices can be stationary, embedded in a computer screen, or miniaturized in a pair of glasses for free moving studies
having data from the audience pretesting is an important strategy for overcoming gatekeeper resistance to a message or media concept
it is much better, and cheaper, to find this out with a small group of people at the concept, message, or even materials testing stage than after a multimedia campaign has been released to the public or materials have been printed in color to distribute to patients in a hospital
settings include places where an audience must go to receive your message (e.g. a health care facility, shopping mall, bar or restaurant in town, or special event) and places where the media reaches them closer to home, such as radio or television programs, online environments and the like.
t
timing is very important. a place that seems like a good setting for your audience might be impractical if your communcaiton is ill-timed for reception or too late to be used;
in general, you can think of communication channels in three broad categories: interpersonal, community, and media
yes
interpersonal channels include healthcare providers, teachers, and others who will interact with the intended recipient in person.
the strength of interpersonal channels is that people tend to trust the spokesperson and will possibly be ready to listen to what they say
face to face Chanels are most effective when tryin to help someone learn a skill, such as how to test their blood sugar or how to safely perform an exercise therapy; they need to trust the spokesperson before adopting a new attitude or belief
two way discussion is necessary to cement a behavioral intent.
interpersonal approaches can also be used with groups, particularly if discussion among group members is part of the communication strategy (think about weight loss or smoking cessation supporting groups)
to ensure the quality of health communication using interpersonal channels, it is often necessary to develop training modules for the communicator and media supports for the audience, such as accompanying brochures or handouts. the major limitations of this channel are its reach
(it reaches only small numbers of people at a time) and the resources required (it requires intense use of people and time)
using formative research strategies, developing messages based ion a creative brief, pretesting those messages, and using a communication channel strategy are the keys to success in reaching an audience with the right messages using the most effective channels
