The Health Messenger, Message and Audience

There are three aspects we need to consider when developing medical communications:
1) the message itself  – what information will be effective, what action do you want people to take
2) the messenger – who is best to deliver the message (not always the health expert), and
3) the audience – what is their culture, their level of knowledge

Let’s take a look at each of these aspects individually, and then summarize as they leverage each other.

The Message
For populations to take health messages seriously, messages have to be important and relevant to the impacted populations. This should not just be the opinion of the health experts. The populations you are trying to reach should be able to understand how the health issue affects them as individuals, their families, their neighbors or others they care about.

The timing of messages is also very important, as it will determine their acceptance and the urgency with which the population responds.  Messaging should change for example if it is in advance of a health issue, vs in the middle of one, vs following one. 

Messages can be focused on health experts and what they should do differently, as well as directed to specific populations, and what take-aways should result.

Health EducationCare must be taken to make sure that the messages are not presented in hard-to-understand medical jargon but in clear, succinct, simple, and understandable language that people can understand irrespective of their knowledge of the issue. In an era where information could be obtained from many sources, especially unregulated social media accounts, it is important that the sources of health information for public communication are credible, reliable, and verifiable. Such information should be based on data and plausible science which a reasonable individual or community could understand. Messages should not create fear or panic, or stigmatize populations based on association, geography, or lifestyle. Most importantly, communities usually want to know what they need to do to reduce their exposures and risks, and improve health outcomes.

(Remember back to the early days of the AIDS crisis, when the disease was first rampant among the gay population.  The homosexual lifestyle was vilified and associated with disease.  We later saw how AIDS became widely distributed through all populations worldwide, regardless of sexual orientation.)

In addition to messaging, every health message is deficient without an appropriate actionable component for your primary audience. Consider that you are not just relaying information to your audience. You are accomplishing two other tasks.  First, you’re also working to increase their health literacy as well. Health literacy is defined as the degree to which a person has the capacity to obtain, communicate, process, and understand basic health information and what services are available to make appropriate health decisions. Second, you are encouraging your audience to take a specific action or series of actions to improve their health outcome.  By crafting messages that follow these guidelines, individuals and communities will be better able to make informed healthcare decisions for themselves.

The Messenger
When we talk about the health messenger, we’re referring to any individual who relays health information. This could mean anyone or any media – a health professional, a media promotion, a family member, a friend, a colleague, a neighbor.

People share health messages with friends and family because they feel a communal responsibility. With a relevant, timely, and credible message, the community can become important advocates for your efforts. For effective health communication, the “messenger” is as important as the “health message” itself.  The messenger should be a good listener, credible, and trustworthy. Their presentation should be straight-forward, honest, and non-judgmental. The message is more credible when the messenger has a track record of dealing with similar issues and providing reliable information in the past. A messenger’s credibility is built from an in-depth knowledge or expertise in the subject area – no matter who they are.

You should not expect audiences to listen to your message if you cannot demonstrate that you have the knowledge to speak on the subject. And for the messenger to have the desired impact, they have to be approachable, culturally sensitive, using appropriately nuanced language, and be perceived as a dependable partner who will be there for the long haul.

As populations tend to be skeptical of health messages in today’s world of the internet, where misinformation and rumors are easily spread, it is important that there is a perception that the messenger really cares about the health of a population, and has the knowledge and expertise to be that messenger. The notion of a partnership between the health communications expert and the population, working together towards achieving a common goal of good health outcomes, with both parties contributing in their respective ways, is vital.

The Audience
The intended audience should be an equal partner in this communications trifecta. For them to participate effectively, they have to feel that the health issue affects them or has the potential to affect them, their families, or their communities, directly or indirectly. It is important that they don’t feel blamed for the health effects that are being addressed but more as partners in bringing solutions to the health problem.

A key component of this is ensuring that the audience understands and agrees that their views will be factored into developing solutions. In addition, for many community members, knowing that their local leadership is on board with a particular message and messenger, can help build trust, and they may be more willing to listen and act accordingly. Because the audience may have different backgrounds, beliefs, or cultures, and different groups may receive and react to messages differently, every effort should be made to direct messages to the different groups within an audience, considering factors such as age, gender, social morays, and socioeconomic status.

Since these groups would tend to ask about what actions they should take to influence health outcomes, deliberate efforts should be made to provide actionable messages relevant to a specific group based on these same factors.

To do so means understanding the community’s concerns, identifying trusted subject-matter experts, and utilizing the preferred medium for message delivery (tv, radio, print, apps, social media, text-messaging, in-person, as appropriate). Together, you can develop actionable and appropriate messages for various target audiences.

Health communication and reporting to achieve desired health outcomes should not be a single event. It should be an ongoing activity that utilizes all available media tools. These are powerful tools, when combined with:
1) the correct message,
2) adapted to the right medium,
3) delivered by the right messenger, and
4) whose message is directed at the appropriate audience.

To ensure effectiveness, measurements have to be in place at each stage to assure that:
1) the messages are delivered appropriately,
2) the intended audience received the credible message, and
3) then took actions to address the health issue.

This dynamic process should result in adjustments to each pillar of our communications – the message, the messenger, and the intended audience – until the desired health outcomes are achieved.

Doctor-Patient Communications are Key to Improving Health Literacy

Effective healthcare communication policies and practices, including provider health proficiency, contribute to improving the quality of services for culturally and linguistically diverse people as well as parties with limited health literacy skills.

Doctor-Patient Communications are Key to Improving Health LiteracyHealthcare communication is a synergy of three influences: medical proficiency, cultural competency, and linguistic competency. These three points interplay with one another in dynamic natures. A  person’s health literacy may be affected by socio-cultural factors including education, income, country of origin,  and stage of assimilation to their new culture, to mention a few.  Cultural factors not only include lingo, gender, socio-economic status, sex orientation, and gender issues but likewise physical and mental capacity, age, religion, and regional differences. Culture also includes diversity within specific ethnic groups. All key factors are very dynamic and interdependent. They are difficult to separate and they tend to interact and affect one another. 

The U.S. has become increasingly linguistically and culturally diverse. The number of people who speak a language other than English at home has more than doubled in the past three decades and is growing at a pace four times greater than the nation’s population growth.In this time frame percentages non-English speakers grew by one hundred and forty percent while the nation’s overall population was increased by thirty-four percent. The rise in our nation’s non-English speakers calls for rapid and inventive responses on the part of health care systems to ensure that competent translators are available when required.

Health equity is the attainment of the highest level of health for all beings.

The National Partnership for Action to End Health Disparities has prepared a helpful toolkit for action in addressing health literacy.

You can download the toolkit here.