Leslie Snyder, Ph.D.

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21 Νοε 2013 (πριν από 3 χρόνια και 4 μήνες)

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Leslie Snyder, Ph.D.

University of Connecticut

Communication

Campaigns &
Programs

Communication campaign:


Organized
communication
activities,


Directed
at a particular
audiences,


For
a particular period of time,


To
achieve
specified goals.

Communication program:


Organized communication activities


Directed at particular audiences


To achieve specified goals.

What Can Health Communication
Accomplish?


Population behavior change


Policy change


Change language to alter perceptions of problems &
solutions


Identify & support people in need


Professional training & improved patient
-
provider
encounters


Organize stakeholders (boards, coalitions)


Diffuse /translate successful programs


Wellstart’s

Comprehensive Int’l
Breastfeeding Campaign

1. Change international policies.

2.

Organize conferences to gain
support of national leaders,
medical elites, & key orgs.

3. Change national policies.


"Right to breastfeed" at work.

4. Change hospital policies.

5. Train professionals

6. Organize national chapters of
the int’l org. for trained
prof
., &
support with media materials,
newsletter,reference

materials.

7. Change curriculum in medical
& nursing schools.

8. Media campaigns to reach
pregnant & lactating women,
fathers, influential older
women.

9. Organize support groups for
lactating women.

10. Language changes


"Baby formula" becomes
"
breastmilk

substitute."


Issue is dubbed, "Lactation
management".

11. Organize means of collecting
feedback on progress made to
date.

4

How to Create a Health
Communication Campaign More
Likely to Succeed


Follow the steps for strategic communication


Use appropriate theories of behavior change &
communication


Pay attention to contextual factors, including
differences among the target populations and their
environments


Strategic Communication Steps

7

Research

behavior,
resources, targets, contexts
(social, political, economic,
legal)

Communication
Plan

goals, targets, persuasive
strategy, channels, behavior

Management
Plan
:
personnel, resources, timetable,
integration with other

organizations & events.

Prepare M
essages

Develop & pretest messages,
media, & train interpersonal
channels.

Implement
&
Monitor


Evaluate &
Adjust

communication plans,
messages, etc.

Goals & Behaviors


State specific, realistic goals that
include behavior change for each
target group




8

Average Effects of Media Campaigns
by Topic


Meta
-
analytic findings

0.03

0.04

0.05

0.05

0.06

0.07

0.09

0.13

0.13

0.14

0.15

0.20

0.00
0.05
0.10
0.15
0.20
0.25
Smoking cessation
Mammography
Heart disease prevention
Organ donation
Family planning
Seat belt use
Alcohol use
Oral health
Fruit & vegetables
Condom use
Seat belt use
Fat consumption
Average Effect
Sizes (
r
)

Campaigns promoting a new
behavior are more effective

10

12%

4%

5%

Snyder et al., 2004

Breast Cancer Prevention &
Support Potential Behaviors


Nutrition


Exercise


Smoking Cessation


Minimize 2
nd

hand smoke exposure


Moderate alcohol (1 drink/day?)


Screening behaviors


Genetic testing


Obtain family history


Seek support if indicated


Targeting



Who are you trying to reach?


Divide the potential target into “segments”


Demographic groups


Target theoretically meaningful segments of the
audience.

12

Thoughtful Segmentation:

by outcomes


1.
Goal behaviors

2.
Current & past
behaviors

3.
Needs



4.
Decision
-
makers



5.
Attitudes, perceptions,
values

6.
Knowledge



Who should do what?


Who has been doing
what?


Who has the most need &
who knows it?


Who has the power to
make it happen?


Who needs to believe
what?


Who needs to know what?

13

Breast Cancer in Young Women


Some potential Segments


By risk:


African
-
American women


Ashkenazi women


American Indian/Alaska Native women???


Other women???


family history


genetic predisposition


smokers


living with smokers


Overweight & obese


By needs: Young survivor support & cancer prevention


Decision makers:


health care providers


families


Break groups down further based
on target behaviors


who needs
to start doing what



1.
E
ase of change /motivation

2.
Timing of information
-
seeking & decision
-
making

3.
Communication channel
use & accessibility

4.
Social, cultural, linguistic
communication differences

5.
Political & organizational
concerns



Who is closer to change?


When are which people more
open to change?


Who is reachable through what
means?


Who treats communication
about the topic differently?


Who should be targeted and
who cannot be targeted, given
the political and organizational
reality?

16

Thoughtful Segmentation:

by communication issues

Break down groups again by who
needs different messages &
channels.

Narrow or Broad Targets?


Trade
-
off




Narrow target groups, can message more effectively


Broad target groups, (often) more reach


Compromise


start off broadly with common message
points, then design special messages/ channels for
populations who need further communication.


OR


use tailored (individualized) messaging when
applicable.



Exposure, exposure, exposure


Greater exposure is associated with greater behavior
change
(Snyder et al., 2002)


Average exposure 40% US health campaigns


Pay attention to intensity of messages


frequency of
exposure


Use multiple channels & formats, especially novel
ones


19

Sources of information for Hispanic
families with kids 5 & under in LA, 2002

0
10
20
30
40
Organizations
From work
Use internet
Listen to radio
Read leaflets & folders
Read book or magazine
Read newspaper
Contact health care providers
Talk with family & friends/phone
Watch TV
Percentage of users, N=327
20

Cheong, P.H., Wilkin, H.A., & Ball
-
Rokeach, S. (2004). Diagnosing the communication infrastructure in order
to reach target audiences: A study of Hispanic communities in Los Angeles. In Whitten, P. & Cook, D. (Eds.).
Understanding health communication technologies.
San Francisco, CA: Jossey
-
Bass, 101
-
110.

Channel considerations


Effectiveness at reaching & affecting people


Cost


within budget


Cost
-
effectiveness


Timing


When are they ready to hear you


How to sustain behavior change

Channel comparisons:

Meta
-
analysis of meta
-
analyses


Searched for all meta
-
analysis of interventions
using media, through 2010.


Compared to a synthesis of interpersonal
-
only
meta
-
analyses (Johnson et al., 2010).



Snyder & La Croix (in press) In Rice & Atkin, Ed. 4, Public Information
Campaigns.

Mammography Screening Interventions

0.10

0.06

0.21

0.19

0.03

0.00
0.05
0.10
0.15
0.20
0.25
Average Effect Sizes

Smoking cessation & prevention
interventions

0.12

0.07

0.08

0.24

0.03

0.09

0.09

0.05

0.00
0.05
0.10
0.15
0.20
0.25
0.30
0.35
Interpersonal interventions
Computer-based interventions
Phone interventions (not mobile)
Mobile phone interventions
Media campaigns
Cessation (adult)
Web-based interventions
Cessation (youth)
Interpersonal interventions
Media campaigns
Prevention (youth)
Average Effect Sizes

Internet
& health



Internet use: 93% teens; 95% 18
-
29, 87%30
-
49 (2011)


Wireless internet use: 79% of 18
-
29 year olds; 60% 30
-
49 year olds (2009, 2011)


Search
the net for health
information 28% teens; 75%
adults


Patients (2008)


Internet searches affect
treatment
decisions.


Use
info to ask docs new
questions.


Medical professionals still dominant source of info for
people with urgent health questions


Recognition of misinformation on the web
BUT ¾
do
not check the source of the info they
find

25

Susan Fox, Aug 26, 2008, The Engaged E
-
patient Population. http://www.pewinternet.org/pdfs/PIP_Health_Aug08.pdf

50% of Adults Use Social
Networking Sites

Pew Internet & American Life data, 2011

Social Media


To get news out:


YouTube & Red Cross


videos about the Haiti
earthquake within 30 min.


valuable
bcs

already
recognized as a resource for reporters.


Messages:


Teen dating violence PSAs & peer messages


That’s
not cool.com 250,000 hits on 3 videos. Target 8
th

&
9
th

graders.


Sex info for teens via text or web.


Text4Baby




27

Match formats for goals & target
groups


Tailored / individualized (more effective than non
-
tailored)


News/ PR (less expensive; need news hook)


Advertising (free often aired at poor times)


Entertainment (may reduce
counterarguing
)

Example

Tailored Calendars to
Promote Childhood
Immunization


(
Kreuter, Caburnay, Chen, & Donlin, 2004
)



Parents of babies aged birth to
1 year received calendars
tailored by:


child’s age


picture & name of child,


immunization dates


local health center info,


child developmental info,


other health & safety info.



Results:
More intervention
than control babies were up to
date on their vaccines at age
24 months (66% vs 47%,
d
=.43).

Use promotions to help “normalize” the
message


Objects


Contests


Events


Tie
-
ins

30

Interpersonal Channels


Make sure patient
-
provider encounters are
high quality


“Brief interventions” can be effective
(
Babor
,
2005)


Train outreach staff in both content &
communication skills


Outreach workers from the target audience is
associated with better campaign messages in
Uganda for AIDS
(
Kiwanuka
-
Tondo

& Snyder, 2002)


May increase sustainability by
institutionalizing interventions

31

Outreach workers vs. peer
-
driven snowball
communication for AIDS with IV drug users
(
Broadhead

&
Heckathorn
)

Cost to educate per person
$0
$100
$200
$300
$400
$500
$600
$700
Peer-driven site
Outreach workers
32

Messages


Pretest & improve all messages & media before use


Make sure all channels share consistent messages


including physicians


Select simple, memorable concepts to promote


33

Brand
Thoughtfully

Emphasize information NEW to
the target group

To capture attention, use
high quality executions
& fresh messages


To increase memory, use
execution elements like logos,
slogans, & jingles


To increase attention, use



multiple executions



refresh media messages often


Celebrities, characters, babies,
animals

36

37

Use explicit, intense, or entertaining messages


Other potential message issues
from theory


Stage of behavior change (e.g. unaware,
contemplating, decision, maintenance)


Beliefs, including risk
-
taking, psychological reactance


Essential knowledge (e.g. “how to”, “when to”, clear up
misconceptions)


Peer norms, perceptions of commonness of the
behavior, & identification with people doing/not
doing the behavior


38

Analyze current messages



Evaluate if need 2
-
sided messages that attacks
incorrect messages.


Evaluate need to undermine credibility of
misleading message sources.

39

Too Smart to Smoke, Colorado

Coke “girl band” ad, linking Coke
with a macrobiotic diet.
http://mfile.akamai.com/332/rm/cocacola.download.akamai.com/332/co
rporate/_media/tv/us_girlsbandfirst_300k.ram

Consider advocacy for
environmental changes


Reduce access to unhealthy products & increase
access to healthy options (e.g. dining out)


Use price strategies to encourage healthy
choices


Easy/free distribution of products that support
healthy choices


Condoms, calcium supplements

40

Evaluation


Monitor to make sure the plan is being followed


check distribution of materials


observe interpersonal outreach


periodically solicit feedback from all staff


Design evaluation with pretest & control group, if possible


need to rule out secular trend causing change


better designs have better chance of detecting change (Snyder et
al., 2009)


Measure intermediate steps to behavior change to track
progress

41

Gaps in health communication
research


Behavior maintenance,
sustainability, & cultural (belief)
change


Coordinate common behavior
change


e
.g
. Diet & exercise promotion


42

Leslie Snyder


leslie.snyder@uconn.edu