Health Communication and Mass Media

An Integrated Approach to Policy and Practice

Rukhsana Ahmed,Benjamin R. Bates

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317123330
• Edition: 1
• Topic: Business
• Subtopic: Public Relations
• Index: Business

Health Communication and Mass Media is a much-needed resource for those with a professional or academic interest in the field of health communication. The chapters engage and expand upon significant theories informing efforts at mediated health communication and demonstrate the practical utility of these theories in on-going or completed projects. They consider how to balance the ethical and efficacy demands of mediated health communication efforts, and discuss both traditional media and communication systems and new web-based and mobile media. The book's treatment is broad, reflecting the topical and methodological diversity in the field. It offers an integrated approach to communication theory and application. Readers will be able to appreciate the ways that theory shapes health communication applications and how those applications inform the further construction of theory. They will find practical examples of mediated health communication that can serve as models for their own efforts. While the book serves as an introduction to mediated health communication for students, professionals, and practitioners with limited experience, researchers and advanced practitioners will also appreciate the exemplars and theoretical insights offered by the chapter authors. This book will be of interest to anyone involved in health communication programs or more generally with communication and allied studies, as well as to those in the health professions and their related fields.

PART 1 Introduction

CHAPTER 1
Communicating Health through Mass Media: An Overview

RUKHSANA AHMED AND BENJAMIN R. BATES

Introduction

Health communication has been defined as the study and use of communication strategies to inform, influence, and motivate individuals, institutions, and communities in making effective decisions to improve health and enhance quality of life (U.S. Department of Health and Human Services 2005). Considering this wide scope of health communication, scholars, practitioners, and policy makers recognize the significance of health communication to public health (Rimal and Lapinski 2009, Schiavo 2007). In today’s media-saturated world, the importance of research on health communication in mass mediated contexts cannot be overemphasized, especially given that mass media are important communication channels for advancing health education and promotion, disease prevention, and shaping public policy.

Much of the public’s understanding of health and health policy is not from their direct experience. Instead, most of their understanding is mediated. Health and illness discourses are pervasive in the print media, television, cinema, and the Internet (King and Watson 2005). Media channels, including print journalism, advertisements, fiction films, television shows, documentaries, and computer technology affect the healthcare system and individuals’ use of that system (Friedman 2004). Clearly, media representations of health and illness shape our understanding of the experience of illness, health, and healthcare and influence health beliefs, health behaviors, healthcare practices, and policy-making (Seale 2002, 2004).

In addition to shaping general understandings, mass media play an important role in promoting public health (Abroms and Maibach 2008, Atkin and Wallack 1990, Viswanath, Wallington and Blake 2009). As Wallack (2000) argued, media “can be a delivery mechanism for getting the right information to the right people in the right way at the right time to promote personal change” and that “they can be a vehicle for increasing participation in civic and political life and social capital to promote social change” (338). In today’s media rich landscape, and especially with the advancements of Information and Communication Technologies (ICTs), increasing efforts are underway to incorporate mass media strategies into health education, promotion, and disease prevention practices (Melanie, Wakefield and Hornik 2010, Parker and Thorson 2009, Viswanath, Wallington and Blake 2009). At the same time, scholars have documented mass media’s reach to select audiences and specific, limited, and moderate effects in influencing health knowledge, attitude, and behavior (Atkin 2001, Rice and Atkin 2009, Atkin and Salmon 2010, Salmon and Atkin 2003). To fully realize mass media’s role in facilitating the pursuit of health education and promotion, and disease prevention, health communicators need to exploit multiple mass media and interactive digital media channels and carry out carefully planned media strategies to reach intended audiences.

Regardless of medium or strategy, Griffiths and Knutson (1960) argued that “three effects might occur: the learning of correct health information, the changing of health attitudes and values, and the establishment of new health behavior” (515). Scholars interested in the role of mass media in health communication have studied effects of media use on health outcomes and effects of planned use of media to achieve health outcomes in many areas (Finnegan and Viswanath 2008). Programs designed to promote changes in health behavior and prompt treatment of illness have demonstrated the effectiveness of mass media channels in health promotion and disease prevention efforts such as discouraging alcohol, tobacco, and drug use (Snyder et al. 2006, Strasburger and Wilson 2002); minimizing harmful effects of violent television (Rosenkoetter, Ozretich and Acock 2004, Rosenkoetter, Rosenkoetter and Acock 2009); addressing eating disorders (Shields 2005, 2006); promoting physical activity (Strasburger and Wilson 2002, Van den Berg, Sztainer, Hannan and Haines 2007); curbing aggressive behavior and violence (Murray 2008, Strasburger and Wilson 2002); and promoting responsible sexual decision-making (Strasburger 2005, Strasburger and Wilson 2002), among other areas.

Collectively, these studies encourage us to attend to two issues for a successful mass mediated health communication intervention: the issue of theory and the issue of medium.

THE ISSUE OF THEORY

Health communication, when delivered effectively in mass mediated contexts, has considerable potential to promote the health of individuals, communities, and populations. These mass mediated messages are more likely to be successful in affecting health knowledge, attitudes, behavior, practice, and policy if they integrate health communication theory into their design and evaluation (Atkin and Wallack 1990, Dutta-Bergman 2005, Hornik 2002, Maibach and Parrott 1995, Murray-Johnson and Witte 2003, Noar, Harrington and Helme, 2010, Palmgreen and Donohew 2010, Randolph and Viswanath 2004, Rice and Atkin 2001, Salmon and Atkin 2003, Silk, Akin and Salmon 2011, Slater 2006). Although there are many specific communication theories that can be brought to bear on mass mediated messages, three families of theoretic approaches have been most commonly used: media advocacy approaches, social marketing approaches, and entertainment – education approaches.

Media advocacy approaches include theories that involve “the strategic use of mass media for advancing a social or public policy initiative” (Stewart and Casswell 1993: 167). Although these approaches are used for public health promotion, they do so in a way that addresses institutional and governmental decision makers through indirect lobbying efforts (Wallack et al.1993). As a powerful health communication strategy, media advocacy plays an important role in engaging people in dialogue about health promotion and disease prevention, facilitating community organizing to generate demand or support for health services, and potentially influencing policy-making on critical public health issues (Marchibroda 2009, Rock et al. 2011, Wallack and Dorfman 1996). In general, such efforts are likely to draw on communication theories from the realm of rhetoric, public relations, and agenda-setting.

Social marketing approaches involve the use of marketing concepts and techniques “to design and implement programs to promote socially beneficial behavior change” (Grier and Bryant 2005: 319). Social marketing approaches – such as the Theory of Reasoned Action, the Health Belief Model, and the Transtheoretical Model – have become a popular health promotion tool to influence perceptions, beliefs, attitudes, and behaviors regarding health issues (Edgar, Volkman Logan and 2011, Paço et al. 2010). Scholars have identified social marketing as an important condition for successful public health mass media campaigns because of its potential to “create the appropriate messages for distribution and, where possible, message theory and tailoring (creative marketing and messages)” (Randolph and Viswanath 2004: 422, Huhman 2010). However, health communicators and practitioners require understanding of the theoretical underpinnings of social marketing to effectively use it to plan public health interventions (Dooley, Jones and Desmarais 2009, Grier and Bryant 2005, Walsh et al. 1993). Because most social marketing approaches seek to affect individual beliefs, attitudes, or behaviors, the theories used in social marketing tend to be derived from psychological theories of decision-making.

Entertainment-education approaches consist of:

purposely designing and implementing a media message to both entertain and educate, in order to increase audience knowledge about an educational issue, create favorable attitudes, and change overt behavior (Singhal and Rogers 1999: xii).

Studies have documented how, through combining entertainment and education, this mass media strategy has been applied to produce behavior changes for HIV/AIDS and Sexually Transmitted Disease (STD) prevention (Glik et al. 2002, Kennedy et al. 2004), syphilis screening (Whittier et al. 2005), and condom use (Collins et al. 2003). Entertainment-education approaches emphasize partnership among entertainment media practitioners, public health and health communication professionals and academics for designing effective health promotion and disease prevention interventions (Kennedy et al. 2004). Most entertainment education approaches draw from the family of theories that emphasize social learning and social psychology.

As important as a strong theoretical basis for mass mediated health communication is, a strong theory needs an equally strong consideration of the medium to be used.

THE ISSUE OF MEDIUM

Any health communicator has a variety of media from which to choose when attempting to influence health beliefs, behaviors, and policies. These media include, but are not limited to, news media, mass mediated advertising, and new communication technologies. For different issues and different audiences, different media may be more or less effective in spreading the desired message.

Print and electronic news media are major sources of health information (Rice 2001, Winett and Wallack 1996). Health news media coverage has an important role in shaping health behaviors at the population level (Pierce and Gilpin 2001, Niederdeppe and Frosch 2009) and influencing public health policy (Tong et al. 2008, Asbridge 2004). However, as health news coverage becomes more prevalent in the media, researchers are calling into question the quality, completeness, and validity of reporting (Cassels and Lexchin, 2008, Hayes et al. 2007, Hoffman-Goetz and Friedman 2005, Jaffery et al. 2006, Moynihan et al. 2000, Cassels et al. 2002, Larsson et al. 2003). Given the role of news media in shaping public perception of health issues and public policy agenda-setting, journalists, healthcare researchers, and professionals should work together in assuring quality, completeness, and accuracy of reporting is vital (Schwartz and Woloshin 2004, Moynihan 2003, Entwistle 1995).

Health promoting advertising is also used as a medium for health communication. As part of a multimedia campaign to promote healthy behavior, advertising on television, radio, or cinema and in print outlets can play a central role promoting public health (Peddecord et al. 2008). However, while health promotion advertisements can influence health through demonstrating health effects (Hyland et al. 2006, Siegel 1998) and raising awareness of health messages (Levy and Stokes 1987), the efficacy of health-promoting advertising has yet to be established (Lynch and Dunn 2002). Therefore, scholars call for more research to map its potential for health promotion (Fennis 2003, Lynch and Dunn 2002, Peddecord et al. 2008).

In today’s media saturated environment and within a global context of bio-terrorism, infectious disease threats, and natural disasters, traditional one-way delivery of messages from a central source can be usefully complemented by more interactive platforms that allow people to engage with health issues, help them find acceptable and appropriate solutions to health problems, and encourage them to play a central role in self-care. While public health mass media campaigns traditionally rely on “television, radio, newspaper, and printed materials, especially broadcast spots, press releases, and pamphlets” (Salmon and Atkin 2003: 461), ICTs have “the potential to transform health campaigns” (468). Yet, as Kline (2003) argues, “there is considerable interest regarding the relationship between the popular media and our understanding of health issues” (575). As such, traditional communication methods have not been replaced by new media; rather there is a complex media ecosystem in which health consumers, practitioners, and regulators find themselves. And, as ICTs promise for public health increases with more people turning to the Internet to access healthcare information (Cline and Haynes 2001, Rice and Katz 2001, Shuyler and Knight 2003) and with more public health agencies using these tools for communicating public health issues (Brownstein et al. 2010, Currie 2009, Khan et al. 2010), more studies need to analyze the efficacy and efficiency of new media in this context.

Rapid advancements in mass media technologies continue to offer new and more effective ways to provide healthcare. Web and mobile technologies – including eHealth and mHealth technologies, electronic health records and other communication systems – have shown themselves to be helpful for improving health communication (Glueckauf and Lustria 2009, Whitten, Cook and Cornacchione 2011, Wright 2009). Although these, and other, communication technologies may make medical communication faster and more convenient, and may have developed alongside better medications and surgical techniques, it is important not to confuse improvements in technology with simple improvements in human health. On the one hand, new ICTs have accelerated the means for improving public health processes and healthcare delivery in terms of enhancing the dissemination of health information (Jareethum et al. 2008, Levine et al. 2008); aiding remote medical consultation, diagnosis, and treatment (Handschu et al. 2003, Hsieh et al. 2004); and facilitating communication, collaboration, and team work among and between healthcare professional and receivers (Rice and Katz 2001, Turner 2003). ICT-based health information systems and decision support systems can also help facilitate medical research and increase administrative effectiveness in medical facilities (Murphy, Ferris and O’Donnell 2007, Ortiz and Clancy 2003). On the other hand, efforts to integrate ICTs into healthcare services have given rise to newer health communication challenges. For example, not every individual has access to these technologies, thus widening the digital divide in access to health information (Hagglund, Shigaki and McCall 2009, Lorence, Park and Fox 2006). Increased availability of online health information and services places a demand on consumers to develop additional skills essential to navigate the technology used to obtain, process, understand, and apply health information (Bernhardt and Cameron 2003, Berry 2007, Zarcadoolas and Pleasant 2009). Moreover, while technology will allow more convenient communication between patients and physicians and geographically bounded medical settings, the importance of understanding the effects of technology-mediated communication on patient-doctor relationship cannot be denied (Cullen 2006, Eckler, Worsowicz and Downey 2009, Turner 2003). Hence, we need to better appreciate the ways that communication technologies assist, sometimes, and interfere, other times, with the ability to attain health goals by patients, providers, and public health agencies.

Meeting the Challenge of New Theories and New Media

In light of this rapidly developing and changing media ecosystem, there is a need for scholars and practitioners of health communication to understand multiple perspectives and approaches in the study of health communication if they are to understand the unique contributions, benefits, and challenges of different media technologies on health practices and policies. As Viswanath, Wallington, and Blake (2009: 324) argued:

A clearer understanding of the range of mass media delivery channels; the changing and converging media environment; the communication inequalities that exist; social, institutional, cultural, and policy influences; and new and existing theoretical and methodological frameworks are all necessary to understand the complex influence of mass media on population health. Addressing these issues, both in study and in practice, will undoubtedly help researchers and health professionals harness the best practices of communication and the mass media to improve individual and population health.

As such, in addition to exploring the role of traditional media, such as print and television, we need to examine the role of new technologies in shaping the public’s health. And, even if we understand the technologies, we also need to consider how we use these technologies: are we using these technologies in effective, appropriate, and ethical ways as sources of health information and advocates for health behavior? Against such a backdrop, this volume, Health Communication and Mass Media: An Integrated Approach to Policy and Practice, seeks to contribute to our understanding of traditional media and new media technologies in supporting health policy and practice by bringing together exemplars of current health communication research and applications in mass mediated contexts spanning across geographic regions.

To meet this goal, this volume attempts to accomplish four objectives. First, we seek to offer a broad treatment of health communication practices and theories in mass mediated contexts. We do not seek an in depth exploration of a single medium or a single technology. Instead, we seek to demonstrate the breadth of options available to health communicators to give communicat...