Working on Health Communication

Nova Corcoran

• Publisher: SAGE Publications Ltd
• Year: 2010
• ISBN:
  9781446246764
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

Good communication is at the heart of strategies for effective health promotion and public health. At a time when lifestyle and preventable diseases are still on the rise, practitioners are in need of the skills to deliver effective health messages to the right audience, at the right time.

Responding to this demand, Working on Health Communication provides a practical guide to the process of designing, implementing and evaluating campaigns.

The book follows the campaign design process step-by-step. It covers every stage from selecting theoretical models and identifying the message and target audience, right through to running the campaign and evaluating its success. "Real-life examples" of actual campaigns are used throughout to show how theoretical ideas work in practice.

Working on Health Communication is ideal for students and practitioners in public health, health promotion and other health-related areas who are working on health campaigns.

1

Planning campaigns

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Planning is essential to ensure success in health campaigns. This chapter will highlight the role of planning in the design of health campaigns and consider why planning is integral to success. This chapter will identify four planning models: (1) the nine-step model; (2) the Total Process Planning Model; (3) PRECEDE-PROCEED; and (4) Intervention Mapping. These are taken from various disciplines connected to health and can be applied to health campaigns. This chapter will evaluate these models and consider how they can work in a practical context.

This chapter aims to:

• explore the rationale for using planning models in campaign planning and design
• identify a selection of planning models that can be used in the design of campaigns
• apply theoretical aspects of planning models to health communication practice

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PLANNING

Planning can contribute to a health campaign by helping to:

• identify the main problem and solution;
• identify the correct approach;
• ensure effective resource use and allocation;
• avoid unwanted outcomes.

Practitioners need to ensure that, in any campaign, both the main problem and its solution are identified. Russell et al. (2003) suggest that if the problem is not described accurately, then factors including the inability to identify an alternative solution may not be possible. Tones and Green (2004: 109) suggest that ‘the overall purpose of systematic planning is to identify goals and the most effective means of achieving them’. Planning therefore can ensure success. Godin et al. (2007), in their review of the planning process in STI and HIV campaigns, emphasize that planned campaigns are more likely to be successful. Planning not only helps to organize theories and ideas, but also ensures correct identification of a problem and a solution.

Approaches vary between campaigns. Planning assists the selection of the most appropriate approach. For example, an accident prevention campaign aimed at young children will use a different approach to a campaign that aims to increase knowledge in adults of an infectious disease. There is no single general campaign that can be applied to all health issues or all target groups. There can be considerable differences between campaigns, especially in relation to applicability and transferability of theory into practice (Wang et al. 2005; Corcoran 2007b; see also Chapter 2). Evidence from research in one campaign may not translate well into practice in another campaign.

Planning also helps to ensure that resources are used effectively. Douglas et al. (2007) indicate that failure to demonstrate a planned approach can mean there is a risk that your topic will not be given priority, and thus funding or resources may be allocated elsewhere. They also note that systematic planning can ensure resources are used effectively. From the budget-holders’ or stakeholders’ perspectives, planning ensures value for money and minimizes misdirected time, spending and resources. Planning is essential in ensuring any problems identified are addressed in the preliminary phases to try and eliminate factors such as misdirected messages, or administration failures.

One of the problems of campaigns is the risk of unexpected or unintended consequences, for example, a campaign may run out of resources. Moreover, there is some evidence to suggest that campaigns may have a boomerang effect (for an example, see the section on fear appeals in Chapter 6). In addition, some authors suggest campaigns can have unintentional, negative, impacts. Lee (2007) indicates that some sexual health promotion misses its audience with men who have sex with men, possibly in part due to the advertising imagery used having unintended consequences. Effective planning may help to reduce this risk, especially through the application of planning models.

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Activity 1.1: Unplanned outcomes

You have been working on a campaign to reduce high dietary fat intake in a group of overweight young teenagers. The main messages link appearance and feeling good with eating less fat.

1. What possible positive effects could this campaign have and what possible negative effects could this campaign have on the target group?

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PLANNING MODELS

Planning need not be static, rigid or fixed. It does, however, need to be systematic (Douglas et al. 2007). Health communication is generally based on systematic planning models drawn from health promotion and public health practice. It can be argued that working to a planning model may restrict creativity and imagination in the campaign process, but on the contrary, planning models help ensure that the imaginative and creative process is developed as appropriately as possible. Horst et al. (2009) indicate the importance of adapting campaign planning to prevailing conditions. For example, their project changed elements of the original project in response to new information regarding drug toxicity, decreases of workload, and the changing realities of HIV care. A practitioner therefore needs to view planning as an adaptable process that is flexible enough to change to meet the changing realities of day-to-day health practice.

Effective planning may be based on a variety of models. ‘Models are the means by which structure and organization are given to the planning process’ (McKenzie et al. 2005: 15). This is not to say that a planning model is rigid and inflexible, but is more a framework that ensures everything you want to happen actually does happen. Although campaigns can take place without a planning model to guide them, the risk of the campaign not meeting outcomes, going over budget or not anticipating avoidable factors is then much higher.

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Activity 1.2: Stages in the planning process

1. If you were going to pre-plan a health communication campaign to promote the wearing of a seatbelt in a car, what key planning steps would you need to include? Think broadly from the conception of the campaign to the very end of the campaign.

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Planning models typically follow a series of steps in a logical order. These sequential steps vary somewhat between different planning models. McKenzie et al. (2005) propose that these steps are: understanding and engaging, assessing needs, setting goals and objectives, developing a campaign, implementing the campaign and evaluating the campaign. Other common steps in a planning model include examining the evidence base, identifying budget and resources and identifying methods. The steps included in planning models are usually represented in diagrammatic forms – usually circular or linear – to enable the health practitioner to work towards their desired outcomes.

CHOOSING A MODEL

In small-scale campaigns a basic planning model will suffice. Practitioners can then choose to add other planning tools (see Chapters 2 and 3) to their own campaign plans. Larger-scale projects, especially if they involve more than a small group of people and have larger budgets, stakeholders or target groups, may find that the more complex planning models provide scope for this level of attention to detail. Generally, the bigger the project, the more factors need to be accounted for and therefore more pre-planning is required.

Selection of a planning model is not merely a matter of personal preference. McKenzie et al. (2005) highlight a number of reasons for the choice of a planning model including the preference of stakeholders and the time available for the planning process. A wide range of planning models are used in health promotion and public health practice. The further reading at the end of this chapter indicates where you can find information about additional models not covered this textbook. In this chapter we consider four planning models that can be used for health communication campaigns. They are:

1. The nine-step planning model.
2. Total Process Planning Model (National Social Marketing Council 2006b).
3. PRECEDE–PROCEED (Green and Kreuter 2005).
4. Intervention Mapping (Bartholomew et al. 2006).

The first two of these are sequential planning models incorporating basic stage/ step models of planning. They are less complex than some other planning models as they follow a logical sequence and allow room for additional variables to be included as necessary.

The more complex planning models considered in this chapter are the PRECEDE-PROCEED model and Intervention Mapping (IM). These models are more rigid and prescriptive in nature. While there are a number of other planning models available to practitioners (some of which use computer-based software), these two models are commonly used in health and have demonstrated their use in a range of health promotion and public health-based work, showing adaptability to health campaigns.

THE NINE-STEP MODEL

The nine-step model is cyclical in form. It is based on the idea that feedback from one campaign can contribute to the development of the next. The steps in the nine-step model (see Figure 1.1) are (1) Rationale, needs and priorities (2) Aims and objectives (3) Selection of theoretical model (4) Method and design of method (5) Resources/budget (6) Evaluation (7) Action plan (8) Implementation and (9) Feedback and future. Each step will be described in turn.

Step 1:	Rationale: the rationale is written, including the evidence base to identify the main reasons for the campaign. Needs and priorities are also decided.
Step 2:	Aims and objectives: this is where aims and objectives are set.
Step 3:	Selection of theoretical model: a theoretical model is selected to provide the basis for the campaign.
Step 4:	Method and design of method: the method and how the method will be designed are formulated here. ...