Health Communication

From Theory to Practice

Renata Schiavo

• Publisher: Jossey-Bass
• Year: 2013
• ISBN:
  9781118416396
• Edition: 2
• Topic: Médecine
• Subtopic: Santé publique, administration et soins

Now in its second edition, Health Communication: From Theory to Practice provides a comprehensive introduction to theory, intervention design, current issues, and special topics in health communication. The book also represents a hands-on guide to program development, implementation, and evaluation. This second edition further emphasizes the importance of a people-centered and participatory approach to health communication interventions, which takes into account key social determinants of health as well as the interconnection of various health and social fields. While maintaining a strong focus on the importance of behavioral, social, and organizational results as key outcomes of health communication interventions, this second edition also includes newor updated information, theoretical models, resources, and case studies on:

• Health equity
• Urban health
• New media
• Emergency and risk communication
• Strategic partnerships in health communication
• Policy communication and public advocacy
• Cultural competence
• Health literacy
• The evaluation of health communication interventions

To access a companion website with instructor resources (PowerPoint presentations for all chapters, sample assignments, and other resources), please visit www.wiley.com/go/schiavo2e This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from iTunes, Google Play or the MedHand Store.

Part One

Introduction to Health Communication

As readers approach Part One, I cannot help but wonder what they may already think or know about health communication. I wish this book had eyes and ears to listen to all of your discussions so I could learn about each one of you. I would love to know how health communication may help advance your professional goals and what you find helpful in achieving the kinds of behavioral, social, and organizational results that may support improved health outcomes in your neighborhoods, communities, and countries. After all, one of the main mantras of health communication is to get to know the groups we seek to engage and care about. This is why I hope that as for the first edition, many of youwillwrite and share your experience with this book.

Part One is the backbone of the book. It focuses on defining health communication—its theoretical basis as well as its contexts and key action areas. It also establishes the importance of cultural, geographical, socioeconomic, ethnic, age, and gender influences on people's concepts of health and illness, as well as their approach to health problems and their solutions. Finally, this part addresses the role of health communication in public health, health care, community development, as well as in the marketing or private sector contexts.

This section is divided into three chapters, which are strictly interconnected in their scope and aim to provide a balanced theoretical and practical introduction to the field. Chapter One introduces readers to health communication, its key contexts and action areas, as well as its cyclical nature and the planning framework that we will discuss in detail in Part Three. Chapter Two provides an overview of key theoretical influences in health communication as well as contemporary health-related and public issues that influence or may influence its theory and practice. The chapter also includes a brief discussion of select planning frameworks and models used for the development of health communication interventions by a variety of US and international organizations. Chapter Three discusses the importance of cultural, ethnic, geographical, gender, age, and other factors in communicating about health and illness with a variety of groups and how communication is influenced by and influences all of these factors. It also provides examples of different concepts of health and illness and establishes cultural competence as a core competency for effective health communication.

Once again, welcome to my world!

Chapter 1

What Is Health Communication?

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In This Chapter

• Defining Health Communication
• Health Communication in the Twenty-First Century: Key Characteristics and Defining Features
• The Health Communication Environment
• Health Communication in Public Health, Health Care, and Community Development
• The Role of Health Communication in the Marketing Mix
• Overview of Key Communication Areas
• The Health Communication Cycle
• What Health Communication Can and Cannot Do
• Key Concepts
• For Discussion and Practice
• Key Terms

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Health communication is an evolving and increasingly prominent field in public health, health care, and the nonprofit and private sectors. Therefore, many authors and organizations have been attempting to define or redefine it over time. Because of the multidisciplinary nature of health communication, many of the definitions may appear somewhat different from each other. Nevertheless, when they are analyzed, most point to the role that health communication can play in influencing, supporting, and empowering individuals, communities, health care professionals, policymakers, or special groups to adopt and sustain a behavior or a social, organizational, and policy change that will ultimately improve individual, community, and public health outcomes.

Understanding the true meaning of health communication and establishing the right context for its implementation may help communication managers and other public health, community development, and health care professionals identify early on the training needs of staff, the communities they serve, and others who are involved in the communication process. It will also help create the right organizational mind-set and capacity that should lead to a successful use of communication approaches to reach group-, stakeholder-, and community-specific goals.

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Chapter Objectives

This chapter sets the stage to discuss current health communication contexts. It also positions the importance of health communication in public health, health care, and community development as well as the nonprofit and private sectors. Finally, it describes key elements, action areas, and limitations of health communication, and introduces readers to “the role societal, organizational, and individual factors” play in influencing and being influenced by public health communication (Association of Schools of Public Health, 2007, p. 5) and communication interventions in clinical (Hospitals and Health Networks, 2012) and other health-related settings.

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Defining Health Communication

There are several definitions of health communication, which for the most part share common meanings and attributes. This section analyzes and aims to consolidate different definitions for health communication. This analysis starts from the literal and historical meaning of the word communication.

What Is Communication?

An understanding of health communication theory and practice requires reflection on the literal meaning of the word communication. Communication is defined in this way: “1. Exchange of information, between individuals, for example, by means of speaking, writing, or using a common system of signs and behaviors; 2. Message—a spoken or written message; 3. Act of communicating; 4. Rapport—a sense of mutual understanding and sympathy; 5. Access—a means of access or communication, for example, a connecting door” (Encarta Dictionary, January 2007).

In fact, all of these meanings can help define the modalities of well-designed health communication interventions. As with other forms of communication, health communication should be based on a two-way exchange of information that uses a “common system of signs and behaviors.” It should be accessible and create “mutual feelings of understanding and sympathy” among members of the communication team and intended audiences or key groups (all groups the health communication program is seeking to engage in the communication process.) In this book, the terms intended audience and key group are used interchangeably. Yet, the term key group may be better suited to acknowledge the participatory nature of well-designed health communication interventions in which communities and other key groups are the lead architects of the change process communication can bring about. For those who always have worked within a participatory model of health communication interventions, this distinction is concerned primarily with terminology-related preferences in different models and organizational cultures. Yet, as audience may have a more passive connotation, using the term key group may indicate the importance of creating key groups' ownership of the communication process, and of truly understanding priorities, needs, and preferences as a key premise to all communication interventions.

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intended audiences or key groups

All groups the health communication intervention is seeking to engage in the communication process

Finally, going back to the literal meaning of the word communication as defined at the beginning of this section, channels or communication channels (the means or path, such as mass media or new media, used to reach out to and connect with key groups via health communication messages and materials) and messages are the “connecting doors” that allow health communication interventions to reach and engage intended groups.

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communication channels

The path selected by program planners to reach the intended audience with health communication messages and materials

Communication has its roots in people's need to share meanings and ideas. A review of the origin and interpretation of early forms of communication, such as writing, shows that many of the reasons for which people may have started developing graphic notations and other early forms of writing are similar to those we can list for health communication.

One of the most important questions about the origins of writing is, “Why did writing begin and for what specific reasons?” (Houston, 2004, p. 234). Although the answer is still being debated, many established theories suggest that writing developed because of state and ceremonial needs (Houston, 2004). More specifically, in ancient Mesoamerica, early forms of writing may have been introduced to help local rulers “control the underlings and impress rivals by means of propaganda” (Houston, 2004, p. 234; Marcus, 1992) or “capture the dominant and dominating message within self-interested declarations” (Houston, 2004, p. 234) with the intention of “advertising” (p. 235) such views. In other words, it is possible to speculate that the desire and need to influence and connect with others are among the most important reasons for the emergence of early forms of writing. This need is also evident in many other forms of communication that seek to create feelings of approval, recognition, empowerment, or friendliness, among others.

Health Communication Defined

One of the key objectives of health communication is to engage, empower, and influence individuals and communities. The goal is admirable because health communication aims to improve health outcomes by sharing health-related information. In fact, the Centers for Disease Control and Prevention (CDC) define health communication as “the study and use of communication strategies to inform and influence individual and community decisions that enhance health” (CDC, 2001; US Department of Health and Human Services, 2012a). The word influence is also included in the Healthy People 2010 definition of health communication as “the art and technique of informing, influencing, and motivating individual, institutional, and public audiences about important health issues” (US Department of Health and Human Services, 2005, pp. 11–12).

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health communication

A multifaceted and multidisciplinary field of research, theory, and practice concerned with reaching different populations and groups to exchange health-related information, ideas, and methods in order to influence, engage, empower, and support individuals, communities, health care professionals, patients, policymakers, organizations, special groups, and the public so that they will champion, introduce, adopt, or sustain a health or social behavior, practice, or policy that will ultimately improve individual, community, and public health outcomes

Yet, the broader mandate of health communication is intrinsically related to its potential impact on vulnerable and underserved populations. Vulnerable populations include groups who have a higher risk for poor physical, psychological, or social health in the absence of adequate conditions that are supportive of positive outcomes (for example, children, the elderly, people living with disability, migrant populations, and special groups affected by stigma and social discrimination). Underserved populations include geographical, ethnic, social, or community-specific groups who do not have adequate access to health or community services and infrastructure or information. “Use health communication strategies … to improve population health outcomes and health care quality, and to achieve health equity,” reads Healthy People 2020 (US Department of Health and Human Services, 2012b). Health equity is providing every person with the same opportunity to stay healthy or to effectively...