KEY CONCEPTS
- Framing Of Decisions
- Psychology Of Choice
- Reference Points/Anchors
- Gain vs. Losses And Risk Aversion vs. Risk Seeking
- 6 Elements Of Communication Strategy
- Benefits And Support
- "Wrong Reason" Health Promotion
- "House" Metaphor
- Message Strategies (fear, humor, slice of life, testimonial) & Effects
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There were a lot of great take home messages in yesterdays class. One of of these had to do with a my personal reality check that occurred during the "benefits and support" exercise. When, as a group, we answered the benefit that our target population would get from participating in Project SOL we didn't question our answer. In fact, I don't think we felt that our answer was inconsistent with what our population might really find as a benefit. After Dr.Engelberg's feedback I had a total reality check moment realizing that being in public health really shapes my thoughts and opinions. I mean its kind of obvious that what you study influences the way you see the world. But this realization was more about recognizing how as a future public health professional I always need to keep in mind where I am coming from in creating messages and where my audience is coming from. The other take home message I walked away with had to do with sticking to our core values when making decisions. Again, it seems so obvious but sometimes you just need someone to remind you of these kinds of things. Acknowledging that our core values are there so we can stay grounded, step back to make decisions, and avoid the influence of risk communication, is a concept that I think, as public health professionals, we should keep close to us.
dbc's commentary regarding the importance of remembering one's core values really resonated with me, as it did during class yesterday. So often the values of others, whether it be my peers, faculty members, or the field I am in, influence my judgment. If we were all motivated by our core values, I bet our HP activities would be much more in line with the values of the folks we are attempting to serve. Isn’t it funny how circular it can become when we are concerned about the values of everyone else but ourselves. This circle basically forces us to miss the boat entirely, and instead circle aimlessly around our target population. I am taking this lesson and running with it! Here’s to honoring my core values (and in turn, those of the people I hope to serve).
One of the most interesting points from class on Tuesday was the concept of "wrong reason" health promotion. We, as public healthers, like to think of ourselves as the first defense when it comes to preventive healthcare, but can get discouraged when others do not see it the way we do. And the way we see it is very technical... don't smoke, you have a chance of getting lung cancer and dying. Don't eat a lot of In and Out Burger, you will have a greater chance of getting diabetes or heart disease. I think the line between "wrong reason" and "right reason" health promotion is very blurry. Does it really matter how they get there, as long as they're there? For example, when talking to my little sisters about artificial tanning I want to scream, "But you could get skin cancer!" But what I need to be saying is, "Your skin is going to look like leather, and its just going to make your mild adolescent acne worse in the long run by drying out your skin." Maybe they'll hear me better if I say it that way.
The exercise we did in class was very informative in describing how "framing" works. It's definitely very useful in knowing how "framing" can influence one's action. Of course one's core value also play a very important role. Thus, we as public health professionals need to learn these strategies in "framing" messages for our audience as well as trying to get to know their core values. Another great discussion we had in class was the idea of "wrong reason health promotion". For instance, in that smoking campaign getting kids not to smoke because it would give them bad breath would seem wrong from a public health perspective. However, if this prevents the kid from smoking why not? So, I agree with Emily on how we shouldn't just list all the health risks associated with the behavior but make it more personal and perhaps then they will see a relationship and stop.
Nicer breath, better skin, more sex… These may seem like “wrong” reasons for health professionals to promote why to make healthy choices, but I’m not so sure that I agree that they really are all that wrong. If I understand Emily correctly, I would like to echo her opinion that sometimes “wrong” reasons certainly sound more appealing and are more likely to get someone’s attention than “don’t smoke, you could get lung cancer,” “don’t go tanning, you could get skin cancer,” “use condoms or you could get a sexually transmitted disease…” And what about nice breath, better skin and more sex is so “wrong” anyway? For me, this is where I see customer centered focus and framing coming together. I believe most people would prefer to hear what they can gain from making a healthy choice versus what they might lose if they continue making certain unhealthy choices. I also believe that people make many decisions based on the more immediate and apparent gratifications (i.e. more pleasant breath today versus maybe not getting skin cancer in 20 years). If we ask our audience and they say they would be more easily swayed by the “wrong” reasons, then as long as our message is in the name of health and truly promotes healthier choices, those reasons don’t seem so wrong afterall.
So many times health promotion campaigns are designed to elicit fear, yet the use of fear is often ineffective in achieving the desired behavior change. What does work?? As I have been told fear appeal does not work in getting people to change their behavior and yet we see it all the time. This is what I found and learned: fear is most likely to be effective if the campaign allows for the desired behavior to be reinforced by a reduction in the level of fear. This entails five requirements: 1) fear onset should occur before the desired behavior is offered; 2) the event upon which the fear is based should appear to be likely; 3) a specific desired behavior should be offered as part of the campaign; 4) the level of fear elicited should only be such that the desired behavior offered is sufficient to substantially reduce the fear; 5) fear offset should occur as a reinforcer for the desired behavior, confirming its effectiveness. After having read this, I can help but to think who actually does this? Keep all these points in mind is difficult if not next to impossible. Check this link out, here is what I am talking about:
http://www.allacademic.com/meta/p_mla_apa_research_citation/1/7/3/2/1/p173218_index.html?phpsessid=2e3ba2b122bd1f2ecdfaed1e7a07cc29
This is cool too
http://www.allacademic.com/meta/p_mla_apa_research_citation/1/7/3/2/1/p173218_index.html?phpsessid=2e3ba2b122bd1f2ecdfaed1e7a07cc29
For my HIV/AIDS class I had the opportunity to attend a group counseling session with HIV positive Navy service men/woman. The group session is part the treatment services and is required for those who just became aware of their positive status. There were 2 guys there who just found out 2-3 weeks ago. My professor is the doctor at the HIV clinic at the Navy base and this was one of class field trips. There was another doctor there who led the group discussion. He was able to incorporate all of the different ways to shape message, from using every day relatable situations (slice of life), to using fear, humor, and testimonial from people, in his HIV prevention talk. He used humor on uncomfortable subjects, a bit of fear on important parts (facts and methods), and the HIV positive patients provided the slice of life and the testimonials. For me the testimonials stood out the most because it made everything that I already know about HIV real. They added a face and a voice for me to HIV prevention and awareness. Even though us GSPH student are not the best target audience for this type of message, I was able to inform my roommate and other friends about what I heard and learned. The doctor actually told us to do this. At the beginning of the group discussion one of the patients said that he did not think he could lead an HIV education/awareness group because he was not knowledgeable on the subject, like the doctor. Well he was definitely wrong! His reference point, experience, and words made an impact on me and I believe the other students as well. His testimonial or any other HIV positive person would be a great strategy to deliver HIV awareness/prevention message. I am more aware and ready to spread the word!
After reviewing everyone's comments, I agree with a lot of what has been said. I concur with Emily and Dalila in that "wrong" reason health promotion is actually for all of the right reasons. Changing health behaviors is the bottom line as long as no one gets hurt - no harm, no foul. I thought the psychology of choice was pretty powerful. At first, when I read the article, I was really confused. But, after lecture, it made more sense. Presenting choice in a way that empowers people to make a decision in which there is something to gain and not a lot to lose can make a big difference. It's difficult to frame a message when it's so easy to think you have all the answers. But, as Noni added, the frame of reference can make all of the difference in the world. Delivering the message in such a way where it makes the audience think/feel/do what you want is priceless when it's something that can literally change a person's life and save it in the process. I just have to add that I only regret not knowing more of this earlier in life. While we've learned so much already, I imagine that we've only touched the tip of the iceberg. Health communication is a powerful tool that can be used in so many ways. It's pretty exciting stuff.
Really helpful class on framing decisions and psychology of choice, especially helpful was the actual frame used as an exercise with our groups and using already existing segments--really got me thinking of what's important. The target behavior rules and keeping this message circular and how critical this is to the consumer. Pointers on keeping the message simple, & real, and make it appeal to emotions, fear, humor, testimony and test and retest are great guidelines. THe examples in the video were helpful is seeing what DOESN't work --good pointers/ and PRETEST and get feedback .
Great comments by everyone so far. I especially agree with the thoughts about 'wrong reason' health promotion by Emily, Dalila and Amanda. In order to be effective health promoters we need to be in touch with our audience and be open to capitalizing on their needs, wants and motivations, even if to us these fall into the category of the 'wrong reasons' for practicing a health behavior. And just because we are in this field doesn't mean that we can't be motivated by some of these reasons too...last night I was debating with myself about whether to go to the gym and having a hard time finding the motivation to do so. Even though I am in public health and know all the health benefits of regular exercise, in the end what actually got me to make it inside the gym was thinking about the cruise I'll be going on in a few months and how I will be wearing a bathing point at some point. Superficial I know, but that is where I was at last night. If I as an educated health promoter can't even get myself to exercise for the 'right' reasons, how can I expect to motivate anyone else to?
Your comments have given me a really interesting takes on the take home messages from class. I agree with Sareh that our exercise in framing really led me to understand that its not just what is said, its how you say it. Framing issues for us as health professionals is very important in order to get our message across effectively and get people to understand the relevance. This ties into the idea of making sure we know what is consistent with their beliefs and be able to frame it in a way that its something they can find pesonal relevance in, and not a message that appeals just to us and assume it therefore will appeal to everyone (puttin them in the middle intstead of us). I agree that when viewing tactics like "anti-aging" instead of skin cancer etc. are not the "wrong reasons", but reasons that we are all susceptible to in some way and degree, and if works for a positive outcome, and permits getting a "foot in the door" for introducing more education, I think its the way to go.
The idea of "wrong reason" health promotion strategies resonated the most with me from Tuesday's class. I agree with other comments about the effect a "wrong reason" can have when promoting health, compared to providing the gruesome health consequences like cancer and death. I think this approach is especially beneficial when targeting teenagers as they tend to have an invincible attitude. Most often a teenager will not be effected by the possibility of getting cancer down the road, but they would listen to an immediate consequence, such as bad breath from smoking. I looked online for examples of humor in health campaigns and found one that targeted kids and teenagers and highlighted poor reflexes from eating junk food. The beginning of the ad shows a guy getting kicked in karate as he has a delayed response to block the kick once he is on the ground. I think this strategy of revealing immediate consequences from a poor diet, compared to an attempt to scare them with diabetes, heart disease, and other ailments, would have a greater effect in changing their behaviors.
http://www.youtube.com/watch?v=bs2hqqCPkiA
The lab in class, where we had to choose which one was the best intervention program was great! It made me see that these decisions really does have to be made in real life. When new drugs are introduced in the market, these companies are taking a great deal of risk. They don't know if the drug will correctly or not on all people. It might even be harmful to some people. However, they still must try to find cures for some health problems or pills that make quality of life better.
It is hard to choose which methods are better for which individuals. We want interventions that are good for all indivduals, but it just doesn't work that way. That's where Public Health peeps come in!
The concept of the "Domain of losses" and the "Domain of winning" and how they specially relate to framing decisions of our statements is extremely significant to me. It makes all of the diference! The results that came out of our exercise in class gave more than enough evidence of this. The last part of the class were we participated in the "wrong Reason" way of promoting health really is an eye opener, its just one of those things that I have been hearing as PSA's for a while, but was never able to identify as a strategy. It is my belief that if it works, use it, with certain ethical considerations of course
I liked the way the discussion and class went on tuesday. It was important to hear that we need reality checks and realize who we are talking to. We can not all assume that people care about the issues that we find important or even vital. First step is to put things in their perspective, which is what I am dealing with in my internship. There I work for the Office of Violence Prevention and the latest thing is budget cuts, they do not feel that we should have services everywhere... why they think that, I have NO idea but it works better then when we put into numbers that one example case of a murder due to interveable DV situations costs tax payers over 2 million dollars... knowing who we talk to we then think this may be important to them, because the issue itself is not. Then does the ends justify the means? Does it matter what we do as long as we get positive results?
After Tuesday’s class I paid attention to the health message to see what their catch was. Were they doing “wrong reason health promotion” You bet. Although most on the TV would state their actual reason they were still masked by sex, looks, and money. One of the funniest/strangest I saw was during Good Morning America and it started out talking about finding happiness and showed a mother and a daughter getting ready for a wedding. You think it is for the daughter’s wedding but it turns out it is for the mom and the commercial is for Depends. Like I said, it was strange, yet funny and kind of touching. Not usually the thoughts that go along with Depends but the commercial took something unrelated to get the viewers attention. Were they wrong? I don’t think so. I think they were creative. But it really is a moral dilemma for me. You want people to listen, and the only way you are going to get their attention is to do something extreme. Otherwise your message will just get lost in all the other ads. I guess it boils down to the extreme you go to.
Also, I found the group activity really challenging. I was so suprised with how simple the activity looked and then when we tried it, the class and Dr. E really opened my eyes to what really are the benefits and support.
I apologize for missing class but had some business to tend to. I had a great experience this last Friday,I have a project that involves training Los Coyote and La Jolla Indian Tribal members to teach a Pandemic Flu class to other tribal members. I am having them do formative research on the other members that will be receiving the training. We are looking at literacy levels and best ways to hold their interest. My communication message is very basic but having them go through even very basic steps will improve the level of response from the target audience. They think I am all smart I had to tell them I was just now taking this class and that allot of this is fairly new to me also. I practiced the active listening and they would not slow done with the ideas. It was fun they feel more involved.
It was interesting to break down a message to the core actions and consequence of a behavior. “If I do this…than I will benefit from…” This seems to be a healthy way of setting up goals for any type of behavior change. If we really think about it, our entire day is a bunch of actions and reactions—some may be negative and some positive. It is our intention to acquire more rewards than penalties for our behaviors.
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