mod 3-- framing the message

Module 3 went by quickly, especially since we only really spent one day in class on it, but the content was memorable. How a message is framed is so important. It helps, of course, to know what audience to target and what beliefs/behaviors should change but that's only half the battle in getting a message out to that group that will affect change.

Since I presented on humor, that sticks out most in my mind. My gut told me that fear appeals would be less effective, but it makes sense that they would be more appropriate when targeting screening behavior. We may end up using something like that for our project since one of our target behaviors is STI screening. Bottom line is that all messages need to be tested. That seems to be the case all-around, independent of the chosen method.

The idea that branding should be used in public health campaigns was unfamiliar to me, but now strikes me as brilliant. I remember seeing the Truth ads years ago and wondering who was paying for them as there seemed to be no product... and too interesting and clever to be PSAs. The fact that 5 A Day turned into Fruits & Veggies-More Matters hit home the idea that branding needs to be well thought out so as to be generic enough to be long-lasting.

Module 3 Summary

I find it hard to believe we are already half way through our semester. I took several messages away from module 3 even though we did not have as much time as expected to cover the material. I found the use of humor and fear to stand out the most.

Over the past several years I was under the impression that fear based messages were not as effective as emotional, educational, or humor based messages. Therefore, I tend to shy away from this method. This weeks slides provided a refreshing perspective on fear based messages. I found it interesting to see that fear based messages work well with Latino populations and can offer viewers insight into what their life could be like without changing their behaviors. Again, know your populations!!

Next, I was surprised to see that humor is not used more. Only 1/4 of advertising is humor based. Its easy to remember what stands out to myself as a viewer and assume most people will share my sense of humor. For me, humor tends to grab my attention above all other types of messages. Prior to this weeks lecture, I would have used humor liberally. I will definitely conduct formative research prior to creating any humor based messages in the future to ensure the target audience will appreciate and understand the humor.

In summary, the big take away message is to understand your population, understand how to frame messages, and above all, know what type of messages your audience will remember and what will expedite audience buy in/behavior changes.

Cody

Project 1

The presentations for this week were very informational and allowed me a chance to see what my peers had been working on. It was relieving to know that other groups and not just ours were having trouble segmenting because of our small sample sizes and the similarities in answers. All the groups had very interesting ideas and gave well prepared presentations. This coming week is my individual presentation for the readings and last week's presentation was a good practice.

It was unfortunate we did not get to the lecture but I think that it was worth it to have all the groups present and move the lecture one week.

I was thinking we should start bouncing ideas for our campaign so that we can be ready for our focus group assignment. We should use the blog during break to start brainstorming!

Though we opted not to target by race/ethnicity

The CDC is through social media on facebook and twitter.

Project One presentations

I thoroughly enjoyed viewing the presentations for each of the groups who presented last week. One of my favorites was the Cancer group as they presented information about a real-life opportunity for the viewers to participate in the campaign they were promoting. What an awesome work of their previous networking with and interviewing of the gatekeepers!! They even enecouraged each of us in the audience to continue to spread the word about the Be A Match registry.

In regards to last week's readings, I really felt that the Tversky and Kahneman article was very difficult to read. Although the concept made sense, I found myself having to read the sections over and over again in order in order to comprehend the point that the authors were trying to make. I much preferred the content and organization of the Rothman et al article.

project 1 presentations

I'm glad groups were required to present on project 1. It was interesting to hear the different ideas each group had about how to approach a given public health problem. Even the selection of target behaviors was fascinating--particularly the nutrition group's focus on energy drinks. Something that struck me was the incongruity between expectations and results of target audience interviews. While impractical for this course, it would be much more meaningful to have obtained the desired information through a random sample. For our group it was also difficult to get to the root of the issue because of the sensitive nature of the questions and total lack of anonymity in the way we were selecting interviewees. I think the focus groups on the communication message will go much more smoothly and will elicit better information because participants won't feel like they have to disclose personal information.

On another note, I want to publicly critique my own individual presentation. It didn't go exactly as planned. I tried to keep to time but certainly didn't (has anyone yet??). The most interesting, seemingly crucial components were the example humorous ads I selected but it's easy to forget how much time that takes. Perhaps more importantly, I was not surprised to hear I probably won the award for must "ums" and "ahs" to date. I'm going through a difficult time personally and had barely eaten or slept for days... It's an excuse, but it's real...and I'd like to someday be able to rise above and present myself more professionally in spite of whatever's going on with me. That may be impossible though--I think it's just how my mind works. Overall, I did feel like people were listening and took away from my presentation what I took away from reading the article. I hope that's true, and I suppose that matters more than how polished I seemed.

-Melissa

Framing

The Rothman article brought up an important point for our intended behaviors; how messages are internalized might be different for prevention (condoms, safe, good) vs detection (screening, illness-detecting, scary), and that changing the way the detecting behavior is framed is probably a good call. This is something we've been thinking about from the beginning, and it will be fun to come up with some concrete ways to make screening part of a normal, health-affirming check-up rather than just about potential illness management.

On another note, I saw this the other day: Take a chlamydia test and get free movie tickets! I guess that's one fun way to encourage testing... But also, if you notice the third comment down, this is an example of one of the barriers we mentioned in our presentation, and sort of relates -- There's this seemingly unconscious misconception that all people who get tested are somehow automatically the same people who will test positive. The comment "if everyone goes to the cinema by the end of the film they will all be infected LOL" which, actually, I guess doesn't necessarily mean that the poster thinks everyone already has it, but makes me wonder...I don't follow his logic exactly-- what is the difference between this theater's group and any other theater showing a film primarily watched by a young adult audience?

We had another great round of presentations this week. I enjoyed listening to each group discuss their findings thus far. I also enjoyed hearing the limitations that each group was experiencing. It is refreshing to know that we are all struggling a little to find our exact focus as we enter the next stage of our projects.

I enjoyed Melissa's presentation on the use of humor. She picked out several hilarious videos which continue to stand out in my mind. I particularly enjoyed the urinal clip. I loved how awkward they made the office feel. Great choice!

As for our next step in our group project I think humor is a great tool to utilize when working with screening practices for college aged students. Melissa's presentation will be a huge help for us while we are developing our focus group materials. Another great tool to use as we move forward is Rothman's article on gain and loss framed messages. Specifically, the loss-framed message technique would work well for our group since our focus is on increasing STI screenings. This article illustrated the importance of emphasizing the costs of NOT following through with annual screenings.

I found the Tversky & Kahneman article to offer an interesting perspective on presenting numbers/findings. This article demonstrated that depending on your desired outcome, you can direct the audience into a desired frame of mind by changing the way you report your findings. For example, we could say 1 in 4 students at SDSU has HPV. Or, we could say, 75% of students at SDSU are HPV free. The take away message from this article was to be cautious when presenting outcomes. As a program writer/developer it is important to keep in mind what perspective you want your audience to take. Be sure to fame your outcomes in a way that supports your cause and increases interest in your topic.

Cody

Oh, and speaking of targeting and tailoring...

This website lets you choose how you want to receive the message. Clever, eh? But is it effective?

Clean n Crisp or Urban n Street

End of Module Two

Reading through the blogs and comments, I'm even more disappointed to have missed the first round of book presentations. From what it sounds like, most people were really able to integrate what they took from the presentation readings and make the review their own. My presentation isn't for a couple weeks, and I'm not feeling particularly confident that I'll be able to do the same... I'm definitely one of the "jitterbug" types (though do I get points for not over-practicing? I'm ridiculously superstitious about that) and even though my book is relatively well suited for the theme (reads almost like a coffee-table book) I'm not identifying with the topic as easily as I'd like. It's about individual advertisements that, each in their own way, changed they way we give and accept marketing information. Since the book was written over 10 years ago, and with the way technology had boomed since then.... well, I feel like I need to make the presentation more current; thing is, I haven't owned a television since i was 1998, and I've never had a subscription to any major print magazine- I feel a bit out of the loop. (These days, when I'm in the same room as a TV, it's like I'm hypnotized. Flashing colors! Moving pictures with sound! Sensory overload! Ooo, America's Next Top Model!) I guess the very first assignment should have make pretty clear that I'm bombarded with ads everyday regardless of tv/print choices, but still.. I'm struggling a bit to figure out what's really relevant.

I guess though, in terms of targeting/tailoring (yeah! I hadn't realized the clear difference in terms either- thanks!) those online ads that pop up along side my emails are actually pretty impressive in that respect. I'm not sure I've ever actually clicked on any, and there was definitely a time when I'd try to send emails with wording designed to illicit odd/inappropriate ad popups just for fun- but still, it's a pretty amazing development for ads in general when it actually works.

Regarding class in general, it's been pretty great so far, and there's a lot of information I'm picking up here that I wish I had my first couple of semesters; I feel like this should be one of the first classes we take, rather than the last. The individual presentations continue to be a great way to get the article info; everyone has done a pretty phenomenal job so far, and it's been a pleasure to learn from you guys. Yay.

(Side note: I missed class last week to be there for the birth of my almost-nephew, Jack, and my goodness I think a bit of reality mixed in to that whole "miracle of birth" thing could potentially work wonders for reducing teen pregnancy intentions. Wow.) (Side-side note: That said, he is still the most amazing thing on the planet. Congrats Flo and Jay, he's perfect.)

Now that the audience has been targeted, now what?

Following the material from this module, it's difficult to keep myself from thinking ahead to developing our campaign. I would liked to share some of the treasures I have found regarding sexual health campaigns from the past and present that target the age group of our target audience.

As I noted to the group earlier today, a TV commercial (sponsored by Glaxo-Smith-Kline) began running within the last week with the intention of increasing awareness for cervical cancer. Here's the link for you to view this ad:

http://www.tressugar.com/Cervical-Cancer-Perfume-Commercial-From-Oscars-7662359

Apparently, this and two other GSK commercials were aired during the 2010 Academy Awards show on March 7th. Here are the two other ads:

http://www.youtube.com/watch?v=d9lFRLWCPTU

http://www.youtube.com/watch?v=gq-EAf7kjS8

The "Perfume" ad has already been met with criticism as some feel the ad communicates that women are shallow and easily enticed by things that appeal to materialistic values.

http://www.mmm-online.com/gsk-launches-surprising-cervical-cancer-ads/article/165372/

While I understand this point, I disagree on two levels. First, the truth is often offensive. As a society, both male and female, the US is widely materialistic: always looking for the better car, bigger house, the newest gadget, and fancier purse. I don't believe the "materialistic" suggestion targets women specifically over men; however, I think it's safe to say that cervical cancer is discriminating. Of course, the ad will target women. I assume they could easily target men with a similar ad for prostate cancer or testicular cancer as well.

Second, I believe the analogy of the enticing perfume parallels well to the enticement of romance and physical intimacy that most women desire in romantic relationships. Many of us women, especially young women, are easily disillusioned by our rush of emotions and justify making unsafe sexual choices with the people we (would like to believe we) love. This ad successfully interrupts this thoughtless dream sequence with a bite of reality that needs to be considered logically. Cervical Cancer is a very serious and real consequence of unsafe sexual behaviors that can be easily prevented in a variety of ways. As women, we seriously need to wake up.

Here are some other articles that discuss some of the controversy surrounding these ads and other ads by Merck (for Gardasil HPV vaccine):

http://www.naturalnews.com/028286_Merck_advertising.html
--> Source - http://indiatoday.intoday.in/site/Story/76944/Lifestyle/Vaccine+no+guarantee+against+cervical+cancer.html

http://www.pharmalot.com/2009/12/glaxo-pulls-cervical-cancer-ads-in-india-report/

The following article suggests that the commerical market for cervical cancer prevention is wide open for pharmaceutical companies and health promotion agencies alike to capitalize:

http://www.bioportfolio.com/news/datamonitor_37.htm

Here's one more cervical cancer prevention ad I found that has no ties to GSK, Merck, or any other pharmaceutical company:

http://www.youtube.com/watch?v=6S_tPoYJsAc

Shannon

The end of Module II

The extra presentations this week were very interesting and i enjoyed everyone creative ideas. Izzybeth's presentation was very captivation because of the widget she used at the beginning of the presentation. Frances presented on a book written by the author I will be presenting on as well. It was helpful to see what she included in her presentation because now I can modify mine and take out some of the similar things to not be redundant. I have to say that Lindsay did an amazing job at summarizing her dense theoretical book. The Zen of presentations was another one of the topics that caught my attention. This semester I have multiple presentations and this presentation was very informative. Lastly, I really enjoyed the different video clips that Shairee showed during her presentation they provided a more international perspective on HIV/AIDS.

The second module these past weeks had to do with getting to know target audiences. This module was very helpful with our group projects because it provided different methods and guidelines that could be used when it comes to segmentation. The module also touched upon tailoring health campaigns in particular when it came to health literacy. My favorite readings were the one's that highlighted the high number of people who are health illiterate. It was very insightful to know who this populated was composed of because we tend to think it is the poor and uneducated. Last week I commented on both the health literacy and 'hard to reach' audiences readings. I found these to be very interesting and actually grappled with a few of the issues brought up. Overall, this module was very informative and will help us not only for our group projects but for any future public health campaigns we might engage in.

First round of presentations

Hello all,

This weeks presentations were a fun change of focus for a week. It was interesting to hear the variety of topics covered in each review. The content of each book seemed quite different so it made for an interesting class session. I took away a lot of useful information from each presentation.

One of the most useful pieces I will keep in the forefront of my mind for all future presentations was Anhs book on 'Presentation Zen'. She did a great job of explaining the content of the book. On the other hand, she also illustrated the difficulties she experienced making her presentation more of a story than a slide show. I like that she was honest and real with her presentation. It was a very memorable and relevant presentation.

The other presentations were great as well. I think Shairee's video's were extremely touching. Some of the other books that were presented on seemed a little more 'meaty' than others. Ten minutes seems like a long time to speak, but when you are covering an entire book ten minutes flies. I think everyone did a great job at summarizing what they though were important points in the time given. Someone stated that they wished there were a few more health examples in the presentations. I agree with this statement. It would be a strong addition to the next round of presentations.

I am looking forward to our group presentations this week! It will be fun to hear what our classmates have discovered from their target populations. I will close with a funny video I found this week. It is a little racy, but I found it hilarious. This ad aired in Africa. It has a unique approach.

Enjoy!

Cody

presentations

I enjoyed today's class of presentations. I watched and listened for both content and style so I learned about ideas relevant to public health communication and effective presentations. Anh's fabulous presentation stuck with me and I want to purchase the book (Presentation Zen: Simple ideas on presentation design & delivery by Garr Reynolds). Since we ran out of time in class and I will have to present at a later date (next week?), I will probably go back through my slides and remove a few extra words because even though I felt like I was using restraint I could probably improve upon them further. Anh was right about simplicity in slides making the presenter's job more difficult. In the past I have relied too heavily on my slide content to do the talking for me.

Also the idea of telling a story resonated with me. It's a feature of many of the more memorable talks I've heard and I intend to incorporate it into my presentation. One thing I noticed was largely lacking was the use of humor--maybe it's too difficult or takes more practice? Does one have to be naturally funny to pull this off? Cody showed a funny clip, which definitely help keep me engaged. Her illustration of "world wide rave" marketing strategy of providing special opportunity for super-fans to meet with J.K. Rowlings about the next Harry Potter book was also memorable.

One thing I would have liked to see more public health examples, as it can be somewhat of a stretch to imagine health communications generating the same buzz as, say, Harry Potter. That said, some of these ideas have never been tried with health campaigns and I'm glad to have been exposed. I loved these website examples in Izzybeth's presentation: sexreally.com/ and www.thatsnotcool.com/. This video is cute and gets to a common relationship problem with teens--too many texts!



I was a bit troubled by how the digital harassment issues on this site were gendered (http://www.thatsnotcool.com/VideoIndex.aspx). Text Monsters were both female culprits with male victims, Pressure Pic Problem was instigated by boys asking for nude photos of girls, and The Break-In scenarios both involved boys hacking into girls online accounts. It's important to be mindful of potentially unintended or harmful "hidden" messages included in health communications.

New York City's official condom. Right on.

Healthy Literacy

I loved reading the AMA article about health literacy. It really connects with my research interests in physician-patient relationships and improving physician empathy. As a side note, this article will serve as a valuable addition to the literature review that will contribute to the anticipated sequel of my thesis manuscript. After I study the relationship between physician empathy and various influential factors for my thesis, I look forward to ultimately developing a curriculum to train medical students to provide quality, empathetic patient care. Throughout this proposed training, the physicians-to-be (students) will be placed in various situations/tasks in which each of them will assume the role of the patient. One of the tasks will require students to navigate the health care system with a designated disability such as deafness, paralysis, and/or illiteracy (or dyslexia). The experience will allow the medical students an opportunity to see health care from the patient's perspective and to consider how to communicate with and connect with hard-to-reach patients.

Aside from my thesis, I felt this article enlightened me in other ways as well. In my current place of employment, I work as a social worker in an inpatient psychiatric hospital conducting psychosocial assessments of each patient. While we regularly consider whether the patient has vision/hearing impairments, language barriers, and/or developmental disabilities that may interfere with patient communication, our psychosocial assessments do not specifically assess for literacy. In addition to this, most of the patient education and follow-up care instructions are provided to patient through written materials, including medication instructions, side effects, and follow-up outpatient psychiatric/therapy appointments. It had never occurred to me before that some of our English-speaking patients may be illiterate and unable to understand follow-up instructions for discharge. A patient's misunderstand or failure to follow the doctor's aftercare instructions can be potentially life-threatening or can trigger a recurrence of symptoms.

I feel particularly motivated to begin asking the patients I encounter to read a sample aloud in order to identify whether the patient can read. Furthermore, it seems equally helpful to apply the concepts described with the SMOG readability test in my verbal communications as well (i.e., limited polysyllabic words, specialized medical jargon without clarified definitions).

Shannon

Week 6 - Targeting and Tailoring

This week's lecture slides and readings offered a great set "best practice tips" which Public Health professionals could use to bridge the gap between healthcare messages and hard to reach populations or low literacy populations.

I have read statistics on the U.S. population literacy rates countless times over the past few years. Nevertheless, it ceases to amaze me that approximately 50 percent of the U.S. population is functionally or marginally illiterate (reading at or below 7th grade level). As pointed out in this weeks lecture, this is a huge barrier for day-to-day health activities such as taking prescription medication or understanding what types of food are actually healthy/necessary to control chronic diseases such as diabetes.

Again, this weeks lecture topic is an extremely important concept to keep in mind when creating health messages or campaigns. As we know, doctors have limited time to spend with patients. Therefore I think utilizing lay health advisors/Promotoras is a fantastic way to make health information comprehensible to the target audience. Lay Health Advisors are able to relay the health messages to people of a similar background in a culturally appropriate manner.

Another great avenue to promote health information is the use of word-of-mouth communication. This weeks reading and lecture coincided with the book I will be presenting on next week title World Wide Rave. This book focuses almost entirely on word-of-mouth communication. As discussed in class, word-of-mouth communication is proving to be more effective than traditional mass media efforts. Utilizing Facebook, Twitter, blogs, etc is an amazing easy (and free) way to spread ideas or health messages. Think about it, we surround ourselves with computers and smart phones almost all hours of our day. Thus, focusing efforts utilizing these technologies is a great way to raise awareness. It is also a great way to find out what questions your target audience has about your product or service and offers an easy way to answer their questions.

Cody

Health Literacy & hard to reach audiences

This week's reading on health literacy was very interesting and made clear the difference between health literacy and the broader view of literacy, the latter being the one I was more attuned with. However, this week lecture and readings has made me understand that health literacy goes beyond whether an individual can read and write in English. Rather it focuses on whether people can use these skills (reading & writing) to solve problems at proficient levels and function in society. Sheila highlighted that both the provider and patient have roles to ensure a higher level of health literacy. The provider needs to work on communicating with patients in terms that will be comprehended versus medical jargon that might fly over patients's heads. While, the patients need to make sure the provider recommendations and instructions are understood (if not ask questions until it is clear) because this will help with their self-care.

One of the things that shocked me the most came from the JAMA Report on Health literacy. They report that 60% of patients surveyed from two public hospitals could not understand a standard consent form. When I read this the first thing that came to my mind was, What does this say about the reliability of consent forms? Participants might say they know what they are signing up for but in reality they might just wan to have the researcher they do. It also brought to mind an instance with a participant from a study I helped with. The participant was asked to read the consent form and then sign it. However, the participant said that her reading glasses had been forgotten at home and if we could just provide her with an overview of the contents of the consent form. After the readings and lecture for this week it really makes me wonder whether that instance had something to do with the participants health literacy (as this study was related to health).

On a different note, I was browsing youtube and found a Family Guy episode that resonates with this weeks topic. It is funny but also exemplifies what can happen in situations when patients agree to things they might not fully understand or know the exact procedure to particular examinations.

Targeting & Tailoring

I missed class this week because I had a medical appointment. The UCSD Medical Group seems to have incorporated a number of new ideas into their practice, such as electronic medical records. Related to the course topic this week, part of the "patient demographics" they designated a literacy level. A nurse or medical assistant handed me a visit summary printout with this on there and I remember commenting on it. She seemed embarrassed--she must have printed the wrong version of the form and I wasn't supposed to see how they categorized me. I never completed a (health) literacy questionnaire such as REALM or TOFHLA--somewhere along the line someone made a judgment or assumption about my health literacy based on interaction with me or my education level. As reported by the AMA (1999), education level is not a good predictor of health literacy. I wonder if this designation in my chart makes any difference in how my doctors choose to communicate with me.

The SMOG reading grade level calculations floored me. I didn't know how this was done and was shocked at how simplistic it is. Polysyllabic words don't seem like they would necessarily be the best indicator, but the more I think about it I understand how people with low literacy levels would struggle more with longer words. There are short, one- and two-syllable challenging vocabulary words that would be missed using this rubric (e.g., efficacy or endemic or obviate). As pointed out in the lecture, medical jargon may fit into this category.

The Freimuth & Mettger (1990) article on supposed "hard-to-reach audiences" was thought-provoking. I agree that using pejorative terms can be counterproductive, but nowhere did I see him focus on alternative positive traits of marginalized groups. Nevertheless, it added strength to the lessons we're going over about formative research and audience segmentation on more than just demographics.

Word-of-mouth (WOM) communication may be useful for those "hard-to-reach" audiences. The HIV prevention effort used trained peer educators to get the word out in their communities, which represented an otherwise marginalized group unlikely to seek out the information on their own (until perhaps they felt the need because they were sick). If they do have limited access to communication channels and distrust of dominant institutions, WOM presents an excellent strategy to get around these barriers.

I wonder how great the difference in effectiveness of WOM is when coming from friends or family vs. peer educator. Does the peer educator gain some status of authority like a doctor? Sexual assault prevention began pushing for peer educators, particularly college men for campus prevention efforts, and a bystander approach which generally calls for peer-to-peer dialogue.

Sex Ed by Text

Related to my last quick post, this might be similar to what I was thinking we could look into:

Using SMS Text Messages to Reach Youth with Sexual Health Information

View more presentations from AIDS.gov, Office of HIV/AIDS Policy, U.S. Department of Health and Human Services.

In addition to question answering, we could combine this with the info message service like they're doing in North Country for health pregnancy tips; the idea would be to send out messages encouraging screenings, promoting condom use, general safe sex info, etc.

Texting is a pretty important communication method for this age group, http://mashable.com/2010/02/03/teens-dont-tweet-or-blog/

along with other social media http://mashable.com/social-media/news/

Or maybe an iPhone app with weekly random sex info pop-ups integrated with a suggestion calendar for STI screenings?