Developing health communication campaigns

Description

The Health Communication Unit (THCU) workbook outlines a 12-step process for developing health communication campaigns. Health communication is the process of promoting health by disseminating messages through mass media, interpersonal channels and events. Comprehensive health communication campaigns aim to:

• inform, persuade or motivate behaviour change;
• work at the individual, network, organizational and societal levels;
• target relatively large, well-defined audiences;
• provide non-commerical benefits to society;
• take place during a given time period;
• include a combination of media, interpersonal and community events; and
• involve an organized set of communication activities.

Steps for Using Method/Tool

The "Overview of Health Communication Campaigns" outlines a 12-step process for developing health communication campaigns.

Step 1: Get Started
This step involves project management of five elements:

1. Meaningful participation of stakeholders: Identify key stakeholders and their mandates. Examine the desired directions and stakeholders' perspectives.
2. Time: Consider appropriate timelines for pre-planning (Steps 1–4), planning (Steps 5–9), production (Step 10), implementation (Step 11) and evaluation (Step 12).
3. Money and other resources: Create an inventory of resources that lists allocated budgets, staff, equipment, space, expertise, in-kind contributions from volunteers and partners and other resources.
4. Data-gathering and interpretation: Collect and intepret data to support planning.
5. Decision making: Consider what decisions will be required when, by whom and by what process in the planning stage.

Step 2: Revisit Your Health Promotion Strategy
The goal of health communication planning is to support the health promotion strategy. Health promotion strategies aim to create change at four levels.

1. Individual level change: Outcomes include health behaviours, physical indicators, health status and psychosocial outcomes. Intermediate outcomes that precede changes in health behaviour include awareness, knowledge, attitudes, self-efficacy and skills for behaviour change.
2. Network level change: Characteristics of social networks have a profound impact on health. Health communication campaigns seek to influence the nature and quality of information within a network through opinion leaders or other influential individuals. Outcomes can include changes in the flow of information and communication between network members, garnering support of opinion leaders and creating opportunities for virtual sharing and connecting (e.g., diabetic patients who connect through an online group).
3. Organizational level change: Organizations are both vehicles for health communication messages and sites for change that influence other levels of change. Outcomes include changes in organizational structure to support individual-level behaviour change, shape organizational policies and influence organizations to become healthy models for other community organizations.
4. Societal level change: Societal factors include normative behaviours, policies and physical and information environments that influence health actions at other levels. Outcomes include changes in legislation and mobilizing public opinion to address a health issue.

Step 3: Analyze and Segment Audiences
Audience analysis involves developing a solid understanding of intended audiences to create a relevant and effective communication plan. This requires gathering, interpreting and applying demographic, behavioural and psychographic information about target audiences. Audience analysis helps to:

• segment an audience into smaller 'chunks';
• develop priority segments;
• select the objectives most appropriate for an audience;
• select the best channels and vehicles to reach an audience;
• develop messages that are relevant to an audience; and
• easily plan and evaluate your health communication plan.

Segmentation is the process of breaking down a large audience into a smaller number of subgroups that are relatively homogeneous but differ from other groups.

• Collect data on your audience(s) – use focus groups, individual interviews and intercept interviews to collect data.
• Analyze your audience – a series of questions are provided to analyze information on the demographic, behavioural and psychographic characteristics of target audiences (p. 24–25).

Step 4: Develop an Inventory of Communication Resources
Assess communication resources available in your community by following these steps:

• Form a group of individuals from your organization or partner agencies to brainstorm available communication resources.
• Develop a list of communication resources (e.g., media, interpersonal communication, events).
• Consider these factors for each resource: the contact person and strength of working relationship, ease of delivering your message through that resource, cost, strengths and weaknesses of the resource.

Step 5: Set Communication Objectives
Set communication objectives to support reaching your health promotion program goal.

• List overall health promotion program goal and objectives (Step 2).
• At each level of change, identify communication objectives.
• At some pont in planning, make your objectives SMART (Specific, Measurable, Attainable, Realistic and Time limited).

Step 6: Select Vehicles and Channels
Select the most appropriate channels and vehicles for your communication campaign.

• Identify how to meet communication objectives at individual, network, organizational and societal levels. For instance, media can meet different objectives at the individual level (increase individual awareness of health issue) and the network level (mobilize inter-agency support).
• Use a combination of media, interpersonal communication and events in your communication campaign. A list of strengths and weaknesses of specific vehicles within media, interpersonal communication and events is provided (p. 37–39).

Three factors influence the selection process:

1. Reach – consists of audience size (the number of people who will see the message), multiplicative power (the likelihood the message will interact with other campaign elements to increase the number of people who attend to the message) and specificity (the ability to narrowly reach a defined group).
2. Cost – directly related to material development (Step 10).
3. Communication objectives – vehicles include media, interpersonal communication and events. Media is most effective for simple messages that do not need feedback. Interpersonal communication are ideal for situations where the audience needs interaction, feedback and the chance to shape the communication. Events reach large numbers of people through the mass media, but provide opportunity for feedback and participation.

Step 7: Combine and Sequence Communication Activities
Schedule communication activities on a timeline according to audience needs, opportunities and/or competing messages or events in the local context. This component serves to sustain momentum over the course of the campaign, and also addresses behaviour change if directed at the individual level. Elements of a behaviour change continuum include:

• awareness;
• information seeking;
• knowledge;
• attitude formation;
• behavioural intentions; and
• behaviour.

Strategies for combining and sequencing communication activities include:

• gradually building communication activities to a grand finale;
• fitting communication activities with the season;
• applying this simple rule: 3 messages, 3 times, 3 different ways; and
• linking with larger issues that are capturing the public agenda.

Step 8: Develop the Message Strategy
Define the message elements and approach based on decisions made in previous steps and evidence, and determine the appropriate approach for the message strategy.

The three key elements of a health message are:

1. What? – Identify the key information to be conveyed. The message may contain factual information, it may break behaviours down into small steps or it may address a concern or problem directly by offering alternatives.
2. So What? – Address the reasons or benefits for action that are relevant for the audience. Identify the social, health, psychological, financial and other incentives specific to the intended audience.
3. Now What? – Define a desirable and protective action.

In addition, consider these three elements of approach:

1. Tone – Should the tone be light or heavy?
2. Source – Who should be the messenger?
3. Type of Appeal – Should the message be rational or emotional? Positive or negative?

The authors also provide strategies for the structural presentation of a message (p. 47), message content (p. 48) and stylistic presentation of a message (p. 49).

Step 9: Develop a Project Identity
The project identity is based on the perceptions people have of your issue or project. It will determine how people respond to your communication campaign. It is critical to determine what makes your initiative distinct, of interest and a benefit to your community. Key elements of your project identity include name, positioning statement, logo and images.

Step 10: Develop Materials
These steps outline the production of communication materials:

• Assemble your pre-production work (your goal statement, product name, description of product, communication objective, key messages, audience, desired identity of issue/organization, timeline).
• Create a detailed budget for the product.

Step 11: Implement Your Campaign
Use the blank template to guide implementation of the communication campaign (p. 59). Some steps for implementation include:

• Create a list of all the selected media outlets to be contacted.
• Inform other related organizations about your initiative.
• Prepare staff and others to respond to inquiries.
• Have enough materials for the campaign to be placed at other channels or distribution outlets.
• Inform professionals in the community of your campaign and prep them for responding to inquiries. Specify how and when specific resouces will be needed and when events will occur in your implementation plan.

Step 12: Complete Campaign Evaluation
Evaluation can support communication campaign development:

• Before implementation (formative evaluation) – to describe the audience and determine whether campaign materials are relevant, understandable and acceptable to intended audiences.
• During implementation (process evaluation) – to assess how many people the capaign materials reached and to see if the audience responded.
• After implementation (summative evaluation) – to determine who responded (respondent demographics, who did not respond) and to assess if there were changes in knowledge/attitudes, intentions, actions or policies.

Formative evaluation: Pre-testing draft communication materials is a type of formative evaluation to help ensure that materials will work. Using a variety of methods to pretest materials is an effective way to overcome the limitations of individual methods.

Process evaluation: Monitor the progress of a communication campaign through indicators such as tracking number of inquiries, checking distribution points to assess materials used and follow-up with practitioners to determine their capacity to address the issue.

Summative evaluation: Assess the impact of the communication campaign on intended audiences. There are three models of summative evaluation for health communication:

1. Advertising Model of Evaluation – uses audience surveys to measure exposure, recall, appeal, behavioural intentions and message effectiveness. (p. 72)
2. Impact-Monitoring Model of Evaluation – uses routinely collected data from a larger monitoring system or archival source to assess whether the incidence of an issue is changing. (p. 73)
3. Experimental Model of Evaluation – uses a group not exposed to the campaign to compare effects of the campaign on the experimental community with the control community. (p. 73)

A table on p.76 provides different options to conduct evaluation activities based on available resources.

Appendix A contains additional worksheets for each step (p. 79–99).