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We Have Met the Enemy and He Is PowerPoint

Pushing the Boundaries of Health Communication: Trends and Challenges Rafael Obregon, Ph.D. School of Media Arts & Studies Communication & Development Studies Ohio University Roskilde University, Denmark May 4 th , 2010. We Have Met the Enemy and He Is PowerPoint.

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We Have Met the Enemy and He Is PowerPoint

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  1. Pushing the Boundaries of Health Communication: Trends and Challenges Rafael Obregon, Ph.D. School of Media Arts & StudiesCommunication & Development StudiesOhio UniversityRoskilde University, DenmarkMay 4th, 2010

  2. We Have Met the Enemy and He Is PowerPoint Pushing the Boundaries of Health Communication: Trends and Challenges Rafael Obregon School of Media Arts & StudiesCommunication & Development StudiesWe Have Met the Enemy and He Is PowerPointOhio University, USACommunication for social change: Lessons learned from public healthRoskilde University, DemarkMay 4th, 2010 “When we understand that slide, we’ll have won the war,” General McChrystal, NY Times, April 27th, 2010

  3. Outline of Presentation • A quick tour of international health communication experiences • Health Communication and Communication for Social Change • Trends and Challenges • Conclusions

  4. A quick tour of international health communication experiences

  5. Public Debate and Social Mobilization on HIV/AIDS and Children’s Rights in Southern Africa • Theory and research-driven process • Multimedia / multi-strategy /multi-communication channel platform - contributes to addressing health issues in southern Africa • Change at individual, community, social and policy levels • Promotion of public debate and discussion • Changes in social norms • Focus on community engagement

  6. Community Dialogue and Women’s Rights and Empowerment in the Amazon Minga Peru • Constructivism, interculturality and dialogue to address gender-based violence and promote women’s rights • Radio magazine Bienvenida Salud, education, and income generation – focus on voice and social determinants; long-term approach

  7. Positive deviance and nutritional improvement of children in Asia and Africa Positive deviance (PD) - approach to social and organizational change that enables communities to discover wisdom they already have, and act on it Focus on local/within community solutions and resources

  8. Complexifying social mobilization in health communication: learning from polio communication • Activist SM - community participation and empowerment - bottom-up approach: communities express demands, define goals, make key decisions • Pragmatist SM - means to strengthen health services and achieve goals • Competing understandings of SM • Media as social and political • institution • Interpersonal comm as dialogue • and engagement • Gender

  9. ICTs and access to information in South Africa – Cell Life • Mass messaging for prevention; • Mass information for positive living; • Linking patients and clinics; Peer-peer support and counselling; Building organisational capacity of HIV-related organisations; Monitoring and evaluation.

  10. News agendas and children’s rights in Brazil - ANDI • Media monitoring • Social mobilization • Capacity strengthening and editorial analysis • Accountability • Social control • Media, democracy and governance

  11. What key concepts emerge from those experiences? • Voice • Public debate and dialogue • Participation and engagement • Empowerment and agency • Rights and citizenship • Social mobilization

  12. Health Communication and Public Health

  13. Health care delivery system Community Assuring the Conditions for Population Health Governmental Public Health Infrastructure Employers and Business Academia Media/Communication The Public Health System Institute of Medicine, Public Health in the 21st Century, 2003

  14. Health Communication Health Communication Health care delivery Promotion of public health Interpersonal Communication Mediated Communication From: http://www.drrangarajan.com/comm5000_6000/Class1-Notes.ppt.

  15. Health Promotion Principles C O M M U N I C A T I O N • Developing personal skills • Building healthy public policy • Creating supportive environments • Support/promote community action • Re-orientation of services

  16. Broad social, economic, cultural, health, and environmental conditions and policies at the global, national, state, and local levels Living and working conditions a Social, family and community networks Individual behavior Innate individual traits: age, sex, race, and biological factors --- The biology of disease Over the life span b Social determinants of health Adapted from Dahlgren and Whitehead, 1991. The dotted lines denote interaction effects between and among the various levels of health determinants (Worthman, 1999).

  17. Health communication can… • Increase intended audience’s knowledge and awareness of a health issue, problem, or solution; • Influence perceptions, beliefs, attitudes that may change social norms; prompt action; demonstrate or illustrate healthy skills; • Reinforce knowledge, attitudes, or behavior; • Show the benefit of behavior change; • Advocate a position on a health issue or policy; • Increase demand or support for health services; • Refute myths and misconceptions; • Strengthen organizational relationships Freimuth, 2004

  18. Conceptual trends in communication for social change and health communication

  19. C4D Continuum: Approaches/Theories/Models (adapted from Obregon & Mosquera, 2005) Diffusion/ Individual Participatory/ Structural Diffusion/ Persuasion/ Social Marketing Information/ Education/ Communication Behavior Change Communication Communication For Social Change Social Ecological Approach Convergence model No magic formula New conceptual approaches + diversity of frameworks + diversity of strategies + multiplicity of interventions = (Growth of the field)

  20. Health Communication Continuum: Approaches/Theories/Models (Adapted from Obregon & Mosquera, 2005) • While the field is largely dominated by two theoretical models, its ability to generate new conceptual approaches to development is the result of a creative convergence of diverse frameworks, strategies and interventions. Diffusion/ Individual Participatory/ Structural Behavior Change Communication Information/ Education/ Communication Social Ecological Approach C4D/HC Diffusion/ Persuasion/ Social Marketing Communication For Social Change Diffusion/ Persuasion/ Social Marketing

  21. Communication for social change and health promotion People as objects Agents of own change Delivering messages Supporting dialogue/debate Individual behaviour focus Social norms/policies/culture and supportive environments Persuading people Negotiating the best way forward Away from technical experts People affected in central role

  22. Context & the UNAIDS HIV/AIDS Communication Framework

  23. Communication, Culture and Health Communication campaigns with common-denominator messages relevant to most audiences Unified campaigns with systematic variations in messages to increase relevance for different audience segments, retaining one fundamental message Developing distinctly different messages or interventions for each audience segment

  24. Communication, Culture and Health • Culture as a central element in health communication • Two approaches (Dutta, 2009) • Cultural sensitivity • Culture-centered • Two levels (Resnicow and Braithwaite, in Freimuth 2004) • Surface structure • Deep structure

  25. Audiences and Health Communication • Powerful media assumptions in many health communication campaigns • Effects of health messages • Limited attention to audience reception and negotiation of meanings • Analysis of reception of health messages – an audience perspective • Media ethnography and reception studies

  26. Trends in health communication practice

  27. Trends in HC practice • Evaluate communication strategies and tactics and identify under which conditions they function more effectively • Maximize resources/impact • Identify strategies for synthesis and integration of multiple data sources • Epi data – Polio • Socio-demographic data-marketing – audiences/lifestyles • Qualitative / ethnographic data /sense-making

  28. Trends in HC practice • Integrate communication strategies into broader public health initiatives • Evaluate aspects related to cost, reach, impact, etc. • Interdisciplinary teams • Create trust and credibility • Prepare audiences • Ethical Considerations

  29. Challenges in health communication theory and practice

  30. Challenges Incorporating increasing theoretical growth and interdisciplinarity – from public health, communication, and other disciplines Reflecting trends toward theoretical and methodological convergence– strategic and catalyzing; participatory; multimedia; change at different levels

  31. Challenges Addressing structural issues that determine people’s health or create vulnerability Responding to increased (donor) pressure on demonstrating impact of interventions Incorporating innovative evaluation methodologies - ethnographic approaches that provide deeper understanding of complexity of public health issues

  32. Challenges Positioning itself as a legitimate field through professional and graduate level training (i.e. MPH/SBCC program at Univ of Witwatersrand) Emphasis on competency-based training

  33. Final thoughts Growth of health communication as field – different approaches Expansion of health communication thinking and integration into broader development and social change issues

  34. Social change starts with public debate Amartya Sen

  35. Thank you…time for questions…

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