Health communication exam 1

5 major steps to message development using EPPM

Step 1: Establish Levels for Each of the EPPM Theoretical Variables Step 2: Compare the Means of Each Theoretical Variable to the Others Step 3: Create a Chart of Beliefs Step 4: Determine What Influences the Theoretical Variables Step 5: Create a Chart of Beliefs to Change, Introduce, or Reinforce

In health promotion and health education, we often use _______________ ________________ from health communication and social psychology

Theoretical models

How to select risk issue in the EPPM

identify health issues that have the most potential to improve the public's health (precede-proceed model is often useful). Start with the main factors that influence the quality of life (such as lifestyle and environment)

There are NO good _____________ to measure health literacy in the US

instruments

Theories and models are useful in _____________, ______________, and _____________ ________________

planning, implementing and evaluating interventions

Health communication is not separate from health care but _____________ in itself

therapeutic

Two types of positive affect appeals

• Positive benefit appeals • Heuristic appeals

Verbal intrapersonal

• Private and restricted to ourselves •Silent conversations with ourselves while processing thoughts and actions •When analyzed can be conveyed to someone else or stay confined as our thoughts

Four main types of communication

1. Verbal 2. Nonverbal 3. Written 4. Visual

What is communication? (3 things)**

1. The imparting or exchanging of information or news 2. Means of connection between people or places, in particular 3. Process of acting, reacting and negotiating

Health communication definition

1. "The study and use of communication strategies to inform and influence individual decisions that enhance health." (CDC and National Cancer Institute) 2. "The way we seek, process, and share health information." (Kreps and Barbara Thornton, 1992)

Outcomes related to poor health literacy

1. Medication errors 2. Poor adherence to medical regimens 3. Reduced use of preventive services and more ER visits 4. Ineffective management of chronic conditions 5. Longer hospital stays (2 days) and more re-admissions 6. More hospital visits (6% more) 7. Poor responsiveness to public health emergencies 8. Higher mortality 9. Higher health care costs (4 times higher) 10. Costs US economy $236 billion a year

Basic tenet of EPPM

1. Message must strike a balance between severity of threat and the receiver's susceptibility to that threat • Must identify specific health threat and emphasize the receiver's personal susceptibility to it, as well as the seriousness of the threat • Gory pictures can heighten severity but may lower susceptibility 2. Message must provide an actionable response that gives a strong sense of efficacy • Don't just warn people, but provide doable and effective actions they can take to protect themselves from danger

Description of the EPPM

Extended Parallel Process Model (EPPM) • Allows us to specifically predict how and when self-defense mechanisms in the form of fear and danger control operate • Research using this model demonstrates how health risk messages can be designed to maximize danger control responses and to minimize fear control responses • EPPM suggests that seriousness, susceptibility, self-efficacy, and response efficacy all determine the effectiveness of fear appeal messages

Why we use behavioral models in health communication

Gain and Loss - Framed Messages • Gain - frame emphasizes the advantages of the advocated action or viewpoint • Example: "If you wear sunscreen, you'll have attractive skin." • Loss - frame emphasizes the disadvantages of NOT adopting the advocated view Example: "If you don't wear sunscreen, you will have unattractive skin."

Patient empowerment

Gives patient influence in medical matters

Biomedical model (scientific approach, reductionistic) and biopsychosocial models ( family, culture along with other), what they are and major criticisms of each (blank)

biomedical model. Type: Term. Definitions: 1. a conceptual model of illness that excludes psychological and social factors and includes only biologic factors in an attempt to understand a person's medical illness or disorder.

_____________ can relate to poor health literacy

culture

When __________ ___________ are strong, anger has an effect on attitudes, cognitions, and intentions

efficacy beliefs

Positive benefit appeals

employ positive feelings to directly communicate about the emotional, psychological, or experiential benefits of complying with the desired behavior. Example - father dancing with his daughter at her wedding while in his hospital gown - humor to show how important to get a cancer screening

_______ is a basic human emotion

fear

Competitive behavioral analysis

understand what people's behaviors are and why people engage in them. Consider the advantages and disadvantages that are offered by people's behavioral alternatives. In EPPM, discovering a "competitive advantage" is simply discovering which behaviors for which people have a sense of efficacy. Things they feel capable of doing. • Too often we do not understand "why" people engage in a specific behavior.

Heuristic appeals

use a more indirect approach to target people who do not have the time, skill or motivation to evaluate the attributes and benefits of a particular campaign. Example - showing a sign on a dock by the water. The sign reads, "Please do not drop your cigarette butts on the deck. The fish crawl out at night to smoke them and we are trying to get them to quit."

Who are appropriate target audiences for guilt appeals?

working mothers and adolescents

Health literacy is NOT __________ ___________, ___________ ___________, and _____________ ______________

written brochures, plain language, and cultural competency

World Health Organization definition of health literacy

• "the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health" (World Health Organization, 1998)

Nonverbal communication

• Anything besides words, such as gestures, actions, facial expressions, body language and other aspects of your physical appearance, that when seen, communicate something • Can be tone of voice • Symbols and sign language • It's not what you say, it's how you say it • Actions speak louder than words • Creative and aesthetic forms are music, dancing and sculpturing

Emotional appeals

• Commonly used as persuasive devices in public health • A study in 2007 found that 95% of the 103 direct- consumer prescription drug ads examined employed emotional appeals • Often used in drinking and driving ads and usually those used fear and anger Must pick correct audience, correct time, correct context, and correct reason to be effective. Not doing so can cause failure to create the desired emotion

Danger control process and examples of it

• Engage in danger control when perceived threat and perceived efficacy are both high, involves making efforts to lower their risk • They understand the danger and they know how to avoid it • Example is sexual activity raises risk for HIV but they think they can use condoms to prevent the risk

Description of fear/threat appeals

• Fear appeals - intuitive strategy that is commonly used in a variety of situations • Attempt to alter behavior by explaining the dangers posed by the behavior • Sender hopes the threat will raise people's level of fear and convince them to change their behavior to avoid the threat • Premise - increased levels of fear will result in seeking out ways to reduce the fear, which, in turn will result in protective action • Research shows that most fear approaches do not work

Humor appeals

• Harder to define because they usually do not cause one discrete emotion • Can affect joy, surprise, or hope • Are persuasive using positive affect

Why health literacy is important

• Health Literacy is important because it affects people's ability to: • Navigate the healthcare system, including locating providers and services and filling out forms • Share personal and health information with providers • Engage in self-care and chronic disease management • Adopt health-promoting behaviors such as eating a healthy diet and exercising • Act on health related news and announcements

Individual and systemic factors of health literacy

• Health literacy is dependent on the demands of the healthcare and public health systems. • Health literacy is dependent on the communication skills of lay people and health professionals • Health literacy is dependent on lay person and professional knowledge of various health topics. • Health literacy is dependent on culture. • Health literacy is dependent on the demands of the situation/context.

Message receivers and emotional appeals

• Message receivers are distinctly effected by emotional appeals • Discrete emotions effect information processing, attitude change and recall • Emotion caused by a persuasive message will guide how deeply individuals will process that message and information they will pay attention to. • Individuals will seek out information in the message that satisfies emotion- relevant goals

Written communication

• Messages that are transmitted to receivers in writing. •Advantages include: ◦ Immediacy - geography doesn't matter ◦ Efficiency and accuracy ◦ Flexibility •Unlike other means can be edited and rectified before it is communicated to receiver •Indispensable part of formal and informal communication •Can include visual communication especially when messages are conveyed through use of technology

the overall goal of EPPM

• Overall goal of EPPM - encourage the danger control process • Messages must increase perceived susceptibility and perceived severity • Message should focus on creating high self-efficacy and high response • To work best, efficacy perceptions should be stronger than threat perceptions. If this is not possible, then one should reconsider using additional threats

How people react to messages and existing fear levels

• Research shows that existing fear levels are important in shaping how people react to messages • If people are already scared they may want to listen to another threat message • Additional fear appraisals did not increase the effectiveness of the message when people were already concerned.

EPPM and two types of efficacy

• Self-efficacy - belief of being able to perform the recommended behavior • Response efficacy - feeling that the behavior will actually be effective in avoiding the risk

Elements of communication and what they do (6 things)

• Source (produces message or sequence of messages-information source) • Sender (transmitter) • Channel (medium used to transmit the signal from the transmitter to the receiver) • Destination (the person or thing for whom the message is intended) • Message (concept, information, communication, or statement that is sent to the recipient • Feedback

Components of the EPPM

• Threats - communications that warn of danger - often in the form of a message to someone • Level of threat - the perceived severity and likelihood of the risk • Fear - the felt emotion that is experienced by a person. A threat may cause a level of fear in a person even though that person may not experience a fearful reaction • Efficacy - people's sense of being able to control or prevent negative outcome from occurring and can include self-efficacy and response efficacy

What fear appeals need to be effective

• To get the most from a fear appeal, one must understand the role of fear in human motivation • Fear appeals are the most effective when they convey not only the severity of the threat and personal susceptibility to it, but also convey a sense of self-efficacy and response efficacy to counteract the threat. • To be effective they need to do more than threaten the audience, they also need to motivate feelings of confidence and motivation

EPPM model and how and why it is used

• Used and validated in a variety of cultures and a wide variety of risks • Has value in predicting the effects of fear appeals • Predicts the type of reactions people have to fear appeals and when these will result in action - useful theory and framework for constructing threat messages: 1. Cardiovascular disease 2. Hand washing 3. Hearing protection 4. HIV/AIDS prevention

Danger control

• a cognitive process in which people think about the threat and ways to avert it

Fear control

• an emotional process where people react to the fear evoked by exposure to messages about a threat and engage in a maladaptive coping strategy to control their fear

interpersonal communication

•Between a small group of individuals •Typically face-to-face •Minimally restricted dialogue (familiarity) •Participants swap roles as senders and receivers •Breaks down barriers (become more vulnerable) •Demonstrates caring about the other person

What body language does

•Folded arms •Crossed legs •Shaking hands •Patting and touching •Facial expressions and gestures •Eye contact

Indicators of low health literacy

•Frequently missed appointments •Fail to complete registration forms •Unable to name medications or explain their purpose or dosing •Identify pills by looking at them, not reading label •Be unable to give coherent, sequential medical history •Show lack of follow-through on tests or referrals; and/or •Repeatedly use statements such as "I forgot my reading glasses," "I'll read through this when I get home," or "I'm too tired to read" when asked to discuss written material