New Paradigms in Public Health Messaging. Terry L Dwelle MD MPHTM State Health Officer

Transcription

1 New Paradigms in Public Health Messaging Terry L Dwelle MD MPHTM State Health Officer

2 Message - Meaning Purpose effectively transfer messages that result in meaning to change risky behaviors Meaning = the input of our senses overlaid with increasing levels of abstraction Other Sensory Experiences Messages Creative Process Individual Meaning Bits of Information

3 Outrage Management Outrage Outrage Management Crisis Management Concern Sweet Spot No concern No Problem Public Apathy Low Hazard Medium Hazard High Hazard

4 Contextualization Making concepts or ideals relevant in a given situation Kato Outrage Concern Sweet Spot No concern Time August, 2003

5 Changing High Risk HIV Behaviors in Africa MMWR June, 2001 Editorial Uganda, Zimbabwe, Senegal Attributes High level leadership support Had a good plan Adequate resources committed Community involvement

6 Definition of Community 1. Members know each other by name. 2. Sense of unity, trust, care, and responsibility for each other.

7 Horizontal and Vertical Communications across Classes High to Low Horizontal Low to High 20 0 Prestige Volume Persuasion

8 Layers of Culture Behaviors and Artifacts Institutions Values Ideology Cosmology Worldview

9 Traditional Public Health and Social Marketing? Social Marketing We don t care what a person thinks or feels. We just want a change in the target behavior. Cultural Communications Changes in the beliefs, feelings and thinking of individuals are essential in permanent changes of high risk behaviors Behaviors Instituions Values Ideology Cosmology Worldview

10 Primary Message Systems PMS s s are communicated or learned in 3 ways Formal level mistake and correction Informal level imitation of models Technical level from a teacher If we want to introduce changes particularly in basic beliefs or behavioral patterns of a culture we must introduce or at least mightily reinforce at the informal out-of of-awareness level

11 Communicating in Primary Message Systems Much cultural behavioral change occurs at the informal level and is reinforced at the technical level The technical level can either support or react to informal changes in culture

12 Family influence on Tobacco Use 34.5% of high school students and 15.1% of middle school students use tobacco 70% of middle school and 57% of high school students who currently smoke live in a home where someone smokes cigarettes Family Smoking Informal Imitation Formal Technical MMWR 2001;50(SS-04)

13 Dimensions of Cultural Communications Feedback Source Encoded Message Decoded Respondent Culture X Context Cultural Distance 1. Worldviews 2. Cognitive Process 3. Linguistic Forms 4. Behavioral Patterns 5. Social Structures 6. Media Influence 7. Motivational Resources Noise Culture Y

14 Worldview The way people see or perceive the world, the way they know it to be The colored glasses through which people see themselves and the universe around them The way people characteristically look outward upon the universe or especially to the way a man, in a particular society, sees himself in relation to all else The way people look at reality

15 Worldview Super Nature Man Nature Time (Past, Present, Future)

16 Naturalist Worldview Man Nature Time (Past, Present, Future)

17 Tribal Worldview Super Nature Man Nature Time (Past, Present, Future)

18 Monotheistic Worldview Super Nature Man Nature Time (Past, Present, Future)

19 Naturalist Worldview - Time Past Present Future

20 Time African / Tribal view Past Present Future US Youth, Latin and Filipino views Past Present Future

21 Communicating across Worldviews 1. Invite the respondent to temporarily adopt the worldview of the source 2. Invite respondents to meet the source halfway 3. Source temporarily adopting the worldview of respondents

22 Dimensions of Cross Cultural Communications Feedback Source Encoded Message Decoded Respondent Culture X Context Cultural Distance 1. Worldviews 2. Cognitive Process 3. Linguistic Forms 4. Behavioral Patterns 5. Social Structures 6. Media Influence 7. Motivational Resources Noise Culture Y

23 Trisystemic Approach 1. Conceptual theoretic 2. Psychical intuition, inner experience 3. Concrete Relational relationships and emotions

24 Trisystemic Cognition Psychical Relationships Psychical Concepts Concepts Relationships Concepts Relationships Psychical West Public Health China Tribal Politicians Youth India Faith Based

25 Relational Thinking Reality is seen pictorially in terms of active emotional relationships present in a concrete situation Verbal communication uses symbols, stories, events, objects vs general propositions and principles Relies heavily on non-verbal communication gesture, music, ritual, drama, image projection

26 Summary Be respondent oriented Be message opportunists Community ownership and engagement Incorporate horizontal communication strategies Understand and adapt messages to target culture attributes Realize the importance of informal messaging in changing / establishing behaviors Appropriately utilize the communication tools; social marketing and cultural communications