Gezondheid- risico communicatie literatuur + colleges P5
Risk and health communication
- Inform about health risks
- To motivate to adapt healthy behavior
In order to develop effective health campaigns and interventions
- Factors that predict risk and health behavior
- How to influence these factors through communication
In this course
- Theory and research about predicting and changing risk and health behavior
- The role of (social) media and technology in this context
- How campaign and intervention effects can be measured in practice.
Blok 1: Voorspellers risico-gezondheidgedrag
Lecture 1: Introduction course & assignments (JV)
Communication about risks
- Subjective
- Costs vs. gains
Target various segments
- Specific tone of voice
Artikel Fincet (2020) - Effective health communication – a key factor in fighting the COVID-
19 pandemic.
A massive flow of health information
The scale of the crisis and governments’ responses have been matched by a colossal flow of
information about COVID-19. This massive flow of health information and viewpoints on the
pandemic is unprecedented and varied.
"There may be no way to prevent a COVID-19 pandemic in this globalised time, but verified
information is the most effective prevention against the disease of panic"
Health communication is a key and necessary factor in saving lives during the COVID-19
pandemic crisis → the spread of concise and valid information in different contexts.
Dealing with insecurity and fear
COVID-19 is scary for many reasons → Contagious and lethal the pandemic appears to be
Consequently, both leaders and clinicians face the difficult task of making people feel
safe with uncertainty.
We have limited experience and knowledge on this subject
4 important elements for communication:
1. Open and honest about what is (un)known: talk from facts and recognize the
temporality thereof.
2. Consistent and specific information: clear, specific non-ambiguous
3. Decision making skills: leadership, reliable and honest, acknowledge the visible
experts
1
, 4. Acknowledge emotions: through empathic information, expressing concern and
acknowledging impact
Promote behavioral change
4 important recommendations:
1. ‘Mental model’: overview picture of how COVID-19 works
2. Interventions: in the environment and through regulation; facilities
3. Appeal to collective action: ‘we are in this together’, leaders on all levels (role
models)
4. Maintain behavioral change: requires change in self-regulation, (conscious planning
in the beginning: action self-efficacy), preservation by habit (maintenance self-
efficacy)
How to promote behavior change: lessons from health communication research
To reduce the risk of COVID-19 in the community → critical that we pay attention to optimal
methods to ensure behavior change, both on the individual as well as on the community
level
The relevant behavior changes to fight the pandemic are well known by now
E.g., Wash your hands regularly! Social distancing! etc.
Many of these recommendations require changing subconsciously deployed behavioral
routines → Knowing is not the same as doing
Four recommendations regarding behavior change.
1. First, the usefulness of creating a mental model about how contamination works
and how this can be prevented. → While much of the general public has a mental
model of COVID-19 as a scary and disruptive disease, other sectors of a population
may not share that sense of urgency and thus may ignore behaviors
2. Second, behavior change requires not only verbal recommendations, but also real
interventions in the environment and even legislation. E.g., by placing alcohol-
based hand sanitizer in highly visible locations. → make the behavior easy, for
instance by building it into existing behavioral routines. This will increase self-
efficacy, which is an important determinant of behavior change. Restrictive
legislation may also be required.
3. Third, appeals to collective action and a spirit of we-are-in-it-together are very
important to flatten the curve and reduce the rate of infection. The attitude and
behavior of leaders at all levels are important. A demonstration of concern from role
models may have a role in persuading the public to adhere to recommendations.
4. Fourth, maintaining behavior change over time, in particular when restrictions have
lasted for several weeks or even months. To initiate a new health behavior,
individuals must be confident in their ability and skills to perform that behavior
(action self-efficacy). To maintain behavior, individuals must be repetitive in their
performance of the desired behaviors and confident in their ability to overcome
barriers in order to continue that behavior (maintenance self-efficacy).
2
,Challenges for the clinician
A final important area for implementation of health communication in the COVID-19 crisis is
to consider the challenges clinicians face in clinical encounters with patients whether in
person or to an increasing extent virtual encounters.
Important decisions are to be made with the patient and the family about the pros and cons
of staying at the ICU and its impact on the quality of life in the long run.
We also need to acknowledge the mental health effects of extended social isolation for
many vulnerable individuals.
Effective health communication is a key factor in fighting the COVID-19 pandemic.
Lecture notes: definitions & terms
Risk in this course =
- The likelihood that a specific event occurs (also: lecture4)
- Change that something happens* the severity thereof
- Risk perception: different for everybody
- Subjective! And that is difficult to estimate
Health =
Multiple definitions
WHO (1946): ‘It is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity’ = refers to a “state”
More recently: ‘the capacity of people to adapt to, respond to, or control life’s challenges
and changes’= refers to a “dynamic process”
Objective: health at the organic level, determined by an expert
Subjective: health on the individual level, determined by the individual, perceived health
Social: health on the social level, determined by the social environment, society
Prevention levels
Prevention:
- Risk -and health communication is often about ‘prevention’
- ‘Avoid from happening’
Three levels:
- Primary prevention
- Secondary prevention
- Tertiary prevention
Communication message is different:
- Level determines the message strategy / ‘social marketing’ approach
3 prevention levels:
1. Primary: preventing (the development) of illness
2. Secondary: early detection of illness
3
, 3. Tertiary prevention: limit severity/ consequences of illness. For example: promoting
adherence to therapeutic programs; development exercise programs for obese
people.
Social marketing & persuasive communication
Risk- and health communication has a lot in common with ‘marketing’
Social marketing:
- “Marketing behavior”
- Target group specification
- Connecting to behavior (determinants)
- Message factors
Product: Actual product: behavior; core product: profit from the behavior
Price: Literally: the price of the product; figuratively: loss compared to the promised benefits
Place:‘Action outlets’
Promotion: The most visible part of (social) marketing
- Persuasive communication strategies
- Develop effective messages
Persuasive communication
- Millions of people die every year from preventable causes of death (WHO, 2004)
- Lifestyle: Nowadays, illnesses are often the result of one's own (unhealthy) behavior,
such as smoking, unsafe sex, unhealthy eating patterns, too little exercise (cf.
Stroebe, 2000)
- “Lifestyle diseases” as a major cause of death
An unhealthy lifestyle
- Why do people behave so risky / unhealthy?
- Don’t people know that their behavior is unhealthy?
- Or are unhealthy people just stupid?
- Why don't they just change?
Sometimes people don’t know:
- In that case, it is important to inform people, for example in the early days of AIDS, or
give new knowledge about an unhealthy diet
Often people know:
- But they do it anyway..
- In that case it is important to find out WHY!
- People often know the facts and try to ignore or downplay them (‘unrealistic
optimism’)
➢ Predicting risk/health behaviour: what are the factors that make someone behave
unhealthily?
➢ Changing risk/health behaviour: what should we say and how, to (intrinsically)
motivate someone to actually change unhealthy behavior? (= persuasive
communication)
➢ The relation between the two
4
Risk and health communication
- Inform about health risks
- To motivate to adapt healthy behavior
In order to develop effective health campaigns and interventions
- Factors that predict risk and health behavior
- How to influence these factors through communication
In this course
- Theory and research about predicting and changing risk and health behavior
- The role of (social) media and technology in this context
- How campaign and intervention effects can be measured in practice.
Blok 1: Voorspellers risico-gezondheidgedrag
Lecture 1: Introduction course & assignments (JV)
Communication about risks
- Subjective
- Costs vs. gains
Target various segments
- Specific tone of voice
Artikel Fincet (2020) - Effective health communication – a key factor in fighting the COVID-
19 pandemic.
A massive flow of health information
The scale of the crisis and governments’ responses have been matched by a colossal flow of
information about COVID-19. This massive flow of health information and viewpoints on the
pandemic is unprecedented and varied.
"There may be no way to prevent a COVID-19 pandemic in this globalised time, but verified
information is the most effective prevention against the disease of panic"
Health communication is a key and necessary factor in saving lives during the COVID-19
pandemic crisis → the spread of concise and valid information in different contexts.
Dealing with insecurity and fear
COVID-19 is scary for many reasons → Contagious and lethal the pandemic appears to be
Consequently, both leaders and clinicians face the difficult task of making people feel
safe with uncertainty.
We have limited experience and knowledge on this subject
4 important elements for communication:
1. Open and honest about what is (un)known: talk from facts and recognize the
temporality thereof.
2. Consistent and specific information: clear, specific non-ambiguous
3. Decision making skills: leadership, reliable and honest, acknowledge the visible
experts
1
, 4. Acknowledge emotions: through empathic information, expressing concern and
acknowledging impact
Promote behavioral change
4 important recommendations:
1. ‘Mental model’: overview picture of how COVID-19 works
2. Interventions: in the environment and through regulation; facilities
3. Appeal to collective action: ‘we are in this together’, leaders on all levels (role
models)
4. Maintain behavioral change: requires change in self-regulation, (conscious planning
in the beginning: action self-efficacy), preservation by habit (maintenance self-
efficacy)
How to promote behavior change: lessons from health communication research
To reduce the risk of COVID-19 in the community → critical that we pay attention to optimal
methods to ensure behavior change, both on the individual as well as on the community
level
The relevant behavior changes to fight the pandemic are well known by now
E.g., Wash your hands regularly! Social distancing! etc.
Many of these recommendations require changing subconsciously deployed behavioral
routines → Knowing is not the same as doing
Four recommendations regarding behavior change.
1. First, the usefulness of creating a mental model about how contamination works
and how this can be prevented. → While much of the general public has a mental
model of COVID-19 as a scary and disruptive disease, other sectors of a population
may not share that sense of urgency and thus may ignore behaviors
2. Second, behavior change requires not only verbal recommendations, but also real
interventions in the environment and even legislation. E.g., by placing alcohol-
based hand sanitizer in highly visible locations. → make the behavior easy, for
instance by building it into existing behavioral routines. This will increase self-
efficacy, which is an important determinant of behavior change. Restrictive
legislation may also be required.
3. Third, appeals to collective action and a spirit of we-are-in-it-together are very
important to flatten the curve and reduce the rate of infection. The attitude and
behavior of leaders at all levels are important. A demonstration of concern from role
models may have a role in persuading the public to adhere to recommendations.
4. Fourth, maintaining behavior change over time, in particular when restrictions have
lasted for several weeks or even months. To initiate a new health behavior,
individuals must be confident in their ability and skills to perform that behavior
(action self-efficacy). To maintain behavior, individuals must be repetitive in their
performance of the desired behaviors and confident in their ability to overcome
barriers in order to continue that behavior (maintenance self-efficacy).
2
,Challenges for the clinician
A final important area for implementation of health communication in the COVID-19 crisis is
to consider the challenges clinicians face in clinical encounters with patients whether in
person or to an increasing extent virtual encounters.
Important decisions are to be made with the patient and the family about the pros and cons
of staying at the ICU and its impact on the quality of life in the long run.
We also need to acknowledge the mental health effects of extended social isolation for
many vulnerable individuals.
Effective health communication is a key factor in fighting the COVID-19 pandemic.
Lecture notes: definitions & terms
Risk in this course =
- The likelihood that a specific event occurs (also: lecture4)
- Change that something happens* the severity thereof
- Risk perception: different for everybody
- Subjective! And that is difficult to estimate
Health =
Multiple definitions
WHO (1946): ‘It is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity’ = refers to a “state”
More recently: ‘the capacity of people to adapt to, respond to, or control life’s challenges
and changes’= refers to a “dynamic process”
Objective: health at the organic level, determined by an expert
Subjective: health on the individual level, determined by the individual, perceived health
Social: health on the social level, determined by the social environment, society
Prevention levels
Prevention:
- Risk -and health communication is often about ‘prevention’
- ‘Avoid from happening’
Three levels:
- Primary prevention
- Secondary prevention
- Tertiary prevention
Communication message is different:
- Level determines the message strategy / ‘social marketing’ approach
3 prevention levels:
1. Primary: preventing (the development) of illness
2. Secondary: early detection of illness
3
, 3. Tertiary prevention: limit severity/ consequences of illness. For example: promoting
adherence to therapeutic programs; development exercise programs for obese
people.
Social marketing & persuasive communication
Risk- and health communication has a lot in common with ‘marketing’
Social marketing:
- “Marketing behavior”
- Target group specification
- Connecting to behavior (determinants)
- Message factors
Product: Actual product: behavior; core product: profit from the behavior
Price: Literally: the price of the product; figuratively: loss compared to the promised benefits
Place:‘Action outlets’
Promotion: The most visible part of (social) marketing
- Persuasive communication strategies
- Develop effective messages
Persuasive communication
- Millions of people die every year from preventable causes of death (WHO, 2004)
- Lifestyle: Nowadays, illnesses are often the result of one's own (unhealthy) behavior,
such as smoking, unsafe sex, unhealthy eating patterns, too little exercise (cf.
Stroebe, 2000)
- “Lifestyle diseases” as a major cause of death
An unhealthy lifestyle
- Why do people behave so risky / unhealthy?
- Don’t people know that their behavior is unhealthy?
- Or are unhealthy people just stupid?
- Why don't they just change?
Sometimes people don’t know:
- In that case, it is important to inform people, for example in the early days of AIDS, or
give new knowledge about an unhealthy diet
Often people know:
- But they do it anyway..
- In that case it is important to find out WHY!
- People often know the facts and try to ignore or downplay them (‘unrealistic
optimism’)
➢ Predicting risk/health behaviour: what are the factors that make someone behave
unhealthily?
➢ Changing risk/health behaviour: what should we say and how, to (intrinsically)
motivate someone to actually change unhealthy behavior? (= persuasive
communication)
➢ The relation between the two
4
