Transcript kreps_immediacy - Rhetoricians of Health and Medicine

Promoting Immediacy in Health
Communication
Gary L. Kreps, Ph.D.,
University Distinguished Professor
Director, Center for Health and Risk Communication
George Mason University
Fairfax, VA 22030, USA
[email protected]
How can we communicate to build
meaningful and collaborative health
promoting relationships?
Effective health communication
depends more on the quality of the
messages we exchange than on the
media we use to convey health
messages!
Too many health messages are:
& unimaginative (just the facts m’aam)
 Overly technical (medicalese)
 Overly complex & formal (bureaucratic)
 Insulting/disempowering (clean up your act)
 Directive/prescriptive (we know what’s best for you)
 Static (our way or the highway)
 Not much fun (limited entertainment value)
 One-way (limited interaction)
 Boring
Health communication is often too
artificial to achieve health goals:
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How engaging are most HC messages?
Do we capture audience attention (exposure)?
Do we communicate clearly (literacy)?
Do we communicate humanely (sensitivity)?
Do we communicate persuasively?
Do we adapt well to unique individuals?
Do we promote immediacy?
Immediacy refers to communication
that promotes:
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Physical and emotional closeness
Comfort
Engagement and caring
Personal involvement
Intensity and enthusiasm
Authenticity
Enjoyment
Where is the Passion in Health
Communication Programs (HCPs)?
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Do HCPs move you?
Do HCPs provide both the sizzle and the steak?
Are HCPs robotic?
Are HCPs soulful or soul-less?
Are HCPs alienating or encouraging?
Are HCPs emotionally provocative & engaging?
Are HCPs interesting/relevant to users?
Immediate communication can
enhance health promotion:
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Increase access (exposure) to health information
Improve quality of communication & care
Increase consumer participation/involvement
Promote coordination of care/services
Relieve demands on health care staff
Reduce costs/increasing efficiency
Influence health behaviors/outcomes
Demonstrated outcomes derived
from immediate communication:
 Brings
communicators closer together
 Enhances expression of affect
 Increases cognitive and affective learning
 Increases perceptions of credibility & identification
 Enhances motivation & participation
 Encourages communication and feedback
 Reduces resistance & verbal aggression
Nonverbal aspects of immediacy
can demonstrate:
 Friendliness
(smiling, congruence, proximity)
 Animation (movement, gestures, vocal variety)
 Involvement (eye contact, touch, direct orientation)
 Excitement (vocal intensity, expressions, design)
 Comfort (relaxed body posture, proximity, touch)
 Caring (congruent expressions, appropriate touch)
Verbal aspects of immediacy can
demontrate:
 Familiarity
(refer to person by name, experience)
 Involvement (use collective terms like “we” and “us”)
 Clarity (familiar terms, explain complex concepts)
 Interest (personal interaction, relevant small talk)
 Reinforcement (specific and appropriate feedback)
 Shared Control (input, feedback, and preferences)
 Caring (congruence, concern, and empathy)
Immediacy can help meet
reciprocal interpersonal needs:
 Inclusion
(need to include others and to be included)
 Control (need to exert control and let others control)
 Affection (need to express and receive affection)
(Schutz, W. (1958) FIRO: A Three Dimensional Theory of
Interpersonal Behavior. NY: Holt, Rinehart and Winston.)
The best health interventions use
immediacy to engage audiences
♦ Use relevant communication messages
♦ address personal concerns
♦ are dramatic and interactive
♦ Develop involving messages
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tie in to values and concerns
adjust to unique needs/issues
Immediate health interventions are
responsive to users’
 Beliefs,
values, norms, & expectations
 Experiences and concerns
 Language skills and orientations
 Health literacy levels (language & numbers)
 Levels of motivation to seek health information
 Media use patterns
 Social network memberships
Immediacy helps to capture
audience attention:
 Connects
users on a personal level (empathy)
 Engages users dramatically (dynamism)
 Provides vivid, relatable, models (identification)
 Adapts messages to specific users (personal)
 Uses multiple complimentary messages (reinforce)
 Illustrates key concepts (visual/narrative)
 Provides subconscious encouragement (motivate)
 Tailors messages to individual needs (adapt)
The immediacy of information
sources is influenced by:
 Credibility
(believable)
 Familiarity (comfortable)
 Expertise (knowledgeable)
 Engagement (friendly/convivial/interesting)
 Trust (consistent & fair)
 Reliability (available when needed)
 Sensitivity (caring & appropriate)
The most immediate health
messages are:
 Close
and familiar (comfortable for users)
 Easy to understand (makes sense to me)
 Dramatic and memorable (emphatic)
 Embedded in compelling stories (narrative)
 Easy to apply (builds self-efficacy)
 Reviewable (take-away media & messages)
 Interactive (provides feedback loops)
 Reinforcing (motivating)
Communication research/planning
is key for promoting immediacy!
♦ Audience analysis/needs analysis (foundation for
intervention design)
♦ Participative design (work with audience members)
♦ Message and media testing (develop/refine
communication strategies)
♦ Usability testing (key user response data)
♦ Formative, Process, and Summative evaluation
(adapting strategies, what works & why)
References to immediacy and
instructional outcomes research:
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Andersen, J.F. (1979). Teacher immediacy as a predictor of teaching effectiveness. In D. Nimmo
(Ed.), Communication Yearbook, 3 (pp.543-559). New Brunswick, NJ: Transaction.
Arbaugh, J. B. (2001). How instructor immediacy behaviors affect student satisfaction and learning
in web-based courses. Business Communication Quarterly, 64: 42-54.
Chesebro, J.L. and McCroskey, J.C. (2001). The relationship of teacher clarity and immediacy with
student state receiver apprehension, affect, and cognitive learning. Communication Education, 50,
59-68.
Gorham, J. (1988). The relationship between verbal teaching immediacy behaviors and student
learning. Communication Education, 17, 40-53.
Kelley, D.H. and Gorham, J. (1988). Effects of immediacy on recall of information. Communication
Education, 37, 198-207.
Pogue, L. and AhYun, K. (2006). The effect of teacher nonverbal immediacy
and credibility on student motivation and affective learning. Communication
Education, 55, 331-344.
References to immediacy and
health communication:
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Kreps, G.L. (2014). Achieving the promise of digital health information systems. Journal of Public Health
Research 3:471, pp. 128-129.
Kreps, G.L., & Neuhauser, L. (2013). Artificial intelligence and immediacy: Designing health
communication to personally engage consumers and providers. Pt. Ed. & Counseling, 92, 205-210.
Neuhauser, L., Kreps, G.L., Morrison, K., Athanasoulis, M., Kirienko, N., & Van Brunt, D. (2013). Using
design science and artificial intelligence to improve health communication: ChronologyMD case
example. Patient Education and Counseling, 92, 211-217.
Kreps. (2012). Consumer control over and access to health information. Annals of Family Medicine,
10(5). http://www.annfammed.org/content/10/5/428.full/reply#annalsfm_el_25148
Kreps. (2012). Engaging health communication. In T.J Socha and M.J. Pitts. (Eds.). The positive side of
interpersonal communication (pp. 249-258). New York: Routledge.
Neuhauser & Kreps. (2011). Participatory design and artificial intelligence. In Green, Rubinelli, &
Scott. (Eds.). Al and Health Communication (pp. 49-52). AAAI Press.
Kreps & Neuhauser (2010). New directions in ehealth communication: Opportunities and challenges.
Pt Ed & Counseling, 78, 329-336.
Kreps & Neuhauser (2010). E-Health and health promotion. Journal of Computer-Mediated
Communication, 15(4), 527-529.