Transcript Health communication in practice: Creating a culturally

Health communication in practice: Creating a culturally-sensitive obesity campaign for the state of Florida
Kristy A. Siegel, MPH, CHES and Richard T. Patton, MPH, CHES
Stempel School of Public Health, Florida International University, Miami, Florida
PROBLEM
ABSTRACT
At the Florida International University Robert R. Stempel School of Public
Health, MPH students enrolled in the Health Promotion Communication:
Theory and Design (PHC 6501) course had the opportunity to integrate their
theoretical knowledge with the realities of health promotion practice by
designing an obesity campaign for the residents of Florida, as requested by
the Florida Department of Health. Today, over 56% of the adults in Florida
are either overweight or obese, and among young adults, the prevalence of
obesity has increased 110% in 10 years. Some of the target populations
selected for the campaign included pre-menopausal African American
women, Latina college students, and teenage girls. Students were able to
demonstrate Berlo’s Model of Communication by utilizing the Office of
Disease Prevention and Health Promotion’s eleven attributes of effective
health communication. Contrary to modern obesity interventions that are
based upon the medical model, students used the compensatory model of
responsibility conflict to design their campaign. Work assignments consisted
of a public service announcement, brochure, educational materials, press
release, news article, video, website, and an oral presentation. The
particular challenge in the assignments was to ensure the campaign was
culturally-sensitive to the target population. Students, as part of putting
theory into practice, tested the campaigns they developed to a focus group
of their target population. An important lesson students learned from the
focus groups was any obesity campaign must be free from anti-fat bias.
BACKGROUND
Health communication is a multidimensional, transactional process.
Effective communication incorporates involvement and interaction of all
parties, while also attentive to the content of the message and the
relationship of the speaker to the listener and vice versa. Berlo’s Model of
Communication embodies this idea. The elements of Berlo’s Model are
Source, Message, Channel, and Receiver (SMCR). The Source is affected
by her communication skills, knowledge, social system, culture, and attitudes.
The Message involves the elements (content) and the structure (code) and
the treatment of the content to the code. The Channel is the five senses
used in the encoding and decoding of the Message. The Receiver is affected
by the same constructs as the Source. Berlo’s Model is particularly useful
when socio-cultural issues may arise because it compels the Source to be
attentive to the word choices she makes, the purposes she has for
communicating, the meanings people attach to certain words, her choice of
receivers, and the channels she uses for this or that kind of message. The
Source can expand Berlo’s Model by remembering and utilizing the Office of
Disease Prevention and Health Promotion’s eleven attributes of effective
health communication: accuracy, availability, balance, consistency, culturally
competent, evidence-based, reach, reliability, repetition, timeliness, and
understandable.
Florida has not been spared from the obesity epidemic sweeping the nation.
In 2000, approximately 6,650,395 Florida adults were overweight or obese (BMI
≥25 kg/m2) based on self-reported height and weight. Of those, approximately
2,307,280 adults were obese (BMI ≥30 kg/m2). The prevalence of obesity among
adult men and women in Florida has almost doubled over the past 10 years.
Overweight and obesity is increasing in men, women, and children of all races.
achieve. Conversely, the focus groups did not want to see someone their size on
the cover either. They wanted pictures of someone of healthy, attainable size on
the cover, but also without the words “fat”, “obese”, or “lose weight”. They felt
stigmatized by those words and feared reading or carrying anything in public
view that contained those words on the cover.
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METHODS
Utilizing scientific foundations and research understandings, the students
practiced written, oral, non-verbal, and neurolinquistic communication by
completing assignments regarding obesity. Assignments intended to convey
information in the form of press releases, newspaper articles, flyers, brochures,
educational handout materials as well as public service announcements, oral
presentations, web pages for electronic technology, and video productions. The
assignments allowed for practical application to one target population chosen by
each group of students.
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RESULTS
Seven campaigns were created through collaboration of the students in PHC
6501. The target populations selected by the students included pre-menopausal
African American women, Hispanic post-menopausal women, Latina college
students, and teenage girls. After a series of focus group discussions with their
respective target populations, the students found that campaigns needed to be
sensitive to the particular culture by using their language and colloquialisms,
pictures and images, and specific health and body concerns. For example, for
African American pre-menopausal women, one campaign used pictures that
clearly showed a woman with a darker skin tone and braids in her hair for their
educational brochures. The campaign also highlighted the fact that in the African
American culture larger women are considered sexy.
All the groups of students discovered through focus group discussions that
anti-fat bias is a concern of their target population, regardless of race. Anti-fat
bias can be defined as seeing the fat and pounds and not the person, which is
common in many obesity campaigns today. These campaigns base their strategy
on the medical model, in which causes are sought for individual cases, and
treatment rather than prevention is the aim. The campaigns also tell individuals
to eat less and exercise more in order to lose weight; a vulgar, you have a
problem and I will tell you how to fix it. Students instead chose the compensatory
model of responsibility conflict for their campaigns, meaning individuals have little
responsibility for causing their obesity issues, but have high responsibility for
fixing them. This model removes blame but shifts the action and power into the
individual’s realm.
Another detail of the anti-fat bias concern raised by the focus groups was
choice of images and words in the campaign. Many focus groups commented
that the person on the cover of many fitness and health magazines had an
unrealistic body image that someone with weight concerns would not be able to
REFERENCES
• Northouse, L.L, and Northouse, P.G. (1998). Health Communication: Strategies for Health Professionals. Appleton & Lange: Stamford, CT.
• U.S. Department of Health and Human Services. (2000). Healthy People 2010: Chapter 11- Health Communication. U.S. Government Printing Office: Washington, D.C.
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CONCLUSION
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The Health Promotion Communication: Theory and Design (PHC 6501) course was
successful in allowing MPH students the opportunity to work on a real issue facing
Americans today and to explore their campaigns in their target population to receive
feedback and to adjust their content as needed. Along the way, students also adjusted
their knowledge and attitudes towards their population and the obesity epidemic. One
innovative campaign titled “Think Before You Eat” by Charles Platkin and Thor
Barraclough has been selected by the City of Hollywood, FL and the supermarket chain
Publix to distribute to their employees and customers.
ACKNOWLEDGEMENTS
Florida International University
Dev Pathak, MS, MBA, DBA
The students whose work is shown:
Thor Barraclough
David Bissell
Kelly Chevalier
James Churilla
Jodi Clark
Veronica Francis
Nicole Headley
Claudia Millar
Yolanda Payne-Jameau
Charles Platkin
Lisa Marie Quammie
Radha Ramjattan
Barry University
Jeremy Montague, Ph.D.