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Qualitative Research

• Research that collects data that appear in words rather than numbers

• Feelings

• Impressions

• Provides context, details

• Generates creative strategy

• Gain in-depth understanding of motivations, behaviors of small group of target population

• Explains "why"

• Indicative findings, not predictive

• How do women with fibromyalgia make meaning of their illness experiences?

• Is subjective

• Enables discovery

• Is exploratory

• Allows insights into trends, behavior, so on

• Interprets

Quantitative Research

• Research designed to count and measure knowledge, attitudes, beliefs, behaviors"

• Yields data analyzed statistically

• Identify problems, precursors to intervention at population level

• Evaluate delivery, impact of intervention

• Answer "What" and "How many"

• What percentage of US men and women exceed daily calorie allowance

• How many calories do US men and women consume each day?

• Advantage

• Help form benchmark of population's attitudes, behaviors

• Disadvantage

• Time-consuming

• Expensive

• Measures level of occurrence

• Asks "how often?" and "how many?"

• Studies actions

• Is objective

• Provides proof

• Is definitive

• Measures level of trends, actions, so on

• Describes

Common data collection methods

o Individual in-depth interviews

• Complex subject matter, respondents highly knowledgeable about topic

• Need to understand individual decision making

• Highly sensitive subject(s)

• Geographically dispersed audience

• Topic may be influenced by peer pressure and/or social desirability

o Focus groups, with 6 to 10 individuals

o Surveys

Audiences (Primary, Secondary, Tertiary; Audience Segmentation)

o Primary audience:

• Group whose behavior you hope to influence directly

• Group most affected by health issue

• Primary beneficiary

• Caretakers acting on behalf of others

o Secondary Audience

• Group with direct influence on primary audience

• Teachers, grandparents, primary health-care providers

o Tertiary Audience

• Group that affects behavior of secondary audience that in turn may affect behavior of primary audience

• "Public at large"

• Gatekeepers (healthcare professionals, support behavior change goal)

o Audience Segmentation

• Division of a large group of people into smaller, more homogenous groupings

• Culture, demographics, geographic location

• Relationship with a particular illness, disability

• Education, literacy, language use, media use

• Readiness to change, theory-based constructs

• Affiliations (community or national organizations)

• Needs for training or educational outreach

Formative Research (definition & uses)

a. "The information-gathering activities you conduct prior to developing a health communication strategy"

i. Involves small group of target audience in development of concepts, messages, materials and media selection

ii. Uses qualitative and quantitative methods

a. Identify themes, norms for messages

b. Identify key behaviors for intervention

c. Assess knowledge or gaps in knowledge

d. Determine channels for communication

e. Understand local health, illness concepts to target, segment, and test messages and build rapport

Advantages of mixed methods research

a. "A research design that combines quantitative and qualitative methods"

b. Complements strengths, overlaps weaknesses

c. Provides better evidence for results

d. Helps narrow findings that might have been missed if only one method use

e. Comparison

f. Triangulation: Form of verification of results

Questions (4) in BEHAVE Framework

a. Who are you trying to reach? (target audience)

b. What do you want them to do? (actions)

c. What factors influence their behavior? (determinants)

d. Which actions will most effectively address these factors? (interventions)

e. In order to help (specific target audience) to (perform a specific behavior) we will focus on this benefit (something the target audience values). We will approach these factors (e.g., self-efficacy, lowered barriers, enhanced health literacy, etc.) and use these activities (means of reaching the audience: media channels or other contact opportunities).

Underlying principle of BEHAVE Framework

If you can't answer the questions, then you have to conduct formative research

Explain Behavioral Lever

a. Simple behaviors such as washing your hands, are comprised of several small steps and require multiple resources to complete. Any one of these steps (or resources) can be a limiting factor if people cannot perform the behavior without it. Inversely, once the limiting step is taken, the remaining steps may follow in sequence without further input. This step is a behavioral lever.

b. Limiting or facilitating step or resource that aids completion of the ideal behavior

Describe Stages of Change

AKA trans-theoretical model

a. Pre contemplation-No intention of taking action in next 6 months—increase awareness of need for change. Personalize information

b. Contemplation—Intends to take action in next 6 months—motivate, encourage making specific plans

c. Preparation—intends to take action within the next 30 days and has taken some steps in this direction—assist with developing, implementing concrete action plans; help set gradual goals.

d. Action—has changed behavior for less than 6 months—assist with feedback, problem-solving, support reinforcement

e. Maintenance—has changed behavior for more than 6 months—assists with coping, reminders, finding alternatives, avoid slips

Best Practices for Facebook

• Listen:

• ˃ Know audience

• ˃ Identify goals

• ˃ Make a plan

Manage content:

• ˃ Create editorial calendar

• ˃ Use checklists

• ˃ Learn from Facebook analytics/insights

• ˃ Repurpose content across platforms

• Have a policy:

• ˃ Content guidelines

• ˃ Account ownership

• ˃ Rules of engagement, inappropriate comments

• » Have a voice:

• ˃ Speak, write in first person

• ˃ Build an online personality consistent with brand

• ˃ Share stories, photos

• Engage

• Be visual

1. Post succinct content

2. Post photos, videos

3. Post regularly

4. Try a "fill in the blank" post

5. Be timely

Best Practices of Twitter

1. Follow

2. Create

3. Engage

(educate, raise awareness, call to action)

• Do:

• Be strategic, have a goal in mind

• Create descriptive bio for Twitter page

• Listen to what people are saying about you (use Twitter Search function)

• Provide value for followers

• Be dedicated, have active presence on Twitter

• Ask questions of, get feedback from followers

• Don't

• Just Tweet - follow, be followed

• Just broadcast information - have a conversation

• Be boring

• Panic if something negative is said - address the issue

• Be the sole person in charge of Twitter - takes a team

Best Practices of YouTube

• Create "snackable" content

• » Tell a story

• » Be real

• » Make videos interactive

• » True view: 5-second test

• » Capture existing audience

• Promote video content:

• ˃ In-stream

• ˃ In-search

• ˃ In-display

• » Use YouTube Insight:

• ˃ View statistics about uploaded videos

• ˃ Access video-level data on who, what, when, where, how

• » Drive traffic to site:

• ˃ External annotations

• ˃ "Info" section of video

• ˃ Call to action

• Create YouTube Channels

• 1.0: Leverage current content and share

• other's high quality and high demand content

• 2.0: Videos = Short, Narrative, Creative,

• Emotional, Real People, Sharable

• 3.0: Solicit appropriate user generated content

Define Viral Marketing

The process of encouraging individuals to pass along favorable or compelling marketing information they receive in a hypermedia environment: information that is favorable or compelling either by design or by accident.

Example: marketing campaigns for Paranormal Activity encouraging audiences to demand it be shown in theaters

Example: Whatcha Doin? teens spread message that fruits, veggies and physical activity is cool

Define Entertainment Education

"The process of purposely designing and implementing a media message to both entertain and educate ... [and] a communication strategy to bring about behavioral and social change."

Define Social Networking Sites

Online communities where people can interact with friends, family, coworkers, acquaintances, and others who share similar interest. Social networking sites provide an immediate and personal way to share information with individuals or groups within a personal network.

Define Earned Media

Term meaning you do not pay to disseminate information, it is "picked up" by the news, local programming, or run as a PSA.

What are the characteristics of health communication?

Accuracy, Clarity, Consistency, Credibility, Relevance, Tone and Appeal

Define Cognitive Research

Refers to a number of techniques derived from psychology that help us understand how we process information.

Example: Likert scales - 5pt scale, strongly agree, strongly disagree, ranked but not truly measured

Other Examples:

Galvanic Skin Response (lie detector)

Heart Rate

Pupil Dilation

Eye Tracking

EEG & fMRI

Define a Pilot Tests

A small-scale trial of all the elements of the strategy in a limited number of locations for a brief period of time. The data collected from this trial are then used to adjust the final product.

Development/Types of Objectives

o "Communication objectives are the intermediate steps that need to be attained in order to meet the overall program goals as complemented by specific behavioral, social and organizational objectives."

types: learning, behavioral, environmental

o EXAMPLE: to raise awareness by the year 2014 of the need for annual mammograms among X percent of Latino women over 40 years of age who live in Alachua County, Florida.

Rules of Objectives

• "WHO will do or change ...

• "WHAT by ...

• "WHEN and by ...

• "HOW MUCH?"

TIPS for developing Objectives

• Make objectives specific to audience

• Exclude (leave out) tactical elements

• Limit number of objectives

• Analyze barriers, success factors

• Define time frames

Objective Expressions

• To raise awareness...

• To increase knowledge...

• To break the cycle of misinformation ...

• To change attitudes...

• To facilitate interactions...

• To help build expertise or skills...

SMART Objectives

Specific, Measurable, Appropriate, Realistic, Time-bound

Learning Objectives

• Educational (learning) tools needed to achieve desired behavior change

• Raise awareness

• Expand knowledge, understanding

• Attain, maintain attitudes to help deal with concern

• Possess necessary skills to engage in behavior

Behavioral Objectives

• Describe behaviors (actions) in which the target population will engage to resolve the concern

• Adherence (regular exercise)

• Compliance (taking medications)

• Consumption patterns (diet)

Environmental Objectives

• Outline the non-behavioral causes of a health concern that are present in the social, physical or psychological environment

• Social (access to services)

• Physical (clean air and water)

• Psychological (emotional learning climate)

Development of Goals

o "Destination"

o A future event toward which a committed behavior is directed (the desired behavior)

• Are much more encompassing, or global

• Are written to include all aspects or components of a program

• Provide overall direction for a program

• Are more general in nature

• Usually take longer to complete

• Should be simple, concise

o Examples:

• To reduce the incentive of cardiovascular disease in the employees of the Tyson Chicken Plant

• To reduce the spread of HIV in the youth of Florida

• To reduce the cases of lung cancer caused by secondhand smoke

• To reduce the spread of STDs among UF students

Strategies

A statement describing the overall approach used to accomplish the communication objectives.

Creative Brief

a. A document that includes information that will be needed by a creative team to develop concepts and messages.

Example: Folic Acid First Campaign

b. Elements of a Creative Brief

i. Project overview

ii. Target audience segment

iii. Objectives

iv. Obstacles

v. Benefit, key promise

vi. Support statements

vii. Tone

viii. Distribution opportunities

ix. Creative considerations

x. Other elements

Concepts

a. A concept is an idea that can be communicated symbolically or artistically for discussion, sometimes referring to some broad (i.e., germ theory) or new (i.e., nanorobotics)

b. A concept describes "ways of presenting the information to intended audiences"

c. gestalt interpretations - try to grab the main idea and give it personality

Messages

A message consists of memorable, explanatory words or images that convey an idea. In health communication, the literal words or images that communicate what you want people to know, feel, or do

Effective Messages are...

• Concise, to the point

• Credible

• Relevant to intended audience

• Consistent

• Simple

• Easy to remember

Communication channels

Paths used to reach intended audiences with relevant information and communication.

Interpersonal Channels/Groups (healthcare providers,clergy, teachers, others who interact with intended recipient in person)

Organizational/Community

Mass Media

Communication tactics

Materials, events, activities or other ways used to deliver messages through communication channels.

What is the purpose of pretesting

a. Ensures criteria of draft concepts, messages and materials are met

b. Relies on traditional marketing and communication research methods

c. Needs to be cost-effective

d. Answers "What can audience do after that they couldn't do before?"

e. Assesses comprehension (literacy level)

Elements of Patient-Provider Communication

o Respect

o Preparation

o Listen first

o The "story"

o Progressive dialogue

o Review and summation:

• Inform, teach-back

• Support, comfort

Goals of Patient-Provider Communication

o Diagnosis/information

o Behavior modification

o Adherence to treatment

o Understanding

o Support

Models and Theories of Patient-Provider Communication

Collaborative Interpretation Model

Uncertainty Reduction Theory

Collaborative Interpretation Model

Proposes that health communication is most effective when patients actualize the roles of decision-makers and problem-solvers and caregivers function as counselors or friends who work alongside patients to help them achieve shared goals

*model of patient-provider communication

Uncertainty Reduction Theory

• Uncertainty is reduced through increased verbal communication - Introduction with name, position, descriptions

• Uncertainty is decreased with increases in nonverbal expressiveness - Smiling, gestures, eye contact

*patient-provider communication theory

What does Physician-Centeredness mean

a. "Communication in which health provider does most of the talking, chooses topic of conversation, and begins and ends the communication episode"

b. Cultural expectations (Western attitudes)

c. Medical traditions, education:

i. Assertive

ii. Focused

iii. Non-emotional

Implications of Physician-Centeredness

i. Doorknob disclosures, where patients blurt out main concern as doctor is leaving room

1. "What can I do for you today?"

2. "You're having body aches" or "You're sick, huh?"

ii. Questions and directives (instructions or commands)

iii. Stutters, stammers

iv. Blocking, process by which caregivers steer talk away from certain subjects

v. Nurses avoid emotional disclosures

vi. Doctors ignore personal revelations

vii. Patronizing behavior, whereby patients are treated as inferior (power inequality)

viii. Withholding information

ix. Speaking down

x. Shrugging off concerns

Characteristics of Patient-Centered Communication

a. "Array of communicative behaviors than can enhance quality of relationship between health-care provider and patient, or patient's family"

b. Explore patient's reason for health visit

c. Understand medical and emotional issues

d. Enhance doctor-patient relationship

Doer vs. Non-Doer Analysis

o Looks at individuals who are already using the desired product (or already participating in a behavior)

o Also looks at individuals who are NOT using desired product, substituting something else for it, or doing nothing instead of the desired behavior

Positive deviance approach - both doers and non-doers need to be identical in terms of SES and environmental conditions, eliminate as many cultural differences as possible

Advocacy Strategies

o Search Engine Optimization (SEO)

• Including terms in a website resulting in better search

o Traditional Media Advocacy

• Know those responsible for researching and presenting news

• Focuses on newspapers, radio stations, local TVs

o Media Relations Tools

• Communication between an organization and its publics, mainly through the news media

• Press release

• Media alert

• Backgrounder

Risk Assessment Executive Summary

o Quantitative process

o Hazard identification (and possibly benefit identification)

• Identifies the agents of concern (drugs, pesticides, pollutants, etc.) or other factors related to a risk

• Primary filtering step in the report

• A judgment process

• Hazard assessment = qualitative; risk assessment = quantitative

o Exposure assessment

• Identify the human receptors (target audience) likely to be exposed to chemicals of concern

o Dose-response assessment

• Description of the relationship between the magnitude of exposure (dose) and the risk (probability) of occurrence of adverse health effects (response) associated with the chemicals of concern.

o Risk Characterization

• The results of the exposure assessment are integrated with the dose-response assessment to provide quantitative estimates of risk

• Little to no commentary

• Objective format

o Conclusions

• Include a summary of the findings of the preceding assessment

o Uncertainty Analysis

• Discusses uncertainties associated with the calculated exposures and potential health risks

• Includes aspects that may have caused the results to be biased