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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 Barry University Jeremy Montague, Ph.D. Florida International University Dev Pathak, MS, MBA, DBA The students whose work is shown: Thor Barraclough Nicole Headley David Bissell Claudia Millar Kelly Chevalier Yolanda Payne- Jameau James Churilla Charles Platkin Jodi Clark Lisa Marie Quammie ABSTRACT 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. BACKGROUND 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. 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. 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. 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 RESULTS 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. CONCLUSION 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 PROBLEM 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/m 2 ) based on self-reported height and weight. Of those, approximately 2,307,280 adults were obese (BMI ≥30 kg/m 2 ). 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. Cover of Brochure Inside of Brochure (from left) Cover of Brochure Inside of Tri- fold Flyer Inside of Tri- fold Flyer Cover of Brochure Cover of Handout Inside of Handout Homepage of Website Page of Website Press Release Newsletter Cover Outside of Tri-fold Flyer Inside Back Cover Outside of Tri-fold Flyer Inside Back
