Using communications to deliver change in healthcare

Has public understanding improved?  

For the past two years, health, wellness and healthcare have been hot topics; who doesn’t know an armchair epidemiologist or vaccine expert? More and more people have become familiar with PCR techniques, R rates and the intricacies of lateral flow testing. But have we really got any better at rationally evaluating health data, identifying credible sources of information, or identifying when our decisions are being driven by emotion rather than facts? You only have to look at the rise of the anti-vax movement¹, or stories such as those of wellness guru and con-woman Belle Gibson² to conclude that the answer is perhaps not. 

As we have previously discussed, there is a challenge in public health literacy. In England, 42% of working-age adults cannot understand and make use of everyday health information, rising to 61% when numeracy skills are also required for comprehension.³  

Increasing health literacy and our ability as healthcare communicators to influence decision-making is critical in a world where increased antibiotic resistance is driven by non-adherence to therapies and overuse.⁴ Early diagnosis through screening and the preventative management of chronic conditions such as cardiovascular disease and diabetes can save lives and have a huge impact on the wellbeing of patients.⁵ 

Why individual behaviour change isn’t the whole story 

However, it is not just individual behaviour that drives these epidemics. Behaviour takes place in social environments and efforts to change. Therefore, it must take account the social context and the political and economic forces which directly impact people’s health, regardless of any individual choices people may make. 

Yet over the years, most efforts at getting people to change behaviour with respect to alcohol misuse, the prevention of obesity and promoting physical activity have had limited success.⁶ 

As communicators, we must understand what’s going on to effect change. Research published by Public Health in 2016, identified common errors we need to avoid when communicating healthcare information.⁷ We assume by simply communicating our message, our targets will apply the knowledge and act rationally in a way that is easy to predict.  

We ignore that human behaviour is influenced from the interplay between habit, automatic responses to immediate and wider environmental and cultural settings.⁸ It was thought that the “Just Say No” anti-recreational drug campaign and long-running anti-smoking campaigns such as “Stoptober” were obvious and common-sense solutions. However, they struggled to gain impact as they were insufficiently focussed on changing the wider social norms surrounding health issues such as smoking and too geared towards individual behaviour change.  

How to use communications to make a difference 

The research shows that marketing campaigns can have an important role and can be effective, but they are only one part of a comprehensive strategy and behaviour change that is not just about messaging.⁷  

If we are going to drive change, we need to understand what motivates people, including healthcare professionals (HCPs), the social, organisational, and economic pressures that influence decision-making and how we can influence them. 

We need to consider three main areas of activity:

1. Disseminating knowledge widely, while making it personally relevant and promoting positive feelings about behaviour change – “This is a positive change that I can make for my patients”

2. Tapping into “herd mentality” by increasing visibility and social approval and making the behaviour change seem the norm. In healthcare marketing, this might be raising the profile of the change through case studies, user testimonials, KOL speaking events and lobbying for guideline changes

3. Increasing the individual’s belief in their ability to effect change through goal setting, facilitating the sharing of plans or goals, tapping into social relationships to bolster individuals and tools to overcome difficult situations. For example, by facilitating early adopters to become product champions, assisting procurement dialogue with health economic models and validation studies 

These strategies use “nudge theory” to break down the change into a series of choices or actions which influences the behaviour and decision making of patients or HCPs. One of its key concepts focuses on how people make decisions, based on changes in their environment, and how the presentation of the different choices available to them can elicit the desired decision.^9,10 

This is important when we communicate with patients and HCPs to allow the recipients to weigh risks versus benefits properly. Getting the communication strategy right is essential to making a difference.

References