Category: We Heart Health Literacy

Remember when you were young and people would tell you, “Don’t roll your eyes or they’ll get stuck up there!” That, dear readers, is a classic example of a fear appeal.

A fear appeal is a persuasive message that emphasizes the potential risk or danger of an action (or a non-action) in order to inspire behavior change. Aside from classic “parent-isms,” these types of appeals are commonly used in political campaigns, marketing efforts, and — you guessed it — public health!

The overall impact of fear appeals is up for debate — and it can be really tricky to use fear appeals effectively in a public health campaign. After all, we’ve definitely seen a few cases of fear-based messaging gone wrong.

Take the abstinence-only sex education programs that used to be popular in the United States. These programs were created to keep teens from having sex and to lower teen pregnancy rates. They used fear-based tactics to try to scare teens out of having sex (think: alarming photos of STDs). In the end, abstinence-only programs weren’t effective at delaying youth sexual activity or reducing teen pregnancy rates.

But not all fear-based messaging has been such a flop. The Centers for Disease Control and Prevention (CDC) tobacco education program Tips From Former Smokers® has proven to be extremely impactful. It’s definitely one of the more effective fear-based messaging campaigns we’ve seen in a while.

Studies like this one help explain why some fear-based campaigns are more effective than others. Fear appeals have more success when the messages:

• Recommend a one-time behavior, like quitting smoking
• Emphasize risk severity — for example, “Smoking can cause serious, immediate damage to your body and it shortens your life.”
• Include the benefits of taking action, like: “Quitting now helps you prevent serious health problems.”

At the end of the day, dear readers, the fear factor conversation is complex. So if you’re thinking of using a fear appeal, make sure it’s the right fit for your messaging — and execute it effectively.

P.S. We’re interested in your thoughts on this issue! Please let us know what you think about fear-based messaging in the comments or on Twitter.

The bottom line: Fear can help motivate behavior change when used effectively — but it’s not always the way to go.

Tweet about it: Should fear be a factor in #PublicHealth messaging? @CommunicateHlth weighs in: https://bit.ly/2qregoI #HealthLit

Today, dear readers, we’d like to bring to your attention a fascinating book that investigates vaccines and the fears that make some people hesitant to get them.

Part memoir, part historical and cultural study, On Immunity: An Inoculation by Eula Biss documents the author’s decision-making process as she considers whether to get the recommended vaccines for her newborn son. After asking other new moms for advice, Biss learns just how nervous many of them are about vaccines. So, she examines these anxieties — including the harmful myth that vaccines cause autism — and asks why some fears persist even when they’re proven untrue.

Biss takes a closer look at the blind spots in the anti-vaccine movement. She compares a spreading disease to a vampire to remind readers how powerful fear can be. But people who fear vaccines so much, she explains, often forget about the danger of the diseases they prevent. We can all carry and spread diseases — so our own bodies can be as dangerous and scary as any monster.

To address the fears surrounding vaccines, Biss offers an appeal to public well-being. If our bodies can be dangerous, she says, they can also be protective. When we get vaccines, we act as shields, protecting others who can’t get vaccinated. And she isn’t merely being philosophical — she’s talking about herd immunity! (Just don’t call it that in your plain language materials.)

Biss ultimately chooses to get her son the recommended vaccines — and she says that she’s not just doing it for her own family’s safety, but for everyone’s. Now that’s the kind of thinking we ❤.

The bottom line: Check out On Immunity for an exploration of how to rethink the fears that surround vaccines.

Tweet about it: With #COVID19 vaccine development underway, @CommunicateHlth’s We ❤ #HealthLit Book Club revisits “On Immunity: An Inoculation” by Eula Biss: https://bit.ly/2Gmbeg8 #communicateCOVID

Here at We ❤ Health Literacy Headquarters, we get really excited about innovative research methods (Design the Box! Collaging! OMG see?!). So this week, we’re plugging another technique that falls a bit outside of the norm.

Photovoice, created by Caroline Wang and Mary Anne Burris, is a research technique that encourages members of a community to document and discuss their values, needs, and behaviors using original photographs.

The idea is simple: enough with outsiders barging in and assessing the needs of communities they don’t really understand. Instead, if you ask people to show you what’s going on for them, you’ll get better information about their everyday lives.

Let’s say people in a community are worried about air pollution and want to show policy makers how it affects their lives. Here’s an example of how you could do photovoice with them:

• Start by giving participants a brief rundown of ethical considerations around visual research
• Encourage them to spend 1 to 2 weeks taking photos of pollution’s impact on their lives
• Gather everyone together to share their photos and discuss common themes
• Display or present the photos to policy makers or other groups
• Write up the study findings based on the community’s discussions and presentations

Like other research techniques, photovoice has limitations. (After all, if a perfect method existed, we’d be using it all the time and our Testing Techniques series would be really short.)

In this case, photovoice’s greatest asset can also make it tricky to pull off. Since photos can be so personal — and, ultimately, an outsider will be writing up the research results — community members may not always feel comfortable with the approach. For example, some communities may be reluctant to take photos related to things like mental health or substance abuse.

But when it works, dear readers, the results can be pretty amazing. Getting an actual snapshot into the lives of community members we’re trying to reach? Yeah, we really ❤ that.

The bottom line: Photovoice empowers community members to show us their lives and communicate what matters to them.

Tweet about it: Use photovoice to get a snapshot into people’s everyday lives and needs: http://bit.ly/2DsuQZX #HealthLit

When the weather outside is frightful, we like to get cozy with a good public health book. In this edition of the We ❤ Health Literacy Book Club, we’re curling up with Adventures of a Female Medical Detective by Dr. Mary Guinan, a memoir reflecting on her remarkable career in public health.

In 1974, Dr. Guinan began her stint in the Epidemic Intelligence Service (EIS), a prestigious training program at the Centers for Disease Control and Prevention (CDC). She describes being the only woman in her class of medical detectives (or “epidemiologists” in public health speak). And that wasn’t the first — or last — time in her career that she smashed a glass ceiling!

She became a true public health pioneer, remaining at CDC to help eradicate smallpox in India and to serve on the front lines of the early HIV/AIDS crisis. The latter even landed her a role in another book we ❤: And the Band Played On.

Along with describing these historic events, Dr. Guinan discusses the role of communication and the media in public health. She laughs about interview gaffes and recalls being misunderstood or misquoted (read the book to find out how she won the nickname “Dr. Herpes”!). Our favorite: the watershed moment in 1987 when CDC hired a communication expert to teach scientists about main messages and simple writing.

This collection of public health tales — some inspiring, some frustrating, some hilarious — weaves together the personal reflections of a medical detective solving serious public health problems. And we really ❤ that.

The bottom line: In Adventures of a Female Medical Detective, a public health pioneer shares stories and wisdom from her remarkable career.

Tweet about it: The We ❤ #HealthLit Book Club reviews “Adventures of a Female Medical Detective”: http://bit.ly/2tv1JFH via @CommunicateHlth

This week, we’re answering one of the great grammar questions of our time: to Oxford comma, or not to Oxford comma?

This tiny punctuation mark, also called the serial comma, comes before the “and” or “or” in a list of 3 or more things. Simple enough, right? Not so fast, dear readers!

The Oxford comma may seem straightforward, but it gets grammar nerds up in arms. Different style guides either take it (Chicago) or leave it (we’re looking at you, AP Stylebook). Americans use it more than Brits. It even has its own pop song (warning: explicit lyrics).

Fortunately, we’re here to put an end to this controversy and say unabashedly that the answer is clear: always use the Oxford comma — especially in plain language writing.

Why, you ask? To avoid (often hilarious) misunderstandings, of course!

You may have heard the classic, and likely fake, example of a book dedicated to “my parents, Ayn Rand and God.” Without the Oxford comma, the author is stuck with an atheist and a deity for a mom and dad. They do make a good comedic duo, but clearly that’s not the intended meaning.

And that’s nothing compared to the fate of poor Merle Haggard. A newspaper article describing a documentary about the famous country singer skipped the Oxford comma and spiced up his life story: “Among those interviewed were his two ex-wives, Kris Kristofferson and Robert Duvall.”

Still not convinced of the Oxford comma’s super powers? Then consider the 2017 court case decided on the absence of a single Oxford comma in a Maine state law.

So keep those Oxford commas handy — they’ll make your language plain, clean, and clear!

The bottom line: When writing lists in plain language, always use the Oxford comma.

Tweet about it: In #HealthLit and in life, @CommunicateHlth loves the #OxfordComma. Find out why: http://bit.ly/2FmTYnw

If there was a fly on your conference room wall, would it ever overhear a conversation like this? “Cool. Let’s do it this way.” “But wait, what if this way is better?” “Well, we have to pick one. So, which do we go with?” (Conversations like this happen a lot here at We ❤ Health Literacy Headquarters.)

Fortunately, in this latest installment of testing techniques, we have a solution for you! It’s called A/B testing, and we really ❤ it. With A/B testing, you put 2 versions of a message or design out into the world — that’s the “A” and the “B” — and gather data about which version is more effective or impactful.

Emails are prime A/B testing material — you can test different subject lines, calls to action, or designs. Let’s say, for example, you want to know which type of email subject line will get more readers to open your e-newsletter.

First, pick the types of subject lines you want to try out. Maybe the first takes a question-style approach and the second is a bit more clickbait-y, like so:

• Option A: Does someone in your family have allergies or asthma?
• Option B: 5 ways to help a loved one with allergies or asthma

When you have an A and a B, you’re ready to test them out. Using your email delivery system, send a random sampling of half your subscribers the email with subject line A. Send the other half of your list the same email, but with subject line B.

Then, look at the analytics and you’ll see which subject line led to a higher open rate. Pretty cool, right? The more times you do this, the better sense you’ll get for which type of subject line readers prefer. After that, as they say — lather, rinse, repeat.

Note that it’s best to do A/B testing with large numbers of participants — like your organization’s e-marketing list — to make sure you get a meaningful response.

And one last thing: with A/B testing, it’s important to eliminate variables. For example, if you’re trying to gauge the click rate with a new layout of your e-newsletter, use the same content in both options. Otherwise, your findings could be muddled. Did users respond to the layout or to a different content approach? You’ll never know.

The bottom line: Don’t know which way to go? Use A/B testing to explore 2 ideas at once.

Tweet about it: Don’t know which way to go? A/B testing to the rescue, says @CommunicateHlth: http://bit.ly/2o9MGLE #HealthLit

Since the dawn of We ❤︎ Health Literacy, our posts have focused on tips and tricks to help health communicators like you better reach your audiences. But what if we told you that you could apply these same health literacy best practices to interactions at your workplace?

Let’s use giving feedback as an example.

Here at We ❤︎ Health Literacy Headquarters, we’re big fans of giving and receiving feedback. We get feedback from audiences in user testing, we get feedback from our clients, and of course, we give feedback to each other every day. Feedback makes us stronger, smarter, and more motivated to do our best.

Here are a few pointers from the health literacy playbook that you can use to make your feedback more impactful:

• Be positive. Research shows that people are more likely to change their behavior when they’re rewarded for doing so. If a colleague did an excellent job on a project, tell them! And if you need to give constructive feedback, focus on the benefits of trying a different approach. A little praise and encouragement go a long way.
• Be specific. When you’re giving feedback, make sure to share concrete examples so your colleague is clear on what they’re doing well and what they need to work on. You may think you’re being clear when you say, “I’d like you to come prepared to meetings,” but it’s clearer to say, “I’d like you to prepare an agenda for our meetings and share it with me ahead of time.”
• Be actionable. Make sure your colleague walks away from the conversation with a plan for how to apply your feedback. Work together to come up with specific action steps — then check in later to see how it’s going.
• Make time to listen. Part of giving good feedback in the workplace is hearing the other person’s perspective. Ask questions to try to understand where they’re coming from.

The bottom line: When you’re giving feedback, take a page from the health literacy playbook: be positive, specific, and actionable — and make time to listen.

Tweet about it: How can #HealthLit principles help you give better feedback at work? @CommunicateHlth has tips: http://bit.ly/2nMRrLQ

Imagine you have come up with an awesome new health literacy initiative. You’ve put in the time planning, developing, and testing it. You’re about to educate hundreds — scratch that — thousands. You can see it catching on: health literacy is taking the world by storm.

Now, how do you make your vision a reality? That, dear readers, is a very important question! The sad truth is that most big ideas don’t make it because more attention is given to creating the ideas than spreading them.

Fear not, health literacy warrior! Look to the Diffusion of Innovations Theory. This theory describes many things, but where we see its value is in explaining how new innovations catch on. Understanding this can help you better promote and market your program.

Use the following concepts when you explain the benefits of your program to the masses. (Don’t be intimidated by the fancy buzzwords!)

• Relative advantage: How much better your innovation is than whatever it’s replacing
• Compatibility: How your innovation connects with potential users’ experiences and values
• Complexity: How easy or hard the innovation is to adopt (we’d like to rename this one Simplicity)
• Trialability: Whether or not users can try out the innovation before committing to it
• Observability: How easy it is for users (and the people they know) to see results from using the innovation

By applying these concepts when you promote your program, you’ll greatly increase the chance that people will give it a try.

The bottom line: When promoting a new idea, use the Diffusion of Innovations Theory to increase the chance of it catching on.

Tweet about it: Diffusion of Innovations Theory to the rescue! http://bit.ly/2rYimsF via @CommunicateHlth #HealthLit

Chances are, dear readers, you’ve seen at least a few episodes of Sesame Street over the years. Or maybe you’ve seen a lot more than that — and some of your earliest lessons in literacy and numeracy came from Elmo, Big Bird, Cookie Monster, and friends. (There are lots of us out there!)

Sesame Street is famous for finding fun ways to teach kids the ABCs and 123s — and even lessons in empathy. So you may not be surprised to hear us say that this show has plenty to teach us about effective public health messaging.

Despite being a show for kids, Sesame Street doesn’t shy away from complex topics like HIV/AIDS, poverty, and racism — and its cast of Muppets (and humans!) is very diverse. The show helps challenge stigma by featuring accurate, sensitive portrayals of characters who are dealing with everything from autism to having a parent who’s in prison. They’ve even created materials to help children deal with the effects of trauma.

Sesame Street also excels at providing kids with super actionable messages. Characters share tips for healthy behaviors — like riding bikes safely and oral health care — with catchy song-and-dance numbers that keep kids’ attention (talk about knowing your audience).

Finally, in using language that kids can understand, Sesame Street is a model clear communicator. Check out how Elmo and former Surgeon General Vivek Murthy tackled the tricky issue of vaccine confidence — we just ❤︎ Dr. Murthy’s funny, compassionate, plain language explanation of how vaccines work.

The bottom line: Keep an eye on Sesame Street to learn strategies for communicating important public health messages.

Tweet about it: Look no further than @sesamestreet to see #HealthLit strategies in action, says @CommunicateHlth. (It can even help us #communicateCOVID!) https://bit.ly/3euamTT