COVID Comm Lessons from the Safer Sex Toolbox

Alt: A doodle looks at a text conversation on their phone. Their friend asks, “Wanna hang today?” The doodle responds, “Yeah!! You cool with keeping masks on?” “For sure! I’d feel safer outside too,” says the friend.

As health communicators, we know that harm reduction is key to preventing the spread of COVID-19. But helping people choose safer ways to socialize is only part of the equation — we also need to help people communicate with friends and family about these social choices.

And lucky for us, the public health toolbox has tips for this situation all ready to go! That’s because there’s a lot of overlap in communication strategies for safer socializing and safer sex. Let’s start with this one: both scenarios require open communication — and both work out a lot better if everyone gets on the same page before anyone’s in the heat of the moment. That’s why conversation tools can be so helpful in both situations.

So this week, we want to help you help your audiences have the talk. Share these tips and talking points for navigating tricky COVID chats:

  • Start with questions. Try asking your friends how they’ve been socializing and what level of contact they’re comfortable with. That way, you can work together to set group boundaries — and take each person’s risk of COVID exposure into account. Try: “Have you been hanging out with friends outdoors? How would you feel about going on a masked hike together this weekend?”
  • Use “I” (not “you”) statements. With these kinds of touchy topics, it’s best to avoid making people feel defensive. So instead of leading with assumptions or demands about the other person’s behavior (“You’d better put your mask back on as soon as you’re done eating”), frame it in terms of your own perspective and behavior (“I’ll feel safer if we all keep our masks on when we’re not eating or drinking”).
  • Share why it matters to you. If others aren’t taking the risks as seriously as you are, try explaining why safety precautions are important to you. “This can be deadly, and I’m not willing to take unnecessary risks. So I’m only comfortable seeing you outdoors.”
  • Be firm about your boundaries. It’s great to be as polite and friendly as possible when starting these conversations — but don’t compromise on your safety. If you can’t agree on reasonable safety rules, feel free to call off your plans and explain why: “It sounds like we have different comfort levels around socializing right now, so I’ll have to skip it. I just don’t feel safe spending time indoors with such a large group.”

And remember, even if these tips seem obvious, all this social distancing has really eroded our social skills. So concrete talking points can go a long way.

The bottom line: Take a page from the safer sex communication playbook to help your audiences navigate social situations during COVID-19.

Tweet about it: How do we help people socialize safely during COVID-19? Take a hint from safer sex communication, says @CommunicateHlth: https://bit.ly/3jIj0AP #communicateCOVID

Communicating About Correlation and Causation

Alt: A newscaster doodle on TV says, “Studies show that putting a cat on your head causes cat head!” A doodle watching TV at home puts a cat on its head and looks confused.

Here at We ❤ Health Literacy Headquarters, we love to back up our health advice with solid research. And that means we’re always on guard against mistaking correlation for causation.

Of course, as health communicators, we like to think we can spot the difference a mile away. But let’s be honest: it’s easy — and even tempting — to conflate them. Spend enough time mining a broad data set, and you’ll see all sorts of tantalizing correlations that are just too good to be true. Red wine linked to heart health! Chocolate associated with winning Nobel prizes! And before you know it, you’re trying to guzzle and munch your way to a tip-top ticker and a major academic award.

Let’s start with a quick refresher of the difference between causation and correlation:

  • Causation means we know that X causes Y to happen. In health research, demonstrating causation is a pretty big deal.
  • Correlation means there’s a relationship between 2 things, but we don’t know what kind. Is X causing Y? Is Y causing X? Is there a sneaky Z factor waiting in the wings to muck up the whole equation?!

Before we move on, it’s important to keep in mind that showing causation can look different depending on what researchers are studying. The gold standard here is a randomized controlled trial, but those aren’t always possible. Take smoking and lung cancer — asking an experimental group to smoke so we can see if they get cancer would be wildly unethical! And yet, we know that smoking causes lung cancer. Because at the end of the day, overwhelming observational evidence can get us to what’s called causal inference. (Especially astute readers will notice this is part of what tripped us up in our first attempt at tackling this topic.)

Now, there are 2 main things to keep in mind when you’re writing about cause and effect in health materials. First, check the original source. Online news is notoriously click-baity when it comes to reporting the latest health-related studies. So don’t take someone else’s word for it! Instead, look at the original study and other sources to confirm whether experts agree that it’s cause and effect.

This may well send you down an internet rabbit hole here and there, but it’s well worth it to make sure you’re not accidentally leading your dear readers astray, dear readers. (And this type of dutiful sleuthing can also help you avoid falling prey to pseudoscience.)

And once you’re sure you know what you’re working with, choose your words carefully.

  • If you’re writing about causation, knock yourself out with strong verbs like “X causes Y.”
  • If you’re writing about correlation, try something like “X may help lower the risk of Y” or “X is linked to Y.” (Don’t be alarmed — we know it’s passive voice. But every once in a while, the dreaded passive can serve a purpose.)

And while you’re at it, be upfront about any uncertainty. It’s better to tell your readers that experts just aren’t sure than to have to pull a U-turn in your health advice later on.

The bottom line: When writing about cause and effect in health materials, keep the distinction between correlation and causation in mind.

Tweet about it: When writing about cause and effect in health materials, keep the distinction between correlation and causation in mind, says @CommunicateHlth: https://bit.ly/34xQsDK #HealthLit

Unlocking Content Strategy with Key (and Sample!) Messages

Alt: A doodle wearing a “key message” sign and another wearing a “sample message” sign hold hands and skip together.

This week, we want to bring your attention to a content strategy nugget that we’ve been mulling over lately. It’s a bit nerdy, but we figured our fellow content strategy fanatics out there would be interested. So let us talk, dear readers, about the lovely symbiotic relationship between key and sample messages.

First, quick refresher on key messages. A key message is a short sentence or 2 that conveys exactly what you want your audience to know. Your elevator pitch, so to speak. Every communication product (or campaign or what have you) needs at least 1 key message — otherwise, we’d all just be blathering into the void.

Here are some examples of key messages:

  • The We ❤ Health Literacy newsletter offers practical guidance for making health information easy for people to understand and use.
  • Wearing a mask whenever you’re around other people can help slow the spread of COVID-19.
  • Cat Heads Across America is uniting stakeholders nationwide to find a cure for the curse of cat-covered craniums.

So once you’ve got your key messages nailed down, your work is done, hey? Well, not so fast. Because depending on the project, it may also be helpful to develop some sample messages at this stage. That way, teammates and partners can easily jump in and use these sample messages for specific channels, activities, or audiences — and you can rest assured that your key points won’t get mangled in a game of telephone.

Here are 3 potential sample messages for the key messages above:

  • Calling health literacy advocates everywhere! Sign up for our newsletter today to get tips for creating easy-to-understand health information.
  • Help #SlowTheSpread of #COVID19 by wearing a mask every time you need to be around other people.
  • We’re committed to finding a cure for cat head by 2030. Check out our Cat Heads Across America campaign to join the conversation!

See how the key and sample messages join forces to flesh out in more detail what you’re working with? The sample messages may home in on different situations, audiences, and platforms — but they all clearly map back to the original key messages above.

Sample messages are especially useful in planning outreach campaigns. They can help stakeholders and collaborators get on the same page and understand how you’ll actually use your key messages to communicate with your audiences across channels.

The bottom line: The next time you’re developing key messages as part of your content strategy, think about inviting some sample messages to the party, too.

Tweet about it: #ContentStrategy nerds unite! @CommunicateHlth explains why key and sample messages are a match made in #HealthComm heaven: https://bit.ly/3iHatO5 #HealthLit

Gearing Up for Effective COVID-19 Vaccine Communication

Alt: A doodle sitting in an armchair reads a newspaper with a headline that says: “COVID-19 Vaccine: All You Need to Know.”

Here at We ❤ Health Literacy Headquarters, we’re eagerly awaiting a COVID-19 vaccine — and bracing for the challenge of communicating about it when it finally arrives. So the question on our minds this week is: How can we start building public trust in a COVID vaccine before we have all the info?

Try these tips to lay some solid groundwork for COVID vaccine communication:

  • Resist the urge to overpromise. The best way to avoid confusing U-turns in health messaging is to avoid going beyond the facts in the first place. Politicians may bluster about a still-hypothetical vaccine that’ll be X percent effective, or ready in Y months. But as the premature hype around experimental treatments has shown, jumping the gun on health claims leads to a loss of public trust in the long run. So beware of spreading vaccine news that might be too good to be true.
  • Be honest about what we don’t know. At this stage in vaccine development, there are lots of unknowns. How long will immunity from a COVID vaccine last? Will the vaccine totally prevent a COVID infection or just make the illness less serious? Unfortunately, we just don’t know. So be up front about what researchers are still figuring out — remember, transparency in health communication is a good thing!
  • Stick to solid ground. You can still give your readers plenty of hopeful, helpful information about the search for a COVID vaccine. For example, experts agree that we can and will make an effective vaccine for this virus — something we haven’t been able to do for some other viruses, like HIV or herpes. So keep reassuring your readers that a vaccine is in the works. And while it won’t mean an instant, magical return to a pre-COVID world, an effective vaccine will certainly be a major step in the right direction.
  • Build trust in the process. One reason vaccine development takes so long is that we have strong systems in place to make sure vaccines are safe. But with scientists and researchers speeding up that timeline, people may worry that they’re skipping important steps. So how can we help people feel confident? Explain the process! Tell your readers about the 3 phases of vaccine trials — and stress that while companies are finding ways to combine phases, they’re not skipping any key safety steps.
  • Go back to basics. While we’re all waiting for more concrete info about an actual vaccine, now’s a great time to raise awareness about some basic vaccine concepts. So take this chance to tell your readers all about antibodies. Or explain why getting a vaccine helps protect everyone around you, too.

The bottom line: Follow these tips to start communicating now about a future COVID-19 vaccine.

Tweet about it: How can we lay some solid groundwork for #COVID19 vaccine communication? @CommunicateHlth has #HealthLit tips: https://bit.ly/3he9MtT #communicateCOVID

Going Beyond 6 Feet

Alt: A masked doodle looks at a ruler that measures the safety of 3 different activities. From safest to riskiest: “Cozy solo evening at home,” “6-feet-apart outdoor chat,” and “maskless indoor mosh pit.”

Here at We ❤ Health Literacy Headquarters, we love a super clear, straightforward safety rule. So, like many health communicators, we’ve been shouting the 6-feet-apart social distancing tip from the rooftops. But as experts learn more about how COVID-19 spreads, it’s becoming clear that 6 feet may not be a silver bullet — especially indoors. So this week, we’re looking at ways to bring some nuance to the safe distance conversation.

Try these tips to communicate more clearly about social distancing:

  • Make it clear there’s no magic number. The 6-feet rule is a good start, don’t get us wrong. But is there a mystical barrier hanging in the air, taking out pesky respiratory particles that dare to float an inch beyond 6 feet? Alas, no! There is not. So make sure not to drop the “at least” from “at least 6 feet apart.” And if you have the space, you could try something like this to really drive the point home: “Staying at least 6 feet apart is good, but more distance is always better.”
  • Treat distance as 1 tool in the toolbox. Distance is key to preventing the spread of COVID — but we also need to talk about other factors, like masks, ventilation, crowding, length of time, and type of activity. So help your readers picture risk on a spectrum. On the safer end, you could give the example of 2 masked people chatting quietly from either side of a neighborhood street. On the wildly risky end, try 50 unmasked people shouting in a small room with no airflow. When people have the full picture, they can better adjust their behavior to stay on the safer side.
  • Use secondhand smoke as a helpful analogy. We’ve seen some experts comparing airborne COVID particles to cigarette smoke — and we think that’s pretty clever! Just think: You can get a whiff from 20 feet away, but the closer you are, the stronger the stench. It’s much more noticeable indoors than outdoors. And passing a smoker briefly on the sidewalk is a lot less risky than spending hours sitting next to someone who’s smoking. So if you’re looking for a comparison to help your readers understand why these variables matter, consider making the connection to secondhand smoke.

Now, dear readers, you might be wondering: Isn’t it confusing to tell people that 6 feet isn’t enough when so many reopening plans rely on this distance guideline? Yep, that’s a valid concern. But the reality of this (constantly evolving) public health crisis means that people may need more details to make truly informed decisions about COVID. And that’s something we can help with.

The bottom line: Help people go beyond the 6-feet rule to slow the spread of COVID-19.

Tweet about it: When communicating about #SocialDistancing, the 6-feet rule is a good place to start. But we can do better, says @CommunicateHlth: https://bit.ly/2DrKb2Z #communicateCOVID

Writing About Race, Racism, and Disease Risk

Alt: Text on a chalkboard reads: “Race increases the risk of…” A doodle on a ladder replaces “Race” with “Racism.”

Here at We ❤ Health Literacy Headquarters, we’ve been thinking a lot about how we discuss race, racism, and risk in our health materials. And with COVID-19 killing Black people and other people of color at vastly disproportionate rates, it’s more urgent than ever to get this tricky conversation right.

So let’s take a run-of-the-mill risk statement like this: “Black people are at higher risk of dying from COVID-19.” At first glance, that might seem like a useful piece of information. After all, the data clearly show the racial disparity in death rates. And communicating about risk can help people make informed health decisions, right? So… what’s wrong with it?

Well, there’s the little wrinkle that race is a social construct. So when we cite race as a risk factor for a biological condition, we’re often using it as a clumsy proxy for either genetic ancestry — which doesn’t neatly align with race — or social factors like access to health care.

So how can we do better? If a racial health disparity is related to a genetic trait (like sickle cell disease), be specific about that. And if it’s related to systemic racism or other social determinants of health, be specific about that, too. Try a statement like this: “Due to the health effects of racism, Black people are dying of COVID-19 at higher rates than white people.”

Naming racism as the risk factor here is more accurate — and it places the burden where it belongs: on racist systems and institutions. And systems and institutions can change if we all recognize their failures and work to correct them.

The bottom line: As health communicators, it’s our job to name racism — not race — as a risk factor for disease, when that’s what we’re really talking about.

Tweet about it: We need to name racism — not race — as a risk factor for disease when that’s what we’re really talking about, says @CommunicateHlth: https://bit.ly/34hQUr7 #HealthLit #communicateCOVID

Numeracy 101: Making Sense of Numbers During COVID-19

Alt: A newscaster doodle on TV says, “Stay tuned for more daunting data points…” A doodle sitting on the couch and watching TV says, “But what do those numbers MEAN???”

We’ve written before about how numeracy can impact health decisions. And we know numeracy skills tend to decline when we’re under stress — like, say, during a global pandemic! So as health communicators, we need to help our readers parse the data in the COVID conversation.

Use these tips to help your audiences make sense of COVID numbers:

  • Use numbers on a need-to-know basis. When people are bombarded by lots of numbers, they tend to tune out. So each time you use a number, ask if your reader really needs to see it. For example, in a short how-to about COVID testing, is the exact false positive rate need-to-know information? Or could that number distract from the key action step of getting tested?
  • Define key data terms. Terms like “positive test rate” get thrown around so much these days that they start to feel familiar. But to most people, that’s still unfamiliar jargon. So instead of writing: “Your state has a 20 percent positive test rate,” try: “In the last week, 1 in 5 people in your state who got tested for COVID-19 had the disease.”
  • Put numbers in context. Defining data-related terms is only half the battle! Readers also need context to understand why the numbers matter in the first place. So provide the relevant takeaway: “This high positive test rate means that your state isn’t testing enough people. That means lots of people in your state could have the virus and not know it.”
  • Follow up with action steps. Turn information into action by pairing numbers with steps readers can take to keep themselves and others healthy. For example, “Right now, there are more than 500 cases of COVID-19 in your county. That’s a very high number — so it’s especially important to stay home as much as possible and wear a mask whenever you leave your home.”
  • Help readers visualize data. Use graphics to bring the numbers to life. For example, the Covid Act Now map offers a visual snapshot of how the virus is affecting communities across the United States. These types of colorful visuals can help readers quickly grasp the level of risk in their area — and make more informed health decisions.

The bottom line: Help your readers understand COVID stats and use them to make better health decisions.

Tweet about it: Help your audiences make sense of stats when you #communicateCOVID! Use these #HealthLit numeracy-boosting tips from @CommunicateHlth: https://bit.ly/3kJc2fS

Communicating About Antibodies

Alt: A poorly disguised virus doodle stands outside the Immune Saloon in front of a “wanted” sign with their picture on it. An antibody doodle says, “I recognize you…”

Here at We ❤ Health Literacy Headquarters, vaccines are a topic near and dear to our hearts. We’ve written in the past about tricky aspects of vaccine communication like herd immunity. And with a COVID-19 vaccine on the horizon (we hope!), we thought it was time to tackle another sneaky vaccine-related term: antibodies.

You might be thinking, do we really need to get into these weeds? Can’t we talk about vaccines without mentioning antibodies? Alas, no. Not in the time of COVID, anyway. With headlines about coronavirus antibody tests all over the news, health communicators will need to educate readers about these powerful little proteins.

So use these tips when you communicate about antibodies:

  • Explain antibodies in plain language. Try this: Whenever your immune system meets a new germ, it makes new antibodies that “remember” that germ. So the next time that germ shows up, those antibodies will sound the alarm and help your body fight it off before it can make you sick.
  • Stress that vaccines are the best way to get antibodies. It’s true that you can get antibodies from being sick with a disease. But vaccines let you skip the sickness and go straight to being protected. Doesn’t that sound more pleasant?

Your readers may also be wondering what it means to have antibodies to COVID-19. And unfortunately, experts just aren’t sure! Because COVID is so new, we’re still figuring out whether having COVID antibodies means that you’re immune to the disease.

And of course, dear readers, that’s why vaccines are so important. Through the trial process, scientists will find a vaccine (or more than 1) that is proven to give people effective antibodies to coronavirus — without risking their health in the process.

The bottom line: Explain antibodies to help your readers understand the amazing power of vaccines!

Tweet about it: With so many news headlines about #COVID19 antibody tests, we need to teach readers about these powerful little proteins. Check out @CommunicateHlth’s #HealthLit tips: https://bit.ly/33FCPmW #communicateCOVID

Book Club: Bellevue

Alt: A doctor doodle presents a copy of the book “Bellevue.”

We don’t know about you, dear readers, but in this time of social distancing, we’ve been doing a whole lot of reading! So in this week’s edition of the We ❤ Health Literacy Book Club, we wanted to draw your attention to an absolute must-read for health nerds like us.

In Bellevue: Three Centuries of Medicine and Mayhem at America’s Most Storied Hospital, David Oshinsky tells the story of the oldest — and most notorious — public hospital in the country. This book has it all. Public health! Antiquated medical techniques! The city that never sleeps!

It’s also chock-full of something that’s top of mind as the COVID-19 pandemic drags on (and on and on): disease outbreaks. If you’re like us, you might find it calming to read about the many outbreaks (cholera, yellow fever, TB, typhus) that helped shape the hospital’s history — and that do not include coronavirus. Seems like the one place you won’t hear about COVID-19 these days is in a book that covers plagues from the past.

Bellevue touches on so much that it’s hard to choose the elevator pitch. Of course you’ll learn all about the history of the hospital itself — but that’s not all. In this historical page-turner, you’ll also find out:

  • Why President Garfield might have survived that pesky assassination if he had gotten shot a liiiittle bit later
  • What it was like to travel to the hospital in a horse-drawn ambulance
  • How the groundbreaking report Sanitary Conditions of the City got people thinking about hygiene and sanitation before public health was really a thing
  • What the AIDS crisis looked like to the doctors who treated the first wave of New York City patients (for more on this topic, check out our past Book Club picks And the Band Played On and Voices in the Band)
  • Why you had to watch out for… dun dun dun… Prohibition poison liquor!

It’s also striking that this history book is full of challenges we’re still facing today, including the devastating health effects of racism and discrimination, the constant tension between public and private health care, and the consequences of an inadequate mental health care system. In this way, it can feel discouraging — how are we still grappling with so many of the same issues?

But if we return to the COVID-19 lens, things look brighter. The diseases behind the outbreaks in Bellevue’s pages all have one thing in common: they are now under control — and we have measures to effectively treat and prevent them. Let’s hope we’ll be saying the same of our current viral opponent before too long.

The bottom line: David Oshinsky’s Bellevue is a must-read for public health nerds everywhere.

Tweet about it: Need a summer book rec? Look no further than David Oshinsky’s Bellevue — it’s a true #PublicHealth page-turner, says @CommunicateHlth’s Book Club: https://bit.ly/30HvEry

Keeping the Public in COVID-19 Public Health Guidance

Alt: A doodle wears a sign that reads: “Save the humans!” Above the doodle are images of a mask, a speed limit sign, a vaccine vial, and a no smoking sign.

We’ve seen lots of good guidance lately that focuses on how people can keep themselves safe and healthy during the pandemic. And that type of guidance is useful and necessary.

But here at We ❤ Health Literacy Headquarters, we’ve been thinking a lot about what’s missing from that advice: how to protect other people. Because in a pandemic, every personal risk is a public risk — and every personal choice to wear a mask or stay at home is a public service. That means when we focus too much on self-protection, we’re missing half the message.

Fortunately, most people want to do good and help others — and this desire to help those around us can even help motivate behavior change. So when you write about COVID-19, use these tips to keep the public front and center in this public health crisis:

  • Help people feel helpful (or even heroic!). Tell your audience that even if they aren’t worried about themselves or their families getting sick, they have a chance to protect other people. Going out to eat? Think about the server and the person at the next table. Traveling by plane? Think about the flight crew and other passengers. Stress that when they avoid exposing others to the virus, they could be saving a life. And to make these public effects feel more, well, personal, try highlighting real stories of people who’ve been affected by COVID-19.
  • Call out “COVID privilege.” Not everyone has the option to stay home, and many people working non-remote jobs are risking their lives for less than a living wage. So remind readers who have the privilege of isolating themselves and their families to consider this power imbalance. Encourage them to take a question like this: “Is it safe for me and my family to go on vacation/have someone clean our house/go to a salon?” And reframe it like this: “Is it safe for us and everyone we’ll come in contact with?”
  • Draw helpful public health parallels. People may bristle at mask mandates because the concept is so new. So help your readers make the connection with more familiar public health measures. Do they pay attention to speed limits when driving? Refrain from smoking in restaurants? Cover their mouth when they cough? Masks are just like that — something we all need to do to keep our fellow humans safe and healthy.
  • Keep their eyes on the prize. There’s no point pretending that COVID prevention is all a (socially distant) walk in the park. And your audience may feel that their responsible choices are meaningless in light of irresponsible choices by their elected leaders. But individual actions do make a difference in a pandemic. So remind them that joining in collective efforts to prioritize public health now could lead to a healthier future for all of us.

We also want to acknowledge that it’s only useful to understand how your choices impact others… if you actually have choices. For many people, doing things that expose others to risk — like coming within 6 feet of coworkers and sending kids to daycare — are economic necessities. So keep this distinction in mind, and offer harm reduction tips to help your readers reduce the risk to themselves and to those around them.

The bottom line: COVID-19 is a public health crisis — so help your readers act for the good of us all.

Tweet about it: When you #communicateCOVID, telling people how to protect themselves from #COVID19 isn’t enough. @CommunicateHlth explains how to keep the public in public health: https://bit.ly/2OwgfEH