Health lit

This week's class was by far my favorite class of the entire semester. Yesterday, we learned about health literacy-- obtaining, processing, and understanding health info. We also watched "In Plain Language," a video created by the Harvard School of Public Health to raise awareness about the need for effective communication in medicine and public health. I loved it. I was amazed at the number of Americans who do not understand health information, and the video definitely made me appreciate my education. I had no idea that ~ 50% of Americans have low literacy skills. The personal stories told by students from an adult learning center were fascinating, and I couldn't help but want to help them. In the video, the students describe how limited literacy has affected their health. For example, one woman did not know what "twice daily" meant. She wasn't sure if this meant twice in the morning, twice at night, or at different times throughout the day. Another man explained that when answering questions on a health survey, he often answers "no" to questions he really just doesn't understand in order to avoid embarrassment. One woman accidentally got a hysterectomy, and another woman went to the store to find cough drops without sugar for her diabetic husband, but didn't know that fructose and glucose were sugars. The video was extremely interesting, but very sad at the same time.

"In Plain Language" also touched on the need for health care professionals to use language that can be understood by patients. Many times clinicians forget that not everyone has had the same schooling, and that the vocabulary they use may be confusing or misunderstood. This reminded me of a conversation I had with my neighbor-- a pretty intelligent guy might I add. He asked me what my thesis topic was and I explained that I was looking at house rules in relation to TV viewing while eating meals and its association with child BMI. He gave me a confused look and asked what BMI meant. 'What? Who doesn't know what BMI is?' is the first thing I thought. "Body Mass Index. Duh." is the first thing I said. I soon realized, as a econ major, my neighbor doesn't talk about promoting healthy lifestyles, behavior change, BMI, etc. etc. on a daily basis. When he still didn't understand Body Mass Index, I simplified it by using "plain language" and said, "basically body fat." Then he got it.

After the video we played with a health literacy program called SMOG... so much fun! This site determines the readability level of written material, and helps match the reading level of health information with the reading ability of target audiences. I liked it.

It's the end of Module 2-- Know Your Target Audiences-- and my top three learnings were the importance of segmentation to categorize and understand your target audience, the effects of low literacy on health, and the drastic need to improve health literacy in the United States. I thought Rocio's presentation on hypertension was amazing, and it gave me a much better understanding of what we should be doing for our group projects. I enjoyed reading "Is There a Hard-To-Reach Audience?" and thought Dervin's "alternative conceptualizations" to preconceptions of "hard-to-reach" individuals were fascinating. As far as designing health campaigns, I learned that effective communication should be viewed as an exchange between participants and that engaging members of your target audience is necessary to clearly understand them. I also enjoyed VALS, PRIZM NE, and SMOG-- all of which I am sure I will continue to use!

Vals and prizm ne

This week we learned about VALS and PRIZM NE, two online segmentation tools used to categorize individuals and help businesses create more effective campaigns. While the VALS survey segments individuals based on personality traits, PRIZM NE uses zip codes to describe an area's demographic characteristics, lifestyle preferences, and consumer behaviors. I loved the PRIZM NE website and spent a good amount of time entering various zip codes of cities in which I have lived. When I entered 92109, the typical stereotypes of PB were shown in its segments. These segments included "City Startups," "Up & Comers," and "Brite Lites, Lil City." The population was described as young, college graduates interested in athletic activities, nightlife entertainment, cafes, blind date MTV, and snowboarding. I entered 92648 for home in Huntington Beach and got a little homesick! The stereotypes of Orange County were a bit much but pretty true and made me laugh. The segments for this area included "American Dreams," "Money and Brains," and "Bohemian Mix." The population was described as ethnically diverse, high income professionals interested in fitness clubs, clothing boutiques, and technology. Interests that reminded me of my family included the mini cooper, a car my sister has been dying to get, and Newsweek, a magazine that can always be found next to my father's spot on the couch.

These segmentation tools help answer questions about target audiences in regards to what they like, where they live, and how they can be reached. This week I learned that people do like to categorize themselves. I learned the importance of active listening skills and understanding the mind of the consumer. Classifying people into segments is an important tool in designing effective campaigns and something I will definitely use in my group project on walkable communities!

Being fat sucks

'Being Fat Sucks.' Such a good article- long, but good! I found it in the SD Reader, and the author makes really good points about making lifestyle changes and losing weight to be healthy, not just skinny. She also touches on the social stigma that is associated with overweight and the fact that while we live in a society preoccupied with food and eating, many overweight and obese individuals experience stigmatization and discrimination. Her story is touching and inspiring. Here's the link. Copy, paste, and enjoy!

http://www.sdreader.com/php/cover.php?mode=article&showpg=1&id=20070927

I love health promotion

Guts and sushi

Spill You Guts Part II
So, this week we were supposed to use our formative research techniques (body language, eye contact, open ended Qs, etc.) with strangers outside the health promotion program in order to get them to talk. We were also supposed to bring up some kind of health message. Each one of the strangers that I used my techniques on this week made me laugh. I learned that one of the easiest ways to get people to start talking about health is to mention that I am a public health grad student working for an obesity prevention research project. Right away each of the strangers went off on how fat America is, and made it quite clear how healthy their families are. One of the strangers I was talking to was a man at the car wash. He had just eaten lunch from the in-n-out next door, had a strawberry milkshake in hand, and was bashing on McDonald's and TV. He then went on in detail to explain both his exercise regimen, and the reason for his red and white, palm tree covered to-go cup. Another woman at the grocery store had me look inside her shopping cart to verify that she was a healthy eater. Ha.

Segmentation by Sushi
As always, lab was fun. Not only did I get a better understanding of segmentation, but I also learned a little more about my classmates. 'Segmentation by Sushi' showed me many different ways of breaking down your population. It also showed me assumptions and stereotypes we make based on how we group our target audience. For example, when we divided into groups based on geographic location of our houses, one student said that the students who lived at the beach were "partiers". A smarter student (Kidding, Saps!) said the beach people were probably very active since most people who live near the beach spend time outdoors riding cruisers, walking, surfing, etc.

Again, another informative and interesting class!

Anti-smoking advert 'is too frightening'

I found this article online and it totally reminded me of this week's health comm class. Dr. Engelberg had us think about how far we would be willing to go in order to get the right behavior. Would we use sex appeal? Deception? Social influence? Fear? As the article describes, the adverts used in this campaign were too frightening for children in the UK. Although graphic, it's pretty powerful.



A health campaign which showed smokers being snatched by fish hooks in their mouths has been criticised for frightening children.

The Advertising Standards Authority received 744 complaints about the Department of Health TV commercials and posters.


A TV advert showed a woman folding clothes while a child watched TV. The next second the woman was dragged from the room by a fish hook attached to a wire.

A man walking down a street was also seen being dragged along the ground and over a car bonnet by a hook and wire into a shop selling cigarettes.


The aim was to demonstrate the addiction to tobacco and highlight a Government campaign to help smokers kick the habit.


A series of billboard posters showed smokers with pained expressions and a taught wire pulling on hooks embedded above their lips.


The campaign attracted the highest number of complaints to the Advertising Standards Authority for two years. Today, the authority criticisesthe handling of the Government-health initiative.


The official watchdog said most of those who complained considered the images were "offensive, frightening and distressing", particularly to children.


It ruled that the commercials cannot be shown during children or family viewing times. It seems the posters will be banned outright.


The Department of Health said the adverts were designed to confront smokers with the controlling nature of their addiction and were not meant merely to attract attention or to be gratuitous.

Week 4 was not a bore

What motivates someone to care about an issue? This is the main idea of Wrong Reason Health Promotion, one of the major concepts of this week’s class. I was somewhat confused in the beginning of class, as I kept thinking “wrong” meant something negative. However, Dr. Engelberg soon explained that “wrong” simply refers to the fact that the reason someone engages in a behavior is based on a reason that works for them, and not a traditional public health reason. One student gave a funny but perfect example of students at SDSU’s gym. While the traditional public health reasons for exercising include managing your weight, having more energy, reducing risk of developing depression and diseases, strengthening your heart and bones, improving overall well-being, etc. etc. etc., many students (and in my case almost everyone who goes to the 24 Hour in Pacific Beach) go to the gym to strut around in spandex and meet someone of the opposite sex. Although it might be the “wrong reason,” at least they are going!

This week we also discussed formative research and selectivity. Formative research seeks to answer questions about the interests, characteristics, and needs of the target audience. Selectivity refers to personal relevance and where we choose to put our attention. Every day we are bombarded with thousands of messages, and personal relevance greatly influences which messages we pay attention to and remember. Selectivity applies to formative research as we must understand what is relevant to our target audience and what will best capture their attention.

My favorite part of class was practicing our formative research skills in lab. One way of learning about your target audience is through focus groups. So, divided into groups of 3, we had pretend focus group time. Although I have never participated in focus groups, I have always been extremely interested in them and other forms of qualitative research. In lab I practiced being an observer, an interviewer, and a 14 year old pregnant interviewee. At first it was hard to be serious as I worked with two of my closest friends in the program (Sorry Dr. Engelberg, I know we weren’t supposed to!) , but I learned a lot from the experience. As an interviewer, I learned you have to keep asking open ended questions or the conversation will stop, and that you must be attentive and prepared for anything the interviewee might say-- no matter how shocking it is. As an interviewee, I was able so say anything I wanted and discuss anything that was on my mind. Finally, as an observer, I got to see the importance of using body language and nonverbal behaviors such as eye contact and posture to show interest in your group and your topic.

So, it’s the end of Module 1- Establishing a Framework for Health Communication, and after only 3 classes of PH663, I feel like I have learned a great deal about communication and target audiences. I even learned how to blog! :) To me, the top three learnings have been on the importance of understanding your target audience, Dual Process Persuasion, and focus groups as a means of formative research. I loved the focus group lab and hope that real focus groups will be in my future. I will definitely take what I have learned about understanding your audience and personal relevance and apply it to any career I may have in behavior modification.

Oh! One more thing I want to say. This week we were assigned to a group project and I am so very excited about it. My group will be working with the Healthy Communities and Lifestyles Committee to promote safe and walkable communities within San Diego. The idea behind this is that environmental barriers reduce the amount of physical activity that many children engage in, which contributes to the childhood obesity epidemic. Healthy Communities & Lifestyles Committee is considering using the “Walking School Bus” model and a project called “Taking Back the Park” to promote walkable communities and increase physical activity. My group will interview members of the target audience and develop and test messages for a campaign to connect community members with the Committee's project. I think it will be a lot of work, but I am very excited to get more involved with the community, and of course, contribute to obesity prevention!