3 Key Best Practices for Public Health Communication, Education

December 30, 2020 - When an emergency strikes, like a global pandemic or a devastating natural disaster, mass education and direction becomes crucial. Federal, state, and local leadership lean on public health communication, messaging, and education more than ever.

That much became apparent during the COVID-19 pandemic, when viewers across the country tuned in daily to press conferences and consumed a higher than usual number of public health messages in person, on television, and on social media.

But public health messaging isn’t just important during those times of crisis; it is an essential element as public health leaders work to improve the health of populations and prevent future health disasters.

As public health leaders continue in this work, refining their public health communication strategies will be crucial Below, PatientEngagementHIT breaks down the best practices for public health communication.

Consider clear, concise messaging and copy

Fundamentally, public health messengers need to gain the trust of their audience and motivate that audience to do something. This will require being judicious in the actual crafting of the public health message, whether that be part of a social media campaign of a live press conference.

“Without trust, transparency, and truth, public health officials and government leaders will struggle to inform people and drive behaviors to serve the greater good,” wrote Richard E. Besser, MD, current president and CEO at the Robert Wood Johnson Foundation and former acting CDC head, and Jeffrey P. Koplan, MD, vice president of global health at Emory University and CDC director from 1998 until 2002, called on public health to do better about messaging.

As part of a June op-ed published in Barron’s, the two former CDC heads advised public health messengers at the local, state, and federal level to strive for patient trust and avoid getting political. Politics can obfuscate the important public health action a messenger may want to make, Koplan and Besser said.

“Just as a physician’s top priority must be the patient, a public health official’s top priority must be the people,” they asserted. “A line must be drawn as to what one can tolerate when politics collides with public health. It pays to have this red line in mind when truth is compromised, science is ignored, or sound advice is repeatedly obstructed.”

These principles are important in crafting a written public health message, where officials need to make sure the actual copy is understandable to patients. The CDC recommends public health leaders craft public health messages that tell a story and are clear.

The World Health Organization (WHO) advises messengers cater to the “heart and the head” and write messages that have a clear call to action. Public health officials should avoid using numerous abbreviations, the same word that has different meanings, technicisms, and complex sentence structure. The anatomy of a good public health message, WHO said, includes:

• Appeal
• Approach
• Content
• Text or image
• Context
• Trustworthy source

These small details matter, research has shown. A 2020 analysis from the bipartisan de Beaumont Foundation showed that certain verbiage is more effective than others in crafting effective public health messaging.

In the context of the COVID-19 pandemic, the analysis revealed that words conveying the seriousness of the pandemic were more effective. Additionally, words that did not suggest a limitation on freedom were more effective at generating good will among the public.

The researchers advised public health officials to utilize the following language more frequently in their public health messaging:

• the pandemic
• eliminate/eradicate/get rid of the virus
• social distancing
• an effective and safe vaccine
• protocols
• face masks
• essential workers
• personal responsibility
• a stay-at-home order
• public health agencies
• policies that are based on facts/science/data

In addition to using words that will motivate the public, Besser and Koplan suggested messengers lean on understandable language. Using high-level vocabulary or convoluted language will increase the odds the public doesn’t even understand the public health message, let alone heed it.

“People being asked to do something—whether to social distance, wear masks, or stay home—will be less likely to comply if they don’t understand the message or trust the messenger,” Besser and Koplan explained. “The level of detail should be commensurate with the audience’s roles and needs. A jargon-free message relayed in clear, layperson’s language is the best way to reach a skeptical public. A compassionate, calm tone helps.”

Strive for inclusivity, diversity

Once a public health agency has created a message, it must ensure that message is reached by everyone. This means designing a public health message that is inclusive and appeals to the needs of a diverse population.

For Shiva Biedar-Sielaff, the chief diversity officer at the Wisconsin-based UW Health, that meant leaning on community health partnerships to ensure their public health message reached traditionally marginalized populations.

“There are a lot of issues of trust with institutions and governments, but there is a lot of trust that gets built when the message comes from organizations and leaders within the community itself,” she pointed out during an interview with PatientEngagementHIT.

In addition to leaning on the typical strategies of offering messaging that is culturally competent and in the region’s most commonly spoken languages, Biedar-Sielaff partnered with trusted, non-medical messengers within the community.

The healthcare organization connected with Madison365, an online news platform that focuses on communities of color. The publication has an entire section dedicated to COVID-19, and UW Health has seen that as an opportunity to get sound health advice in front of the eyes of traditionally underserved populations.

What’s more, these community health partnerships have helped UW Health better target their practices.

“This has been a way to hear back from communities,” Bidar-Sielaff noted. “What is it that you're needing? What messaging? Do you think we need to reiterate messages in other ways? What kind of language access needs are there in the community?”

Public health messaging must also account for populations who are disabled, according to Bonnielin Swenor, PhD, MPH, an epidemiology and ophthalmology expert from Johns Hopkins Medicine.

“This issue with messaging for people with disabilities is centered on accessing the information,” Swenor said in an interview. “When you think about people who have vision or hearing loss, there are a lot of challenges to even accessing that information. By and large, the messaging is not and has not been accessible.”

Messages don’t usually use plain language, add captions at the bottoms of videos, or use adequate alternative text for screen readers, she said. Accounting for those adaptations and designing messaging for individuals who are vision or hearing impaired will be important for ensuring every population has access to public health messaging.

Consider artwork, campaign design

Written public health information should in most cases come accompanied by some artistic or visual element. This is important for individuals who have lower reading levels or who may not speak the language in which the message is written. Visual elements can also be helpful for individuals who do speak that language or have high reading levels.

According to the CDC, public health messages should be designed with a messaging hierarchy in mind. The most important element of the message should be at the top of a poster or social media post, or given the most prominent spot.

Most readers want to navigate a page from left to right and from top to bottom, CDC noted, so information should flow based on importance along that pathway. Additionally, careful utilization of different font sizes and colors can help guide the reader through the post.

Messages should also group related information together in manageable chunks. Utilization of white space on the page will prevent the reader from becoming overwhelmed and help her compartmentalize the information in her mind.

Event factors like font matter, the CDC added. Large sans serif fonts are good for communicating a bold message. For larger chunks of text, like the body of a subheading, may utilize serif fonts to help guide the reader’s eye from left to right across the page.
And in as much as images go, CDC recommended using clear images that are recognizable. For example, a red exclamation point universally suggests importance and urgency. Utilizing such a symbol could help draw a reader’s attention. Other familiar cues, like the red, yellow, and green of a stoplight will also be recognizable for a large portion of the public.

Finally, visual representations of data should be easy to understand. CDC said public health officials should use whole numbers, not fractions or decimals, and lean on visuals to convey the data’s meaning.

Public health messaging is critical to addressing health emergencies, like the COVID-19 pandemic or a natural disaster. As leaders work to improve health outcomes during such events, it will be critical that they understand the best practices in communicating with the public during disasters.