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HOW COMMUNICATION CONTRIBUTES TO COMPLEX BEHAVIOR CHANGE
One can imagine how the process of change occurs: A woman sees some public service
announcements (PSAs) and a local TV health reporter’s feature telling her about the
“symptomless disease”—hypertension. She checks her blood pressure in a newly accessible
shopping mall machine, and the results suggest a problem. She tells her spouse, who has
also seen the ads, and he encourages her to have it checked. She goes to a physician who
confirms the presence of hypertension and encourages her to change her diet and return
for monitoring.
The physician has become more sensitive to the issue because of a recent article in the
Journal of the American Medical Association, some recommendations from a specialist
society, and a conversation with a drug retailer as well as informal conversations with
colleagues and exposure to television discussion of the issue.
STAGE 1
Meanwhile, the patient talks with friends at work or family members about her
experience. They also become concerned and go to have their own pressure checked. She
returns for another checkup and her pressure is still elevated although she has reduced her
salt intake. The physician decides to treat her with medication. The patient is ready to
comply because all the sources around her—personal, professional, and media—are telling
her that she should.
This program is effective not because of a PSA or a specific program of physician
education. It is successful because the National High Blood Pressure Education Program
has changed the professional and public environment as a whole around the issue
of hypertension.
Note. From “Public Health Education and Communication as Policy Instruments for Bringing About
Changes in Behavior,” by R. Hornik. In Social Marketing: Theoretical and Practical Perspectives (pp.
49–50), by M. E. Goldberg, M. Fishbein, and S. E. Middlestadt (Eds.), 1997, Mahwah, NJ: Lawrence
Erlbaum Associates. Adapted with permission.
period during which change should
take place
• Measurable, to allow you to track progress
toward desired results
• Prioritized, to direct the allocation
of resources
Be Reasonable
Objectives describe the intermediate steps
that must be taken to accomplish broader
goals; they describe the desired outcome,
but not the steps involved in attaining it
(you’ll design strategies and tactics for
getting there later). Develop reasonable
communication objectives by looking at the
health program’s goal and asking, “What
can communication feasibly contribute to
attaining this goal, given what we know
about the type of changes the intended
audiences can and will make”
Communication efforts alone cannot achieve
all objectives. Appropriate purposes for
communication include:
Making Health Communication Programs Work 21