Public Health Leadership and Communication

As a public health leader, how would you develop a health education program to increase the health literacy of the people in your service area?

In order for a health education program to be effective it should be based on a relevant theory and it should be created based on a needs assessment of the target population. Program creation requires that the relevant background information be reviewed, program objectives be identified, audience segments be determined for targeting; message concepts should be developed and pre-tested, communication channels should be identified, messages should be created and tested, an implementation plan must be created, implementation and process evaluation must occur, outcome and impact evaluation must be carried out, and finally feedback must be integrated to improve the program or effort.

What are the barriers to successful communication and how have you personally overcome them?

There are many barriers to successful communication. The intended recipient’s mental state and cultural frame of reference can be barriers to receiving the sender’s intended message.  Anger, apathy, anxiety, confusion, disinterest, and fatigue can all influence how the intended message is received. Additionally, thoughts and attitudes of the message sender can influence the sender’s body language and pitch and cause the intended conscious message the sender wishes to transmit to be distorted in meaning by subconscious projections. Negative feelings toward or judgment of the other party may cause both the sender and the receiver to negatively influence the communicative process.

There are also many cultural and linguistic barriers to communication that the book did not explore in this chapter. The words of health care providers who are attempting to communicate with people who speak another primary language may be misunderstood. Additionally, cultural beliefs may influence the conceptualization of a message. In Peace Corps, there was a volunteer who was working with a group of women in her village to help them understand their birth control options. In explaining how a condom should be used, she demonstrated how to unwrap and place the condom, by demonstrating with a broom handle. After several months women in the village began to contact her: they didn’t understand what was happening to them. They had put condoms on their brooms and placed them in the corner of their homes exactly as she had done, and yet they had gotten pregnant. The volunteer and the women both had culturally established beliefs that caused them to make leaps of logic and meaning. The village women had a magical-tribal worldview and their health belief system was based on tribal practices. The volunteer had a “western-scientific” world view that caused her to assume that the women would understand that the broom was only the symbol of a penis and that the condom would have to be placed on their partner’s penis.

One of the ways I have found to be most effective in overcoming cultural-linguistic communication barriers, (as well as message corruption with people of the same cultural/linguistic group) is to ask for message receiver teach-back. Asking the message receiver to tell me the message they have just been given can help determine if the message was transmitted effectively and if the meaning they received was my intended meaning.   

What would be a workable communications strategy to get more funds for an expanded childhood immunizations program?

The first step in creating an initiative is to build a coalition of equal partners for the purpose of planning, operationalizing, and evaluating the scope of the issue. The next step is to examine the barriers to effective functioning of the coalition and address how these barriers can be overcome. All partners should have a vested interest in the success of the initiative. After the responsibilities of the partners are defined, the next step is to establish a consensus on the initiative and develop action plans for implementing the initiative.

What strategies might you use to increase your interpersonal communication skills?

Continuous growth in emotional intelligence is imperative for all public health leaders, as they must be careful to avoid allowing hostile feelings to interfere with good judgment. Additionally, there are steps that the leader can take to ensure that their interpersonal communication skills are top notch. Leaders should converse with others in a meaningful way on meaningful topics, they should state their positions assertively (not aggressively), control their hostile feelings, allow people’s demonstrated expertise be the basis for evaluating the their suggestions, make judgments carefully, be open to new ideas, respect other people’s boundaries, and use understandable language that is accessible to the listener.

What are the advantages and disadvantages or oral as opposed to written communication?

One of the major advantages of the written word is that it creates a permanent tangible record, and thus allows verification of past activities and events. At times the written word may be clearer than the spoken word, as the message sender has time to fully develop her/his thoughts before transmitting them. On the negative side, written communication can at times lack tone and inflection, which in spoken word would evoke a different emotion in the message receiver. Another drawback is that written communication takes more time to create. While the spoken word can be created and exchanged instantly face to face, written communication requires the message sender and receiver to set down their thoughts. When writing is intended to convey facts or important research, the message sender must prepare the facts and organize them in a way that will allow the message receiver to understand the message.

What are the characteristics of active listening?

The characteristics of active listening include the intensity of the engagement on the part of the listener, the listeners empathy for the speaker, the listener acceptance of the speakers message without judgment or interjection until the speaker finishes talking, and the listener remains open to the information the speaker is sharing, even if the listener dislikes either the speaker or the speaker’s message.

What are Walton’s five rules of conversational etiquette?

Walton’s five rules of conversational etiquette include the following: 1) don’t hog the floor (the time), 2) don’t change the subject, 3) don’t step on the sentences of others, 4) do hold your tongue, and 5) don’t forget that there is always tomorrow. If you are enraged or confused, it may be well advised to wait until a later time when you have had a chance to cool down and reflect on your feelings.

What speaker’s aids can be used to enhance a public talk and what are their advantages and disadvantages?

Speakers have a number of aids and strategies available to them to help them capture the audience’s attention. Many times the audience may not wish to attend the event, and is present because attendance was mandatory. Especially in those cases, the speaker needs to find ways to engage the audience in order to be able to transmit the message. Depending on the setting, the speaker may be able to ask for volunteers to answer a question, allow members of the audience to put on an impromptu skit about the topic under consideration, or the speaker may tell a joke that leads into the important topic of discussion. In more formal settings, such jovial approaches may not be appropriate and the speaker may attempt to capture the audience’s attention by telling a story or sharing illustrations or key takeaway points with tools such as PowerPoint slides, overhead projector slides, handouts, videos, and product/example demonstrations.

In cultural settings such as that of the United States, listeners are often primed to believe that the most important part of the speech will come at the beginning of the speech. In the United States it is usually best to have the message be clear, remarks be short, and the key idea might be repeated several times to help the audience follow along. In other countries that practice indirect communication, it is more important to use stories to communicate the main point in a way that allow both the audience and the speaker to “save face”. Furthermore, it may be necessary to talk for a longer time than what would be customary in the U.S., because the audience is primed to hear the message at the end of the speech as the most important part, and/or to believe that if a speech wasn’t long, what was said was not important.

What are the guidelines for interviewing job candidates?

Interviewers should prepare a series of questions ahead of time, they should ask all the candidates all of the prepared questions, they should have an appropriate interview structure, they should arrange for an appropriate setting for the interview, they should learn different interview techniques and how to use them appropriately, and they should keep job candidates informed about the process of selection.

What are the differences between media advocacy and public education?

Media advocacy can be defined as a form of empowerment in which public health leaders galvanize community residents to fight for policies that will benefit them. In traditional health promotion programs, the individual is the target audience, and the goal is to alter the individual’s behavior. In media advocacy, the individual becomes empowered and becomes involved in the push for policy changes. Advocacy is aimed at policy makers, and the goal of advocacy is to get beneficial policies legislated and put into action.

What are the advantages of engaging in dialogue before engaging in discussion or debate?

Dialogue is a process whereby people can speak freely. Generally, when people feel free to say whatever is on their mind, their values and agendas will be revealed. Dialogue is a communication process where everyone can win; it encourages win-win thinking. (Win-win thinking seeks to find outcomes where both parties engaged in a discussion feel that they have “won” in the negotiation and everyone is better off).  In dialogue, participants can share information, identify areas of concern, assess causes of conflict, and find new ways to further personal and organizational development. When dialogue is used first, participants have a better chance of using discussion to develop and implement action plans because their different perspectives can be addressed. Discussion is the form of discourse in which attempts to come to an agreement are paramount; hence it is less useful for discovering new information and strategies.

What are the differences between health communication and social marketing?

In health communications the target audience is the community or population at risk, and the long-term goal is to help the population increase control over and improve their health. Social marketing is aimed at increasing the acceptance of an idea, social practice, or social cause among the target audience. The desired goal of public health social marketing is to induce the public and policy makers to support disease prevention and health promotion.

Why is storytelling important? Describe the different types of stories.

Stories are often more engaging that facts and statistics. There are basic stories about the life of the presenter. Such stories can demonstrate the speaker’s values and help her/him build the audience’s trust, either in him/herself or in the speaker’s organization. There are stories that help the speaker define her/his relationship with the audience. Some stories are said to follow a springboard narrative pattern- these stories help move the listener to action. Through stories the speaker is able to reach the audience on an emotional and practical level. There are also stories about the future that can help the audience conceptualize the message shared into future time. Some stories allow knowledge to be shared. There are also stories that help move people towards collaboration, while others create humor or inspire people with a shared vision.