Traditional Health Communication Channels

The different ways through which health information can be delivered

What is public health communication?

The American Journal of Public Health defines public health communication as the scientific development and strategic dissemination of relevant, accurate, accessible, and understandable health information communicated to and from intended audiences to advance the health of the public. It is a cross-disciplinary science that draws from mass communication, education, marketing, journalism, psychology, and informatics.

When developing health communication strategies, the optimal channels need to be chosen through which the messages will be delivered. These channels broadly fall under three categories: mass media, organization and community, and interpersonal.

Mass media

Whether we are at home, out walking on the streets, or even stuck in a traffic jam, there is an undeniable omnipresence of mass media in our daily lives. Television, radio, newspapers, magazines, outdoor and transit advertising, direct mails, flyers, brochures, and social media tools all fall under the umbrella of mass media. Mass media channels have the potential to reach a large and wide audience as they occupy a central role in the lives of many.

The types of mass media channels used to disseminate health information have also changed over the centuries. For example, in 1721 in the United States, Reverend Cotton Mather used pamphlets to promote immunization during a smallpox epidemic in Boston. Now, a multilateral mass media approach is used by national governments and major health organizations to promote immunization. This includes local and national newspapers, television, radio, news websites, social media channels, blogs, and podcasts. Mass media is and will remain an important tool for disseminating health information, although continual evolution in the channels used is always expected.

Organization and community

The community and places within the local environment that people frequent can be leveraged as health communication channels. Health information can reach groups that share common characteristics (such as geography and occupation) and interests (such as religious beliefs). These channels can include local radio talk shows, organization newsletters, community-based activities such as health fairs, events at workplaces and houses of worship, street theatre, and dance and road shows.

These channels provide opportunities to tailor health information to specific groups of individuals. Such targeted messages have the potential to resonate more strongly among recipients. Community-based health communication interventions have made great strides in both developed and developing countries. During the Ebola outbreak in Sierra Leone, radio was used to broadcast messages to community members for them to welcome back and accept Ebola survivors. In the US, churches have been shown to be valuable sources of health information. Worshippers trusted church-published items such as flyers and church-organized health fairs as sources of information about screening, medical services, and health insurance.

The role of community ownership and participation in improving public health is being increasingly recognized. Community-based health communication interventions have been instrumental in controlling epidemics and promoting preventive behaviours.

Interpersonal health communication

Family members, friends, colleagues, peers, faith leaders, teachers, counsellors, and doctors — these are people we often interact with and can also be sources of health information, sometimes rather unwittingly. Given the personal connections with these different individuals, they are often considered the most trusted channels of health information.

Interpersonal communication still has a stronghold in the doctor–patient relationship, especially with the spotlight on the importance of mental health interventions. Several studies have noted that doctors and other healthcare professionals remain the most trusted and primary source of health information by patients and caregivers. The “human component” involved interpersonal communication has been shown to comprise 40% of a patient’s therapy success. In clinical practice, strong interpersonal communication can lead to higher patient satisfaction, improved treatment adherence, and better patient confidence.

However, interpersonal health communication can also fuel misinformation spread. Given how technology has made it convenient to exchange information among friends and family members, the scientific credibility of the information is largely overlooked. We discussed how technology in the hands of the health consumer can be detrimental to public health by citing the example of how social media played a role in driving the anti-vaccine movement. Thus, interpersonal communication has its shortcomings regarding the exchange of unverified health information.

COVID-19 at the intersection of these health communication channels

The most contemporary example of the utilization of these communication channels in the public health space is the COVID-19 pandemic. The pandemic forced information to be disseminated to the public via various digital routes.

During the early stages of the pandemic, mass media was critical in getting information to the public. As COVID-19 started to spread worldwide, every form of media in several countries presented emerging updates, opinions, and perceptions about the then mysterious respiratory illness. People could follow the evolution of the pandemic in real time through live dashboards, interactive maps that showed each country’s case load, and live interviews from representatives of the World Health Organization and other public health bodies. Despite the plethora of information sources available today, news media is still considered a trusted source by many. In a study by the University of Oxford, people across six countries reported the news media as more credible than social media, and around 60% of them claimed that the news media helped them understand the crisis better.

Face-to-face health communication through organizations and communities took a dive during the pandemic. Lockdowns restricted or banned gatherings in places of worship and community events. However, health communication through this channel took on a new form. Online platforms were used to boost community morale and resilience, and even to impart important information about preventive measures. For example, on social media, there was a “support local” campaign that aimed to encourage users to purchase goods and avail services from local, independent businesses to keep them afloat. Some community organizations and places of worship turned to online platforms to reach members, and messages such as “stay home” and “wear a mask” were emphasized time and again.

Interpersonal health communication during the pandemic also primarily took place via social media channels. As news of the respiratory illness broke out, rumours and conspiracy theories started brewing about its origin, symptoms, and preventive and curative measures. All this information could be shared to thousands of people in a matter of seconds. This “infodemic” fuelled by social media posed serious challenges to the public health efforts in tackling the spread of the pandemic.

The pandemic also propelled a radical shift in the patient–doctor relationship. In-person consultations were rendered challenging due to mainly two reasons: the high risk of contracting SARS-CoV-2 in hospitals and clinics that are treating infected patients and deprioritization of other routine health services. The focus turned to telehealth services — services that involve consulting doctors via video conferencing or text messaging. In India, official “Telemedicine Practice Guidelines” were released in response to the first nationwide lockdown in March 2020. This was the first concrete framework regarding telemedicine to have rolled out in India. Practo, a digital health platform in India, witnessed a surge in teleconsultations by 100% weekly and an increase in doctors joining the platform by 50% since March 2020. This underscores the embrace of digital health tools for routine healthcare delivery.

Health communication — the present and future

Health communication strategies no longer involve the unidirectional flow of health information. With the evolution of passive recipients into empowered health consumers and dramatic transformations in tech tools, health consumers have a myriad of health information sources at their disposal. Thus, health communication has the ability to drive behaviour change among health consumers through multidimensional channels. This has implications for both preventive medicine (through better tracking of healthy behaviours) and curative medicine (through improved disease self-management). Traditional health communication strategies are here to stay, they are just becoming increasingly digitized, as has been during the COVID-19 pandemic. Pamphlets and brochures are becoming infographics posted on social media. Interpersonal communication tools now include platforms such as WhatsApp.

Health communication will remain instrumental for public health in this digital age; only the channels used to disseminate health information will continually evolve.

Schenelle Dlima is a Scientific Content Writer at Saathealth, an AI-powered, chronic care digital health platform.