Monday, January 20, 2014

Expert Insight: Dr. Michael D. Slater on Health Communication

I’ve been asked by the editors of our Coalition for Health Communication website to share my thoughts on where the discipline of Health Communication is going.

The answer may be an obvious one—rising to the opportunities and challenges associated with social media and mobile technologies.  This brief essay or column will focus on the nature of those challenges and opportunities—including that which I believe has the greatest untapped potential.

The new and distinctive opportunities for behavior change intervention associated with emerging communication technologies include tailoring, interactive apps, the potential to deliver personalized messages via smartphone.  Social media is more difficult to shape, as it provides new ways to convey social norms and influences, both amongst general population and among one’s friends.  Such norms may be pro-social or part of the problem.  The negative influences of social media practices are one important dimension for research study; another involves ways to create positive peer influence experiences socially.  After all, influencing perceived social norms is a brass ring for which we often reach in attempting to influence pro-social behaviors, but one we can seldom grasp. 

These opportunities are exciting, though theoretically and technically challenging.  However, these technologies also provide difficult challenges to public health communication practice in particular.  The ideas I’ve mentioned assume that the person we are hoping to reach has signed on to some website, some app, some texting service.  This makes perfect sense for client populations—patients in treatment, persons signing on to programs to lose weight or quit smoking, employees of an organization incentivized to participate.  But what about those members of the public who may be more resistant/hard to reach, those who have been traditionally reached through mass media channels, or those who simply aren’t part of some organization or provider relationship that can encourage use of such media?  The increasingly fragmented communication environment, in which the audience has increased ability to select and filter messages, is likely to often make conventional mass media communication interventions more difficult to carry out effectively, especially among younger, technology-savvy audiences.

There is one direction, though, that I believe provides particular potential for moving health communication research and practice forward.  I believe we will increasingly see a convergence of public health intervention communication and provider/patient communication, facilitated by technology.

In coming years, clinical practice will be under tremendous pressure to reform, for improved patient outcomes, at lowered costs.  Achieving such outcomes will require that the value of the very limited interaction between patient and provider be maximized; technology provides a means to do so. 

Imagine, for example, clinical practice settings in which histories of behavior, patient hopes and concerns, and related psycho-social issues are collected via tablet and streamed wirelessly to a clinic server.  Algorithms provide an on-screen summary to the provider.  In the examination room, the screen displays key questions for the provider to ask and lifestyle modifications for the provider to recommend during the brief visit, while offering suggestions as to how to frame these recommendations, given the patient’s psychosocial profile, family situation, etc.  The provider can use voice-activated keywords to add supplemental information. A handout presenting these recommendations, tailored by algorithm to take into account the patient’s demographic and psychosocial profile to increase the likelihood of patient cooperation, and providing follow-up guidance, is provided at the close of the visit.  Afterwards, the server can send periodic text messaging, emails, and snailmail as reminders and to identify issues and provide referrals for assistance.  If need be, staff can be flagged to make follow-up phone calls. Social media can be used to facilitate support groups for patients and family when indicated.

Such approaches are likely to improve outcomes at reduced cost, and facilitate increased continuity and personalization of care even as pressure on the health care system to provide more care at less cost grows.  All our knowledge, insight, and skills regarding public health persuasive message design, patient-provider communication, and utilization of new media technologies can, and eventually must, be harnessed together to address these critical needs.

MichaelD. Slater
Social and Behavioral Sciences Distinguished Professor
School of Communication, The Ohio State University
3022 Derby Hall, 154 North Oval Mall
Columbus OH 43210-1339

1 comment:

  1. Great insights, thank you. One big plus of patient-provider communication would be in the context of pediatric care. Many parents are afraid to talk about body issues and obesity in the clinical setting with their children there. The fear of stigma or the inadvertent triggering of body issues in the child keeps them off topic, and providers may be hesitant to speak up for similar reasons. Electronic media allow parents and providers a channel through which to discuss pediatric issues without worrying about harming the child's views of his or her body.