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The Formidable Journey to Quality Healthcare for All

featured / public health / health communication / behavioral change

Early April in D.C. typically marks cherry blossom season; however this year’s early bloom means we’re freed up to celebrate other important events like National Public Health Week. While it may not be as festive, NPHW is a time of year to recognize not only what we’ve accomplished in public health but also what is left to be done. This year’s theme, to “make the U.S. the healthiest Nation in One Generation,” establishes a vision for vastly improving the health of our country by 2030. Achieving this vision requires not only transformation in the policy and structure of our healthcare system but also health behavior change at the community, family and individual level.

One objective of this vision is to achieve "quality healthcare for all" – a formidable task to be sure. Significant strides have been made in expanding health insurance coverage to millions of Americans as a result of the Affordable Care Act. National Public Health Week 2016 However, it begs the question – Is having health insurance enough to meet the goal of quality healthcare for all? Well the answer is resoundingly NO! Truly moving the needle on the health of our nation requires not only improving access to healthcare (via health insurance) but also ensuring that individuals can connect up with a healthcare provider, receive (what they perceive to be) quality care and engage in ongoing care and prevention. The concept of patient engagement typically includes both an "activated patient" (who takes responsibility for their own health) and the interventions or people that support the person in the process. So it stands to reason that we – as public health researchers and communicators -- play a role in achieving quality healthcare for all and improving the health of our nation.

And here’s what we can do…

Embrace multi-modal health communication

As communication researchers our mantra is to know thy audience and that means understanding how they receive and process messages, where they seek out information and who they’re likely to believe or trust. Gone are the days of healthcare providers being the single authoritative medical source. With myriad credible (and not so credible) health information available by phone, web, text, post and tweet there is an imperative for health educators and providers to embrace these forms of communication to promote patient engagement. Increasingly providers are using patient portals, text reminders, secure email systems and other online forms of communication to deliver messages to their patients. However, establishing mechanisms for two-way communication within the clinical setting has shown to be an effective method for increasing patient engagement and improving patient outcomes. Furthermore health promotion campaigns should target not only individuals to promote healthy behaviors but also leverage messages and channels that promote interpersonal and community level conversation and/or action.

Let communities drive the (intervention) conversation

The fields of medicine and public health have certainly evolved from the old days of patriarchal messages like "you should do this because it’s good for you." However, we still have much to learn about what motivates people to be healthy (or not) and what messages influence people to change (or not)! Every health topic, behavior and community is unique; which requires us as interventionists to have a deep and nuanced understanding (of these things) if we have any hope at making a difference. Letting communities and individuals drive the conversation about their lived experiences, what barriers they face in seeking care and what motivates or discourages them, can go a long way in the development of tailored and meaningful health messages. It is also critical to hear from communities directly who they are most likely to trust as the "messenger" of health information. For some, federal health agencies are considered an authoritative and trustworthy source and therefore influential at the individual level. For others, they may rely on community or faith leaders as a trusted source and should be reached at that level. Involving the community in each step of the intervention process allows them feel a sense of ownership and provide that rich and nuanced context that is critical for successful health promotion.

Craft messages that support varying levels of health literacy

Knowing the "who", "when" and "how" for message dissemination is important; but if people cannot understand the message itself then it is all for not. Health literacy, or the ability to obtain, process, and understand basic health information and services to make appropriate health decisions, is a significant issue affecting our healthcare system. The health literacy of an individual can impact their ability to navigate the healthcare system, to follow provider recommendations or respond to health campaign messages through behavior change. It is truly imperative, on the path to quality healthcare for all, that health messages are designed in such a way that they can be accessible to individuals at all levels of health literacy. The CDC, among others, has recognized the importance of this issue and designed a handy tool known as the Clear Communication Index, to support health messages that are clear, jargon free and that improve comprehension.

As the healthcare service "access gap" begins to close, we must continue to push forward by promoting patient engagement through clear, multi-modal, community-driven communication. The path to achieving quality healthcare for all is indeed formidable – but a worthy endeavor this week and every week of the year.

Tell us how you are celebrating National Public Health Week!

NPHW 2016

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