February 9, 2010
I received a ‘smileworthy’ email from my friend and colleague, Ed Maibach, on Monday. He had received word that one of the articles we co-authored had been named to the 50 most read articles in the Sage journal, the American Behavioral Scientist. In fact, the article is #5 on the list, as you can see if you visit http://abs.sagepub.com/reports/mfr1.dtl
The article’s title, “Competencies for the health communication specialist of the 21st century,” gives some idea why it has been one of the most read publications. The importance of this area both theoretically and in application has been widely recognized. This has contributed to a surge in adding health communication classes to undergraduate and graduate programs around the world. And in adding these programss, the debate continues about the focus of education and training.
As I looked back at the lessons learned to develop the article, I realize that many of these competencies are ones that we all need in order to successfully navigate the health information that might only be described as overwhelming in quantity and sometimes questionable in quality. One of the competencies that health communication specialists may choose as a focus focuses on gaining access to and using various electronic databases. As we’ve discussed on this site before, we all need to harness the skills to do this. One of the most important issues remains the ability to identify the sources of these messages in order to consider the validity of their claims.
The emphasis in the article reflects the importance of understanding the role of both media and interpersonal communication on our health habits. To continue the conversation from yesterday, we too often do not seek formal health care because our family or friends don’t support doing so. And we frequently substitute care from our support networks for formal health care. In fact, one of the roles that many faith-based organizations assume relates to providing support to members sruggling with illness or recovering from events that limit their well-being. This may include injuries on the job or the death of a loved one.
Perhaps one of the most surprising and least considered areas of health communication competence relates to impression management. This, too, flows from the knowledge generated from research and practice in interpersonal communication. I reflect on my own hesitation to reveal my failure to behave in ways that I know I should. I want others to form a positive impression of me and to like me. And it carries over into health realms. Besides wanting to present our own best image, we often–with little thought–help others project their own best image. So we may fail to ask our doctor about something we thought we would be talking about in our appointment because we are thinking that to do so might seem to imply that we are ‘criticizing’ our doctor.
Other competencies related to the 21st health communication specialist that we identified more than 15 years ago that all of us will benefit from include media literacy skills associated with understanding gatekeeping relating to content. As discussed in the former post, media stories about medical research likely appear far ahead of therapies to benefit our well-being related to the research findings. Understanding that media seek to give us novel content supports our ability to reflect on the gap between a story and its translation to our care.
So a competent health communicator likely begins with our intention…to understand, to reflect, and to participate in making decisions about our health in informed ways guided by our efforts and experiences.
Hi Dr. Parrott – is there a way to get a copy of the article you reference here? I have checked online, and at Emory, and cannot find it. Thanks.
surely. send me your email address to which you would like to receive it. send to my campus address at rlp18@psu.edu
I picked this entry because it relates to the case study that I presented to the class on Monday. Two things popped out at me. The first was “To continue the conversation from yesterday, we too often do not seek formal health care because our family or friends don’t support doing so.” I feel that this rings with pre-contemplation. Not supporting doing so also means that they are not making you aware of a needed change and not raising your conscious about an issue. The second was “So a competent health communicator likely begins with our intention…to understand, to reflect, and to participate in making decisions about our health in informed ways guided by our efforts and experiences.” As far as the transtheoretical model you are saying it is most important to get the patient to contemplation phase, then preparation phase, then guide them into action.
I learned something from this important post. That is the way, I want to thank you.
http://soft-7.com
Thanks for making my morning a little bit better with this great article!!
Thanks for good information that comes out to
read.
Just want to say what a great blog you got here!
I’ve been around for quite a lot of time, but finally decided to show my appreciation of your work!
Thumbs up, and keep it going!
Cheers
Christian,Earn Free Vouchers / Cash
nice share, good article, very usefull for me…thanks
Just want to say what a great blog you got here!
I’ve been around for quite a lot of time, but finally decided to show my appreciation of your work!
Thumbs up, and keep it going!
Cheers
Christian, iwspo.net
This post really encourages me to be a competent health communicator. I think I need to consciously try to understand, to reflect, and to participate in making decisions about my health instead of just relying on a doctor and expecting him/her to tell me everything I should do to improve my health.
You hit on something we cannot escape: we want the other person to like us and that it influences health realm as well.
I am curious…
Let’s say I have a friend who has very low self-esteem.
Usually people with low self-esteem have less self-confidence. They are more likely to try even harder to make the others like them but at the same time they easily get hurt emotionally.
If I have this kind of friend, would it be a good idea to accompany her when she goes to see a doctor? Or would it make her even less confident? It seems like a dilemma… I want to let her know that I like her and that’s why I’m willing to accompany her… but at the same time, it would make her look like a less competent health communicator who needs a helper.
What would a competent health communicator do in this kind of situation?
Hello All! – Please – if you do care – continue reading
Executive Beryl Zyskind is raising tents for the children of Haiti
Are you aware that over 500k people died in 1hr in Haiti’s earthquake? The people of Chile & Haiti need Food, Clothing & Financial Assistance
Writer Beryl Zyskind supports peace
Good job. I’m definitely going to bookmark you!
Great article Thank
you so much!
I did my thesis on the competency of peer health educators, and I know this is a topic of great importance. I’ve been out of academia for so long…is emotional intelligence a core part of public health communication?
Sounds great! Thanks, Rox. We enjoyed it! To be continued…
Thanks to all… I enjoyed it as well… take a look back through earlier posts folks and add some comments to guide our future discussion.
For example (in response to what I would tell to folks who are attempting to reform health care), I would tell them we need some “simple” communication fixes, such as improving providers’ use of technology (i.e., email) to make it easier to schedule appointments, ask questions, and coordinate care. We also need some improvements in communication that are more systemic and complex, such as improving/increasing communication training in medical schools. Both types of improvements would likely increase patient satisfaction and compliance as well as save time and money.
That’s the reality that not everyone can recieve “ideal” health care for various reasons.So what should we to do for ourselves. It seems to me that policies cound not totally change the situations of lack of recourses, however, should we make some effort in empowering ourselves related to health issues. I mean the health resourse could be distributed in a way and demysitified. Especially supported by the Internet technologies. There may be many ways to reduce the health care expenses.
this has been great… we have raised some issues that I would love for us to continue to discuss. I will add some posts in the next days and weeks to expand on some of what we have discussed and if you will just visit each day and keep the conversation going, perhaps we will come up with some ideas worth giving to policymakers…
I absolutely think we should teach students about the public health system in high school. I never understood how much of a role public health plays in our daily lives until I worked in Cancer Control.
The “assumptions that are made in the health care setting about those who do or do not need care” as Karyn discusses, are EXACTLY why we (the patient) tip toe around trying to present a certain image to our physician. By “projecting that positive image”, we therefore assume that our physician will take us seriously and treat us to the best of his or her ability. To appear in a negative light leads us to fear that we will be thrown into the quagmire of
of pathetic care.
Karen, with your nursing background, where would you begin in terms of guiding the public?
Jingwen — I totally agree. I think this sort of “life” education is lacking. In health class, we learn about some diseases, etc., but we don’t learn about the right questions to ask at the physician, how to communicate with the physician, what our rights are as patients, how insurance works, etc.
…excellent topics… I wonder how the school administrators and the health education teachers would view this addition.
I think we should tell them that we need to first communicate with doctors (private and working in hospitals) about how they feel this would change their patients’ experience in their office.
I believe we will find, after talking to most doctors that they feel that the quality of communication, like Melissa said, would only decrease when more eligible patients were added to the patient list of doctors. If we are discussing all of the health care problems and “time restraints” now as it is, imagine the health care problems when we only increase the amount of patients yet have the same amount of doctors.
If people who previously could not afford health care were now treated the same way as people who CAN afford health care, the communication and attention they received from their doctor would be spread so thin.
Is there a point where we have to realize that not every one can receive “ideal” health care for a reason?
…wouldn’t it be fun to take the growing list of health care specialist and sort through the maze, add to that list the specialists in public health, sort it in ways to create a kind of ‘triage’ system… to determine how to guide us to utilize other sources who themselves become part of the overall system. and how to navigate online resources to content that would save time and boil our questions down to only the most relevant rather than broad open-ended and unfocused queries.
I just think the power of health awareness and education could be incorporated as an aspect of the health care we receive.
The education on health issues and health communication needs to be emphasized.Not only for the medicine school students, but for a life-long education for everybody. I don’t see we have enough health eduction in school and maybe this lack of education contributes to the problematic and complex discourse around health.
…so true… public health, for example, is not a phrase that I can remember hearing before college and even then, I had no real idea about the organization of public health until graduate school. Considering how important public health is–I would advocate for an introduction to pbulic health as a high school class.
This is just sort of a guess, but I would think that if we have many more Americans with access to health coverage, and the same number of physicians, that patient-provider communication would like become even more problematic. Physicians often already cite time as their biggest constraint.
I think the first thing I would tell them is that they are not listening well enough to what their constituents want and need. We do not need to completely overhaul our entire system–much of our health care system works quite well and is more than adequate to fulfill most Americans’ needs. But there are cracks that need filling–and processes that need streamlining.
…Especially us “educated” and “professional” people who are supposed to be able to take care of ourselves and already know what we need to know. Too many times assumptions are made in the health care setting about those who do or do not need care or should or should not seek support just based on one’s social status.
…if we all had those folks responsible for health care reform in front of us right now, what could we tell them about communication that might reframe the debate? I think we can spend all the money in the world to change access to insurance and the organization of health insurance delivery, but still find that we continue to use excessive amounts of resources for health in this country…
Melissa- In response to your question, with my experience working in a doctor’s office, I have witnessed quite regularly an elderly woman or man stating that their spouse wanted them to “do this” or “do that” before seeing a doctor. I feel MOST of the influences that families have encourages a family member TO see a doctor rather than to delay a physician’s appointment. However, from my experience, it seems there really might be social influences that prevent some from seeing a doctor more often than we think.
Brittany, I think your point is excellent in several ways. A lifespan perspective relating to seeking health care is important for us to consider. There is quite a bit of literature that sorts through the effects of being married on health and well-being…some really good and some not so much…
I agree that impression management is one of the biggest challenges in health communication in general–but also especially in seeking support from others (both informational and emotional). We don’t want others to perceive us as weak, needy, or uninformed–and as a consequence don’t get the support or services we need. Right?
so true… Who wants to be a burden on our friends or family? who wants to be the sick one?
I agree that many patients won’t ask questions for fear that they should know the answer and the doctor will form an “uninformed” opinion of us as patients. For example, when I recently went into the doctor and was diagnosed with a virus, I didn’t want to ask the simplest questions because I felt I should know the answers. It wasn’t until I got home I realized it would be hard to find the answer online (how will I know which source to believe) so I called back and asked a nurse! How silly, I should have just asked in the doctor’s office!
I feel doctors might not address certain problems for this same “impression management” also.
…how true. I believe that a doctor, for example, who is overweight will have a harder time raising that issue with an overweight patient. But I think we have evidence from communication research to support belief that patient feelings of similarity with a doctor increases their compliance [a study in Communication Monographs in 1987 with Judee Burgoon as first author is an early citation to support this]. So that is probably a lesson from communication that should be better communicated in doctor medical interview training…
Before reading this book, I had never even thought about impression management as playing a role in our health communication. Now I understand that similarly to the way that impression management impacts other contexts of communication it plays a significant role in how we communicate with others about our health.
Although I understand that impression management is generally something that is human nature, it is a dangerous thing in health communication. While everyone wants to be liked and manage image, our health is so much more important than what our doctor/family/friends/support network thinks about us. Our class is learning from our reading that sometimes the difference in deciding to discuss something and avoiding a topic can be the difference in life and death. Regardless of how hard it might be, when it comes to (at least talking to our doctors) we need to try and put impression management to the side and focus in on what is most important – our health.
I think you raise an excellent point. I cannot think of an example of any ad–from advertisement world or from public health messages–that makes us aware that we have this tendency to manage our impression…even when doing so can be a matter of life and death…literally. It would be interesting to consider how to go about making us more aware.
For the discussion of “impression management”,we know there are lots of socially constructed discourses shaping the stereotypes of certain deseases or health problems.How should doctors and patients positively deconstructed these nagative stereotypes and communicate openly? Like the issue of youth pregnance?
…wow. We could spend our careers thinking about that one. First, I would say that we don’t want to place the responsibility on doctors when the stereotypes form from friends and family, socially constructed. I think about HPV, for example, and a recent study we have completed here at Penn State that shows how the commercials for the vaccine have contributed to males believing that they are not at risk for HPV–a stereotype then that it is a female disease… a deadly stereotype that needs to be tackled…
How often do you find that people do not seek medical attention because the family does not approve? This seems surprising to me — not shocking or unheard of — but it surprised me that this would be a big issue in preventing people from seeking care.
There is a large literature in cancer that shows that someone diagnosed with cancer, for example, may not elect to participate in a therapy because it is culturally inappropriate, it is viewed as something that will burden the family, and even may be denied due to fear of the unintended effects. Fear of impotence. Fear of sexuality. Fear of loss of employment due to treatment burdens and so on.
hi all, you must comment and I must approve your comment the first time you post…then you should be approved for all comments that follow… Roxanne