Is it better to tell people about the harms of certain health decisions or about the benefits of positive health related decisions? Studies that delve into this very question have differing results. However, a new paper just published by the Cornell Food & Brand Lab in Nutrition Reviews, finds that the type of health messaging that is most effective might vary depending on certain characteristics of the target audience.

Those who are highly involved in the field that a message relates to are more influenced by negative loss-framed messages such as: “If you don’t use sunscreen you are more likely to get skin cancer.” Co-author Lizzy Pope, Associate Professor and Director of the Didactic Program in Dietetics at the University of Vermont explains: “A medical doctor would be more influenced by this style of messaging because they have the knowledge base to process the message and feel a duty to maintain a healthy lifestyle. Therefore, in this case, the negative nature of the message would be perceived more as a call to action than as a threat.”

Alternately, positive gain-framed messages are more effective for the general public who have less knowledge about the subject, feel that healthy behaviors are a choice rather than a duty, and have less firsthand knowledge of the consequences of their actions. Instead, they are more likely to look at the big picture and respond to messages that are framed more positively and focus on what is gained by a certain behavior such as, “wearing sunscreen can help your skin stay healthy and youthful.”

When it comes to effective health messages, focusing on what to do, rather than what not to do will put you on the road to success. That’s what a new study out of Cornell finds. A positive message, researchers say, works better than a negative one in getting people to get people to adopt healthy behaviors.

Although this study by lead author Brian Wansink, PhD, focused on nutrition (as in,Don’t eat that cookie because it will make you fat,vs.,Eat an apple so you can stay healthy, I think this reasoning can apply to most things.Although it seems obvious that a positive message would work better than a negative one (it is, isn’t it?), so many times those negative messages have a way of getting stuck in our heads. Then there’s little or no room for the positive messages to take root.

These findings show how those who design health messages, such as health care professionals, will be impacted by them differently than the general public. When writing a health message, rather than appealing to the sentiment of the experts, the message will be more effective if it’s presented positively.

The general public is more likely to adopt the behavior being promoted if they see that there is a potential positive outcome. Lead author Brian Wansink, PhD, director of the Cornell Food and Brand Lab and author of Slim by Design concludes, “Evoking fear may seem like a good way to get your message across but this study shows that, in fact, the opposite is true telling the public that a behavior will help them be healthier and happier is actually more effective.”

One of the key components of any health program is communication. How do we let people know what we are trying to do? How do we get people involved? How do we get people to change?

While every potential audience we work with is inherently different, many of the same principles apply when we talk about creating communication and messaging that works. Regardless if your audience consists of college-aged males in St. Louis or expectant mothers in a remote village in Bolivia, it all comes down to knowing your audience. Here are a few things you’ll want to learn about your target audience before you plan any health communication strategy.

Talk to those who influence the audience.

One of the first things you want to learn about your audience is who influences them. Is there a church leader or community elder they will listen to? Is there someone in the community you need to talk to first? In collectivist cultures, this step can be especially critical.

When health workers from the International Trachoma Initiative (ITI) offered to provide free surgery for village members with trachoma, an infectious eye disease, villagers completely refused to have the surgery. It became clear over time that villagers were upset that social norms had not been observed; village elders had not been consulted prior to the community surgery program. Once the elders were consulted, the village members were enthusiastic about the opportunity for surgery.

Find out what the audience believes.

One of the most crucial components of developing messaging for your program is finding out what your audience believes. What do they believe about the illness? Where do they believe the illness comes from?

A great example of this comes from the Guinea worm campaign managed by the Carter Center in Atlanta, Georgia. Members of Guinea worm-infected communities were divided on where the Guinea worm originated. Many believed the worm was the result of a curse by a neighbor or friend. Others thought the worm was given to them by God.

 (2) It is quite difficult to convince someone to stop drinking contaminated water when they don’t believe it is what causes their illness. The Carter Center used this information to help construct their messaging and education materials.

Use focus groups to form messages and pre-test materials.

There are two ways to craft health messages to reach people with disabilities. You can include them in generic health promotion campaigns, or you can design materials that specifically target them.

You need to include people with disabilities in your focus groups. You need to find out what they think and feel about your topic, regardless of whether they are part of your audience or are your only target.

When you think you have crafted the right message, and have presented it in the appropriate format and medium, (along with the appropriate ethnic and cultural messages) invite people with disabilities to pre-test your materials:

• Ask local Independent Living Centers (ILCs) and other service providers and associations (i.e, United Cerebral Palsy Association, American Limb Loss Association, etc.) if they can set up focus groups for basic research as well as to pre-test materials. Compensate focus group participants for their time and effort.
• Subscribe to listservs and chat lines on the Internet and ask if you can post questions for discussion or submit drafts of your educational materials for comment. The office also sponsors an electronic bulletin board. The Disability and Health Program of the New York State Department of Health offers a listserv for individuals with spinal cord injury.

Talk like the audience.

Find out what words and descriptions your audience uses on a regular basis. Is the phrase “expectant mother” going to resonate with your audience? Or is “baby ma” more appropriate to describe a pregnant woman? Learn how your audience talks. If they don’t understand what you’re saying, the rest won’t matter.

Meet the audience where they are.

Find out: Does your audience have activities or hobbies? Do they go to church? Do they go to school?  What technology do they use? What social media sites do they engage with? Do they participate in community activities? If you find out your target audience is active in a community theater each week, try to integrate your messaging into the theater events. Meet your audience where they are.

Use images and design elements that resonate with the audience.

A key component of health communication strategies relies on images and design elements. Can your audience relate to the images in your communication materials? Do the people depicted in your materials look like the audience you’re trying to reach? Are the background images something your audience has seen before? Use images and colors that draw your audience to the materials in the first place.

Pre-test and revise.

Once you’ve created your messages and materials, be sure to test them with your audience. Pretesting includes asking key stakeholders and a few members of the audience if the messages are clear and understood. If, over time, you discover messages are unclear or confusing, it’s time to step back and make some changes.

The communication process is continuous. It entails dialogue, out-of-the box thinking, and ultimately, building relationships. Getting to know your audience can be a time-consuming part of program planning, but it’s an invaluable step.This post is part of the September 2015 “Global Health” series of the Institute for Public Health’s blog.

Here are five common “don’ts” we’re hearing lately, along with the flip-side “dos,” which we’d do well to remember.

A] DON’T: Sit too much.

The more time people spend sitting, the more likely they are to die prematurely. Excessive sitting has been linked with being overweight and obese, type2 diabetes, some types of cancer and even premature death, according to studies.

DO: Stand up every 30 minutes.

Remind yourself to take active breaks from sitting: stand on the train or bus; take the stairs rather than the elevator; walk up the escalator rather than standing still; stand or walk around while on the phone; alternate working while seated with working while standing.

B] DON’T: Drink diet soda.

Researchers who studied a large group of healthy, postmenopausal women in the United States found that those who were “heavy consumers” of diet drinks might be more prone to heart attacks, blood clots and other cardiovascular problems. Other studies have linked diet sodas to abdominal obesity in adults over 65 and an increase in sweet cravings.

DO: Spruce up your water.

If you don’t like the taste of plain water, add your favorite fruits and veggies, like cucumber, strawberries, oranges, lemons, mint or limes,Or freeze chopped-up fruit in an ice cube freezer tray and add to your plain water. Drinking a glass of water before eating a meal can help you feel fuller and may have a positive effect in cutting your portions, thus helping you lose weight.

C] DON’T: Snack between meals. 

Eating often throughout the day may make people gain weight and can make you even hungrier, some experts say. We should eat three “proper” meals a day, they say.

DO: Work snacks into your daily quota.

The reality is that more people are snacking, according to the market research group The NPD Group. Snacking can help avoid that “I’m starving what’s for dinner?” tendency to overeat or grab something unhealthy in a desperate attempt just to fill up. If you’re a snacker, make those snacks healthy: fruit, a handful of nuts, edamame, some yogurt or a nutrition bar containing healthy grains like amaranth, quinoa and oats are all smart choices.

(According to a study published in JAMA Internal Medicine, with each additional daily serving of whole grains, there’s a 5 percent lower mortality risk and a 9 percent reduction in death from cardiovascular causes.) The trick with snacking is to keep calories between 100 and 200 so your total daily caloric intake doesn’t skyrocket.

D] DON’T: Exercise for less than 30 minutes each day.

That’s the minimum time experts recommend working out each day for weight loss and fitness.

DO: Split your exercise into 10-minute increments.

One study found that women who did this were more likely to exercise consistently. And these women lost more weight after five months than the women who exercised for 20 to 40 minutes at a time. Breaking exercise into small(er) chunks can give you a measure of achievement and alleviate the guilt that comes with skipping it altogether.

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