Renata Schiavo
Publication Date
December 16, 2016

Health Equity Initiative; Columbia University Mailman School of Public Health; Strategic Communication Resources

"Many organizations have come or should have come to the realization that the development and production of unrelated 'communications' outside of any strategic planning framework and concerted effort are not effective in achieving the kinds of behavioral, social and organizational results that may lead to improved health and social outcomes."

In this editorial, Renata Schiavo discusses the need for a diverse global workforce that is capable of implementing key principles, strategies, and planning frameworks for health communication interventions. Strategic health communication for behavioral, social, and organisational change - more broadly, social and behavioural change communication (SBCC) - has been highlighted as a key discipline within national and global agendas, academic programmes and their accrediting institutions, and various meetings and conferences. Based on her own experience as a global health communication practitioner and researcher as well as those of her colleagues, Schiavo here explores a few of the many opportunities and challenges for pre- and post-graduate instruction and training on global health communication.

Some opportunities include:

  • Integrating the concepts of equity, social change, community engagement, systems-change, and social accountability within the theory and practice of global health communication - "A systematic approach to health communication can help build bridges among different people and professions and create systems-change via multi-level interventions that look at policy, organizational, community, interpersonal, and individual behavior change. It is only by promoting systems change that we can create a favorable environment for individual behavioral change to occur." Figure 1 (shown above and on page 233) illustrates the many intervention levels that Schiavo contends should be considered to create the kind of social and policy-related support that is needed to motivate people to wash their hands with soap or alcohol-based hand rubs at critical times. In this context, she suggests, there is an opportunity for global health communication programmes (both in academia and within the realm of professional and community development) to prepare future practitioners and researchers to address the complexity of our increasingly interconnected world and to promote equity and social justice - in part by fulfilling our commitment to create ownership of all solutions and to encourage social accountability among ordinary citizens, civic society organisations, local businesses, corporations, government agencies, and other stakeholders.
  • Sharpening our focus on evaluation to showcase the impact of our work, advocate for increased funding, and convince other professionals of the value of well-designed and well-executed global health communication interventions - "[P]re-graduate training and post-graduate/professional development programs need to equip practitioners with research methodologies that are of course inclusive of randomized control trials, the gold standard for any kind of evaluation, but also reflect local resources and infrastructures and include other kinds of surveys, qualitative methods, and case study analysis to support evidence on the path to behavioral change and, most importantly, behavioral sustainability."
  • Making sure that global health communication education and training is readily accessible to students and professionals in low-and-middle income countries and some developed countries - One idea for expanding the reach of such courses is to use technology (e.g., online programmes and/or video conferencing) as well as to advocate for more convenient and accessible venues for this kind of global health communication education and training in workplaces and universities around the world. "Moreover, empowering communities via human- and user-centered design methodologies to participate in the development of health communication interventions is another area of great importance and, hopefully, future growth."
  • Providing future and current practitioners with practical skills in health communication planning, media development, community and public engagement, cross-cultural communication, health equity communication, and much more - Bridging theory and practice involves focusing on the need for training in areas such as: how to engage different groups and stakeholders on communication topics as well as tailor interventions to the needs and preferences of an increasingly diverse urban population; communication planning and evaluation; and health disparities. Moreover, Shiavo argues, innovative methods are needed to bring to life topics and skills. Such hands-pon methods include: role playing; interdisciplinary courses and training modules that foster understanding about the "language" and priorities of multiple sectors; media and activity labs that are designed to enable participants to produce visual media, new media, theatre performances, peer-to-peer training materials, events, presentations, community dialogue guides, and more; and opportunities to practice participatory methodologies (e.g., by actually engaging youth and specific communities in the process of communication planning, implementation, and evaluation as well as in development and production of youth- and community-driven media).
  • Recognising the transdisciplinary nature of population health issues and making sure that SBCC courses and training programmes are offered across the fields of public health, medicine, healthcare, community development, international development, business, transportation, education, nutrition, housing, poverty alleviation, and much more - The field of health communication is well positioned, Schiavo believes, to strengthen understanding of the interconnection of the many of factors that determine health, economic, and social outcomes and to contribute its know-how to the toolbox of future practitioners in a variety of fields.

Some challenges include:

  • Arming new and future practitioners with practical tools and resources that would result in the sustainability of behavioural and social gains - "Moving past behavior change to behavioral and social change sustainability is always a challenge for most people and interventions." Schiavo explores some of the reasons, such as the limited number of generalisable, effective, and sustainable interventions and lessons learned and the multiple definitions of the concept of sustainability. "[T]he future of global health communication research and practice is we can all create the kind of systems-level change that can support people and organizations in maintaining specific health or social behaviors in the long term."
  • Simplifying our language, finding common terminology, and focusing on best practices - The many different communication models reflect organisation-specific preferences, language, and mission; "this may be confusing for people who are new to communication planning and/or work in limited resource settings under pressing conditions. A focus on best practices that can be extrapolated from different international models and planning frameworks (at least within the context of pre- and post-graduate instruction and training) may enable future professionals to focus on 'what works' and help them implement key principles and strategies of global health communication for social and behavioral change no matter which model they may need to work with."

Journal of Communication in Healthcare: Strategies, Media, and Engagement in Global Health, 9:4, 233-237, DOI: 10.1080/17538068.2016.1264103 - sent via email from Renata Schiavo to The Communication Initiative on May 15 2017. Image credit: © Renata Schiavo. All rights reserved. Used by permission.