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Does Your Message Have the Same Old Frame? Message Framing and Health Disparities

NPHIC Annual Conference September 2007

Susan D. Kirby, Dr.P.H.susan@kirbyms.com

Sponsored by the Southern Center for Communication, Health & PovertyA CDC-Designated Center for Excellence in Health Communication and Marketing

www.southerncenter.uga.edu

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Message Framing

• Gain vs. loss framing• Usually aimed at direct health behavior audience

• Strategic frame analysis• Used for policy and societal mobilization

audiences

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Gain versus Loss Framing

• Gain = Lives saved • Loss = Lives lost• Gain promotes risk aversion

• Prefer small certain gains to large possible gains• Best for prevention behaviors

• Loss promotes risk seeking• Prefer possible large/small loss to any certain loss• Best for detection or screening behaviors

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Gain versus Loss Framing

• If ‘certain’ of screening outcome• Gain framing is more effective

• If ‘uncertain’ of screening outcome• Loss framing is more effective

• Pointing out health disparities• Creates negative reaction

• Cultural targeting • Enhances effectiveness with “right” frame• Not more effective if combined with ‘wrong’ frame

• More disparity research needed

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CVD versus Diabetes35 Overweight AA Male

‘Certain’ CVD

You can add years to your life if you get tested and treated for CVD today

‘Uncertain’ Diabetes

You can prevent losing a leg, foot, or toe by getting tested and treated for diabetes today

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Strategic Frame Analysis

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How We Process Information

• Mental shortcuts help us make sense • Communication has cues about where

to fit information into existing knowledge

• Helps us connect to shortcuts or “dominant frames”

• New information seen through dominant frames

• Our understanding is frame-based• Not fact-based

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Strategic Frame Research

• Identifies deep values, beliefs, and assumptions

• Studies their impact on policy preferences

• Uncovers ways to change how issues are framed

• Communication shift attitudes and behaviors

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Why It Matters …

• Perceptions shaped by core beliefs

• New thinking challenges core beliefs

• If challenged we revert to familiar

• Makes it hard for people to hear new messages• We have to connect people to a different frame

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By connecting an issue to an existing valued high-level frame, we can reframe how people think and feel about an issue.

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‘Estate tax’ is one way to frame tax debate

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‘Death tax’ reframed this tax debate

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Framing Strategy Includes

• Connecting issue w/ valued frame

• Thematic not episodic context• Simplifying model or metaphor• Social math• Messengers• Visuals• Tone

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Framing Levels• Level One

• Big ideas, like freedom, justice, community, success, responsibility

• Level Two• Issue types, like the environment or child care

• Level Three• Specific issues, like rainforests or earned

income tax credits

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Level One ExamplesWe want to live in a society that is …

• Authentic• Caring• Committed• Community focused• Competitive• Connected to others

• Increasing Knowledge

• Nurturing• Positive in Outlook• Responsible• Safe/ Secure

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Level Two

• Level 2 frames can focus on issues like children, elderly, education, friendship, or corporate America

• Level 2 can also be a new or novel way of grouping issues together

• Prisons and education• Children and corporate America

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Building a Framing Story

• Connect your issue to a Level 1 value• Ask what kind of world people want to live in

• Ask what would that world look like?• Level 2 connected to level 1

• Many issues can fit into Level 2 for different purposes

• Level 3 specifies how Level 2 is achieved

• Tell a story linking levels 1 to 2 to 3

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Linking Levels Together

Tobacco• Level 1 - We want to live in a truthful

society• Level 2 - Companies are honest about their

products• Level 3 – Policies that require disclosure of

product contents

Cancer• Level 1 -  We want to live in a hopeful

society• Level 2 - Diseases like cancer can be cured• Level 3 – Program to identify cancer cures

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Context

Families should handle their own stuff, We should stay out of it. The family bubble.

Andy needed the support of others, and a solid town like Mayberry to avoid abusive situations as a single parent

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Numbers – Social Math

• GOOD - In the 60s, about 11 of 25 kids walked or biked to school. By 2001, only 4 of them were getting exercise that way.

• BETTER – Today lots of schools are ere farther away from their students. Now walking or biking to school is the equivalent of doing a 5K race or more - twice a day.

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MessengersHIV and Hispanic Communities

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VisualsWhat are youth doing today?

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Metaphor or ModelBrain Foundation = Architecture

• Early experiences affect the architecture of the maturing brain.

• The quality of that architecture establishes either a sturdy or a fragile foundation for all following development

• Getting things right the first time is easier and less costly than trying to fix them later.

=

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Disparity-related FramingThe Dominant Frames We Know

• Individual responsibility• People are the ones who decide if they smoke!

• In-Community responsibility• It’s that community’s fault!

• Poverty isn’t the problem• Education is problem with poor health choices!

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Disparity Framing Research

• Disparity focus increases stereotyping

• Stimulates negative reactions in all parties

• ‘Quality of Life’ resonates• ‘Community conditions’ also

• Civic wellbeing resonates• Cost prevention resonates

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Disparity Framing Research

• Physical and org structures are useful terms

• Include ‘elderly as examples’ • Stay solutions focused

• Community needs to involved• Use close to home examples

• ‘Patchwork with gaps” metaphor• Does not trigger stereotypes

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• Focus messages on solutions not the problem - early in the message

• Avoid negative stereotypes

• Do not repeat the current ineffective frames

• Repetition, repetition, repetition

More Framing Advice

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Resources

• Getting the Biggest Bang for Your Health Education Buck: Message Framing and Reducing Health Disparities. Schneider American Behavioral Scientist. 2006; 49: 812-822

• FrameWorks Institute Report• http://www.frameworksinstitute.org/clients/commhealth_civicwell

being.pdf

• Berkley Media Studies Group• Kirby Marketing Solutions at www.kirbyms.com• Southern Center for Communication, Health &

Poverty at www.southerncenter.uga.edu

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Question and Answer

Small Group Activity