Science and Art in Public Health:The Struggle to Turn Sows’ Ears

into Silk Purses

Science and Art in Public Health:The Struggle to Turn Sows’ Ears

into Silk Purses

R. Elliott Churchill, MS, MA

Centers for Disease Control and

Prevention

R. Elliott Churchill, MS, MA

Centers for Disease Control and

Prevention

Source: Teutsch SM, Churchill RE. Principles and Practice of Public Health Surveillance. New York: Oxford U Press, 1999.

Reporting unit of science: the fact

Reporting unit of communications: the message

Where is the wisdom we have lost in knowledge? Where is the knowledge we have lost in information? T. S. Eliot

Where is the information we have lost in data?CDC Editors

Data: The smallest units of

description—may be words, numbers or other symbols

Information: Data that have been interpreted to provide meaning and contest

Message: Information conveyed in such a way as to instruct the intended audience of its importance or relevance to them

DATA INFORMATION MESSAGE

1,000 casesof measles

1,000 cases of measles (50% more than last year)

Have all infants vaccinated for measles before their first birthday

DATA INFORMATION MESSAGE

1,000 casesof measles

1,000 cases of measles (50% more than last year)

For every dollarspent on vaccines, $21 are saved in health-care costs

Communications is a process—

not a product.

**B actson the

basis of themessagereceived

A conveysinformation

to B

Breceives

A'sinformation

A and Bagree on the

message sent and received

B conveys to A the meaning

and intent of A's

information

B analyzes A's

information

__________________________** Sometimes included in loop.

sendermessagereceiverchannelimpact

evaluation

The Communications LoopThe Communications Loop

CommunicationsCommunications

• REACTIVE in a control setting

• PROACTIVE in a prevention setting

• REACTIVE in a control setting

• PROACTIVE in a prevention setting

Steps in a Successful Public HealthCommunications Campaign

Steps in a Successful Public HealthCommunications Campaign

1. We must develop rapport with our public.1. We must develop rapport with our public.

Steps in a Successful Public HealthCommunications Campaign

Steps in a Successful Public HealthCommunications Campaign

1. We must develop rapport with our public.

2. We must be patient and persistent.

1. We must develop rapport with our public.

2. We must be patient and persistent.

Steps in a Successful Public HealthCommunications Campaign

Steps in a Successful Public HealthCommunications Campaign

1. We must develop rapport with our public.

2. We must be patient and persistent.

3. We must repeat, modify, and update.

1. We must develop rapport with our public.

2. We must be patient and persistent.

3. We must repeat, modify, and update.

Steps in a Successful Public HealthCommunications Campaign

Steps in a Successful Public HealthCommunications Campaign

1. We must develop rapport with our public.

2. We must be patient and persistent.

3. We must repeat, modify, and update.

4. We must use all appropriate avenues.

1. We must develop rapport with our public.

2. We must be patient and persistent.

3. We must repeat, modify, and update.

4. We must use all appropriate avenues.

Steps in a Successful Public HealthCommunications Campaign

Steps in a Successful Public HealthCommunications Campaign

1. We must develop rapport with our public.

2. We must be patient and persistent.

3. We must repeat, modify, and update.

4. We must use all appropriate avenues.

5. We must ultimately speak person-to-person.

1. We must develop rapport with our public.

2. We must be patient and persistent.

3. We must repeat, modify, and update.

4. We must use all appropriate avenues.

5. We must ultimately speak person-to-person.

Pattern of Use of CDC'sHIV/AIDS Telephone Hotline

Pattern of Use of CDC'sHIV/AIDS Telephone Hotline

0

10000

20000

30000

40000

50000

60000

70000

80000

1989 1990 1991 1992

Years

Cal

ls t

o H

IV/A

IDS

H

otl

ine

1989 1990 1991 1992 1993 19940

5,000,00010,000,00015,000,00020,000,00025,000,00030,000,00035,000,00040,000,00045,000,00050,000,000

Years

Cal

ls t

o H

IV/A

IDS

Ho

tlin

e

Pattern of Use of CDC'sHIV/AIDS Telephone Hotline

Pattern of Use of CDC'sHIV/AIDS Telephone Hotline

Communications messages mustCommunications messages must

• Reach people

• Persuade them of the validity of the information

• Convince them to take appropriate action

• Reach people

• Persuade them of the validity of the information

• Convince them to take appropriate action

Public Health News Public Health News

1. Information describing or confirming a new discovery

2. Information revising (or contradicting) an earlierhypothesis

3. Information connecting, for the first time, two or more already-available pieces of information

4. Any (or all) of #1-#3 above, crafted to providethe information to an audience not previouslyaddressed or one identified as now havingbeen reached in previous efforts

1. Information describing or confirming a new discovery

2. Information revising (or contradicting) an earlierhypothesis

3. Information connecting, for the first time, two or more already-available pieces of information

4. Any (or all) of #1-#3 above, crafted to providethe information to an audience not previouslyaddressed or one identified as now havingbeen reached in previous efforts

Planning a Communications ProgramPlanning a Communications Program

1. What do I want to say? (MESSAGE)

2. To whom do I want to say it? (AUDIENCE)

3. Through what means can I convey it most effectively? (CHANNEL)

4. When will it have the most advantageous effect? (TIMING)

5. What do I want to have happen as a result of my message?(IMPACT)

6. How will I assess the effect of my message? (EVALUATION)

7. How will I improve the message for its next presentation?(MODIFICATION)

1. What do I want to say? (MESSAGE)

2. To whom do I want to say it? (AUDIENCE)

3. Through what means can I convey it most effectively? (CHANNEL)

4. When will it have the most advantageous effect? (TIMING)

5. What do I want to have happen as a result of my message?(IMPACT)

6. How will I assess the effect of my message? (EVALUATION)

7. How will I improve the message for its next presentation?(MODIFICATION)

Marketing Public Health InformationMarketing Public Health Information

• Use graphic displays

• Focus message into one basic statement

• Highlight and package the information

• Release the information in a timely manner

• Use graphic displays

• Focus message into one basic statement

• Highlight and package the information

• Release the information in a timely manner

2,167

632

207

44

107

9

194

47

370

378

6

DISEASE DECREASE INCREASECASES CURRENT

4 WEEKS

Hepatitis A

Hepatitis B

Hepatitis, C/Non-A, Non-B

Legionellosis

Malaria

Measles, Total*

Meningococcal Infections

Mumps

Pertussis

Rabies, Animal

Rubella

Ratio (Log Scale)†

Beyond Historical Limits

4210.50.250.1250.06250.03125

FIGURE I. Notifiable disease report, comparison of 4-week totals ending Novem-ber 4, 1995, with historical data — United States

SOCOSingle Overriding Communications Objective

SOCOSingle Overriding Communications Objective

• What is new?

• What works best?

• Who is affected?

• What is new?

• What works best?

• Who is affected?

In one brief paragraph, please state the key point or objective of your submission for publication or presentation. This statement should resemblewhat you, the writer (speaker), would like to see as the lead paragraph ina newspaper story or in a broadcast news report about your submission.

What are the three facts or statistics you would like the public to rememberas a result of reading or hearing about your report?1.2.3.

What audience or population segment would you like this report to reach? Primary Secondary

What is the one message the audience needs to receive from this report?

Who in your office will be available to answer questions posed by mediarepresentatives or by members of the reading/listening audience?

Name _______________________ Telephone number _____________Date and times available __________________________

Checklist for Authors of Publications and Presentations,Centers for Disease Control and Prevention

Checklist for Authors of Publications and Presentations,Centers for Disease Control and Prevention

Channels of Communicationsfor Large Audiences

Channels of Communicationsfor Large Audiences

• Publications

• Electronic Applications

• Broadcast and Print Media

• Public Forums

• Publications

• Electronic Applications

• Broadcast and Print Media

• Public Forums

Report

Oral Written

Inform Persuade Inform Persuade

Audience

Within the Health Care System

Friendly Neutral

Outside the Health Care System

Hostile Friendly Neutral Hostile

Form

Purpose

Direction

Attitude

IMMRAD

If the purpose is to inform,the standard formula for the scientific report

is

If the purpose is to inform,the standard formula for the scientific report

is

SOCO

First Middle Last

Most important things first . . . move to details

If the purpose is to persuade,the standard formula for the scientific report is

If the purpose is to persuade,the standard formula for the scientific report is

SOCOSOCO

Supporting Evidence

SOCOSOCO

Citation of Authority

SOCOSOCO

Elements of Persuasion

SOCOSOCO

SOCOSingle Overriding Communication Objective

SOCOSingle Overriding Communication Objective

Intro-duction

SOCOSupporting Evidence

SOCOCase Studies

SOCOEtc.

SOCO

To Inform To Persuade

M&M

Results

Discussion

Audience’s Attention Span

IMRAD SOCO

Introduction, Materials and Methods, Results and Discussion Single Over-Riding Communication Objective

Figure 1. Architecture of Scientific PresentationsFigure 1. Architecture of Scientific Presentations

Where is the wisdom we have lost in knowledge? Where is the knowledge we have lost in information? T. S. Eliot

Where is the information we have lost in data?CDC Editors