Definition and Characteristics of Strategic Health Communication
Strategic communication is based on a combination of:
1. Data, ideas, and theories integrated by
2. A visionary design to achieve
3. Verifiable objectives by
4. Affecting the most likely sources and barriers to behavioral change, with the
5. Active participation of stakeholders and beneficiaries (Piotrow & Kincaid, 2001)
In other words, strategic communication takes advantage of science and facts, in addition to ideas and concepts, to set forth a long-term vision and realistic behavior change objectives to address a health issue. The vision and objectives are developed through dialogue with the intended audience and various stakeholders. In the dialogue process, both the “senders” and “receivers” are affected, moving toward mutual adjustments and convergence. A blending of science and art is essential to crafting a sound strategy.
Specific Characteristics
For communication to be strategic, it should be:
1. Results-oriented. The ultimate proof that a strategic communication effort is effective lies in health outcomes. Research should be designed to gauge increases in audience knowledge, approval, and adoption of healthy behaviors. Equally important is increasing the capacity of local partners to carry out these kinds of programs on their own.
2. Science-based. A science- and research-based approach to communication requires both accurate data and relevant theory. It begins with formative research and adequate data to define a specific health problem, identify feasible solutions, and describe the intended audience. This approach relies on the health sciences to make sure that the content and context of a strategic communication effort are correct. For example, in Brazil a series of focus groups was conducted with potential audience members to identify the sexual practices of street children, in an effort to determine the risk of contracting HIV/ AIDS. Results of the focus groups were compiled and analyzed according to several variables, such as number of partners, type of partners (e.g., same sex, commercial sex workers), type of sexual contact (e.g., oral, anal, vaginal), frequency, and reasons for the occurence of the sexual activity. This analysis formed the basis for developing a communication strategy that was designed to reduce HIV/AIDS transmission among Brazilian street children.
Strategic communication also depends upon appropriate social science models or theories of behavior change, which might include:*
- Stages of change/diffusion theories
- Cognitive theories
- Emotional response theories
- Social process and influence theories
- Mass media theories
3. Client-centered. A client-centered approach requires starting with an understanding from the client’s point of view of what the health needs are. Discussions with the potential audience provide insights about those health needs and the barriers to meeting the expressed needs. Through research, especially qualitative research and participatory learning approaches (PLA), members of the intended audience can help shape appropriate messages and can offer insights for other communication-related decisions that need to be made. A client-centered approach also implies understanding strategic changes that can affect the balance of power, including the gender balance of power, in service programs. For example, encouraging greater community participation, allowing clients to choose their own methods and treatment, or having clients set the program priorities for health services are ways to strengthen a clientcentered approach.
4. Participatory. Strategic communication promotes participatory decision making by stakeholders and beneficiaries in all stages of the “P” Process, including planning, implementation, and evaluation. It is critical to involve the key stakeholders at the inception of the strategy design process. Building a sense of ownership will help ensure that the strategy will be implemented in a meaningful way. See the resource book titled How To Mobilize Communities for Health and Social Change published by Johns Hopkins Bloomberg School of Public Health/CCP in collaboration with Save the Children for further information on this topic.
