Appendix II

Critical Process Steps in Health Risk Communication Planning

STEP 1: Analyze Communication Situation
STEP 2: Establish Communication Objectives
STEP 3: Analyze and Select Audience
STEP 4: Design, Develop, and Pretest Prototype Message
STEP 5: Select and Implement a Diffusion Strategy
STEP 6: Perform Process and Outcome Evaluation

STEP 1: Analyze Communication Situation

Collect and assess information on factors, both internal and external to the organization, and their impact on achieving communication objectives. Examples of such factors are as follows:

External Factors: (1) Nature and extent of the health problem or issue; (2) Organization's mandate, mission, goals, objectives, and strategic plan; (3) Changing environmental, economic, political, technological, legal, social, and cultural trends; (4) Interorganizational linkages and arrangements; and (5) Public perceptions and opinions.

Internal Factors: Organizational barriers (e.g., staff, resource capabilities, budget constraints, performance trends, and policies and regulations).

STEP 2: Establish Communication Objectives

First, identify appropriate objectives for health risk communication strategies. Second, describe expected outcomes and impacts, and then select audiences that can be reached by the health communication effort. Objectives are precise statements that map out the tasks necessary to achieve communication goals. A clear, specific, and measurable objective might appear as follows:

"Maintain contact with our audiences on a monthly basis as a way to increase communication effectiveness by the end of the project period."

STEP 3: Analyze and Select Audience

Audience segmentation is commonly used to identify and group audiences (e.g., primary and secondary) according to behavioral, demographic, ethnic, and psychographic categories. Surveys, for instance, can be used to obtain vital information on the intended audience's attributes, values, expectations, and level of involvement in the health risk communication process. Specific information is collected about an audience's internal forces such as knowledge, attitudes, behaviors, perceptions, learning styles, and motivations. Equally important are external forces such as income, social class, culture, and reference groups.

STEP 4: Design, Develop, and Pretest Prototype Message

Existing theories (i.e., social learning theory) and models can help in developing a message concept around the appropriate audience and target behavior. Pretesting ensures that the message concept, content, and structure are consistent with specified communication objectives. Focus testing and individual interviews can provide useful information about the format and style, accuracy, completeness, relevance, and credibility of the message.

STEP 5: Select and Implement a Diffusion Strategy

Diffusion, in the field of health communication, refers to the process by which health information or innovations are communicated through certain channels over time among members of a social system.6 Several practical considerations guide the selection of an appropriate diffusion strategy. That is, a decision about implementation is, to a point, a function of the planning process.

STEP 6: Perform Process and Outcome Evaluation

Process evaluation is concerned primarily with how efficiently a health risk communication strategy is implemented. Of concern is whether it was implemented on time, within budget, and with available staff and resources. Market media mix, cost-efficiencies, and the number of materials distributed are additional examples of process indicators.

Outcome evaluation moves a step beyond process to assess how the message affected the awareness, knowledge, attitudes, and behavior of the target audience. Effectiveness is a measure of how well the communication objectives were achieved in terms of audience reach, and if the audience, in processing the message, took the recommended actions and made informed health decisions.

Health Risk Communication Planning Model

Stage 1:
Analyze Communication Situation

Stage 2:
Establish Communication Objectives

Stage 3:
Analyze and Select Audience

Stage 4:
Design, Develop, and Pretest Prototype Message

Stage 5:
Select and Implement a Diffusion Strategy

Stage 6:
Perform Process and Outcome Evaluation