Health communication in practice: Creating a culturally-sensitive obesity campaign for the state of Florida

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Health communication in practice Creating a
culturally-sensitive obesity campaign for the
state of Florida
Kristy A. Siegel, MPH, CHES and Richard T.
Patton, MPH, CHES
Stempel School of Public Health,
Florida International University, Miami, Florida
achieve. Conversely, the focus groups did not
want to see someone their size on the cover
either. They wanted pictures of someone of
healthy, attainable size on the cover, but also
without the words fat, obese, or lose
weight. They felt stigmatized by those words
and feared reading or carrying anything in public
view that contained those words on the cover.

PROBLEM
Florida has not been spared from the obesity
epidemic sweeping the nation. In 2000,
approximately 6,650,395 Florida adults were
overweight or obese (BMI 25 kg/m2) based on
self-reported height and weight. Of those,
approximately 2,307,280 adults were obese (BMI
30 kg/m2). The prevalence of obesity among
adult men and women in Florida has almost doubled
over the past 10 years. Overweight and obesity
is increasing in men, women, and children of all
races.
ABSTRACT
At the Florida International University Robert R.
Stempel School of Public Health, MPH students
enrolled in the Health Promotion Communication
Theory and Design (PHC 6501) course had the
opportunity to integrate their theoretical
knowledge with the realities of health promotion
practice by designing an obesity campaign for the
residents of Florida, as requested by the Florida
Department of Health. Today, over 56 of the
adults in Florida are either overweight or obese,
and among young adults, the prevalence of obesity
has increased 110 in 10 years. Some of the
target populations selected for the campaign
included pre-menopausal African American women,
Latina college students, and teenage girls.
Students were able to demonstrate Berlos Model
of Communication by utilizing the Office of
Disease Prevention and Health Promotions eleven
attributes of effective health communication.
Contrary to modern obesity interventions that are
based upon the medical model, students used the
compensatory model of responsibility conflict to
design their campaign. Work assignments
consisted of a public service announcement,
brochure, educational materials, press release,
news article, video, website, and an oral
presentation. The particular challenge in the
assignments was to ensure the campaign was
culturally-sensitive to the target population.
Students, as part of putting theory into
practice, tested the campaigns they developed to
a focus group of their target population. An
important lesson students learned from the focus
groups was any obesity campaign must be free from
anti-fat bias.
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METHODS
Utilizing scientific foundations and
research understandings, the students practiced
written, oral, non-verbal, and neurolinquistic
communication by completing assignments regarding
obesity. Assignments intended to convey
information in the form of press releases,
newspaper articles, flyers, brochures,
educational handout materials as well as public
service announcements, oral presentations, web
pages for electronic technology, and video
productions. The assignments allowed for
practical application to one target population
chosen by each group of students.
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RESULTS
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Seven campaigns were created through
collaboration of the students in PHC 6501. The
target populations selected by the students
included pre-menopausal African American women,
Hispanic post-menopausal women, Latina college
students, and teenage girls. After a series of
focus group discussions with their respective
target populations, the students found that
campaigns needed to be sensitive to the
particular culture by using their language and
colloquialisms, pictures and images, and specific
health and body concerns. For example, for
African American pre-menopausal women, one
campaign used pictures that clearly showed a
woman with a darker skin tone and braids in her
hair for their educational brochures. The
campaign also highlighted the fact that in the
African American culture larger women are
considered sexy. All the groups of students
discovered through focus group discussions that
anti-fat bias is a concern of their target
population, regardless of race. Anti-fat bias
can be defined as seeing the fat and pounds and
not the person, which is common in many obesity
campaigns today. These campaigns base their
strategy on the medical model, in which causes
are sought for individual cases, and treatment
rather than prevention is the aim. The campaigns
also tell individuals to eat less and exercise
more in order to lose weight a vulgar, you have
a problem and I will tell you how to fix it.
Students instead chose the compensatory model of
responsibility conflict for their campaigns,
meaning individuals have little responsibility
for causing their obesity issues, but have high
responsibility for fixing them. This model
removes blame but shifts the action and power
into the individuals realm. Another
detail of the anti-fat bias concern raised by the
focus groups was choice of images and words in
the campaign. Many focus groups commented that
the person on the cover of many fitness and
health magazines had an unrealistic body image
that someone with weight concerns would not be
able to
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BACKGROUND
Health communication is a multidimensional,
transactional process. Effective communication
incorporates involvement and interaction of all
parties, while also attentive to the content of
the message and the relationship of the speaker
to the listener and vice versa. Berlos Model of
Communication embodies this idea. The elements
of Berlos Model are Source, Message, Channel,
and Receiver (SMCR). The Source is affected by
her communication skills, knowledge, social
system, culture, and attitudes. The Message
involves the elements (content) and the structure
(code) and the treatment of the content to the
code. The Channel is the five senses used in the
encoding and decoding of the Message. The
Receiver is affected by the same constructs as
the Source. Berlos Model is particularly useful
when socio-cultural issues may arise because it
compels the Source to be attentive to the word
choices she makes, the purposes she has for
communicating, the meanings people attach to
certain words, her choice of receivers, and the
channels she uses for this or that kind of
message. The Source can expand Berlos Model by
remembering and utilizing the Office of Disease
Prevention and Health Promotions eleven
attributes of effective health communication
accuracy, availability, balance, consistency,
culturally competent, evidence-based, reach,
reliability, repetition, timeliness, and
understandable.
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CONCLUSION
The Health Promotion Communication Theory
and Design (PHC 6501) course was successful in
allowing MPH students the opportunity to work on
a real issue facing Americans today and to
explore their campaigns in their target
population to receive feedback and to adjust
their content as needed. Along the way, students
also adjusted their knowledge and attitudes
towards their population and the obesity
epidemic. One innovative campaign titled Think
Before You Eat by Charles Platkin and Thor
Barraclough has been selected by the City of
Hollywood, FL and the supermarket chain Publix to
distribute to their employees and customers.
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ACKNOWLEDGEMENTS

• REFERENCES
• Northouse, L.L, and Northouse, P.G. (1998).
  Health Communication Strategies for Health
  Professionals. Appleton Lange Stamford, CT.
• U.S. Department of Health and Human Services.
  (2000). Healthy People 2010 Chapter 11- Health
  Communication. U.S. Government Printing Office
  Washington, D.C.

Barry University Jeremy Montague, Ph.D.
Florida International University Dev Pathak, MS,
MBA, DBA The students whose work is shown Thor
Barraclough Nicole Headley David Bissell
Claudia Millar Kelly Chevalier Yolanda
Payne-Jameau James Churilla Charles Platkin Jodi
Clark Lisa Marie Quammie Veronica Francis Radha
Ramjattan