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Vamos al Grano...or Going to the Grain!
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New NIDCD Disks Ease the Search for Information
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Clearinghouse Update
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Information Exchange
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WISE EARS!® Update
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CHID Online
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Calendar of Events
NIH Pub. No. 01-4202 |
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Vamos al Grano...or Going to the Grain!
We are looking at fundamental challenges ahead for health communication professionals. According to current Federal data, there are at least 329 languages spoken or signed in the United States. In some cities, less than 60 percent of the population has English as a first language. We have seen census statistics about the growth of the Hispanic/Latino/Latina population by 2030, but in that same time frame the Asian American community will grow by 132 percent. The multilingual environment in New York State is reflected in a statewide analysis of students receiving language services. Spanish, Chinese, Russian, Haitian Creole, and Korean were the top five languages of those students in a 1995-96 analysis.
Communication and literacy, health communication and health literacy are entwined in a way that will have an impact upon the health of the whole society. Parents who do not understand that antibiotics do not kill viruses still ask for antibiotics for ear infections that will self-resolve. Parents who do not understand that a full course of an antibiotic must be given to be not only effective, but safe, have stopped midway in the treatment if they see an improvement in the child. They have then been known to "save" or "hoard" the remaining medicine for another illness in that child or in another sibling. Other parents fail to understand that different antibiotics they are given may differ in their handling. They are more likely to notice if it is "pink" than if it is the same medicine. This confusion can provide an opportunity for unsafe handling of the storage temperature for the antibiotic. Another example of a simple, but important message, is to explain that it is necessary to use a measuring spoon or medicine cup, rather than a random spoon from the drawer. Multidrug-resistant bacteria are a serious problem. Many of these parents who do not understand the purpose of an antibiotic or its use and handling come from other language and English-literacy-challenged communities.
Health communication professionals have attempted for many years to reach underrepresented communities. If we stop "targeting," "aiming at" "hard-to-reach" audiences, producing "for," and emphasizing producing "with" other communities, we will be more successful in transferring knowledge, and the power of that knowledge, into the community in a form that will be useful to the community.
Almost a decade ago, Vicki Freimuth, now head of Communication for the Centers for Disease Control and Prevention, wrote about what had been called "hard-to-reach" audiences. Essentially, she indicated that there were no hard-to-reach audiences; there were inadequate messages. She urged looking at groups of people with common attitudes and lifestyles (not dividing people into SES status) as a determination of how to reach them, psychographics not demographics.
It is clear, no one can afford to stand on street corners handing out brochures one-by-one, certainly not in 329 languages! At an NIH health and science communication conference, Kathleen Hall Jamieson, Dean of the Annenberg School of Communication at the University of Pennsylvania, described the need for a tiered approach to health communication. Primary sources need to work with organizations and community groups and with the press to ensure the initial message is accurate, complete, timely, and credible. Paralleling that model, health and science information professionals are making material available to organizations and to groups who know their own communities.
All of us are also concerned about the digital divide. However, as one classroom teacher in a rural State reported, although she has only a $100 budget for her entire year of science supplies, the students have web access. The web has opened the world to her students. However, for some of their parents, the web will not be fully accessible until they are able to not only own or have proximity to a computer, but to have the ability to navigate the web, often using, what is for them, a second or third language. The current web environment requires logic and precision in entering queries or searches. The challenged novice does not have the experience to make judgments about the credibility of the source or ways of corroborating accuracy. The community leaders, however, can provide that bridge if given the right material and support.
Some strategies for considering collaborators to reach audiences who have language and literacy challenges:
- Find the voluntaries, professional organizations, and groups that have improved health at the core of their missions. Work with programs that are focused on health and people who have momentum.
- Identify the key people in the organization who are committed to improving health and work with them, discussing the best approaches and formats to offer material to them so they can work with it in the most efficient and effective way. Organizations will need to seek out credible sources and test the scientific accuracy of messages offered.
- Look for the earliest possible intervention opportunity with a health or prevention issue. In our WISE EARS!® campaign to prevent noise-induced hearing loss, a fully preventable loss that has already affected 10 million Americans permanently and a loss to which 30 million Americans are exposed daily, we and other coalition members are paying special attention to vocational high school students as well as students who are attending vocational classes in standard high schools.
- Work with the local press who serve "other language populations." Give them good, clear materials and work with health reporters to help them to develop health pieces. Be prepared to explain why there is a problem in the community and what the impact of that problem is.
- Prepare in advance for areas where translation might be difficult or the cultural context a problem. For example, use local examples of foods for the health pyramid. Plantain may be very appropriate in some settings where sugar beet would be appropriate in others. This may seem obvious, but these are precisely the places where some materials lose their audiences.
- Understand the flow of the organization and do not expect it to model your own.
- Be sure to engage the intellectual capacity of your partners; do not simply expect them to take your material and "pass it on."
The challenges provided by a multilanguage, varying literacy level society can be met if we work together as colleagues to find the right way to bring urgent health messages into a format that will help those who are going to make sure it reaches their communities in a useful and accessible form.
Adapted from the Keynote Luncheon Address, "Vamos al Grano," by Marin P. Allen, Ph.D., at the Fourth Multi-International Research and Education Alliance on Latino, African-American and Native-American Health and Disabilities (REALAN) Conference, "Parents and Children in Risk Circumstances," March 27, 2001. |