overview
Without knowledge of the behaviors and priorities of individuals receiving health communications and the careful tailoring of health communications to compensate for them, the effectiveness of health communication to persuade and motivate behavior change will remain negligible.
Billions of dollars are being spent on health communications based on the belief that improved health literacy is central to empower patients to manage their own health. Unfortunately, people can respond to health communications in ways that undermine the objective of the communication.
Person – Communication Interaction
An excellent case in point is the recent controversy about Maria Kang, 32, who received hundreds of thousands of comments about a picture she posted on Facebook showing her physically fit body and three children below the phrase “What’s your excuse?” Maria Kang’s Facebook posting certainly represents a health communication, and it generated both positive and negative reactions. While many people were inspired by her health communication, many felt she was bullying obese people: their response to seeing her health communication was a strong negative reaction.
Many public service announcements (Obesity Public Service Announcement) have been produced that were likely perceived as bullying obese people and creating negative affect among people the PSAs were supposed to help. The culprit behind the positive or negative impact of a communication on a person is that person’s goal semantics and behavioral signature.
Goal-Semantics
Response to health communications is also an element of individual’s “health behavioral signature,” a collection of stable goal-directed, situation-behavior interactions encoded symbolically in the brain as habits and goal semantics. Goal semantics are the encoding of goal-states and goal-directed behaviors in language. Goal semantics are intimately tied to a person’s stable, salient goal states that move from one situation or context to another. Through goal semantics, literally, the meaning of goal-directed behaviors, actions, and habits, a person responds to different situations and differentiates between aspects of the situation that are goal-supportive or goal-detracting.
Situation-Behavior Profile
Each of us is made up of a collection of “if…then” response patterns to situational characteristics and factors. Bill experiences X health-related situation, Bill does Y; Mary experiences Y situation, Mary does Z. Bill experiences a tray of sweets and a tray of veggies; he eats the veggies and avoids the candy. In the same situation, Mary does the opposite. Bill becomes aware of a physical problem and he makes a doctor’s appointment. Mary becomes aware of a physical problem and waits to see if it will go away on its own. The health situation-behavior profile is directly powered by a person’s preferences, immediate goals, short-term goals, and long-term goals encoded in goal semantics. A big part of each person’s situation-behavior profile is nonconscious, automatic, and driven by habit.
Goal-Semantics and Response to Communications
Consistent with a person’s health-behavioral signature, there are some predictable dynamics that underlie an individual’s behavioral response to health communications. These dynamics are shaped by a person’s selective attention motivated by goal semantics, likelihood and type of contemplative activity, and direction of contemplative valence.
Selective Attention and Avoidance
When a health communication comes into the field of vision of an individual, that individual implicitly (e.g., non-consciously) processes it against an implicit affective goal set. If the health communication does not effectively address elements of that affective goal set, nonconscious cognitive elements will inhibit the individual’s perception of that health communication. Basically, the individual never sees it. Their response to health communications is selective avoidance.
If a health communication does address elements of the individual’s affective goal set, the individual will become aware of it and start to process its content. If the health communication then fails to meet the relevance threshold relative to the individual’s affective goal state, the individual will tune it out. When this occurs, there is little opportunity for a person to learn, recall the information presented, or act on the information presented. Seeking or not seeking health information is a part of that affective goal set that directly influences health literacy and selective attention for health information.
Contemplative Activity
When this happens, a state of low contemplation activity will result: the person is not likely to think further about the topic of the health communication. The result of this is poor retention; poor recall, poor learning, and reduced likelihood the individual will act on the information. If the health communication does successfully address elements of the individual’s affective goal state, the individual will be naturally motivated to look at the communication, pay attention, and actively consume the topic consistent with the situation-behavior profile. This results in a state of high contemplation activity where the individual thinks about the content of the message and relates it to prior knowledge, beliefs, and goals. The result of this heightened activity is better message recall; better retention, better learning, and a greater likelihood the individual will act on the information.
Contemplative Valence
When an individual has high contemplative activity around a health communication, that contemplative activity can have a negative, neutral, or positive contemplative valence: the person will either think positively, neutrally, or negatively about the message. If the health communication arouses a state of negative contemplative valence, it means the content of the health communication discounts or confronts beliefs and actions intimately linked to a person’s affective goal set. When this occurs, a state of dislike, resistance, and avoidance is likely to occur consistent with the situation-behavior profile. If the health communication arouses a state of positive contemplative valence, it means the health communication supports and agrees with beliefs intimately linked to a person’s affective goal set. The result is a state of like, positive feeling, and a greater likelihood the person will adopt the content of the health communication, again, consistent with the situation-behavior profile.
Implications
The objective of every health communication should be to hit the sweet spot of positive contemplative valence because of its relationship to positive affect and greater likelihood of behavioral adoption of the communication’s message. However, positive contemplation only occurs when the message recipient agrees with the content of the health communication more than disagrees with it.
Conclusion
The effect of health communication campaigns on actual behavior change has been minor. The behavior of individuals is driven by long-standing affective, goal-directed responses to specific contexts (situation-behavior profiles). This adaptive behavior is triggered by local contexts and goal-directed patterns of “interest/disinterest – attraction /repulsion” to the experienced situation. These cognitive and motivational dynamics power selective attention, contemplative activity, and contemplative valence. Without knowledge of the intrapersonal dynamics of individuals receiving health communications and the careful tailoring of health communications to compensate for them, the effectiveness of health communications to motivate behavior change will remain negligible.
-Frederick H. Navarro
Person – Communication Interaction
An excellent case in point is the recent controversy about Maria Kang, 32, who received hundreds of thousands of comments about a picture she posted on Facebook showing her physically fit body and three children below the phrase “What’s your excuse?” Maria Kang’s Facebook posting certainly represents a health communication, and it generated both positive and negative reactions. While many people were inspired by her health communication, many felt she was bullying obese people: their response to seeing her health communication was a strong negative reaction.
Many public service announcements (Obesity Public Service Announcement) have been produced that were likely perceived as bullying obese people and creating negative affect among people the PSAs were supposed to help. The culprit behind the positive or negative impact of a communication on a person is that person’s goal semantics and behavioral signature.
Goal-Semantics
Response to health communications is also an element of individual’s “health behavioral signature,” a collection of stable goal-directed, situation-behavior interactions encoded symbolically in the brain as habits and goal semantics. Goal semantics are the encoding of goal-states and goal-directed behaviors in language. Goal semantics are intimately tied to a person’s stable, salient goal states that move from one situation or context to another. Through goal semantics, literally, the meaning of goal-directed behaviors, actions, and habits, a person responds to different situations and differentiates between aspects of the situation that are goal-supportive or goal-detracting.
Situation-Behavior Profile
Each of us is made up of a collection of “if…then” response patterns to situational characteristics and factors. Bill experiences X health-related situation, Bill does Y; Mary experiences Y situation, Mary does Z. Bill experiences a tray of sweets and a tray of veggies; he eats the veggies and avoids the candy. In the same situation, Mary does the opposite. Bill becomes aware of a physical problem and he makes a doctor’s appointment. Mary becomes aware of a physical problem and waits to see if it will go away on its own. The health situation-behavior profile is directly powered by a person’s preferences, immediate goals, short-term goals, and long-term goals encoded in goal semantics. A big part of each person’s situation-behavior profile is nonconscious, automatic, and driven by habit.
Goal-Semantics and Response to Communications
Consistent with a person’s health-behavioral signature, there are some predictable dynamics that underlie an individual’s behavioral response to health communications. These dynamics are shaped by a person’s selective attention motivated by goal semantics, likelihood and type of contemplative activity, and direction of contemplative valence.
Selective Attention and Avoidance
When a health communication comes into the field of vision of an individual, that individual implicitly (e.g., non-consciously) processes it against an implicit affective goal set. If the health communication does not effectively address elements of that affective goal set, nonconscious cognitive elements will inhibit the individual’s perception of that health communication. Basically, the individual never sees it. Their response to health communications is selective avoidance.
If a health communication does address elements of the individual’s affective goal set, the individual will become aware of it and start to process its content. If the health communication then fails to meet the relevance threshold relative to the individual’s affective goal state, the individual will tune it out. When this occurs, there is little opportunity for a person to learn, recall the information presented, or act on the information presented. Seeking or not seeking health information is a part of that affective goal set that directly influences health literacy and selective attention for health information.
Contemplative Activity
When this happens, a state of low contemplation activity will result: the person is not likely to think further about the topic of the health communication. The result of this is poor retention; poor recall, poor learning, and reduced likelihood the individual will act on the information. If the health communication does successfully address elements of the individual’s affective goal state, the individual will be naturally motivated to look at the communication, pay attention, and actively consume the topic consistent with the situation-behavior profile. This results in a state of high contemplation activity where the individual thinks about the content of the message and relates it to prior knowledge, beliefs, and goals. The result of this heightened activity is better message recall; better retention, better learning, and a greater likelihood the individual will act on the information.
Contemplative Valence
When an individual has high contemplative activity around a health communication, that contemplative activity can have a negative, neutral, or positive contemplative valence: the person will either think positively, neutrally, or negatively about the message. If the health communication arouses a state of negative contemplative valence, it means the content of the health communication discounts or confronts beliefs and actions intimately linked to a person’s affective goal set. When this occurs, a state of dislike, resistance, and avoidance is likely to occur consistent with the situation-behavior profile. If the health communication arouses a state of positive contemplative valence, it means the health communication supports and agrees with beliefs intimately linked to a person’s affective goal set. The result is a state of like, positive feeling, and a greater likelihood the person will adopt the content of the health communication, again, consistent with the situation-behavior profile.
Implications
The objective of every health communication should be to hit the sweet spot of positive contemplative valence because of its relationship to positive affect and greater likelihood of behavioral adoption of the communication’s message. However, positive contemplation only occurs when the message recipient agrees with the content of the health communication more than disagrees with it.
Conclusion
The effect of health communication campaigns on actual behavior change has been minor. The behavior of individuals is driven by long-standing affective, goal-directed responses to specific contexts (situation-behavior profiles). This adaptive behavior is triggered by local contexts and goal-directed patterns of “interest/disinterest – attraction /repulsion” to the experienced situation. These cognitive and motivational dynamics power selective attention, contemplative activity, and contemplative valence. Without knowledge of the intrapersonal dynamics of individuals receiving health communications and the careful tailoring of health communications to compensate for them, the effectiveness of health communications to motivate behavior change will remain negligible.
-Frederick H. Navarro