Tag Archive | health communication

Sex education: Time to level-up with online content?

You’ve got all the facts on your side, scientists are affirming your position, and you’ve identified a plan of action that paves the way to social change…but nobody will bite. What’s a person to do?

We’ve discussed the reasons for which the uptake of knowledge into practice isn’t consistent: information is poorly packaged; connections between knowledge producers and knowledge users are weak or non-existent. However, even if we manage to overcome these obstacles, ideology can block the way. It’s responsible for inaction (or poor action) on many pressing issues, such as climate change, poverty reduction, and sex education.

We can characterize approaches to sex education in the US as either comprehensive or abstinence only. Comprehensive sex education generally includes information about contraception use and reducing the risk of transmitting sexually transmitted infections (STIs). The catch is that this sort of sex education is morally objectionable to some people. Specifically, many social conservatives object to lessons that acknowledge or condone sex between unmarried individuals. These values have informed laws mandating abstinence-only sex education; presently, nineteen states have such legislation (Guttmacher Institute, 2013). Unfortunately, abstinence-only sex education fares poorly in terms of reducing unwanted outcomes when compared with comprehensive education (Kohler et al., 2008)

So, what to do? On the issue of climate change, Geoff Dembicki (2013) argues that climate activists need to reframe their rhetoric to better match the way in which conservatives see the world. Advocates for sex education might heed this advice and point to reductions in pregnancies that occur out of wedlock and a reduction in the number of abortions, which touch on two issues important to social conservatives.

Another option is to expand efforts to provide information online. This isn’t uncharted territory; there are already many online resources that provide comprehensive information about sexuality and sexual health. However, current efforts don’t appear to be sufficient. In a recent study of American youth aged 13-18, Mitchell et al. (2013, p. 6) found that only 19 percent of participants who identified as heterosexual accessed information about sexual health online.[1] Of those, nearly half (46 percent) did so purely out of curiosity; an additional 43 percent cited privacy concerns as their primary motivation. What this suggests is that online materials may be of benefit to a wide swath of youth, including those who already receive comprehensive sex education. Taken together with Buhli et al.’s (2009) finding that much online sexual health information is of low quality, this points to an opportunity for public health practitioners to make new efforts to develop and promote online material.

These efforts might involve finding new ways to promote existing websites. Sex educators could attempt to piggyback on popular websites and platforms. The Khan Academy is a popular site that provides series of educational videos on a variety of subjects, many of which have been viewed hundreds of thousands of times. Public health practitioners might look to collaborate with this and other similar websites to incorporate content about sexual health and well-being.

Where resources permit, we should invest in targeted advertising on Google and social media platforms such as Facebook and Twitter. Other efforts could include developing material that requires engagement from the user. Rather then simply present facts, these websites might transform the material into games (see Kapp, 2012 for discussion of the “gamification” of education). Additionally, they might provide mechanisms by which youth could contribute their own content.

I do not believe that more, better quality education alone is enough to ensure good sexual health for all youth. Sex education efforts will not be sufficient if we do not also address problems that pose barriers to sexual health and well-being such as stigma and poverty (Lichtenstein, 2003). However, under the current circumstances, online sex education can play a useful role.


Buhi, E. R., Daley, E. M., Oberne, A., Smith, S. A., Schneider, T., & Fuhrmann, H. J. (2010). Quality and accuracy of sexual health information web sites visited by young people. Journal of adolescent health47(2), 206-208.

Dembicki, G. (2013). How to talk to a conservative about climate change. Retrieved from http://thetyee.ca/News/2013/07/29/Conservatives-and-Climate-Change/

Guttmacher Institute. (2013). State policies in brief: Sex and HIV education. Retrieved from   http://www.guttmacher.org/statecenter/spibs/spib_SE.pdf

Kapp, K. M. (2012). The gamification of learning and instruction: game-based methods and strategies for training and education. Retrieved from http://library.books24x7.com.proxy.lib.sfu.ca/

Kohler, P. K., Manhart, L. E., & Lafferty, W. E. (2008). Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health42(4), 344-351.

Lichtenstein, B. (2003). Stigma as a barrier to treatment of sexually transmitted infection in the American deep south: issues of race, gender and poverty. Social Science & Medicine57(12), 2435-2445.

Mitchell, K. J., Ybarra, M. L., Korchmaros, J. D., & Kosciw, J. G. (2013). Accessing sexual health information online: use, motivations and consequences for youth with different sexual orientations. Health education research, Advance online publication.

[1] The authors note that a much larger percentage of LGBTQ-identifying youth used the Internet to access information about sexual health. They argue that this is because LGBTQ youth may lack other places to which they can turn.


Knowledge Translation focus re-direction this fall

Fall 2013 about a dozen of us (united under the rubric of SFU’s HSCI 891 graduate seminar) are embarking on explorations related to KT, aka dissemination and implementation. Join in! Enjoy! Save the world!


C4H Blog Announcement!

Hello dear readers!

This blog was originally created for a graduate course in Advocacy and Communication for Health taught by Dr. Kitty Corbett in the Faculty of Health Sciences at Simon Fraser University.

As of 5pm today, all the grades have been submitted and a collective sigh of relief has gone up from those of us finishing the term. Many are graduating, others are spending the next few months working on practicums, and a few are taking courses during the summer term. As a class, we contributed 108 blog posts from Jan. 17th to April 23rd 2013.

And it turns out – we’re pretty popular!

In just a few months, we’ve had almost 4000 views from 64 different countries around the world!

Screen Shot 2013-04-28 at 2.43.27 PM

Together we have built up a useful resource that many have taken the time to send their thanks for – here are just a few of the reader comments that have been left on our blog:

I love your website! Thank you so much for sharing and imparting.” -Anonymous From India

Thanks for posting this! – Philadelphia Theatre for the Oppressed

Great article. Never consider marketing ethics being played out in religious groups! Thanks for posting the bullet points for ethical behaviour, very useful!” – MorallyMarketing.com

I wholeheartedly believe that when you are creating any type of health communication materials, it is absolutely critical to have members of the priority community participate on the development team because they do, in fact, have a rich lived experience that simply cannot be overlooked or minimalized. Thanks for sharing!” – Ohio Government member

I’d like to thank all of my colleagues for their amazing contributions and insights. This blog is an excellent example of the great synergy that comes from collective work in our Master of Public Health program at Simon Fraser University.

Since this is such a great resource, and it seems to be helping people around the world who are interested in public health, I volunteered to continue contributing to and moderating the blog, and a few of my fellow graduate students have also chosen to come forward as continuing authors. We look forward to continuing to build on these ideas and share them with you!

If you have a specific interest that you would like us to write about, or if there is a resource you would like us to review, please leave a comment below or if you prefer, send me an email: stopps@sfu.ca

Sarah Topps 2013 [Communication4Health moderator]


A note to my colleagues: please send me an email by May 31st if you are interested in continuing to contribute (as little as twice every 6 months) and I will make up an author profile for you on the about page. After May 31st, I will be changing the status of anyone who has not emailed me so that they cannot modify the blog entries.

Entertainment Education and Sexual Assault

TRIGGER WARNING – This blog post pertains to sexual assault.

I recently came across a news article that links back to our discussion of entertainment education. It notes that a study published in the Journal of Health Communication found that frequent viewers of Law & Order, CSI, or NCIS “are more likely to help prevent sexual assault or intervene if they have the opportunity”. The study authors document a shift in how sexual assault has been portrayed in television crime dramas. While story-lines that placed blame on the survivor were common in the late 1980s and early 1990s, more recent analyses have focused on debunking such “victim-blaming” and have included instances of bystander intervention.

The study is grounded in the integrative model of behavioural prediction, which holds that the likelihood of an individual performing a certain action is dependent upon their attitudes toward performing said behaviour, perceived norms about the behaviour, and perceived self-efficacy to carry out the behaviour. In the context of the study, the authors defined the behaviour as “taking action before or during a sexual assault or by speaking out against attitudes that support sexual violence” (Banyard et al., 2007 in Hust et al., 2012, p.107). Given that norms may vary according to setting the researchers controlled for beliefs that seemed likely to influence bystander intervention: rape myth acceptance, perception of social norms and peer expectations. A detailed explanation of how the researchers defined these variables is provided in the article. After controlling for these factors the authors found that “exposure to crime dramas was positively associated with intentions to intervene. Exposure to primetime crime dramas explained .7% more variance after considering all previous predictors” (Hust et al., 2012, p.118). Although this might not seem like much, it is important to consider that these cases differ somewhat from the case-studies of entertainment education highlighted in class. Most notably, they did not occur in the context of a planned health communication intervention and were not based on a specific methodology (cf. The Sabido Method). They raise the possibility of planned and coordinated health messaging in primetime crime dramas, which may prove more effective. Hust et al. (2012, p.119) argue that “larger effect sizes may be generated by exposure to crime dramas that have a greater focus on sexual violence” as well by the frequency with which individuals watch said programs.

This study has some obvious limitations. It only addresses sexual assaults that occur in a public or otherwise communal space. Most serious sexual assaults occur in private, where intervention by a third party is unlikely. Furthermore, the study participants were drawn from freshmen university students living in residence. This may limit the generalizability of the study’s findings to the broader population. However, the choice of sample does not seem unwise given concerns about sexual assault on university campuses.

The publication of this study is, unfortunately, timely in light of recent cases that have seen much attention in the media. The sexual assaults that took place in Steubenville and in Cole Harbour occurred at parties and communal gatherings, the very sort of contexts cited in the study. Although we must make comprehensive efforts at combatting the rape culture that enables perpetrators of sexual assault and shames survivors, the potential for entertainment education to play a role is cause for some hope.

Hust, S. J., Marett, E. G., Lei, M., Chang, H., Ren, C., McNab, A. L., & Adams, P. M. (2013). Health Promotion Messages in Entertainment Media: Crime Drama Viewership and Intentions to Intervene in a Sexual Assault Situation. Journal of Health Communication18(1), 105-123.


Presenting Health Data to Low Literacy Populations

Ever wondered how to effectively present your health materials to low literacy populations? Check out the following presentation for some useful tips and tools:

Health Data for Low Health Literacy

The purpose of this document is to get you to understand why health communication is important within the context of low health literacy. It addresses some key strategies that you can use to effectively communication health information to these kinds of populations. At the end of the presentation is a list of some valuable resources that you can further consult when preparing to present your materials.

Here are some additional helpful links on the topic:


http://phil.cdc.gov/phil/home.asp (a cool CDC public health image database!)


On a somewhat related note, here’s an interesting approach to providing a health message that is culturally appropriate:

– Misha B.

Must-see YouTube Channel: Doc Mike Evans

I have a love-hate relationship with YouTube.  I love that I can visit YouTube and find a video about every event imaginable, search for any scene from my favourite tv shows, look for that memorable performance I missed last night or stumble across the classic scene from that famous film.  On the flip side, I hate that I am tested every time I visit YouTube and forced to exercise a large degree of self control to see whether I am disciplined enough to simply watch that one video I initially went online to find or instead, spend the next several hours clicking on the various video suggestions that automatically come up on the right hand column of the page.

However, I recently came across the YouTube Channel Doc Mike Evans and find myself less guilty for watching video after video that I never intended to watch.  In the theme of social marketing, Doc Mike Evans (in my opinion) successfully manages to utilize social media in a creative way for health communication.  Having been described a leader in “sticky health messaging”, he brings me back to childhood nostalgia by using cartoon illustrations while narrating to provide entertainment education.

Doctor Mike Evans is a family physician at St. Michael’s Hospital and an Associate Professor of Family Medicine and Public Health at the University of Toronto.  He describes himself as someone “interested in engaging users and people with varied skills, particularly creatives, and mushing them together with researchers and clinicians to re-invent patient education.” So, he launched a video back in December 2011 called “23 and ½ hours” (see below)

that went somewhat viral (not Psy Gangnam style calibre) but has now been viewed by more than 3 million people (and I just noticed that this video was posted in How to Add Some Pizzazz to Your Blog Posts.  What I appreciate and find unique about his style is that he is extremely knowledgeable but simplifies the health information using artistic expression so that it is understandable.  Additionally, he does all the narration and producing but gives credit where its due at the end and most importantly, thanks you for listening to him (if you make it to the end of his videos).

In one of my undisciplined YouTube sessions, I came across one of his recent posts from December 2012 called “What is the Single Best Thing You Can Do to Quit Smoking?” (see below)

and thought it was especially fitting for our class.  In this video, he discusses steps of the stages of change theory (without identifying it as that) on exactly what the title says, what the single best thing you can do to quit smoking.  It was a compelling visual aid for me, a non-smoker, to be guided through the thought process of smoking patterns by breaking it down into different parts of change.  I felt like he provided me with accurate and valuable information that raised a level of self-awareness about relationships, describing it as a journey, which helped me gain a better understanding from a non-smoker perspective.  It’s a little bit of a longer YouTube video but if you have 12 minutes to spare, watching the video will introduce you to Doc Mike Evans attempt to use social media and marketing to provoke what I believe is positive behaviour change.

Maybe I’m the only one who is this obsessed with YouTube.

Maybe I need an intervention and I need Doc Mike Evans to create a video on YouTube addiction.

But if you share my love-hate relationship, I do recommend subscribing to Doc Mike Evan’s channel for some creative social marketing.

How-To: Ethical Imagery

This presentation introduces the issue of ethical imagery, presents the complexities related to creating ethical and effective communication tools, and provides an alternative approach organizations can use to guide the creation of communication tools proposed by the Canadian Council for International Co-operation (CCIC) .

How-To_Ethical Imagery Feb 7

Presented by Gaju Karekezi, February 7, 2013.

Rethink Breast Cancer Social Marketing Campaign

Recently I came across a video advertisement on Facebook:Rethink Breast Cancer: Your Man Reminder . As a young female I find many of the side panel advertisements targeted to my demographics, however this one was particularly daring. I remember hearing about it a few years ago when it was originally released, but thought I’d mention it again on our course blog as it has to do with Social Marketing in the Health domain.

Rethink Breast Cancer is an innovative approach to breast cancer education, support and research that attracts a younger target audience (<40 yrs) and attempts to meet their continually changing needs.

The target audience is suggested to be: modern, bold, culturally aware, youthful, and upbeat. In their 20’s, 30’s or early 40’s who are not necessarily responding to the typical breast cancer awareness campaigns of pink ribbons, teddy bears, cancer walks, or other brochure-type information packets.

The goal of Rethink Breast Cancer is to bring BOLD awareness to a prominent health concern by “foster[ing] a new generation of young and influential breast cancer supporters; infus[ing] sass and style into the cause; and most importantly, respond[ing] to the unique needs of young women going through it” (www.rethinkbreastcancer.com).

They are attempting to motivate young women to take responsibility for their breast health, focusing on prevention and early detection. By redesigning dated images, ideas, and language associated with breast cancer they are creating high-impact, fear-free messaging. Partnering with like-minded organizations to bring more awareness and resources to the cause and inspiring a new generation of breast cancer supporters.

This video is only way of the many creative advertisements for the Rethink Breast Cancer campaign, other outlets include: Support Saturdays, Breast Fest Film Festival, TellHER2.ca, appropriate print advertisements (ie. Chatelaine, Canadian Living, etc), and other partnerships (ie. American Eagle, Telus, Blackberry, O.P.I., Rebook, etc.

(abrubacher, 2013)