Health Communication and Interviews

Health Communication

Health Communication is an exchange of ideas, feelings, and information in the field of health.  It's an important part of community medicine, as a public health specialist needs to deal with many people and communities. So, it's important to know how to approach them, how we try to present them, etc.

Communication cycle

The communication cycle has two components: the sender and the receiver. The sender frames a message, which goes through a proper channel to a receiver or audience. We then receive feedback from the receiver. This is the correct sequence of the communication cycle:

Sender - message - channel - receiver - feedback (sent back to sender) 

Communication should generate awareness. It should be interesting and motivating. The person should evaluate it, and ultimately, it should be adopted. This sequence of events towards the receivers is also very important. The sequence:

Sequence: - Awareness- interesting/motivation- evaluation - adoption. 

For Example- An advertisement in which Amitabh Bachchan is saying two drops of polio can save the lives of people. Here, Amitabh Bachchan is on the channel here, through whom the sender's message is sent to the receiver)  

The Sender is usually a government or non-government organization that wants to bring change. They frame the message and send it to the channel (Amitabh Bachchan). Feedback can be taken as an exit poll or survey. 

Barriers of communication

A barrier is an obstruction that stops the communication of information. Following are Some barriers: 

1. Physiological: difficulties in hearing, expressions 
2. Psychological: It includes Emotional disturbances, levels of intelligence, neurosis, and language or comprehension difficulty.
3. Environmental: environmental disturbances include Noise, invisibility and congestion.
4. Cultural: these disturbances include Illiteracy, levels of knowledge/understanding, customs, beliefs, religion, and attitude.

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Types of communication

One-way Communication or Didetic Communication

Learning is authoritative and Knowledge is imposed in this type of communication. There is Little or no audience participation. No feedback is taken. It does not influence human behavior or remove misconceptions. There is only one active participant. For Example -TV, radio, newspaper, internet, lecture.

Two-way communication or Socratic communication

Learning is active, participatory, and democratic, and it is more likely to influence behavior. It is better than one-way communication. We can expect the desired changes if both people are active or talking. One is delivering the message, and one is taking the feedback. It includes the following ways of communication:

• Panel discussion
• Symposium
• FGD (Focused Group Discussion)
• Workshop 
• Conference/seminar
• Role plays 
• Demonstration 

Methods in Health Communication

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Lecture

Lecture is also known as the chalk and talk method. Theoretically, it is one-way or didactic. The size of the group should be no more than 30 people. The duration of the lecture should be 15-20 minutes. The type of Learning is passive.

Demonstration 

Demonstration is a two-way or Socratic communication. It Relies on the principle of "Seeing is believing and learning by doing." It is one of the most efficient methods of behaviour change because it involves 'community participation.' This method has high motivational values. Example: ORS Demonstration or preparation, application of Scabies ointment, installation of hand pump, construction of sanitary latrines. 

Focus Group Discussion (FGD)

It is a technique of qualitative data collection. There are 6-12 participants. They usually sit in a circle. A Moderator leads the FGD. The moderator puts forward the 10-12 leading questions. These questions are open-ended. A Socioogram will reflect the quality of FGD. Quality here means how interactive FGD is. A sociogram is a type of diagram or chart made by a person present there. The sociogram reflects who is actively talking and making arguments and who is not doing anything. One more person is there who is a recorder, who records everything with prior permission. 

Analysis would be done on certain common themes. FGD is a two-way or Socratic method of communication. For Example - Suppose there is a community where there is a problem of domestic violence. To find out why this is happening, one can either do a quantitative study design or a qualitative one. This means one can frame a questionnaire, where they can put 20 close-ended questions such as Are you a victim of domestic abuse? What is the reason why it is happening? etc. So, one will get an answer in numbers: 20 women say that their husband drinks and beats them, and 30 women say that their family has expectations.

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Panel Discussion

A panel discussion involves 4 to 8 experts. It is a Two-way or Socratic method of communication.

Symposium 

A symposium has 4 to 8 experts. It is a Two-way or Socratic method of communication. 

Difference between Panel Discussion and Symposium

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Workshop

A workshop is a Two-way/Socratic method of communication. A workshop is like a series of ≥ 4 meetings under an expert. It always has a purpose to impart skills and develop problem-solving skills. One always leaves a workshop with an agenda in mind. It requires lots of preparation. 

Conference

Conferences are like macro events. They can be held at the national level, state level, or regional level. It happens on a big scale and has a huge audience. It is a good place to develop social relations.

Seminar

Seminars are like micro-events. They can last from half a day to a week and happen on a small scale. They involve in-depth discussions of a single topic, which can be more comprehensive. Simultaneously, many activities take place. Seminars are a good place to develop social relations. 

Role Play

Role-playing is also known as Nukkad Natak or Sociodrama. It is a type of Two-way or Socratic method. The audience size is a maximum of 25. There is a huge audience participation.

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Delphi Technique

A structural communication technique that relies on a panel of experts is regarded as an exploratory and detailed procedure. It is highly used in collective intelligence, i.e., shared or group Intelligence that emerges from the collaboration, collective efforts, and competition of many individuals and appears in consensus decision-making. 

The process remains anonymous, and the experts can share feedback without any discretion. It is a group method. There is a need to reach a level of agreement. Example-.KAP (Knowledge attitude practice) study among Medical students on genetics. So, one frames the questions on this and sends them to a group of experts. Every question will be given a ranking, and then experts will mail the feedback. If, from the feedback, we know that we have not achieved the desired level of agreement, then we will make the changes and then resend them to experts. This will continue until we reach "consensus decision-making." The purpose of the Delphi Technique is to select the best possible questions with the best possible answers. 

Types of interviews

• Direct or Structured: A schedule containing a set of predetermined questions is prepared. 
• Nondirective or Unstructured: No predetermined questions. The researcher collects information by free discussion.
• Focused Interview: To Study the social and psychological effects of mass communication. For Example, reaction to a film show
• Repetitive Interview: To study the gradual influence of some social or psychological process

Steps for conducting an interview

The following are the steps to conduct an interview:

• Establishing contact: Look eye to eye 
• Starting an interview
• Securing rapport 
• Recall
• Probe questions (if gone off track, bringing one back to the point)
• Encouragement 
• Guiding the interview
• Recording
• Closing 
• Report

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Some other methods

Gather Approach/counseling

It is an approach for contraceptive counseling. Initially, we had a cafeteria approach for counseling and now it has been replaced with a Gather Approach.  In the cafeteria approach, a basket full of contraceptives is offered to the clients. The gather approach can be remembered using a mnemonic GATHER.

• G- Greet the couple 
• A- Ask them what they want
• T- Tell them
• H- Help them choose
• E- Explain 
• R- Return to follow up

Spikes Approach

This approach is adopted when one needs to break the bad news to the patient or their family. The Mnemonic used to remember the spikes protocol is SPIKES

• S- Set up an interview
• P- Assess Perceptions 
• I- Invite to explain
• K- Share your knowledge 
• E- address their Emotion
• S- Strategies

Flannel Graph

It is a Flannel Graph, a method of health communication that involves a series of pictures of a piece of clothing. It is a way of making people learn. 

Flipcharts

It is similar to a Flannel Graph. It is just like a small calendar in which one can turn the pages and know the details. So, Flipchart can be used to share knowledge. 

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Frequently Asked Questions

Question: Which of the following is the correct sequence of various components of the 'communication process'? 

1. Receiver, Message, Channel, Feedback, Sender
2. Sender, Feedback, Message, Channel, Receiver
3. Sender, Message, Channel, Receiver, Feedback
4. Message, Sender, Channel, Feedback, Receiver

Answer. c) Sender, Message, Channel, Receiver, Feedback (Receiver  is the Audience)

Question. Which one is an example of ONE-WAY communication?

1. Socratic method 
2. Didactic method
3. Visual communication
4. Telecommunication

Answer. b) One way - Didactic method

Q. Which of the following is the Socratic method of teaching?

1. Lecture
2. Films
3. Exhibition
4. Panel discussion

Answer. d) Panel discussion (two-way communication) 

Q. All are true about Panel discussions except 

1. A panel of 4-8 experts discuss a health topic
2. Audience is present
3. Specific order, Set speeches
4. Audience can take part

Answer. c) Specific order, Set speeches

Q. Workshop is

1. Discussion of 4-8 experts in front of an audience (hint: panel discussion)
2. Discussion between 6-12 members (FGD)
3. Series of 4 or more meetings
4. Series of speeches on a given subject (Symposium) 

Answer. c) Series of 4 or more meetings

Q. Most popular media for mass education of the general public is

1. Television 
2. Radio
3. Newspaper 
4. Internet

Answer. a) Television

Q. Loss of Interpersonal communication is managed by 

1. Group counseling
2. Individual counseling
3. Check telecommunications
4. Improving language

Ans. c) Check telecommunications

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