When does common sense make little sense? How do we sense-make evidence when it seems to make little sense? The answers could lie in getting inside the heads of those we seek to influence and designing our communications for empathy and health.
Evidence in public / health
Last week there was a brief uproar in the mainstream media and on Twitter created by a tweet from Toronto Public Health to their Twitter followers suggesting they contact the producers of the TV show The View and protest their recent hiring of Jenny McCarthy a a co-host. Ms McCarthy is an outspoken critic of childhood vaccinations in spite of overwhelming evidence to show that they generate enormous benefits over the relative and small risk for many conditions and for promoting the falsified science used to prop up the myths that they cause autism (which is her primary concern).
That post led to much discussion, including posts on Censemaking and the Public Health and Social Media blog (reposted here) and Twitter on the challenges of communicating evidence, engaging the public, and the role of public health in these conversations. Watching comedy duo Penn & Teller offer a humourous if angry take on evidence for vaccinations and health might make the risks and benefits obvious, yet this isn’t the case. Why?
It turns out, that some of these supposed obvious connections still don’t impact those who support the anti-vaccination movement. Indeed, evidence from Australian researchers shows that engaging these audiences does relatively little to influence their behaviour. To some, they may be immune to the evidence (pardon the pun).
In a qualitative study of parents on their pro and anti-vaccination beliefs, the authors found a complex mix of beliefs that governed how information was received and processed. For example, expectations of guilt at the thought that a child would fall ill because of something that could have been prevented due to a vaccine or conversely due to a vaccine side-effect were prominent in the findings.
What arose in the dialogue arising from the Jenny McCarthy / Toronto Public Health flurry was familiar territory: health professionals using the moment to logically persuade the public to choose vaccination, hand-wringing over why people fail to believe evidence or why they believe celebrities, the awful use or mis-use of evidence in the media, and gasps of collective frustration at how out of sync public health is in its engagement with the public on these issues.
What was missing was empathy.
Stories trump evidence
The above quote has been uttered many times in public health circles when the use of evidence in health communication emerges in conversation. Journalists know this and that is why they tell stories in their reportage and not “just the facts”. All one needs is a story about the human experience on one side of an argument and all the evidence to suggest it is an anomaly or rare event gets covered over. It’s why we bristle at news stories of violent crimes and fear for our safety despite wildly declining crime rates throughout countries in the ‘developed’ world.
A Problem of Perspective
Public health professionals — indeed all of us in any field — need to get out more. It’s easy to scoff at the ignorance of people when you have an advanced degree, spend great amounts of time contemplating or generating evidence, see the health effects of faulty reasoning firsthand, and associate with many others who share the same view. It’s obvious what the right course of action is.
But obvious is a matter of perspective. Health professionals tend to design their materials for themselves. Looking at much of what is developed for health promotion and communication with the public, we might make some assumptions:
- People are able to read and understand health related materials (and they like to read in the first place)
- They like printed materials and learn best from text
- They trust scientists, physicians and health professionals for information on health issues above all
- Health is something they think about a lot and always want to learn more about issues
- The public is invested in carefully weighing evidence claims to make the right choice
- Health behaviour change is a linear, knowledge-driven process
There are more, but let’s examine these briefly. I am not going to dive deeply into the evidence for each of these points (that is for another day) rather ask you to consider how true these are in your observations.
These are all assumptions and mostly based on a rational, linear model of decision making and behaviour. They are based on a model that correlates knowledge, expertise and authority and assumes that people respond to such authority. It emphasizes the use of media that is appropriate (and historically priviliged) for academic and technical communications, not public consumption.
On that last point, many educated professionals — particularly academics — are shocked to find people that neither need or want to read. Yet, we propel print materials and websites at people in text form to audiences that we imagine value the same things.
When you study health for a living or treat people with health problems you spend your entire day thinking about health. It may come as a surprise to realize that many others don’t really care much about their health until it’s compromised. They aren’t constantly mired in decisions about evidence, long-term implications of daily decisions, or the social determinants of their wellbeing. Health is just another thing to think about among many.
If we are to be better at communicating with our audiences, we need to empathize more and design our messages, media and services in ways that reflect the reality they perceive and the one they live in knowing that might not be the same thing and nor is it necessarily the same one we live in and perceive.
It also means confronting some big questions about what we are doing in the first place.
What is the destination and the journey we wish to take with the public? Do they want to take it with us in the first place? And if not, what might we do to inspire people to want what we have to offer — and do so in a manner that promotes what they want to accomplish, not just what we want them to.
This avoids us taking the approach to dealing with people who don’t speak our language by talking slower and louder as if they are deaf and stupid rather than unfamiliar with our native tongue.
This is the realm of design and empathic design thinking about communications and perhaps its time to start bringing more of it into our work. Maybe then we might not be so surprised when the obvious answers are no longer so.
Photos: Cameron Norman, Joe Ross (used under Creative Commons License via Flickr)