Recently, we celebrated the first anniversary here at the Health Communication Partners website.
If you’ve been following along, you know that at HCP we believe in taking a resource perspective rather than deficit perspective. On everyone—providers and patients.
We understand that health communication is a subset of everyday communication. We know everyone can learn (and teach). We understand that everyone has what we believe to be perfectly good reasons for doing what we do in life.
And we know that health professionals acting on these beliefs is a key to all sorts of good outcomes – for professionals, the public, and the communities, institutions, and organizations where we all live, learn, work and play.
You’re here because you tend to agree. And you appreciate some support in this area.
So today, I’m going to give you the single best piece of advice I have for communication and education. No matter who you are, what your purpose is, or who your ‘audience’ is.
Not a simple transfer of information
It can be tempting to think about communication and education as a simple sharing of information.
Kind of like sharing chocolate. Or digital photos of your cute pets. The idea that “I have it, and I give it to you, and now you have it.”
Except ideas and information don’t travel between people as neatly as pocket snacks, or funny animal pictures.
So here’s my single best piece of advice: whoever your audience, whatever your topic,
Begin with what people already do, know, believe, and have.
Otherwise known as starting where people are.
The points is for you first to understand how people are making sense of the topic. Then you build on and enlarge their understanding.
Now, I’ll break this down and show you ways to get going.
Where and why this works
Starting where people are works in many scenarios:
- You’re a provider trying to get through to a patient
- You’re a medical educator preparing for a room full of different learners
- You’re a community health worker educating individuals during home visits
- You’re a public health professional translating research into messages for providers
- You’re on a hotspotting team researching patients in their communities
- You’re an administrator tasked with boosting patient engagement
Yet starting where people are performs one function that’s part of all of these scenarios and more. And it is the single most important reason why you should start where people are.
It builds a connection.
It’s where you begin to connect what your patient, client, or student knows to what you know. And it is the only starting point you need, because of how much it matters to your efficiency and your effectiveness.
The reasons for this are simple.
First, we learn best when education links the known to the unknown. That is, we learn quickly when new information is explicitly related to what we already know.
Second, we attend to what matters to us. We will learn what we want to learn. We learn what we feel suits our purposes.
As much as you may wish that it were different, people don’t simply absorb the information given to them. But too often, a transfer of information seems to count as communication or education.
Starting where people are benefits your communication and education, no matter what your purpose or audience. And there are multiple ways to do it.
Today we’re going to explore two of them. I give examples from provider/patient interactions, but you’ll see the core advice applies across scenarios.
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Start with what people already do
When you wish to encourage an action, don’t start from scratch. To give your recommendation a greater chance of happening, let someone see how it already fits in their life.
Too often, the focus is on what people are not doing. Find out (or bring to people’s attention) what they are already doing, related to your topic. This is a powerful place to begin an education process.
To put this a different way: rather than look for what people seem to be lacking, or doing wrong, begin by learning about the activities which people are engaged in.
For example, I spoke with a wound care clinician. She knew that simply telling patients to get out of their wheelchairs for 3 minutes a day wasn’t having much of an impact. She laughed as she told me how patients were nodding, agreeing, and then going on their way.
We talked about starting with the assumption that people are already attempting to take good care of themselves. Her starting point then shifted from telling people what to do, to finding out what people were already doing.
She quickly said, “So instead of telling patients ‘You should get out of your chair for 3 minutes,’ we could ask them, ‘how long do you get out of your chair?’”
We quickly brainstormed some more. ‘When you get out of your chair, how do you do it?’ ‘What do you do to relieve pressure?’
These put more emphasis on the patient as capable, active, and involved. A person who is already making sense of their health and what it means to take care of their bodies.
When it comes to the topic or goal of your education, ask people what they are doing already, in that area. This also extends to what people already read, say, view, write, or listen to–especially when health literacy is a concern.
Start with what people already know and believe
Making your words matter means thinking about what matters to your audience.
Our understandings of a topic shape how we read, write, talk about, think about, listen to, process, and act on that topic.
When it comes to a topic where you’re the expert, it can be easy to think of the ways other people understand that topic as…problematic. Especially when it’s not what you think should be basic knowledge or common sense. This can lead to a deficit perspective on the person, and put a wrench in your professional relationship.
When it comes to patient/provider interactions, I’ve heard several providers mention that patient education should to ‘get patients from A to B.’ If that’s the case, consider patient knowledge as an important part of ‘A.’
Certainly, the average American just doesn’t know a lot of things that health professionals know. Whether or not our understandings of health and being healthy correspond to the latest medical knowledge, they make sense to us.
You know by now (and you’ve heard me say) that our understandings of health are culturally mediated. This means we each draw on a range of ways of understanding the body, science, procedures, insurance, nutrition, and more. These ways of understanding are shaped by our knowledge and our experiences–with our bodies and with the health care system. They’re culturally shaped, but these ideas are not fixed or homogeneous. They shift, and can be changed.
Start with what your audience already knows, and connect it to the unknown (your expertise).
HCP can help
You have the power to start where people are, and begin the work of talking across difference. Bridge-building, if you will.
Starting with what your audience already does, knows, and believes also helps you catch where things might be going wrong. People may have misconceptions. But even these misconceptions are important in your communication and education.
If you or a group in your organization would like some help starting where people are, let me know. I might even bring chocolates and pictures of cute pets.