Health communication, digital health literacy and community engagement
Scope
The domain tests how health messages are designed, framed and evaluated, how risk and uncertainty are communicated, and how communities are engaged in digital and offline settings.
Core rules
- Health literacy has functional, interactive and critical levels. Plain language, chunking and teach-back improve comprehension; numeracy is often the weakest link.
- Absolute risk communicates better than relative risk alone. A relative risk reduction of 20% from 5% to 4% means an absolute reduction of 1 percentage point and a number needed to treat of 100.
- Message framing matters: gain frames work for prevention and cessation; loss frames can work for detection, but effects are context-dependent. Fear appeals succeed only with clear efficacy statements.
- Risk communication under uncertainty requires transparency about what is known, unknown and being done, plus consistent messaging and trusted messengers. The infodemic requires rapid monitoring and rebuttal of misinformation.
- Digital health literacy includes finding, appraising, applying and creating health information. The digital divide affects older, rural and low-income groups, so digital channels must be combined with community and face-to-face routes.
- Community engagement ranges from inform and consult to involve, collaborate and empower. Empowerment requires shared decision-making and community assets, not a deficit model of telling people what to do.
Worked example
A campaign reports that a vaccine reduces severe disease by 90%. The baseline risk is 10 per 1,000. Absolute risk falls to 1 per 1,000, an absolute reduction of 9 per 1,000; about 111 people need vaccination to prevent one severe case. The reasoning: the relative figure sounds larger but the absolute figure supports informed choice. The message should state both, name the baseline, and add that benefits and risks are monitored.
Traps
Do not report relative risk without baseline; do not assume a digital campaign reaches everyone; do not confuse consultation with empowerment; do not use fear without a feasible action.