Communication: health literacy, framing, and risk
Communication items test message design, channel choice, health literacy, and whether you can communicate risk honestly without manipulating. Items rarely ask for theory names alone; they ask what a practitioner should do.
Core rules
- The basic chain is sender, message, channel, receiver, with noise and feedback; channel choice should follow audience habit and message complexity, not preference of the sender.
- Health literacy includes prose, document, and numeracy skills. Plain language at roughly 5th–8th grade reading level is a starting point, not proof of comprehension - test materials with the audience and use teach-back.
- Numeracy: give natural frequencies with a consistent denominator ('2 in 100' rather than '0.02'), and present absolute alongside relative risk.
- Framing: gain frames emphasise benefits and usually suit prevention messages; loss frames emphasise costs and often suit detection or cessation prompts. Match frame to audience, not to your own taste.
- Theory in use: Health Belief Model (perceived susceptibility, severity, benefits, barriers, cues to action, self-efficacy), Transtheoretical Model, Social Cognitive Theory, and the Extended Parallel Process Model, in which threat without efficacy produces avoidance rather than protection.
- Social marketing: product, price, place, promotion, plus audience segmentation and exchange - what the audience gives up for the benefit.
- Risk communication: dread, voluntariness, controllability, and trust drive perceived risk as much as probability. Always pair a risk statement with a concrete action.
- Cross-cultural practice: qualified interpreters rather than family members, back-translation, and cultural adaptation of images and examples.
Worked example
A medication reduces fracture risk 'by 50%'. Said alone, that is technically true and decision-poor. Better: 'Out of 1,000 people like you taking this for five years, about 3 avoid a fracture and 997 would not have had one anyway. Three people in 1,000 will have a serious side effect.' Same evidence, honest denominators, real trade-off.
Traps that cost marks
- Treating a readability score as evidence of comprehension.
- Fear appeals with no efficacy component.
- Relative risk with no absolute baseline.
- Translating a document without cultural adaptation.
- Vague quantifiers such as 'moderate activity' or 'eat less'.