HLN #5: 😲Hmmm! What did they mean by “rear entrance”?
A few days ago, a professor I follow on Twitter retweeted a post that had the image of a hospital sign post with these words:
“Family planning advice: use the rear entrance”
At first, I was confused. I took it as a health campaign message. If like me, you did not consider that it could also mean, “use the rear entrance to the facility,” as in, the exit or back door, well, that’s why we’re all humans. 🤷
I always say that multiple truths can exist in a story. The rear entrance could mean anal sex, as much as it could mean the back door. But there is a problem which patients and readers could have: poor comprehension. Why? Because the narrative is unclear and incomplete.
I analyzed this tweet and thought to share the lessons I learned, just as I did when I engaged with the professor.
Most importantly, before we take things too seriously, this image is doctored. It was digitally manipulated to create a meme. The National Health Service (NHS) in the United Kingdom, would never create such material for health promotion purposes.
I consider this a wrong use of humor. When expressing a professional medical opinion to a wide range of people on social media, or offline (billboards, flyers, etc), we need to call to mind, as health professionals, that people have different ranges or thresholds for what they find funny. This is not just based on their lived or shared experiences, but also because we now live in a hypersensitive world... Would this have been acceptable when hanging out with a group of friends at the bar? Most likely. But on a hospital sign, official health educational material, or documents that signify the authority that you carry as a health provider? No, please!
This health campaign messaging or design did not factor in audience segmentation. Audience segmentation means different important subgroups within a target prioritized population, that require tailored or unique approaches in health communication. For instance, if “rear entrance” meant anal sex, what would happen to a woman with a history of obstetric fistula and/or who may have just recovered from the surgery and treatment? How about alternatives for couples who based on personal, religious, or sociocultural influences do not like or indulge in anal sex?
Interestingly, for those to whom “rear entrance” meant “back door” or “exit”, do you think this would have come to the mind of someone else if you shared this image with them? No? Well, let me then add that for good user experience, a good medical facility, business or practice, should have a health communications team who make their messaging so clear that there would be little or no room for assumptions by patients or other end-users (the public, couples, patients’ relatives, clinicians, etc). Assumption is the mother of all frustrations.
It is important to test your messaging before you publish. Keep a checklist that includes testing campaign materials with focus groups. Focus groups are a small subset of the type of people for whom these health literacy/promotion materials are created. Hopefully, I get to someday share how doing this saved my life from a potential Twitter palaver. One way to do this is to create a range of messaging, just like a graphic designer creates various versions or edits of a design, and ask for what version appeals most to them and why?
Clinical team and management level edits are non-negotiable. These should be the final review done before publishing health materials for online or offline use. Why is this important? Because in this day and age, we have a rise in content creators churning out health content without fact-checking with the clinical team. Not all writers, for instance, are privileged to have a medical background, like you and I. In fact, we, as professionals, still pass our health copies through a series of edits, because we know that science is ever-changing. Unverified or panel-beaten messages can harm a life, irrespective of the intent to make people laugh or happy.
So? Your turn, now! What other lessons can we learn from here? Feel free to share in the comments of this blog post.
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Some important public health events in October.
Oct: Health Literacy Month
Oct: Breast Cancer Awareness Month
Oct 13: Metastatic Breast Cancer Awareness Day
Oct 14: World Sight Day
Oct 15: Global Handwashing Day
Oct 15: Pregnancy and Infant Loss Awareness Day
Oct 15: International Day of Rural Women
Oct 16: World Food Day
Oct 16: World Spine Day
Oct 17: International Day for the Eradication of Poverty
Oct 20: World Osteoporosis Day
Oct 22: International Stuttering Awareness Day
Oct 24: World Polio Day
Oct 29: World Stroke Day
Download this 2021 Health and Wellness Calendar to see and plan for more important health days in the year.
Happy Health Literacy Month,
Chidindu Mmadu-Okoli
Health Literacy Notepad