October is [Fill in the Blank] Awareness Month

Today’s post is by Leah Roman, a guest blogger for The Public’s Health. Roman, a project manager for the Firefighter Injury Research & Safety Trends (FIRST) project at the Drexel University School of Public Health, blogs regularly about the intersection of public health and pop culture at “Pop Health.” She can be contacted at lar92@drexel.edu.

By Leah Roman

Are you wearing pink this month for Breast Cancer Awareness? Or perhaps orange for National Bullying Prevention? According to the National Health Observances calendar from the Department of Health and Human Services (HHS), there are 23 national weeks and months of health observances for October, including Domestic Violence Awareness Month, and, if you are Canadian, it's Autism Awareness Month in the great white north.  This number does not include many other designated observance days for this month such as National Depression Screening Day and World Arthritis Day

As a health educator and health advocate, I have participated in many of these campaigns over the past decade.  I have seen them deliver numerous positive outcomes such as: marketing the services or mission of organizations, spotlighting an array of health conditions (both those widely and lesser known); providing a sense of empowerment to participants; and of course- successful fundraising!  However, with the enormous personnel and financial resources dedicated to “awareness raising”, we must ask ourselves a key question:  Are these campaigns effective in actually improving the public’s health?

In my work I have found that the ability to answer this question is largely limited by the language that we use to describe these campaigns. What is “awareness”? I have often asked colleagues and community members this very question. I ask because in public health it is essential to have a clear, agreed upon definition for a concept so that it can be tracked and measured.  When I ask this question, I usually get an answer related to knowledge.  For example, “Awareness is increasing knowledge about symptoms and risk factors”.  I have two concerns about this answer.  First, if we mean “knowledge” then we should say “knowledge”.  Using a vague concept like “awareness” makes it almost impossible to measure change.  Second, research has shown that knowledge alone is not enough to change behavior.  If it was enough, then everyone would have quit smoking when warnings were added to tobacco packaging.   

It may be time to step back and consider if the often education-heavy annual “awareness” month is the most effective way to reach the public.  Is the public getting burned out with over 20 health observances per month?  Are organizations getting burned out as well?  They are encountering an increase in competition for the public’s attention.  This is making it harder for organizations to brand their health color (e.g., pink for breast cancer) and marketing materials (e.g., wrist bands).  This is a sharp contrast to what we saw just a few years ago.  When the yellow Livestrong wrist band debuted in 2004 as a fundraising item for the Lance Armstrong Foundation, it was unique and easily recognizable.  Recent stories in The Atlantic and National Public Radio (NPR) have discussed the public’s fatigue with these campaigns and questioned their benefits for patients.

As a result of these concerns, I encourage both organizations and individuals to explore different, action-oriented goals for their health campaigns or individual contributions.

For organizations: It is time to shift from education-only into action.  For example, a breast cancer foundation could set the following goal for October: “Increase mobile mammography screenings in two Philadelphia neighborhoods with the lowest health care utilization”.  Campaign organizers can then focus their efforts on real barriers that keep residents from screening.  It may not be their lack of knowledge!  Residents may be dealing with lack of health insurance, sick time to attend their appointment, or access to personal or public transportation.  All the education and brochures we give out will not address these barriers in their environment.  Other tips include:

  • Measuring your outcomes (e.g., track patients who follow-up on mammogram referrals)
  • Tailoring your events or education materials for different audiences.  The message you send to women about breast cancer (e.g., the importance of conducting self-exams) should be different than the one you send to their spouses or partners (e.g., how to encourage a family member to be screened).
  • Research how and where your community gets their health information. (e.g., are they using the internet, social media, physicians, and/orcommunity groups? Who are they most likely to trust? Do they want to hear from physicians or peers?)

For individual contributors: make sure that your contributions directly benefit your health cause by funding research, clinical services, policy advocacy, or support for patients and families.  As the public is overwhelmed with merchandise to support various causes, there is concern about how much of the revenue actually gets donated to health organizations.  For example, there has been much discussion over the past few weeks regarding how much money will be given to the American Cancer Society from the NFL.

Other tips include:

  • Instead of buying merchandise, donate directly to organizations funding research or services.
  • Encourage your family members or friends to follow-up on health referrals.
  • Write a letter to government representatives to advocate for more funding.
  • Become a member of an organization (locally or nationally) that advocates for your issue. 

What do you think:  Is the public burned out on annual health observances? Or are they effective in helping to prevent illness/disease? In what other ways can organizations and individuals become more action-oriented to help improve the public’s health?

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