Ebola Is Real: Using Theory to Develop Messaging in a Health Crisis

"Using theory in health messaging doesn't have to be a massive undertaking, and you don't have to be a researcher to do it. What theory does for health communication is provide a road map to your work."

In this post that originally appeared on the Ebola Communication Network, Lisa Cobb reflects on the impact of theory on messaging in the context of the Ebola crisis. Her launching point was an article in the New Yorker, focusing on the work of the non-governmental organisation Search for Common Ground (SCG) to address Ebola in Liberia through radio soap operas. As Cobb explains, Mike Jobbins, who runs SCG's Africa programming, decided to offset government sloganeering that amounted to "Ebola is real - if you get it, you'll die!" with an alternative message, which was roughly: "Ebola is real, and if you seek treatment you have a fifty-per-cent chance of recovery."

Cobb articulates the distinction between these two messages and the behaviour change they may or may not evoke by pointing to the Extended Parallel Process Model (EPPM). The first message, according to Cobb, "doesn't respond to the fact that when we are confronted with scary, threatening things that we can't control we tend to put our head in the sand and pretend the threat doesn't exist. This all-too-human tendency is described by the EPPM. The theory, however, also gives a solution: although we tend to respond to fear of things we can’t control with avoidance, we respond to fear of things we can control with action. This small bit of theoretical understanding clears the way for a new message: 'Ebola is real! Seek care and you can survive!'"

EPPM is not the only behaviour change communication theory - and, as Cobb explains - may not work as well in the case of family planning, because a woman doesn't tend to think of a baby as a threat to be avoided (even if she is not ready to become a mother). Ideation is perhaps a more fitting theory; it is illustrated in the video, below. Cobb cites Theory Picker, which is a tool that compares the user's description of his or her behaviour change challenge with major components of 6 behaviour change theories: Diffusion of Innovation, EPPM, Health Belief Model, Theory of Reasoned Action, Social Learning Theory, and Trans-theoretical Mode. Cobb explains that this tool can walk the user through a series of questions to see which theory might best fit his or her problem. She says: "When I tried to answer the questions with just 'Ebola prevention' in mind I couldn't answer questions like: 'Many audience members already believe that the consequences of the behavior would be more positive than negative.' But when I thought more specifically of one single behavior (I picked safe burial) the Picker did, indeed, give me the EPPM as one of the top two options to consider. The Picker seems to be a nice tool to explore theory in a really practical way."