Relevant messages made relevant

Discuss, show, and model information

To reach the public with education messages, avoid lectures, says Barbara B. Mintz, MS, RD, assistant vice president of wellness at Newark (NJ) Beth Israel Medical Center.

It is best to engage people, Mintz says. Question-and-answer sessions are good because this format provides a way to address participant's personal issues, she explains. Models also are engaging. Show people what a pound of fat looks like, Mintz advises. Also fill test tubes with sugar to show people how much sugar is in a 20 oz. bottle of soda or that juice actually can have more sugar in it than soda.

Active listening and open dialogue works best, says Jason L. Bittle, community health improvement coordinator at Hanover (PA) Hospital Wellness and Education Center. "Patients really don't get it when you talk 'at' them, but when you talk 'with' them and ask open-ended questions, they feel more comfortable building a plan of action," he says.

Know the population with which you are working such as their age, gender, culture, and economic status, Mintz says. Economics can be a big barrier to making healthy lifestyle changes. While grilled chicken and fresh vegetables might be the healthier choice, it is more affordable and much easier for a mother in a single family home to feed her children a box of macaroni and cheese when she works three jobs to make ends meet, she explains. If the patient population eats at fast food restaurants, teach them how to make healthier menu selections. If they eat certain unhealthy cultural foods, teach them how to modify their recipes, says Mintz.

Many factors are necessary to get an audience to lend an ear, including relevance, buy-in, trust, and being able to relate and understand the message, says Adam Bennett, MSW, LSW, tobacco cessation coordinator at Hanover (PA) Hospital Lung & Sleep Center. If an individual cannot relate a message to their existence, it doesn't mean much at all, Bennett explains. "Education has never been and never will be one size fits all," he says.

While proven programs have been developed for tobacco cessation and prevention, they must be tailored to each individual, Bennett says. Those who use the programs must teach clients how to apply the methods to their own life so they work for that individual. For example, patients in smoking cessation programs are taught that engaging in physical activity is an excellent coping strategy to use when quitting smoking. However, if an individual cannot take a 20-minute walk due to severe emphysema, he or she might be taught how to do chair aerobics in order to be physically active, explains Bennett. In this way, the instructor is sensitive to the limitations the patient is experiencing.

Using members of the community, or lay leaders, to deliver the message often works well, says Bittle. The person already is trusted and understands the struggles of the target population.

Also, the message is better embraced when teachers are willing to model, says Bittle. He provides physical activity instruction to children as part of after-school programs and school health days, and he actively participates. Bittle has done Zumba with third graders, yoga with kindergarteners, and cross-country skiing with middle and high school students.

Remember that often your population has been influenced by the marketing ploys of food, alcohol, and cigarette manufacturers. Mintz says people will drink juice instead of soda because an ad said it was healthier, yet their beverage choice results in weight gain.

Stay abreast of the marketing trends, says Bennett. Those staff who handle tobacco prevention and cessation look at current trends in tobacco marketing. They then adapt counter-marketing efforts, prevention education messages, and cessation promotion to make messages relevant to what children and adults see in the media and communities where they live. Help adults and youth develop discrepancy identification skills, he adds.

"This allows them to discern between the messages they hear and perceive about tobacco use and the reality of it all for their life," explains Bennett.


For more information about smoking prevention and cessation, contact:

• Adam Bennett, MSW, LSW, Tobacco Cessation Coordinator, Hanover (PA) Hospital Lung & Sleep Center. E-mail:

• American Lung Association of the Mid-Atlantic, Camp Hill, PA. Web: Telephone: (717) 541-5864. Youth tobacco prevention program Teens Against Tobacco Use (TATU) instructs teens how to go out and educate kids younger than themselves about the real dangers of tobacco. Freedom from Smoking is an adult cessation program. Both programs allow the messages to be adapted to the populations being served.