LESSONS FROM A PHD - Part 3
This means the community should contribute to defining research problems and strategies in response to their own self-identified needs and concerns.
To make sense of this principle I will draw on lessons from my own research area in health communication. This is a tricky one for health researchers. It requires rethinking hierarchical models where the “expert “ decides what the community wants and needs. For example, your data or a government policy might argue heart disease is a high priority but does the community agree? My mantra is start where the people are. Spend time talking with grassroots groups and community members to prioritise the issues that they perceive as priorities and work from there.
As part of my research I directed a diabetes prevention documentary targeted at Maori at risk of the disease. Ministry of Health recommendations are for thirty minutes of moderate intensity physical activity at least five days a week. However, my research found this was an unrealistic goal given that focus group participants reported participating in little if any physical activity. Community health workers told me they recommend small and incremental steps to their clients. As a result, the documentary messaging focused on incremental changes in diet and exercise. Rather than setting unrealistic goals we recommended targets like taking the stairs rather than the escalator or getting up and moving during commercial breaks.
The relevance principle is particularly important at the early stages of planning health promotion campaigns where creative strategies are being conceptualised. A major finding from my own research is that while they are one of the most critical conditions for effective health interventions, health behaviour theories are rarely utilised and if they are, they are often poor fits for indigenous communities.
I would argue the most effective health communication consults the community throughout the entire process and doesn’t confine a community voice to focus groups that are there to merely validate a creative idea.
Focus group interview guides can often be strengthened by consulting the experts-the community members themselves. During my individual interviews with community health workers I always left time to consult them on my working interview guide for focus groups. As a result valuable insights were gained. For example, the word exercise was completely removed from the questions and replaced with the more inclusive “movement.” This semantic shift reframed the later discussions and encouraged participants to identify and discuss a broader array of daily physical activity. This resulted in richer and more meaningful data at later stages when designing the messaging for the documentary.