Assessing health communication messages

Public Health Ontario; Dalla Lana School of Public Health. Health communication message review criteria. Edition 2. Toronto, ON: Queen’s Printer for Ontario; 2012.


The Health Communication Unit (THCU) developed the Health Communication Message Review Tool to help assess or create health communication messages. It outlines criteria for developing a persuasive health message. Health communication is defined as "the process of promoting health by disseminating messages through mass media, interpersonal channels and events." There are different types of health communication, including persuasive/behavioural communication, risk communication, media advocacy, entertainment education, interactive health communication and communication for social change.

The Health Communication Message Review Tool assesses health messages developed as part of a health communication campaign. Within the THCU's 12-Step model for developing health communication campaigns, the Health Communication Message Review Tool helps decision makers with Step 8, "Develop the Message Strategy."Step 8 discusses three key elements of a health message:

The What? - Identify the key information to be conveyed.

The message may contain factual information, it may break behaviours down into small steps or it may address a concern or problem directly by offering alternatives.

The So What? - Address the reasons or benefits for action that are relevant for the audience.

Identify the social, health, psychological, financial and other incentives specific to the intended audience.

The Now What? - Define a desirable and protective action.

It is challenging to create persuasive health communication messages that bring about behaviour change.

McGuire's Hierarchy of Effects is one theory that explains why messages fail or succeed. For a message to change behaviour, the audience must pass through these sequential steps:

  • Tune in to the message (exposure).
  • Attend to the message.
  • Maintain interest in the message.
  • Understand it.
  • Think about it (generate related cognitions).
  • Acquire related skills.
  • Agree with the message position (attitude change).
  • Store the message in memory.
  • Retrieve the message from memory when relevant.
  • Decide to act on the message (intention).
  • Act on the message (behaviour).
  • Integrate the behaviour into lifestyle.
  • Recruit others to behave likewise.

Steps for Using Method/Tool

The Health Communication Message Review Tool is a 12-step checklist of minimum criteria for persuasive messages. Users can assess whether each point in the message is 'excellent', 'very good', 'fair' or 'fail'. A final recommendation of 'use', 'lose' or 'adapt' allows users to make an informed decision about whether to continue or terminate use of a health message.

The Health Communication Message Review tool includes the following list of minimum criteria for a persuasive message:

Capture and maintain the audience's attention - Have your audience think about the message and rehearse the recommended behaviour. Include visuals and consider using different language styles (e.g., word play, humour, striking statements) to sell the message.

Begin with the strongest points - Position the information that is critical for convincing your audience to adopt the recommended behaviour early in the message.

Provide a clear message - Make it easy for the audience to identify the actions you are asking them to take, the reasons for taking those actions and the evidence for the incentives. Use statistics with caution in messages.

Provide easy actions - Behaviours that take too much effort and sacrifice are not accepted by audiences. Present easier behaviours with fewer barriers. Arrange target behaviours along a continuum for the audience to adapt.

Use incentives effectively - Explain to the audience why they should be interested in changing their behaviour. Incentives for behavioural change may be physical, psychological or economic.

Provide credible evidence of threats and benefits - Provide evidence that threats and benefits of the behaviour are real and likely. Your audience must be convinced that the recommended behaviour will lessen the threat. Remember that different types of evidence works with different audiences.

Use a messenger who is a credible source of information - The person delivering the message must attract attention, model actions and consequences, bolster beliefs and be memorable. It is important to select an appropriate messenger, as no one messenger will always be applicable to the situation. Messenger credibility is enhanced by power, perceived expertise, perceived honesty, attractiveness and similarities with the target audience.

Make messages believable - The messages provided must be realistic. They should not make extreme claims or use extreme examples, have highly dramatic episodes or provide misleading information.

Use an appropriate tone in the message - Match the tone with the intended audience. Always avoid preaching or dictating.

Use appropriate appeal for the audience - Rational appeals are effective with audiences that are already interested in your topic. Emotional appeals are effective with audiences that are not yet interested in your topic.

Avoid offensive messages - Consider the views of anyone who might encounter the message. Ensure that it will not harm or be offensive to someone who may see it. Remember to be sensitive, as behaviours such as smoking, eating, exercising and drinking are complicated behaviours that are not always personal choices. Never assume that the behaviour is the person's fault or responsibility.

Display identity throughout - Include a name, a positioning statement, a logo, a slogan and any other images in the campaign identify. An identity amplifies the impact of a campaign.

Use this list together with audience analysis, message pre-testing and campaign evaluation as part of developing a broader health communication strategy.

These summaries are written by the NCCMT to condense and to provide an overview of the resources listed in the Registry of Methods and Tools and to give suggestions for their use in a public health context. For more information on individual methods and tools included in the review, please consult the authors/developers of the original resources.

We have provided the resources and links as a convenience and for informational purposes only; they do not constitute an endorsement or an approval by McMaster University of any of the products, services or opinions of the external organizations, nor have the external organizations endorsed their resources and links as provided by McMaster University. McMaster University bears no responsibility for the accuracy, legality or content of the external sites.

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