Fish and Shellfish Consumption Advisories Home

The fifth step for developing and implementing a risk communication program for fish and shellfish consumption advisories is to develop outreach plans.

The Outreach Plan describes how each target audience will be reached and which channels will be used to communicate with them.

• Prepare Communication Strategy
• Partnering Plans
• Message and Materials Development
• Developing Effective Print Materials for Low-Literacy Target Audiences
• Developing Effective Websites
• Implementation Plans
• Plan How to Establish Follow-up Mechanisms
  • Tasks and timeline

Prepare Communication Strategy

A communication strategy includes everything that is necessary to know how to communicate with the target audience. It defines the target audience, describes the action its members should take, tells how they will benefit (from their perspective, not necessarily from a public health perspective), and how they can be reached. The communication strategy also should contain guiding principles for all program products and activities. A communication strategy is:

• Based on knowledge of the target audience’s wants, needs, values, and accessibility
• Guided by general communication research as well as theories and models of behavior
• Tempered by the realities of available resources and deadlines

For each target audience, consider writing a communication strategy that includes:

1. A definition and description of the target audience (i.e., target - audience profile). Tip - think of one person in the target audience and describe him or her, rather than describing the group. For example, woman of child-bearing age who eats fish.
2. A description of the action the target audience members should take as a result of exposure to the FCA. The action is the change that the Communication Objective specifies. For example, if the desired action is “switch from eating more contaminated to less contaminated fish,” make sure that is noted in your communication strategy.
   • Find out if target audience members are willing and able to take the action and identify the current behavior to change. Knowing what a target audience currently does—and why it does it—will provide important insights into the behavior change process and can be used to develop communications that demonstrate replacing the old behavior with the new one. For example, it may be advisable for target audience members to switch fish consumption from less to more safe species and change their fish cooking habits.
3. A list of any obstacles to taking action.
   • Common obstacles include target audience beliefs, social norms, time or peer pressures, costs, ingrained habits,  and misinformation.
4. The settings, channels, and activities that will reach target audience members, particularly when they will be receptive to or able to act upon the message.
5. The perceived benefit of taking the action. Many theories and models of behavior change include the idea that people change their behavior because they expect to receive some benefit that outweighs the personal cost of the behavior change. For example, the perceived benefit of switching to consuming a less contaminated species of fish would be improved health for women of child-bearing age and healthier babies.
6. A description of the support that will make the benefit, and its ability to attain it, credible to the target audience. Supporting information which can be provided through hard data, peer testimonials about success, demonstrations of how to perform the action, or statements from organizations the target audience finds credible. Tailor the particular supports to the concerns target audience members have about the action. For example, if they are worried they cannot modify their fish consumption, a demonstration may be warranted (e.g., a brochure covering how to change fish cooking habits); if they question why they should take the action or whether it will have the promised health benefits, hard data or statements from credible organizations may be in order; if they do not believe they need to take the action (e.g., they deny being in the target audience), a peer testimonial can be compelling.
7. The image that the FCA program plans to convey through the tone, look, and feel of messages and materials. The goal should be to convey an image that 1) convinces target audience members that the communication is for them and 2) is culturally appropriate. Image is conveyed largely through executional details, whether the materials are printed, web-based or audio. Printed materials convey image through typeface, layout, visuals, color, language, and paper stock used. Web materials convey image through design, typeface, color, layout, and ease of use. Audio materials convey image through voices, language, and music; in addition to these details, video materials convey image through visuals, characteristics of the actors (including their clothing and accessories), camera angles, and editing.

Partnering Plans

Partners can help plan and implement the Outreach Plan for these hard to reach target audiences. Partners can participate in planning, product development and review, and distribution of an Outreach Plan. Partners can also help with evaluation of the FCA program. Partnerships can be valuable mechanisms for leveraging resources while enhancing the quality, credibility, and success of outreach efforts. Partners might include local businesses, environmental organizations, schools, associations, local health departments, local planning and zoning authorities, and other local or state agencies.

Message and Materials Development

The following guidelines can to help in developing materials that target audiences understand, accept, and use:

• Ensure the message is accurate. Scientific accuracy is vital to producing desired outcomes and to the FCA program’s credibility.
• Be consistent. All messages in all materials and activities should reinforce one another and follow the communication strategy.
• Recognize any inconsistencies between the message and what the target audience may have heard from other sources. The best way to determine whether and how to address such inconsistencies is to ask the target audience what impact the disparities have on them and what they need from your program to make decisions and take the desired action.
• Use the same graphic identity in all elements. In print materials, use the same or compatible colors, types of illustrations, and typefaces. If there is a logo or theme, use it in all materials. Graphics and messages should reinforce each other, not send different signals.
• Be clear, keep it simple. Clear messages for lay target audiences contain as few technical/scientific/bureaucratic terms as possible and eliminate information that the audience does not need in order to make necessary decisions or take desired actions. Readability tests can help determine the reading level required to understand material and can help writers be conscientious about the careful selection of words and phrases.
• Prominently feature the action you want the target audience to take. Give people an explicit recommendation of what you want them to do as a result of the message.
• Choose a presentation style appropriate to the target audience’s norms and expectations; people must be able to see themselves in what your program presents.
• Use target audience experience when creating materials. The target audience will learn new information more easily when it is built from the familiar to the unfamiliar (e.g., “When you have a headache that won’t go away, you take an aspirin to relieve it").
• Create the message to match the readiness of the target audience to make a change. The Stages of Change model (Refer to Making Health Communication Programs Work, Appendix B (PDF) (262 pp, 4 MB, About PDF)) describes five stages that people pass through in making behavior changes: precontemplation, contemplation, preparation, action, and maintenance. Messages created to match readiness to change start where the target audience starts. For example, it is unrealistic to expect a target audience that has never heard of the problem to immediately make changes. A realistic outcome is beginning to raise awareness of the issue (precontemplation) and helping move the target audience to a consideration of the change (contemplation).
• Be credible. Be sure that the person, if there is one, who presents the message is seen as a credible source of information, whether as an authority, or target audience representative. Consider partnering with organizations that are credible with the target audience and emphasize their involvement.
• Be appealing. Produce variations of materials to appeal to specific target audience segments. For example, use cartoon-type graphics for children.
• Get the target audience’s attention. Given the number of health and other messages target audiences receive, the FCA must stand out to be noticed. The best way to command attention will differ among target audiences. It can be useful to know what has interested them before, but concept testing and message testing will help ensure that the FCA program’s approach will grab their interest.
• Produce high-quality materials. If FCA managers feel as though resources are very limited, it is better to choose a simpler way of presenting the message rather than producing poor-quality materials which wastes funds and can damage the FCA program’s credibility.

Developing Effective Print Materials for Low-Literacy Target Audiences

Many target audiences may find it difficult to understand scientifically technical language. This is especially true of target audiences with low-literacy skills, but it can affect even those with high literacy. Present the message in a more easily understood way to these target audiences by making specific choices about writing style, vocabulary, typography, layout, graphics, and color. These choices can directly affect whether the message is read and how well target audiences with low-literacy skills understand it.

A common misconception is that low-literacy materials are synonymous with low-reading level materials. That is, if polysyllabic words and long sentences are not used, then the materials will be understood. In fact, low-literacy encompasses more than reading level. The following list includes pointers for designing materials for low-literacy target audiences:

• Include only the information needed to convey the behavioral objective and support the target audience in attaining it. Poor readers may struggle with every word, often reading letter by letter. Keep the FCA short and focused. The biggest challenge for those developing the FCA will be excluding concepts and content points that fall outside of the category of “information the reader must know.” Do not include information just because it may interest the reader.
• Organize topics in the order the reader will use them. Less skilled readers have particular difficulty connecting topics and processing the flow of an argument.
• Present the most important points first and last. Studies show that target audiences with limited literacy skills remember these best.
• Group information into chunks, with a clear, ordered format. Use steps (1, 2, 3), chronology, or topical arrangement (main heading, subheadings), depending on how the person will use the information.
• Respect the target audience. This is especially critical when designing low-literacy materials. The low-literacy population encompasses people of different ages, genders, cultures, and socioeconomic status, including highly intelligent adults with significant life experience who just cannot read very skillfully.
• Follow these guidelines:
  • Use short sentences and paragraphs.
  • Write in the active voice.
  • Clarify concepts with examples.
  • Avoid jargon, technical terms, abbreviations, and acronyms.
  • Include a glossary if necessary (but define key words within the sentence).
  • Give the reader an action step he or she can take right away (e.g., call your clinic, send in a request); this tends to improve retention of information and encourages the reader to begin practicing the desired behaviors immediately.
  • Use graphics and design to make the reader’s job easier and to increase comprehension and recall; make sure they support, rather than compete with, the text.
  • Do not assume that pictorial signs, symbols, and charts are more effective than words for low-literacy target audiences. Some experts suggest that “universal” symbols, such as an arrow, or a big black “X,” usually test well. Do not confuse this target audience with large, busy matrices.
  • Avoid using all capital letters; they are more difficult for everyone to read, particularly so for less skilled readers.
  • Use captioned illustrations that are relevant to the subject matter and model the desired behavior.
  • Use headings and subheadings to convey a message and help reinforce the flow and content.
  • Use bullets and other graphic devices to highlight key messages and to avoid large blocks of print.
  • Avoid right-justified margins.
  • Pretest all materials with the target audience. This is absolutely crucial with low-literacy target audiences. Writers and communication specialists are highly literate by definition. It is impossible for a person who reads well and has a good vocabulary to guess what people without those skills will understand.

Developing Effective Websites

A website should be graphically appealing and provide information about the FCA in an informative manner. It is also helpful to make the site easy to navigate.

To ensure that users will find the site well designed and easy to use, pretest the site as you would any other materials. Usability testing, which tests the site to see how well it helps users meet their goals, is crucial to creating an effective site. The best time to do this testing is as the site is being developed. If the site is not yet running on a computer, test using paper or poster board mock-ups of pages. Conduct usability testing by having a test group of people who represent the target audience actually sit down and use the site to complete tasks, either by themselves or in pairs. Observe how they interact with the site and ask specific questions once they have completed the tasks.

The experiences of the test group and their responses will enable you to improve the site before it is used. If major modifications to the site are made after usability testing, test again before the site goes live. For more information, refer to usability testing.

Implementation Plans

An implementation plan should include how the products will be distributed and promoted and how the FCA program will evaluate those processes. For some products, the FCA issuing agency might manage distribution. For others, it is possible to rely on partners who are willing to participate in the outreach effort. Some points to consider in selecting distribution channels include:

• How each target audience typically receives information
• Effective distribution mechanisms the organization used in the past for these target audience(s)
• Partners which might be willing to assist in the distribution
• Whether or not the media can play a role in distribution
• Numbers of people the product is likely to reach through the distribution mechanism being considered
• Resources available to fund and implement distribution via the mechanisms of interest

Plan How to Establish Follow-up Mechanisms

Successful outreach may cause people to contact the agency issuing the FCA with requests for more information or express concern about issues related to the FCA that have been addressed. Consider whether and how this interest will be handled. The following can help develop this part of the strategy:

• What types of reactions or concerns are target audience members likely to have in response to the information in the FCA?
• Who will handle requests for additional information?
• Where will the contact information be located for people to go for further information (e.g., provide a name, number, or address, or establish a hotline)?

• Making Health Communications Programs Work
• Fish Consumption and Environmental Justice (2002) (PDF) (185 pp, 2 MB, About PDF)
• What We Know about Fish Consumption Advisories: Insights from Experts and the Literature Exitor National Risk Communication Conference Proceedings Document (PDF) (196 pp, 708 K, About PDF)
• Risk Communication in Action: The Risk Communication Workbook (PDF) (75 pp, 15 MB) (EPA, 2007)
• A community-based approach to disseminate health information on the hazards of prenatal mercury exposure in Brooklyn, NY Exit 

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