CVD Knowledge and Prevention Campaign

The British Health Foundation (BHF) Campaign

Research by Lloyd-Jones et al (2010) mentions cardiovascular diseases (CVD) such as stroke and heart disease as one of the leading causes of deaths among various communities worldwide. Yet, evidence by American Heart Association (2005) indicates that having better knowledge about CVD can influence individuals into adopting healthy lifestyles and behaviours, while lack of such knowledge, compounded with misconceptions about the disease, can lead to an increase in the risk of death as a result of a delay in seeking treatment. The proposed health campaign is a symbol for the public’s CVD health awareness, specifically developed to raise the target audience’s understanding of the disease across all populations , including those seeking healthcare dissertation help, i.e. women, men, children, smokers, and obese persons.

Purpose of the Campaign

The main purpose of the campaign is to reduce the prevalence of CVD among the target population by increasing awareness. This is especially based on the reason that knowledge gap about CVD and healthy habits to avoid it increases the risk profile of such populations towards CVD (Stone et al, 2014). Moreover, according to Vestbo et al (2016), failure to understand basic information about CVD such as the signs of heart attack, or response and management techniques of a stroke may increase chances of death when such incidences occur. Hence, the main purpose of this health campaign was to develop a knowledge base among the target audience about the risk factors, signs, and management techniques of CVD.

Key Message of the Campaign

The campaign holds that a lack of knowledge about CVD, its risk factors and prevention strategies is still an impediment to healthy living among the target audience. Besides, the target audience (i.e. children, obese persons, men women, and smokers) are at a higher risk if they do not adopt healthy behaviours. More importantly, the campaign holds that a number of factors related to this population e.g. sedentary lifestyle, metabolic syndrome, high rates of diabetes, socio-cultural environments and chronic conditions increase the risk for CVD. Therefore, having adequate knowledge about these conditions and how they contribute to the risk of CVD is important (UK Dieticians 2019).

How the Campaign Relates To Recent Health Policy

The current campaign is underpinned on various public policies that not only act as guidance to its implementation but also exists as targets to be achieved by the campaign. For instance, the campaign makes reference to the Childhood Obese Strategy policy that was recently launched by the UK government in collaboration with the NHS. Ideally, according to The Association of UK Dieticians (2019), the policy is based on the knowledge that once a child has developed obesity, it tracks through childhood to adolescence and this phenomenon is a major health concern because obesity is associated with adverse health outcomes both in the long-term and in the short-term. In fact, UK Dieticians (2019) states that in the long-term, children are bound to suffer from CVD diseases including stroke, diabetes and certain types of cancer. On the same note, the policy holds that additional actions are required to address the issue of child obesity, one of them being the promotion of health knowledge on obesity and its health effects. This campaign is also related to the Tobacco-Free Policy. According to Barber (2017), the tobacco-free policy seeks to reduce smoking prevalence among adults and young people in the UK, as well as to reduce the smoking prevalence among pregnant women. The Considering tobacco smoking as a risk factor for CVD, the current campaign will make specific reference to the Tobacco-Free Policy especially in regards to the role it plays in helping users to quit and enhancing effective communication for tobacco control. In this regard, part of the key messages of the campaign was the need to quit tobacco smoking and how quitting would help reduce the chances of CVD. Nonetheless, the campaign also made specific references to the No Health without Mental Health policy, the Smoking Strategy, the Public Health and Safety Policy, and the Ensure Positive Care Experience to Patient policy.

How the Campaign Relates To Recent Relevant Research

There are several pieces of research evidence that validated and informed the current health campaign. For instance, Cannon et al (2015) underscore the importance of conducting a successful health campaign where there is a coordinated effort among different stakeholders to promote a particular aspect of health. More interestingly, recent research by Rowe & Illic (2015) evaluated the effectiveness of poster campaigns in health knowledge transfer and found that well-designed academic posters are effective in communicating health messages, although they highlighted that poster campaigns should be complemented by verbal interactions to enhance their effectiveness. Existing evidence also highlight the important role that mass media can play in creating health awareness and promoting health lifestyle for specific target audiences. for example, a study by Homik & Yanovitzky (2003) emphasized on how mass media can be used in both direct and indirect healthcare pathways to promote healthy living behaviours among a certain population. They observed that the use of mass media campaigns to evoke the population’s emotional and cognitive responses can be highly effective in creating a change their lifestyles. Ideally, the programs are intended to influence the decision-making processes of an individual, and their anticipated outcomes commonly include: elimination or reducing the obstacles of change, enabling the target population to recognize abandon unhealthy social habits and to associate valued emotion with change achievement (Homik & Yanovitzky, 2003). It is based on these evidence that the current campaign adopts the poster as a medium for creating awareness about CVD. The poster intends to use catchy images that may influence the emotional and cognitive responses of the target population towards a lifestyle change.

Implementation of the Campaign

Campaign Initiators

The British Healthcare Foundation campaign was initiated by a team of Health Science students who believe in the power of knowledge transfer and its direct application in the development of health knowledge among the vulnerable populations in society. Upon realising the vital nature of health campaign on CVD, the students approached various stakeholders in the UK’s healthcare sector, including The General Medical Council (GMC), the Nursing and Midwifery Council (NMC), The Department of Health (DoH) and The Socialist Health Association UK (SHA); to support the program and contribute to its success.

The Target Audience

Rose (1985) argues that population-based interventions are among the most effective interventions useful in sustainably reducing the burden of CVD. Nonetheless, Jackson et al (2006) insist that failure to target the individuals at high risk will reduce the impact of the intervention both in the short term and in the long term. Against this backdrop, the campaign was determined to target everyone within the community, as well as individuals who are at most risk of CVD. Ultimately, the target population was settled to be men, women, children, obese persons, smokers and alcoholics.

The Project Time Frame

Developing an effective health campaign requires elaborate planning that considers all the necessary activities and resources required to effectively deliver the campaign. The campaign was scheduled to run from 23rd December 2018 to 3rd January 2019. It was deemed that this timeline would allow a comprehensive implementation of the campaign plans; including needs assessment, campaign designing, campaign adoption, and implementation, and campaign evaluation.

Campaign Costs and Resources

Financial resources are among the most important elements of any health campaigns because any activity involved in such campaigns are accompanied by costs (Rowe & Ilic, 2015). During the entire campaign process, there are specific costs that were incurred or expected to be incurred by the implementation team. The first category of costs was related to writing the poster content, and this was to a tune of £ 1500. Ideally, this category of the cost covered the cost of developing the concept document, conducting research and developing the final content. The next category of cots was those related to publishing the posters. The implementer needed a professional graphic designer to design the pictures, font size and to upgrade the general aesthetics of the poster. In total, 500 posters were published. The third category of costs were those incurred in facilitating volunteers to assist in distributing the posters and verbally highlighting the campaign’s key messages to the target audience. The last category of the cost were those related to the campaign location. The following table highlights the costs and relevant activities.

Theoretical Underpinnings of the Campaign

The activities of this campaign were translated from theory to practice. As such, the campaign relied on various theories and models as a guide to effective implementation of the campaign. The first theory applied in the campaign is the Health Belief Model (HBM) which states that health issued can be evaluated from the perspective of four key elements namely the susceptibility, the severity, benefits, and barriers (Lloyd-Jones et al 2018). Susceptibility is related to the extent to which an individual is vulnerable to the risk of the disease and based on this susceptibility, health professionals can recommend the best intervention for the disease as well as the best support plan to enhance the health and well-being of the patient. Severity relates to the extent to which the disease affects the victim’s ability to engage in activities of daily living (Ha et al, 2014), while the benefits represent the actions taken by various health professionals towards the disease and how the treatment plan may help improve the health and well-being of the individual. The ultimate aspect of the HBM is barriers associated with health care services including lack of proper clinical infrastructure, inadequate health professionals, lack of social support, and lack of enough treatment interventions and/or drugs for viral and bacterial infections (DeFilippis et al, 2018). In this campaign, we draw on the HB model to make the argument that the target population is vulnerable to CVD and therefore as health professionals, we have a collective responsibility to address this susceptibility through various interventions such as health awareness and knowledge transfer. The model’s emphasis on benefits is especially useful to the analysis of CVD and health education campaign as it allows us to think through the benefits the poster education and campaign will bring to the target population. Another theory that this campaign makes reference to is the diffusion innovation theory, which, according to DeFilippis et al (2018) holds that new clinical frameworks of behaviour can be adopted by the healthcare system as well as the professionals in it following an influence by several factors including physician specialty, efficiency, practice location, social perception and willingness to use new drugs, new interventions and new clinical processes. In this campaign, we draw from the diffusion innovation theory to make an argument that the five adaptation processes in healthcare can be used to enhance awareness and knowledge of CVD among the target population. Particularly, the theory’s emphasis on the five processes (i.e. awareness, persuasion, evaluation, implementation, adaptation processes) of the healthcare system is generative in grasping how the poster campaign can create awareness and persuasion among the target audience to adopt healthy behaviours with intent of reducing the risk of CVD. Nonetheless, another theory relevant to the campaign is the theory of changed behaviour.

Partnership and Collaborative Elements

As hinted earlier, the campaign was executed by a group of college students in collaboration with other organizations such as the Socialist Health Association, General Medical Council, Department of Health, Public Health Engineering and the Nursing and Midwifery Council. These partners majorly came in as financial supporters.

Media

The campaign was predominantly conducted through print media (i.e. printed posters), even though the volunteers also used word of mouth to highlight some points while interacting with the audience.

Monitoring and Evaluation

The campaign was constantly being monitored to ensure that all the activities carried out during the process were geared towards achieving the ultimate goal of the campaign i.e. to educate the target audience CVD, its risk factors and management techniques. In doing so, the volunteers were requested to ensure that they allowed the audience to ask as many questions as possible so that progress could be determined. The received questions where then collectively addressed in subsequent posters to give feedback on the questions. In regards to evaluation, the participants were subjected to a series of questions on a questionnaire to examine how much they understood the message.

Structure

Evaluation and Critical Analysis of the Campaign

There are a few studies that have evaluated the effectiveness of poster as a means of knowledge transfer, especially in the healthcare sector. But, a few that exist provide some interesting insight into the use of poster for knowledge transfer, their pros, and cons. For instance, a systematic review by Davis et al (1999) revealed that whereas continuous medical education was effective in knowledge transfer and changes in attitude, there is a knowledge gap in the use of poster presentation as a means of health education despite its common use. Nonetheless, Rowe & Ilic (2015) argue that posters enable the implementers to reach as many people as possible because they speak for themselves (i.e. without the author’s presence) compared to oral presentations that may also consume time. Grant & Booth (2009) also observe that sometimes while presenting the poster, the researcher might have an opportunity to interact with the target audience, a phenomenon that creates a close contact with the audience, closer than when delivering an oral presentation. Thirdly, according to Etter & Laszlo (2005), posters can be presented on several occasions and used in several times. However, on the flipside, posters are difficult to handle because once they are printed; it is difficult to make any corrections of typing errors – meaning that it is less flexible than oral presentations, which can be modified anytime (Etter & Laszlo, 2005). Also, according to Rowe & Ilic (2009), posters require attention and keenness during the design because they are only effective when they are designed attractively, and this becomes even more complicated when presented alongside other posters within a competitive environment. Last but not least, according to Rowe & Ilic (2009), posters require the authors to reduce the content and to be brief to the point. A possible implication of this is that the author is always in a dilemma of what to include and what not to include.

A Comparison of Current and Previous Campaigns

Several other implementers have used posters to successfully drive health campaigns, although not necessarily on CVD. For instance, Williams & Bethea (2011) launched a campaign involving the use of posters together with an oral presentation to pass the information on oral cancer. The campaign was conducted in a patients’ waiting room and it was found that at least 40% of the participants had read the poster content – triggering a conclusion that the use of poster methodology had limited effects on knowledge transfer. This finding corroborates with the findings of the current campaign which showed that at least half of the participants read the posters. In a similar campaign, Jung et al (2010) were interested in using posters to promote knowledge on sun protective behaviour. An evaluation of the campaign showed that only 50% of the participants noticed the posters while two-thirds of the participants were attracted to the poster graphics. More worryingly, only 5% of the participants sought more information about the message being passed by the author. These results are in agreement with the findings of the current campaign which show that only a few participants were interested in gaining further information about the message being passed. While these pieces of research evidence highlight some of the shortcomings of posters, they do not rule out their effectiveness as a means of health knowledge transfer.

Overall Strengths and Weaknesses of the Campaign

A major strength of the poster campaign was its ability to cover a large audience of more than half of the 500 targeted individuals, meaning that it achieved its objective as far as the target population is concerned. Moreover, the poster content was delivered in plain language, making it easier for the audience to understand the content. However, despite the earlier drawn budget, the project faced financial constraints and was therefore not able to wholly execute its activities.

Effectiveness of the Campaign

From the campaign evaluation, it is possible to say that the campaign was effective because at least 50% of the target audience received the leaflets, with a significant number being able to read and understand the poster content. We, therefore, assume that the poster was effective in passing the health information to a significant portion of the target audience. However, the campaigns would have been more effective if there were more financial resources to facilitate a wider coverage of the target audience. We argue that targeting only 500 participants did not give adequate coverage of the health campaign; while covering more than 500 individuals could not be possible due to financial constraints.

Conclusion and Recommendations

The main objective of this campaign was to reduce the risk of CVD by increasing the knowledge of target audience about CVD through a poster campaign. The campaign also targeted to increase the participants’ awareness about diseases such as stroke, AB resistance and various risk factors for the development of cardiovascular diseases. The campaign targeted an audience of 500 people among them being men, women, smokers, obese children, overweight persons, as well as alcoholic individuals. The campaign has achieved its objective by reaching at least 50% of the target audience, a majority of them being able to read and understand the poster content. Through 20 interactive volunteers, the target audience was able to engage and inquire about the information presented in the poster, a phenomenon confirmed by Jung et al (2010) as effective in health knowledge transfer. But based on the evaluation results, similar campaigns should take a different approach especially considering the target audience, resources and time available; against the overall objectives. If given a chance to conduct a similar project, it would be more elaborate in terms of audience engagement and interaction. First, there would be a need for training of the volunteers on effective communication skills, so that they are able to effectively interact with the target audience, even if they encountered those with hearing or speech disabilities. Besides, there would be a need for more time and space for oral presentation, especially considering the views of reviewed literature that oral presentations are effective in reinforcing the message passed on posters. Hence, there would be a need for more organized presentation sessions with different presenters and facilitators taking the audience through the important aspects of CVD and how to avoid risk factors. This would then be followed by poster presentations and sessions for open discussions on the information presented in the posters.

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