Segmentation and the "hard-to-reach" others.

Last week our class discussed segmentation and ways to reach our target audience when trying to inform public of health information. We read an article that discussed "hard-to-reach" audiences and questioned our labeling of this population. I have a little story for you:

During the fires in October, I knife block fell on my hand cutting it very deeply. I was working but not sure at this point if I had insurance, so I waited and called friends for help. By the time I had a friend drive me to student health for stitches, I had gone through 2 towels and 7 t-shirts and the bleeding continued. I was dropped off on campus by a friend (thank goodness campus was closed during the fires so I didn’t scare everyone with my dripping hand) and trying to find the student health services building. It was my first semester and not sure where student health was at this point. I ran into a middle-aged employee driving one of those campus golf carts. I asked if he could give me a ride to student health, mind you I had a dripping towel and trash back over my hand. He looked at me and my wrapped up hand and told me he was not supposed to give people rides. He instead called the police who intersected me (all 9 of them) and wouldn’t let me go any further. They then started interrogated my frightened friend who had finally found parking. I had to defend him and explain the situation and asked them repeatedly to let me go to student health and that they were expecting me. I explained my lack of health insurance. I explained that I was a (poor) student. It didn’t help and next thing I know the paramedics came. They kept calling me the wrong name… “Rachel” or something and next thing we know we were off to Alvarado Hospital. I remember them saying I was “feisty” and “non-cooperative”. They said since it was a short distance and wouldn’t cost that much. I guess I wanted to believe that at the time, or maybe I was too tired or frustrated. At Alvarado I waited for 4 hrs before someone came by to take a look at my hand. I was anesthetized twice since I had to wait so long and it wore off each time. As I waited, I contemplated my escape route and planned all sorts of ways to dash out of that hospital. Eventually, my responsible PH side of me kicked in and I asked if there was a social worker. They said no, she was only there once a week. I asked if I could fill out a CMS form to help pay for the bill, and the nurse said “ we don’t do that anymore” and gave me a form meant for the homeless. I filled this out knowing that I wouldn’t qualify since I was not at a shelter. Long story short, a month later, I got a bill for around 3 thousand. I asked my work about insurance (Blue Cross) and told I was liable for anything under 3 grand, so too bad. I pulled out another student loan. I recently found out that the Dr. who gave me stitches at Alvarado didn’t tie up a serrated tendon. I still don’t have insurance, Ive applied for insurance and been denied for “pre-existing conditions”. I cant afford surgery on my hand or insurance with the crazy premiums. I’m still uninsured and my hand is in its same condition.

Anyhow, the whole point of this story is that if I, as a public health grad student, cant figure out how to get service and help myself, how do I help other people in the same situation? If I see police and paramedics and freak out and start planning my escape, how must other individuals feel that have had negative encounters in the past? If your friend, like me, had the same reaction and worried more about the cost than her health, what’s going with our society? Is there really a “hard-to-reach” population or is it just convenient to have labels?

Catchy

Recently in class we discussed if health campaigns should use a more heuristic approach (such as using women in bikinis) to appeal to a larger target audience and/or catch more attention by using similar appealing icons. Do health campaigns need to set the standard when it comes to choosing how it portrays its messages? Should we “stoop down” to the media’s level in order to drive the point home and minimize the systematic more facts based approach?

I know that I depend readily on cues and have more of a peripheral processing approach when it comes to adds. I tried to answer some of these questions as I flipped through TV channels and imagined myself as an unknowing target audience. I realize that while I have high expectations of health campaigns to set the standard, I don’t have the same expectations of the rest of the media. I’m more likely to be critical of a health campaign because I believe that it is supposed to have some standard of truth and decency. However, when it came to the rest of the media, while I do find an abundance of adds that are offensive, I generally don’t start out with the same readiness to have a critical approach. In fact, I looked forward to watching some advertisements during the super bowl this past weekend in hopes that I would find one to be appealing or catchy. How do we make health campaigns that are just as appealing but that still set the standard when it comes to how it portrays its message?

One approach the Department of Health in the UK is taking for an anti-smoking drive directed toward youth is appealing to their vanity. Messages such as "If you smoke, you stink", and a focus on "minging teeth" and "cat's bum mouth". While these statements and images are attention grabbing, do they run the risk of not giving enough facts? Is is this process of persuasion the only way to get the message to youth? What do you think?