Hong Kong Academy of Medicine. CC BY-NC-ND 4.0
EDITORIAL
Leveraging the power of health communication:
messaging matters not only in clinical practice
but also in public health
Harry HX Wang, PhD1,2,3 #; YT Li, MPH4 #; Martin CS Wong, MD, MPH5,6
1 School of Public Health, Sun Yat-Sen University, Guangzhou, China
2 Department of General Practice, The Second Hospital of Hebei Medical University, Shijiazhuang, China
3 Usher Institute, Deanery of Molecular, Genetic and Population Health Sciences, The University of Edinburgh, Scotland, United Kingdom
4 State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
5 JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
6 Editor-in-Chief, Hong Kong Medical Journal
# Equal contribution
Corresponding author: Prof Martin CS Wong (wong_martin@cuhk.edu.hk)
In routine clinical practice, communicating with
patients in a clear and persuasive manner during
patient-provider encounters is increasingly
important for effective healthcare. This greatly helps
in improving access to care and diagnostic safety,
fostering continuous healing relationships, reducing
medical errors, strengthening family and social
support, enhancing care adherence, increasing
patient satisfaction, and avoiding malpractice
claims.1 2 3 Moreover, effective communication is
a pivotal ingredient in patient engagement and
shared decision-making across the care continuum
from screening and diagnosis through palliative
care built on the patient’s greater knowledge of
health problems and the clinician’s better ability
to recognise individual patient beliefs, values,
needs, and preferences.4 This, in turn, enables the
development and dissemination of evidence-based,
personalised messages from clinicians to inform
diagnosis, treatment options, prognosis, and the
likelihood of severe adverse effects for achieving
optimal care for patients.5
The benefits of effective health communications
in improving patient health outcomes and well-being
also extend beyond clinical care. Whether to
inform people about their health facts or to exert a
long-lasting influence on their behaviour for living a
healthier life, the use of different strategies is crucial
in public health campaigns spanning a variety of
areas, including the ongoing coronavirus disease
2019 (COVID-19) pandemic.6 7 Of equal importance
is the integration of health communication in public
advocacy and outbreak responses, which necessitate
appropriate, practical, and straightforward messages
that fill knowledge gaps for the target audience.
From a public health perspective, eye health
is a global imperative for achieving universal health
coverage and many of the Sustainable Development
Goals. Improving eye health contributes substantially to maintaining independence and daily life activities,
improving quality of life and well-being, ensuring
educational attainment and workplace productivity,
and reducing poverty and inequalities.8 Similar to
the prevention and management of most chronic
diseases, promoting and improving eye health also
require a life course approach that aims to minimise
risk factors through evidence-based interventions at
important life stages from as early as the perinatal
period through early childhood to adolescence, and
into older age. Therefore, school-based public health
efforts that incorporate expertise of education and
communication of health messages to facilitate long-term
behaviour changes in children and adolescents
would have the most impact on reducing disease risk
factors and disease onset in later-life.9 Engagement
in collaborative endeavours from both teachers and
parents has been proven effective in the problem-solving
process to support school-age children with
developmental disorders and impairments in social
interaction.10 Whether the school-family partnership
underpinned by teacher-parent communication
could be linked with improved behaviour changes,
eg, vision screening attendance, in other specific
disease contexts such as vision impairment warrants
further investigation.
Uncorrected refractive error, including
myopia, hyperopia, astigmatism, and anisometropia,
serve as the major and most easily avoidable cause
of vision impairment among school-age children
who are at risk of poor educational performance and
social malfunctioning. In this issue of the Hong Kong
Medical Journal, Du et al11 explore the association
between teacher-parent communication and eye-health
seeking behaviours of primary school students
in a cross-sectional study conducted in rural China.
The authors found that the delivery of a single
clear message to parents from the teacher on the
student’s inability to see the blackboard clearly could substantially improve the refractive examination
attendance and spectacles wearing among students.
It adds evidence to extend the benefits of teacher-parent
communication beyond better educational
experiences, coordinated learning environments,
improved academic achievements, and enhanced
habits development in daily life. The findings also
provide impetus for further in-depth research to
advance our understanding of the extent to which
different modalities of teacher-parent interactions
could inform, educate and empower parents about
their child’s eye health issues. This may help in
generating evidence for developing well-integrated,
innovative strategies to plan and implement school-based
eye health initiatives featured by strengthened
partnership with teachers, parents, students, and
the wider community to address undiagnosed
or untreated refractive error and other vision
impairment.
At the global level, an earlier report from the
World Health Organization in 2019 highlighted
the considerable challenges of a continuum of eye
care throughout people’s lives: over 2 billion people
worldwide are visually impaired or blind, and nearly
half of vision impairments could have been prevented
or have yet to be addressed through cost-effective
and feasible health interventions.12 The subsequent
74th World Health Assembly organised in April
2021 has endorsed the global targets for effective
coverage of refractive errors and cataract surgery—the two leading causes of vision impairment and
blindness. A 40% point increase in effective coverage
of refractive error and a 30% point increase in
effective coverage of cataract surgery is envisaged
by 2030. Apart from refractive errors and cataract,
there are a range of other common ophthalmic
conditions that pose enormous threats to healthcare
such as glaucoma and diabetic retinopathy, which
can lead to eye vision loss if not detected and treated
early. Most recently, the Resolution entitled ‘Vision
for Everyone; accelerating action to achieve the
Sustainable Development Goals’ has been adopted
by the United Nations General Assembly in July 2021
to urge the implementation of integrated people-centred
eye care in health systems across the wide
spectrum of promotive, preventive, curative and
rehabilitative services by 2030. The United Nations
vision underscores the significance of raising
awareness and engaging and empowering people and
communities pertaining to eye care needs and the
importance of vision for all. To achieve this goal, eye
health education and promotion within the wider
community needs to reduce barriers that impede the
affective dimensions of message dissemination and
to optimise knowledge communication and service
uptake.
However, achieving effective communication
of health messages is never an easy task. Previous studies highlighted the increasing need for
strengthening health communication and promotion
in socially disadvantaged groups,13 or those living
in deprived areas,14 and for care empowerment in
managing underdiagnosed long-term conditions that
require better professional education and tailored
messages in primary care.15 16 The need for health
communication efforts and mass media messages
promoting infection control measures and use of
guidelines in public education is also highlighted in
risk communications and community engagement
against the COVID-19 outbreak.17
A growing body of evidence indicates that
digital communication, eg, mobile messaging for
telecommunications or social media platform
characterised by multi-channel communications,
may offer innovative means for sharing, disseminating
and amplifying health messages across all aspects of
the communication spectrum to target audience and
communities with unique merits such as enhanced
audio-visual capabilities, improved attendance at
healthcare appointments, and increased uptake of
comprehensive eye examinations.18 19
The World Health Organization has also
proposed a strategic framework that highlights
the principles of accessible, relevant, actionable,
timely, credible and trusted, and understandable
communication.20 The framework could be used a
basis for operationalising effective, integrated and
coordinated communication across a broad range
of health issues from chronic conditions (eg, vision
impairment) to emerging risks (eg, COVID-19), and
for measuring the impact of tailored communication
efforts on health and well-being over time. A
further step towards empirical evidence from well-designed
studies on the impact of enhanced health
communication with individuals and their families
on disease prevention, health promotion, and
quality of life through public health measures and its
enablers would pave the way for achieving universal
health coverage for individuals, communities, and
society at large.
Author contributions
All authors contributed to the concept or design; acquisition
of data; analysis or interpretation of data; drafting of the
article; and critical revision for important intellectual content.
All authors had full access to the data, contributed to the
study, approved the final version for publication, and take
responsibility for its accuracy and integrity.
Conflicts of interest
The authors have declared no conflict of interest.
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