Today's U.S. Latino population is growing, dynamic and evolving, reflecting a new American reality. Latino culture and family dynamics impact healthcare decisions and behaviors. Recognizing that Latinos are not a homogeneous group, experts from media, academic research and public health promotion will share insights, tips and tools in this timely webinar for closing the cultural communication gap with this diverse population. After this session, participants will be able to: - Identify diversity among Latino populations and take appropriate steps to build a communication ecology relative to that diversity - List at least two healthcare myths about Latinos - Describe the role that media, community and family influences play in healthcare decisions - Describe how to reach Latinos more effectively through culturally relevant communication and outreach Speakers: Sonya Suarez-Hammond, Senior Director of Strategy & Insights/Healthcare at Univision Communications Dr. Holley Wilkin, Professor and affiliated faculty of the department of Partnership for Urban Health Research at Georgia State University Dr. Carmen Gonzalez, Postdoctoral Scholar at the Annenberg School for Communication and Journalism at the University of Southern California. Moderator: Nancy Murphy, Executive Vice President, Metropolitan Group. This presentation was from the fifth session in the CALPACT sponsored Health Communication Matters Webinar Series, which will help participants in all walks of public health to apply health literacy principles to their everyday communications. Please visit here to listen to the audio recording of the webinar: http://cc.readytalk.com/play?id=2peynd Visit these links for the other resources related to this webinar: Resources: http://www.slideshare.net/SPHCalpact/putting-culture-into-context-resources Health Literacy Undervalued by Public Health? A tool for public health professionals: http://www.slideshare.net/SPHCalpact/calpact-training-health-literacy-undervalued-by-public-health-training-tool Follow Us on Twitter: @CALPACT Facebook: http://www.facebook.com/CALPACTUCB Website: www.calpact.org Questions? Email sphcalpact@berkeley.edu

1. Welcome to the Webinar
Health
Communica/on
Ma1ers!
Pu$ng
Culture
Into
Prac0ce:
Communica0ng
with
Diverse
La0no
Communi0es
We
will
begin
shortly…

2. Today you’ll be hearing from. . .
Holley Wilkin, PhD
Georgia State University
Sonya Suarez-Hammond
Univision Communications, Inc.
Carmen Gonzalez, PhD
University of Southern California

3. I will be your moderator. . .
Nancy Murphy, MSHC
Metropolitan Group,
Moderator

4. Agenda
1. Review
of
session
objec0ves
2. Introduc0on
of
today’s
speakers
3. The
New
American
Reality:
Hispanics
and
Healthcare
4. Q
&
A
5. Crea0ng
a
Communica0on
Ecology
6. Q
&
A
7. Specific
ac0ons
and
resources

5. Objectives
• Iden0fy
diversity
among
La0no
popula0ons
and
take
appropriate
steps
to
build
a
communica0on
ecology
rela0ve
to
that
diversity
• List
at
least
two
healthcare
myths
about
La0nos
• Describe
the
role
that
media,
community
and
family
influences
play
in
healthcare
decisions
• Describe
how
to
reach
La0nos
more
effec0vely
through
culturally
relevant
communica0on
and
outreach

6. Health
Literacy:
Undervalued
by
Public
Health?
A
tool
for
public
health
professionals.
Prepared
for
the
American
Public
Health
Associa0on
Community
Health
Planning
&
Policy
Development
Sec0on
Tammy
Pilisuk,
MPH
AUG
2011

7. Who is speaking today:
Sonya Suarez-Hammond
Sonya Suarez-Hammond
Senior Director, Strategy & Insights
Univision Communications, Inc.
Email: ssuarez-hammond@univision.net
Website: http://univision.net

8. Who is speaking today:
Carmen Gonzalez and Holley Wilkin
Carmen Gonzalez, PhD
University of Southern California
Email: cagonzal@usc.edu
Holley Wilkin, PhD
Georgia State University
Email: hwilkin@gsu.edu

9. Who is moderating our
discussion today:
Nancy Murphy, MSHC
Nancy Murphy, MSHC
Executive Vice President,
Metropolitan Group
Email: nmurphy@metgroup.com
Website: www.metgroup.com

10. Introducing Sonya Suarez-
Hammond
Sonya Suarez-Hammond
Senior Director, Strategy & Insights
Univision Communications, Inc.
Email: ssuarez-hammond@univision.net
Website: http://univision.net

11. Pu@ng
Culture
Into
Context:
Communica/ng
with
Diverse
La/no
Communi/es
Presented
by:
Sonya
Suarez-­‐Hammond
Senior
Director,
Strategy
&
Insights
Healthcare
Team
Univision
CommunicaAons
April
8,
2014

12. Agenda
ü U.S.
Hispanics:
The
New
American
Reality
ü Hispanic
Healthcare
Landscape
ü Engaging
Hispanic
Pa/ents
ü Key
Takeaways

13. U.S.
Hispanics:
The
New
American
Reality

14. The
New
American
Reality
55.7M Hispanics in the U.S. Today!
In 2014 Hispanics
represent:
• 17.5% of Total U.S.
Source: U.S. Census Bureau, 2014 National Population Projections July 1, 2012 to July 1, 2060. Released December 2012.

15. The
New
American
Reality
55.7M Hispanics in the U.S. Today!
In 2014 Hispanics
represent:
• 17.5% of Total U.S.
• 24.6% of Children 0-17
Source: U.S. Census Bureau, 2014 National Population Projections July 1, 2012 to July 1, 2060. Released December 2012.

16. The
Changing
Face
of
The
Na/on’s
Youngest
Popula/on
Source: National Statistics Reports Volume 62 Number 1. Births Final Data for 2011 Released June 28, 2013
1 in 4
Babies born in the U.S.
is Hispanic
1 in 2
Babies born in CA and TX
is Hispanic

17. The
New
American
Reality
55.7M Hispanics in the U.S. Today!
In 2014 Hispanics
represent:
• 17.5% of Total U.S.
• 24.6% of Children 0-17
• 19.9% of Adults 18-49
Source: U.S. Census Bureau, 2014 National Population Projections July 1, 2012 to July 1, 2060. Released December 2012.

18. The
New
American
Reality
55.7M Hispanics in the U.S. Today!
In 2014 Hispanics
represent:
• 17.5% of Total U.S.
• 24.6% of Children 0-17
• 19.9% of Adults 18-49
• 9.6% of Adults 50+
Source: U.S. Census Bureau, 2014 National Population Projections July 1, 2012 to July 1, 2060. Released December 2012.

19. Hispanic
Popula/on
Expected
To
Double
31%
of
the
U.S.
Popula/on
Will
Be
Hispanic
By
2060
% ofTotal
Total
14.6
22.4
35.3
50.5
63.7
78.6
94.8
111.7
128.7
6.4%
9.0%
12.5%
16.3%
19.1%
21.9%
25.0%
27.9%
30.6%
1980 1990 2000 2010 2020 2030 2040 2050 2060
Today:17.5%
Actual Forecast
Source: U.S. Census Decennial Census 1980, 1990, 2000, 2010. 2012 National Projections Released
December 2012.

20. A
ques0on
for
Sonya
You’ve just shared some great
statistics to help clarify myths and
misunderstandings about the
presence of Hispanics in the U.S.
now and in the future.
What about some of the myths
specifically related to healthcare?
What are some of the biggest
misunderstandings there?

21. $40Bspent by Hispanics
on out-of-pocket
healthcare
expenditures in
20124
$19B
42%of Hispanics
covered by
private
insurance3
34%of Hispanics
covered by
governme
nt insurance3
vs.
71%of all Hispanics currently
have health insurance
vs. 88% of Non-Hispanics1
10.2 Million
uninsured Hispanics
are ACA eligible for
insurance2
Source: 1. U.S. Census Bureau, 2012 American Community Survey (1-Year Estimate); 2. Center for Medicaid and Medicare Services 2011 Analysis of
uninsured and eligible population; 3. Census Bureau, Current Population Survey, 2012 Annual Social and Economic Supplement.; 4. Global Insight
2013 Hispanic Market Monitor Forecast ; 5. Symphony Health TRx Retail Dollars MAT Ending September 2013, Based on Adults 18+.
Dispelling
Hispanic
Healthcare
Myths
Health
Expenditures
Health Insurance

22. $40Bspent by Hispanics
on out-of-pocket
healthcare
expenditures in
20124
$19B
42%of Hispanics
covered by
private
insurance3
34%of Hispanics
covered by
government
insurance3
vs.
71%of all Hispanics currently
have health insurance
vs. 88% of Non-Hispanics1
10.2 Million
uninsured Hispanics
are ACA eligible for
insurance2
Source: 1. U.S. Census Bureau, 2012 American Community Survey (1-Year Estimate); 2. Center for Medicaid and Medicare Services 2011 Analysis of
uninsured and eligible population; 3. Census Bureau, Current Population Survey, 2012 Annual Social and Economic Supplement.; 4. Global Insight
2013 Hispanic Market Monitor Forecast ; 5. Symphony Health TRx Retail Dollars MAT Ending September 2013, Based on Adults 18+.
Dispelling
Hispanic
Healthcare
Myths
Health
Expenditures
Health Insurance

23. $40Bspent by Hispanics
on out-of-pocket
healthcare
expenditures in
20124
$19B
42%of Hispanics
covered by
private
insurance3
34%of Hispanics
covered by
governme
nt insurance3
vs.
71%of all Hispanics currently
have health insurance
vs. 88% of Non-Hispanics1
10.2 Million
uninsured Hispanics
are ACA eligible for
insurance2
Source: 1. U.S. Census Bureau, 2012 American Community Survey (1-Year Estimate); 2. Center for Medicaid and Medicare Services 2011 Analysis of
uninsured and eligible population; 3. Census Bureau, Current Population Survey, 2012 Annual Social and Economic Supplement.; 4. Global Insight
2013 Hispanic Market Monitor Forecast ; 5. Symphony Health TRx Retail Dollars MAT Ending September 2013, Based on Adults 18+.
Dispelling
Hispanic
Healthcare
Myths
Health
Expenditures
Health Insurance

24. $40Bspent by Hispanics
on out-of-pocket
healthcare
expenditures in
20124
$19B
42%of Hispanics
covered by
private
insurance3
34%of Hispanics
covered by
governme
nt insurance3
vs.
71%of all Hispanics currently
have health insurance
vs. 88% of Non-Hispanics1
10.2 Million
uninsured Hispanics
are ACA eligible for
insurance2
Source: 1. U.S. Census Bureau, 2012 American Community Survey (1-Year Estimate); 2. Center for Medicaid and Medicare Services 2011 Analysis of
uninsured and eligible population; 3. Census Bureau, Current Population Survey, 2012 Annual Social and Economic Supplement.; 4. Global Insight
2013 Hispanic Market Monitor Forecast ; 5. Symphony Health TRx Retail Dollars MAT Ending September 2013, Based on Adults 18+.
Dispelling
Hispanic
Healthcare
Myths
Health
Expenditures
Health Insurance

25. U.S.
Hispanics
Healthcare
Landscape

26. Percep/on
is
Not
Reality
47%
of
Hispanics
rate
their
health
as
very
good/excellent
vs.
38%
of
Non-­‐Hispanics
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.
Even though Hispanics have high
prevalence of many disease states,
their health perceptions are still more
positive…

27. Source: 2010 Yankelovich MONITOR Multicultural Marketing Study, Based on P16+.
Top 2 Box Summary of Amount of Worry or Stress Caused by Each of the Following
In Healthcare
It’s All About the Family
62% of Hispanics vs. 47% of Non-Hispanic
Whites
The Health of Other Family Members
“I worry about….”

28. Source: 2010 Yankelovich MONITOR Multicultural Marketing Study, Based on P16+.
Top 2 Box Summary of Amount of Worry or Stress Caused by Each of the Following
In Healthcare
It’s All About the Family
62% of Hispanics vs. 47% of Non-Hispanic
Whites
The Health of Other Family Members
“I worry about….”
42% of Hispanics vs. 23% of NH
Whites
Taking Care of Elderly Family Members

29. Family
Dynamics
and
Cultural
Values
Impact
Healthcare
Behavior
Multi-
Generational
Household
Structure

30. Family
Dynamics
and
Cultural
Values
Impact
Healthcare
Behavior
Familialismo
& Collectivism
Multi-
Generational
Household
Structure

31. Family
Dynamics
and
Cultural
Values
Impact
Healthcare
Behavior
A Holistic
Approach
to
Healing
Familialismo
&
Collectivism
Multi-
Generational
Household
Structure

32. Family
Dynamics
and
Cultural
Values
Impact
Healthcare
Behavior
A Holistic
Approach
to
Healing
Power
Distance
Multi-
Generational
Household
Structure
Familialismo
&
Collectivism

33. Family
Dynamics
and
Cultural
Values
Impact
Healthcare
Behavior
Power
Distance
Spiritualism
& Religion
Familialismo
&
Collectivism
A Holistic
Approach
to
Healing
Multi-
Generational
Household
Structure

34. Family
Dynamics
and
Cultural
Values
Impact
Healthcare
Behavior
Power
Distance
Spiritualism
& Religion
Familialismo
&
Collectivism
A Holistic
Approach
to
Healing
Fatalism
Multi-
Generational
Household
Structure

35. Family
Dynamics
and
Cultural
Values
Impact
Healthcare
Behavior
Power
Distance
Spiritualism
& Religion
Familialismo
&
Collectivism
A Holistic
Approach
to
Healing
Fatalism
Machismo &
Marianismo
Multi-
Generational
Household
Structure

36. HispanicsRelyonFamilyand
Friends
57% of Hispanics cite
“friends/family” as a
source
of health and nutrition
info
vs.41%ofNon-Hispanics
Source: UCI Patient Journey Proprietary Research 2012; Based on Hispanics who visited a doctor and have a positive relationship.
Note: Survey respondents reflect symptomatic or diagnosed patients suffering from at least one of 9 diseases measured in the study.

37. 25%
32%
45%
46%
57%
67%
5%
11%
52%
61%
39%
58%
Health
Insurance
Companies
Pharmaceu/cal
Manufacturers
Nurses
Pharmacists
Hospitals
Doctors
Hispanic
Non-­‐Hispanic
Hispanics
Are
More
Trus/ng
in
their
Sources
of
Healthcare
Informa/on
Source: Univision / Experian Simmons/ Pharmaceuticals Advertising Awareness Study
Base: Total Respondents Q9. Using a scale of “1” to “5” where “1” is “not at all trustworthy”
and “5” is “extremely trustworthy”, please indicate how much you trust in each of the following.
Cultural
differences
appear
in
varying
levels
of
trust
in
health
care
professionals

38. A
ques0on
for
Sonya
Wow! That’s a great picture you’ve just
painted for us about the influences in
health and healthcare decisions.
So what should we do with that
information? How can we apply that
information to improve communication
and engagement with Hispanics in
healthcare settings?

39. Understanding
and
Engaging
Hispanic
Pa/ents

40. Internal
Tug-­‐of-­‐War
Source: Univision Patient Journey primary researchSource:
2012
UCI
Pa0ent
Journey
Proprietary
Research
-­‐
Focus
Groups

41. Among
Hispanics
Top
3
Challenges
to
Seeking
Medical
Care
Among
Non-­‐Hispanics
1st
Prefer
to
use
a
healthy
diet
and
exercise
1st
Prefer
to
use
a
healthy
diet
and
exercise
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research;
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.
Among
respondents
who
saw
a
Dr/Specialist
for
their
Primary
Condi0on
&
waited
more
than
a
month
to
make
an
appointment
from
the
0me
their
symptoms
started
OR
they
did
not
see
a
Dr/
Specialist
for
their
Primary
Condi0on.

42. Among
Hispanics
Top
3
Challenges
to
Seeking
Medical
Care
Among
Non-­‐Hispanics
1st
Prefer
to
use
a
healthy
diet
and
exercise
2nd
Feel
I
am
in
good
health
overall
so
I
don’t
need
to
seek
medical
care
1st
Prefer
to
use
a
healthy
diet
and
exercise
2nd
Afraid
of
worrying
my
family
if
I
am
found
ill
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research;
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.
Among
respondents
who
saw
a
Dr/Specialist
for
their
Primary
Condi0on
&
waited
more
than
a
month
to
make
an
appointment
from
the
0me
their
symptoms
started
OR
they
did
not
see
a
Dr/
Specialist
for
their
Primary
Condi0on.

43. Among
Hispanics
Top
3
Challenges
to
Seeking
Medical
Care
Among
Non-­‐Hispanics
1st
Prefer
to
use
a
healthy
diet
and
exercise
2nd
Feel
I
am
in
good
health
overall
so
I
don’t
need
to
seek
medical
care
3rd
Afraid
of
the
possibility
of
needing
surgery
1st
Prefer
to
use
a
healthy
diet
and
exercise
2nd
Afraid
of
worrying
my
family
if
I
am
found
ill
3rd
Difficult
for
me
to
leave
home
due
to
family
care
responsibili/es
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research;
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.
Among
respondents
who
saw
a
Dr/Specialist
for
their
Primary
Condi0on
&
waited
more
than
a
month
to
make
an
appointment
from
the
0me
their
symptoms
started
OR
they
did
not
see
a
Dr/
Specialist
for
their
Primary
Condi0on.

44. Key
Drivers
Offer
Mo/va/on
Top
INFLUENCERS
among
Hispanics
to
seeking
medical
care:
“I
want
to
be
healthier
than
I
am
now”
“I
want
to
prevent
any
limita/ons
to
my
ac/vi/es
“
“I’m
afraid
I
won’t
get
be1er
without
medical
care
“
“I
don’t
want
my
illness
to
prevent
me
from
enjoying
family
/me
or
celebra/ons
“
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research;
Based on Hispanics who visited a doctor and have a positive relationship.
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.

45. The
Doctor-­‐Pa/ent
Rela/onship
Needs
A1en/on
Characterizing
Rela/onship
with
their
Primary
Care
Doctor:
Makes me feel at ease
Only 42% ofHispanicsvs. 56%ofNon-
Hispanics
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.

46. The
Doctor-­‐Pa/ent
Rela/onship
Needs
A1en/on
Characterizing
Rela/onship
with
their
Primary
Care
Doctor:
Makes me feel at ease
Only 42% ofHispanicsvs. 56%ofNon-
Hispanics
Understands my needs
Only 40%of Hispanics vs. 55% of
NHs
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.

47. The
Doctor-­‐Pa/ent
Rela/onship
Needs
A1en/on
Characterizing
Rela/onship
with
their
Primary
Care
Doctor:
Makes me feel at ease
Only 42% ofHispanicsvs. 56%ofNon-
Hispanics
Understands my needs
Only 40%of Hispanics vs. 55% of
NHs
Respects my opinion
Only 36%of Hispanics vs. 49% of NHs
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.

48. The
Doctor-­‐Pa/ent
Rela/onship
Needs
A1en/on
Characterizing
Rela/onship
with
their
Primary
Care
Doctor:
Makes me feel at ease
Only 42% ofHispanicsvs. 56%ofNon-
Hispanics
Understands my needs
Only 40%of Hispanics vs. 55% of
NHs
Respects my opinion
Only 36%of Hispanics vs. 49% of NHs
Understands my fears
Only 31%of Hispanics vs. 39% of NHs
Source:
2012
UCI
Pa0ent
Journey
Proprietary
Research
Note:
Survey
respondents
reflect
symptoma0c
or
diagnosed
pa0ents
suffering
from
at
least
one
of
9
diseases
measured
in
the
study.

49. A
Holis/c
Approach
to
Disease
Awareness
and
Educa/on
Family
&
Friends
Healthcare
Professionals
Pharmacists
Clinics
&
Health
Fairs
Media
(Tradi/onal,
Digital,
Social)
Community
&
Cultural
Events

50. Media
Plays
a
Cri/cal
Healthcare
Role
and
Helps
Hispanics
Take
Ac/on
83% of Hispanics
received health
information from
the media, and
79% took action
from the media.
Source: 2008 PEW Research http://pewresearch.org/pubs/923/hispanics-health
79%
Took Action
from Media
IMPACTof MEDIA
83%
71%
63%
31%
From
the
Media:
TV,
Radio,
Print,
Internet
From
Doctors
&
Other
Health
Professionals
From
Family
&
Friends
Church
or
Community
Groups
From the Media:
TV, Radio, Print,
Internet
41%
57%
64%
Affected
decision
on
how
to
treat
an
illness
or
medical
condi/on
Lead
to
ask
a
doctor
or
other
medical
professional
new
ques/ons
Changed
their
way
of
thinking
about
diet
&
exercise

51. Key
Takeaways
ü Today’s U.S. Hispanic market is a growing, dynamic and
evolving population group reflecting a newAmerican
reality.

52. Key
Takeaways
ü Today’s U.S. Hispanic market is a growing, dynamic and
evolving population group reflecting a newAmerican
reality.
ü Hispanic culture and family dynamics impact healthcare
decisions and behaviors. Hispanic cultural insights
should be leveraged in Hispanic communications for
optimal patient engagement.

53. Key
Takeaways
ü Today’s U.S. Hispanic market is a growing, dynamic and
evolving population group reflecting a newAmerican
reality.
ü Hispanic culture and family dynamics impact healthcare
decisions and behaviors. Hispanic cultural insights
should be leveraged in Hispanic communications for
optimal patient engagement.
ü Cultural communication gap must be closed. Reach the
Hispanic patient through culturally relevant
communication outreach.

54. Key
Takeaways
ü Today’s U.S. Hispanic market is a growing, dynamic and
evolving population group reflecting a newAmerican
reality.
ü Hispanic culture and family dynamics impact healthcare
decisions and behaviors. Hispanic cultural insights
should be leveraged in Hispanic communications for
optimal patient engagement.
ü There is a cultural communication gap that must be
closed. Reach the Hispanic patient through culturally
relevant communication outreach.
ü Understanding cultural factors can lead to better Hispanic
patient engagement and improved health outcomes.

55. Thank
You.
Gracias.

56. Discussion/Q&A
Ask Sonya!
Share with Sonya!

57. Introducing
Carmen Gonzalez and Holley Wilkin
Carmen Gonzalez, PhD
University of Southern California
Holley Wilkin, PhD
Georgia State University

58. A Communication Ecology Approach to
Studying Latina Health
Holley Wilkin, Ph.D. & Carmen Gonzalez, Ph.D.
University of Southern CaliforniaGeorgia State University

59. Goals/Preview
¨ Introduce communication infrastructure
theory
¨ Present a community-level case study of
Latina health

60. “85 or 90 percent of the time they’re super full.
They people are sleeping from waiting so long. If
only it were easier, if they had more clinics,
perhaps they’d have better service.…A mother of
a 5-year old girl in Pico Union
Our focus group
participants say…
“There are insurances that they do not accepts in all the clinics,…and some of
the nurses are really mean. We’re not asking for anything for free…it’s even
less [welcoming] if one doesn’t speak English well and doesn’t understand”
A mother of two kids in South Gate
Communication Infrastructure Theory
Neighborhood
Storytelling
Network
RESIDENTS
& FAMILIES
LOCAL
MEDIA
COMMUNITY
ORGS

61. Communication Infrastructure Theory
“85 or 90 percent of the time they’re super full.
They people are sleeping from waiting so long. If
only it were easier, if they had more clinics,
perhaps they’d have better service.…A mother of
a 5-year old girl in Pico Union
Our focus group
participants say…
“There are insurances that they do not accepts in all the clinics,…and some of
the nurses are really mean. We’re not asking for anything for free…it’s even
less [welcoming] if one doesn’t speak English well and doesn’t understand”
A mother of two kids in South Gate
Communication
Environment
Neighborhood
Storytelling
Network
RESIDENTS
& FAMILIES
Ethnic
Diversity
Public Spaces
(Libraries, parks,
Street
Safety
Transportation
Goods &
Services
Work
Conditions
Area
Appearance
Schools
Health Care Resources
Law
Enforcement
LOCAL
MEDIA
COMMUNITY
ORGS
Communication Infrastructure Theory

62. Storytelling Network & Health
Local/
Ethnic Media
Community &
Non-Profit
Organizations
Residents/
Families
The storytelling network
+

63. Storytelling Network & Health
Local/
Ethnic Media
Community &
Non-Profit
Organizations
Residents/
Families
The storytelling network
+
Breast cancer & diabetes
knowledge (Kim et al.,
2011)

64. Storytelling Network & Health
Local/
Ethnic Media
Community &
Non-Profit
Organizations
Residents/
Families
The storytelling network
+
Breast cancer & diabetes
knowledge (Kim et al.,
2011)
Perceived ease of
receiving medical care
(Wilkin & Ball-Rokeach,
2011)

65. Storytelling Network & Health
Local/
Ethnic Media
Community &
Non-Profit
Organizations
Residents/
Families
The storytelling network
+
Breast cancer & diabetes
knowledge (Kim et al.,
2011)
Perceived ease of
receiving medical care
(Wilkin & Ball-Rokeach,
2011)
Exercise (Wilkin et al.,
2012)

66. Inconsistent & Additional Findings
¨ No relationship:
¤ Prostate cancer knowledge (Kim et al., 2011)
¤ Fruit and vegetable intake (Wilkin et al., 2012)

67. A
ques/on
for
Carmen/Holley
So if your research shows that the
storytelling network can have some
real positive outcomes for health,
how do we use it?
What does that look like?

68. Implications
¨ Strengthen STN connections
¨ Turn to the STN to tell stories about health
issues
¨ Identify communication ecologies

69. COMMUNICATION
ECOLOGIES
IN
LOS
ANGELES
|
GLENDALE

70. COMMUNICATION
ECOLOGIES
IN
LOS
ANGELES
|
GLENDALE
Anglos
in
Glendale
26%
38%
32%
Mainstream
TV
M.
Newspapers
Interpersonal
13%
Internet

71. COMMUNICATION
ECOLOGIES
IN
LOS
ANGELES
|
GLENDALE
Anglos
in
Glendale
26%
38%
32%
Mainstream
TV
M.
Newspapers
Interpersonal
13%
Internet
Armenians
in
Glendale
30%
30%
12%
19%
Mainstream
TV
Geo-­‐Ethnic
TV
M.
Newspapers
Interpersonal

72. COMMUNICATION
ECOLOGIES
IN
LOS
ANGELES
|
GLENDALE
Anglos
in
Glendale
26%
38%
32%
Mainstream
TV
M.
Newspapers
Interpersonal
13%
Internet
Armenians
in
Glendale
30%
30%
12%
19%
Mainstream
TV
Geo-­‐Ethnic
TV
M.
Newspapers
Interpersonal
La/nos
in
Glendale
31%
27%
25%
25%
Mainstream
TV
Geo-­‐Ethnic
TV
M.
Newspapers
Interpersonal

73. COMMUNICATION
ECOLOGIES
IN
LOS
ANGELES
|
GLENDALE
La/nos
in
Glendale
31%
27%
25%
25%
Mainstream
TV
Geo-­‐Ethnic
TV
M.
Newspapers
Interpersonal

74. COMMUNICATION
ECOLOGIES
IN
LOS
ANGELES
|
GLENDALE
La/nos
in
Glendale
31%
27%
25%
25%
Mainstream
TV
Geo-­‐Ethnic
TV
M.
Newspapers
Interpersonal
La/nos
in
Pico
Union
19%
45%
17%
33%
Mainstream
TV
Geo-­‐Ethnic
TV
G-­‐E
Newspapers
Interpersonal

75. USC’s Multilevel Study
The Multilevel Study identifies
individual, interpersonal, and
community-level barriers to
cervical cancer prevention
among Latinas.

76. Cervical Cancer in LA County by Ethnicity
9.3
7.6
14.3
7.5
0
2
4
6
8
10
12
14
16
Asian Black Latina White
Incidence rates per 100,000. Source: LA County Department of Public Health, Office of Women’s Health. Health
Indicators for Women in Los Angeles County, February 2010.

77. Multilevel Study Design
1,655 in-person surveys of Latinas in LA County
identification of 25 neighborhood clusters
focus groups with survey respondents from 6 unique
neighborhoods
health communication asset mapping
systematic social observation in 6 unique neighborhoods

78. Theoretical Framework
sister
mom
home
remedy
internet
doctor
neighbor
otc
magazine
home
remedy
clinic
“A communication ecology is a network of communication resources
constructed by an individual in pursuit of a goal and in context of
their communication environment” (Metamorphosis Project, 2011)

79. Transnational Health

80. Transnational Health Findings
¨ 54% use products from a botanica
¨ 52% use home remedies regularly
¨ 37% use non-prescription medicine from their
home country
¨ 30% use prescription medicine from their home
country

81. Transnational Health Findings
ü Women who report higher levels of transnational
health experience higher disregard of their feelings
or emotions on behalf of medical professionals.

82. Transnational Health Findings
ü Women who report higher levels of transnational
health experience higher disregard of their feelings
or emotions on behalf of medical professionals.
ü Women who report higher levels of transnational
health are more likely to be non-compliant with
cervical cancer screening guidelines (having a Pap
test every 3 years).

83. A
ques/on
for
Carmen/Holley
Wow! More great insight to help
us understand the Hispanic
healthcare consumer.
Can you share with us some
specific tools or techniques for
improving communication?

84. Health Communication Asset Mapping (HCAM)

85. Concepts & Definitions
• Communication Assets: physical components of the
urban environment that residents consider positive
spaces of social and community interaction
• Health Communication Assets: spaces where
residents feel comfortable talking about health or
where health information can be shared with the
community

86. Concepts & Definitions
• Communication Assets: physical components of the
urban environment that residents consider positive
spaces of social and community interaction
• Health Communication Assets: spaces where
residents feel comfortable talking about health or
where health information can be shared with the
community
Communication assets can be used as capacity-
building blocks to promote healthier
communities and strengthen neighborhood
storytelling networks.

87. Boyle Heights
HCAM Workshop

88. HCAM Curriculum

89. Collaborative Map

90. Collaborative Map
1. LAC+USC Medical Center
Also known as County/USC, this is the
largest healthcare provider in Los Angeles
County. LAC+USC is one of the few medical
centers in LA that provides low-cost or
free health services, including emergency,
gynecological and pediatric care.
2. East Los Angeles
Occupational Center
ELAOC provides technical training and
job placement for adults and high school
students. It was chosen as a health
communication asset because it is a space
where health fairs or workshops with
residents can be held.
3. Proyecto Pastoral
This community building organization
provides training, education and social
services for the Boyle Heights community.
It is a space that can promote health
by organizing change from within the
community.
4. Self Help Graphics
This is a non-profit visual arts center that
hosts many art events and workshops
for residents of all ages. They are a vital
community resource that can incorporate
health topics in their arts and culture
programs.
5. White Memorial
Medical Center
White Memorial is a not-for-profit, faith-
based, teaching hospital. It provides
inpatient, outpatient and emergency
services to the community, including
general medical care and women’s and
children’s services.
6. Mariachi Plaza
This historic square includes restaurants,
a Metro Gold Line station, and shops such
as the bookstore Libros Schmibros. It has
traditionally served as a gathering place
for the community and would be a good
place to share information with residents.
7. Mendez Learning Center
The Center is a small public high school
that prepares students for success while
maintaining a focus on family and
community. Health can be promoted here
through educational activities that are
already in place.
8. Boyle Heights Technology
Youth Center
This community resource center is part
of the LA Youth Opportunity Movement
and includes an alternative high school,
recording studio and computer lab. It is a
good space to `share health information
with young residents.
9. Hollenbeck Park
This park is very well known in the
community as a space where many
events occur, including large health fairs.
Hollenbeck park is a place where families
go to relax and spend time interacting
with other residents.
10. Stevenson Parents Center
As part of Stevenson Middle School,
the Center was created to promote
the involvement of parents in youth
education. The center can be a good place
to promote community health through
educational activities.
GET INVOLVED! A healthy
Boyle Heights depends on
residents, community
organizations, and health
workers sharing health
information. Here are some
examples of resources to share:
This work was supported by the National Cancer Institute for Barriers to Cervical
Cancer Prevention in Hispanic Women: A Multilevel Approach, which was an
award to the University of Southern California (R01CA155326 - Murphy/
Ball-Rokeach). The content is solely the responsibility of the authors and does
not represent official views of the NCI or of the National Institutes of Health.
There are many spaces in the community where
people gather or feel comfortable talking about health.
Below we highlight some of the health communication
assets in Boyle Heights.
ENVIRONMENTAL JUSTICE
& AIR POLLUTION:
Air Quality Management District
(AQMD): report pollution in your
neighborhood (noise, smells, &
smoke from local industry; pollut-
ing vehicles) – 1-800-CUT-SMOG
Clean Up Green Up: Find out how
to get involved in local environ-
mental justice work. Visit
www.CLEANUPGREENUPLA.org
CLINICA ROMERO:
For information about pap tests,
mammograms, and pre-natal care
213-989-7700 FOR NEW PATIENTS
BUILDING HEALTHY
COMMUNITIES
BOYLE HEIGHTS
COLLABORATIVE:
A collaborative of nonprofit groups
working to make Boyle Heights a
healthier community by improving
employment, education, housing,
safety, environmental conditions,
healthy food access and more. For
information, please contact Joel
Perez at JOELBHC@YMCALA.ORG.
EAST LOS ANGELES
WOMEN’S CENTER:
Ensures that all women, girls, and
their families live in a place of
safety, health, and personal well-
being, free from violence and abuse,
with equal access to necessary
health services and social support.
DIRECT LINE: 323-526-5819,
BILINGUAL RAPE & BATTERING
HOTLINE: 800-585-6231,
AIDS HOTLINE: 800-400-7432
211: A countywide human services
crisis intervention, information and
referral assistance hotline.
311: A citywide toll-free number
that provides immediate access to
information and more than 1,500
non-emergency city services
BOYLE HEIGHTS BEAT:
A bilingual community newspaper
produced by youth. Adult con-
tributors also share their stories
on BOYLEHEIGHTSBEAT.COM/
PULSODEBOYLEHEIGHTS.COM.
Find out how to be a community
contributor by visiting the site or
calling 323-834-975.
Corra La Voz
Spread The Word
“We chose Hollenbeck Park
because it is very well known
among the community, and
in fact there was a health fair
when we stopped there.”
HOW WE MADE THIS MAP:
Promotoras de Salud, community
organizers, and researchers
walked the neighborhood and
mapped good spaces where health
communication can occur.
For more information on this map
go to www.metaconnects.org.

91. GIS MAP

92. Key Takeaways
No “one size fits all” for outreach
Include the perspective of residents and community leaders
Use the indigenous storytelling network in your outreach
Figure out what health storytellers are most important to
your audience
Identify local communication assets and resources

94. THANK YOU

95. Questions for our speakers
Holley Wilkin, PhD
Georgia State University
Sonya Suarez-Hammond
Univision Communications, Inc.
Carmen Gonzalez, PhD
University of Southern
California

96. Evalua/on
&
Ques/ons
• An evaluation will pop up following today’s
webinar ─ please share your feedback that will
help us improve future webinars
• Let us know if you’d like to follow-up on anything
we touched on today
• Additional questions? Contact our presenters or
moderator

97. Resources
• hep://www.univision.net/healthcare
• hep://www.metamorph.org
• hep://www.metaconnects.org
97

98. Speaker
Contact
Informa/on
Sonya
Suarez-­‐Hammond
ssuarez-­‐hammond@univision.net
Carmen
Gonzalez,
PhD
cagonzal@usc.edu
Holley
Wilkin,
PhD
hwilkin@gsu.edu

99. Thank
you
to
our
Sponsors
Community Health Planning and Policy
Development Section, APHA

100. Thank
you
to
our
planning
commi1ee
• Tammy
Pilisuk,
MPH,
APHA-­‐CHPPD
• Erin
Brigham,
MPH,
CareSource,
APHA-­‐CHPPD
• Meghan
Bridgid
Moran,
PhD,
San
Diego
State
University,
School
of
Communica0ons
• Lisa
Peterson,
MPH,
CALPACT
at
UC
Berkeley
• Nancy
Murphy,
MSHC,
Metropolitan
Group
• Stefanie
Smithey,
Metropolitan
Group

101. About
This
Series
• The
Health
Communica<on
Ma=ers
series
will
help
par0cipants
in
all
walks
of
public
health
to
apply
health
literacy
principles
to
their
everyday
communica0ons.
• What
audiences
do
you
communicate
with—consumers,
health
professionals,
disenfranchised
communi0es,
your
public
health
peers?
Whatever
your
role
in
public
health,
it’s
likely
that
you
need
to
communicate
effec0vely.
But
how
do
you
know
your
communica0on
is
effec0ve?
• Only
about
10
percent
of
the
general
popula0on
is
considered
“health
literate.”
That
leaves
the
vast
majority
of
us
with
barriers
to
understanding
the
health-­‐related
informa0on
we
read.

102. Conclusion
Thank
you!
www.calpact.org