1. EXTENSION AND PUBLIC HEALTH:
PARTNERING TO CO-CREATE
HEALTH MESSAGES

2. LEARNING OBJECTIVES &
ENGAGEMENT
 LEARN:
 Participants will be able to understand the
empowerment framework
 Participants will gain an introductory
understanding of how the research findings can
be translated into application.
 DO: Participants will develop up to 3 Core Health
Messages using our template, so they will leave
with the capacity to develop health messages in
other group settings using the provided
template.

3. BACKGROUND: WORKING
WITH RURAL FAMILIES
 Rural, low-income families experience
 Poorer health outcomes
 Limited availability and access to health services
 Inadequate health insurance coverage
 Low levels of health literacy
 Studies focused on rural health disparities
 Rural Families Speak (RFS)
 Rural Families Speak about Health (RFSH)
 Rural Health and Safety: Core Health Messages

4. KEY CONCEPTS:
HEALTH LITERACY
 Health literacy principles suggest that health
information must be
 Scientifically sound
 Easy to understand and do
 Culturally appropriate
 Emotionally appealing

5. KEY CONCEPTS:
EMPOWERMENT THEORY
By playing an active role in the development of
health messages, mothers may gradually feel
empowered to make good health-related decisions
and perhaps extend to their outlook on life
Actively develop
health messages
Perceive control
over one’s life
Feel
empowered to
make good
decisions
Accomplish
goals

6. PARTICIPANTS
 92 ethnically diverse mothers (African American,
Asian American, Hispanic, Native American, and
White) living in rural communities in eleven
states
 Primary caregivers of at least one child between
the ages of 0 and 12
 Income 185% or less than the federal
poverty line

7. DATA COLLECTION
 Tested initial health messages in the areas of:
 Physical health, dental health, and food security
 Health care reform
 Used learner-focused approach to test messages
using focus groups and interviews

8. RESULTS
 Participants responded to questions about:
 Their own health and their health literacy
 Perceived sense of control
 Appeal of test health messages
 Preferences for receipt of health messages
 Participants discussed what elements mattered
most to them in a health message

9. SO WE DEVELOPED THIS
TEMPLATE
FINAL MESSAGE
Empathetic about their busy life
Tells a short story or includes simple steps that the mothers find easy to do
Positive – what good can happen after you do the action
In mother’s voice citing an authority figure
Medium amount of content

10. WE TESTED IT WITH
CONTENT EXPERTS
EMPOWERMENT
MESSAGES
THEMES
Dental Health
Message Set
Food Security
Message Set
Health Insurance
Options Message Set
Physical Health
Message Set
DEVELOPED BY LINDA ALDOORY (2010) WITH BONNIE BRAUN AND ELISABETH MARING, UNIVERSITY OF MARYLAND, COLLEGE PARK.

11. HERE’S AN EXAMPLE:
DENTAL HEALTH MESSAGE
FINAL MESSAGE #2
I have two kids and I am always busy and pinched for money! I want my children to be healthy. I
don’t want my kids to have cavities like I did. Our dentist told me that my kids might get cavities
if they don’t drink water with fluoride and use toothpaste with fluoride. Because our rural water
doesn’t have fluoride, I’ve been buying bottled water and toothpaste with fluoride added to
prevent cavities.
Empathetic about their busy life
(“..I am always busy and pinched for money!”)
Tells a short story or includes simple steps that the mothers find easy to do
(“..I have been buying bottled water and toothpaste with fluoride..” )
Positive – what good can happen after you do the action
In mother’s voice citing an authority figure
(“Our dentist told me…”)
Medium amount of content

12. A PHYSICAL ACTIVITY MESSAGE
FINAL MESSAGE #2
My doctor told me to be more active. He said it is okay to break the activity into small amounts
at a time, like walking to the street to get the mail or parking a distance away from the store and
walking. I have learned to use the time I am being active to be with my kids. They have a lot of
energy so going with them is a good way for all of us to be active and spend time together. Now
I feel calmer and it’s easier to deal with my kids, too.
Empathetic about their busy life
(“I have learned to use the time I am being active to be with my kids.”)
Tells a short story or includes simple steps that the mothers find easy to do
(“..break the activity into small amounts at a time...” )
Positive – what good can happen after you do the action
(“..is a good way for all of us to be active and spend time together.”
In mother’s voice citing an authority figure
(“My doctor told me…”)
Medium amount of content

13. A FOOD SECURITY MESSAGE
FINAL MESSAGE #3
Let me tell you about Maria/Mary. She is a busy mom of three. She’s always pinched for money
for food. A local health educator recommended that she keep a grocery list throughout the
week or month leading to a trip to the store to save time and so she doesn’t buy what she
doesn’t need.
Empathetic about their busy life
(“She is a busy mom of three.”)
Tells a short story or includes simple steps that the mothers find easy to do
(“..she keep a grocery list throughout the week or month...” )
Positive – what good can happen after you do the action
(“..to save time and so she doesn’t buy what she doesn’t need.”
In mother’s voice citing an authority figure
(“A local health educator recommended…”)
Medium amount of content

14. ACTIVITY

15. ACTIVITY: CREATE 3 HEALTH
MESSAGES
FINAL MESSAGE
Empathetic about their busy life
Tells a short story or includes simple steps that the mothers find easy to do
Positive – what good can happen after you do the action
In mother’s voice citing an authority figure
(e.g., “my dentist told me…” “My health educator told me…”)
Medium amount of content

16. ACKNOWLEDGMENTS
Sheila Mammen, Yoshie Sano, Swetha Valluri, and all the
mothers and state Project Investigators who dedicated their
time and expertise to better understanding rural families.
This study is funded by a Rural Health and Safety grant from
the USDA National Institute of Food and Agriculture.
Partners include:
University of Massachusetts, Amherst
Washington State University
University of Maryland Extension
Rural Maryland Council
Maryland Rural Health Association
University of Maryland School of Public Health
Herschel S. Horowitz Center for Health Literacy
And 14 Rural Families Speak state research teams