learning from the ‘kcnd’ communications campaign ann kerr, team head kenny mcdonald,...
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Learning from the ‘KCND’ communications campaign
Ann Kerr, Team HeadKenny McDonald, Communications Manager
Ali MacDonald, Health Improvement Programme Manager
NHS Health Scotland
What the campaign was trying to doHow the evaluation assessed the campaignFindingsImplications for the new HEAT target
Content
Aims of campaign
The campaign supported the Keeping Childbirth Natural and Dynamic (KCND) programme. It ran in 3 phases from winter 2009 through to spring 2011.The activity aimed to raise awareness of the changes among both those supporting the delivery of care and people using services in order to enhance uptake.This evaluation followed pre-testing and aimed to assess what was understood by the key messages, was it successful in reaching target groups, and how was the information used and acted upon.
Evaluation methodology and sample;1. Public
• Face-to-face interviews with: Pregnant women; Women with a new baby; Socio-demographic ABC1C2DE; Aged 16–45; Urban and rural locations (3 HB areas) Including BME and hard to reach groups.
• Mini groups: Pre-family women of child-bearing age; Family women of child-bearing age (with children 1-3
years).
• Depth interviews: community pharmacists; sexual health staff.
• Mini groups: GP practice managers; GP practice receptionists.
Evaluation methodology and sample2: Professional ‘Gatekeepers’
The majority of women in the sample undertaking pregnancy testing at home, purchased mainly in supermarkets or Pound Shops (C2DE teenage/younger women), with some in pharmacies.
Most sought ‘official’ confirmation from GP.
A few had confirmed their pregnancy via a pharmacist, sexual health clinic or GP in the first instance.
How do women find out they are pregnant?
What do women know about contacting services?
There was little awareness:
• That confirmation of pregnancy by GP not necessary• Of the benefit or existence of the new pathway• About the role of the midwife• When to make initial contact with health services
General perception that ‘nothing happens before scan’ (in context of midwife interaction).
Women in specific groups
Who to contact is strongly patterned by age, ethnicity and deprivation:
Young women & lower socio-economic groups - check out with peers and family
Older/more affluent women- GP Gypsy travellers- NHS 24/GP Chinese community-GP South Asian-midwife accepted
• Driven by word of mouth • Choice of who and who to contact also affected by past
experience and peer/family information • Health professionals and gatekeepers in primary care
are key• Some indication that, when seen, the campaign added
weight to peer reports of the pathway• General feeling that it is important to involve GP
What is behind choice of contact?
Campaign awareness- public
Awareness when prompted Message only relevant to women in early
pregnancy Message interpreted as ‘tell a
midwife/doctor/someone if you’re pregnant’
• Benefits of early access not understood by all
• Widely viewed as a secondary message
• Often seen simply as a gentle means of encouragement rather than an important component of antenatal care
Impact on knowledge- getting in early
• Some assumed it meant as soon as you know;
• Others assuming 10-11 weeks into the pregnancy (just prior to the first scan taking place);
• Some simply reading as ‘sooner rather than later’.
What does ‘Get in early’ mean?
• Recall mainly limited to the public facing elements
• Most of the GP practice gatekeepers in Grampian and Lanarkshire recalled receipt of the posters and ‘credit cards’
• Recall of this campaign in Lothian was unclear (awareness related primarily to the materials produced by NHS Lothian)
Campaign awareness:Practice managers and receptionists
• Not aware of the changes to antenatal access• Still automatically referring to GP (practice),
believing practice receptionists will signpost• Some awareness of variation in first point of
contact - not attributable to a change in pathway• Assumption being this is focused on individual
need or local protocols
Campaign awareness: Community pharmacists and sexual health staff and nurses
Across all of the gatekeeper and professional sample, only one individual recalled the information pack:
• No practice managers or receptionists remembered receiving the briefing note;
• Majority felt it would have been very valuable.
Campaign awareness: Professionals
“We get lots of information that comes in
that kind of format.”Practice manager, Lanarkshire
“It just looks like one of those letters you’re always getting; you know, ‘dear colleague…’. Immediately it’s not a letter to you, it’s a general circular letter. If you’ve got time you’ll read it, but most of the time you skim to see whether there’s something you need to do…”Practice manager, Lothian
Campaign awareness : professionals
Implications for HEAT
Women’s pathways to care are complex and socially patterned
There is a very narrow timeframe to get the message across to women
The benefits of ‘getting in early’ are not clearly understood
Health professionals and their ‘gatekeepers’ are critical in providing this information
Professional communication is enhanced by back up resources
Mass media (posters etc) are not the best way to get the message across
Critical role of GP needs to be recognised
Methods of communicating information to ‘gatekeepers’ need to be tested
Key messages about the benefits of ‘getting in early’ for the public need to be explored and tested
Ways of getting the messages across in a range of communities need to be developed
Implications for HEAT
Next Steps at Health Scotland
Health Scotland will be developing social marketing approaches for the new targetPlease get in touch if you would like to be involved in planning this, or in any testing or pilot work
Contacts: www.healthscotland.com [email protected] [email protected] [email protected]
Any questions?