Audience raising their hands

Healthcare Stakeholders – Sustaining Engagement (part 1)

This article is one of two. In this article we discuss the principles of engagement and the impacts on how, when and where people choose to engage. In other words initiating engagement. In the second article to be published later, we will address the challenges of keeping people engaged over the longer term, that is sustaining engagement.

Engagement is a two way relationship

Empathy in primarily a human trait, demonstrating this element is possibly one of the most important factors to achieving sustainable engagement and participation. People are increasingly engaged by the idea that they are accomplishing some social good, while still acting in a way that suits and benefits them as an individual but yields social good.

Engagement is a continuous exchange of information between what is expected and what is really happening. Engagement is about a conversation that draws people out, hears what they are saying and then re-craft the message to suit. Certain words, situations and contexts resonate more with certain people. The more something echoes with an individuals’ experiences, the more it resonates. These days the power of digital enables and requires that every act of communication has to and can be intensely iterative. Such constant iteration maximises the level of resonance with the target audience leading to increased engagement and participation.

Consumers such as patients are more empowered than at any time in our history. If patients feel that they are involved in decision making related to their health and that their voices are being listened to, there is more willingness on their side to continue to actively participate. Such participation leads to better outcomes for patients, healthcare professionals and health systems overall.

Storytelling to create a narrative has to be considered in any long-term engagement, not only as the hook or the primer, but as a method of creating or inducing beliefs. It should not be thought of as merely a method of simplification. Engagement might require simplicity at the beginning, but for it to last, nuanced repetition of the message with additional layers may be required. Engagement is not just about grabbing attention, it needs to last, to sustain attention and keep the relationship strong. Maintaining the relationship is key and requires regular consistent communication through various channels.

Balancing realistic Aspiration vs unrealistic Dream

The goals people set themselves for example to be better informed and make better health choices have to be realistic. We all dream of things we will never be able to reach. Aspirations are possibilities we know that with a lot of effort and hard work, we might be able to reach and will be very rewarding.

Recent research into promoting healthy eating in obese people revealed that showing an image of a slightly overweight person motivates people to follow a diet more than if they were shown an image of a professional athlete. This is because athletes (and their bodies) represent an unrealistic goal, an unattainable dream. The key is to be able to find the right range in which can move the audiences from their current position. To bridge the gap between dream and reality, affordability and potential. Whether patients are made to feel like they can achieve goals or not determines their motivation to connect and participate.

Impact of immediate vs future reward

The brain balances the amount of time and energy we invest with what we expect to receive. Primary rewards tend to be more immediate for example receiving a positive message on social media is instantly pleasing and processed by the brains’ more primitive unconscious system. More abstract rewards or future facing choices are processed by a more evolved part of the brain. For example achieving weight loss after weeks of sticking to a particular diet versus the pleasure of eating something very desirable today.

The ‘wanting’ system is the primary or basic reward system while the ‘liking’ system is activated when anticipate receiving something in the future. The more controlled motivational system is conscious of urges and associated with planning. Short direct messaging stimulates the primary unconscious system. Provision of more rational in depth information satisfies the conscious system. It is interesting to note that research has shown loyalty is a subconscious indicator of engagement.

Studies have demonstrated that engagement and motivation are decided within an instant. We can influence a person’s choices without them knowing, yet people feel they made a rational decision. Unconscious priming has been demonstrated to have a large influence on how we subsequently perceive a service or communication. Products or messages that are subsequently deemed to be highly attractive seem to instantly engage both the visual and the emotional systems of the brain. As the old saying goes, first impression last.

Communication, Engagement and Participation

There was a time when communication spoke with a megaphone and bellowed the message to everyone. There was little attention to the details of how individual’s were responding or to individual responses. The same old message was repeated. Moving to engagement is about being responsive, nuanced, customised, companionable and playful.

Communicators must craft a different kind of signal to engage people because people are now vastly more literate in all matters than ever before. In today’s world everyone is so media literate, if want people to engage, we must craft a message that sparks curiosity. So people think ‘’wait a second what?” that’s the secret of engagement. The worlds of public relations, communications and marketing have changed radically. The misconception of engagement is that the traditional means of communication are, ironically, preventing the very thing it was trying to achieve.

To bring about participation, it’s important to remember ‘manageable difficulty’. A task that’s too easily dispatched gives no real satisfaction, a task that’s way too difficult gives no satisfaction. Bringing about participation requires a balance it should be difficult but not impossible, that is the sweet spot. Active participation helps drives positive behaviours such as being more physically active, making better dietary choices and when relevant improved medical adherence. Interactive quizzes are an excellent means of developing participation.

Engagement Practicalities

Sustained engagement requires forming a relationship over two stages first create curiosity and capture the target audiences or patients’ attention. Secondly investment in time and effort required to build trust by demonstrating integrity through honouring commitments. Imminent reward and delayed reward are processed by two different brain systems. Sustained engagement comes from taking a multi-layered approach to the implementation of the elements of engagement which we will discuss in the next article.

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