Health communication in and out of public health emergencies: to persuade or to inform?

Abstract

Much health communication during the COVID-19 pandemic has been designed to persuade people more than to inform them. For example, messages like "masks save lives" are intended to compel people to wear face masks, not to enable them to make an informed decision about whether to wear a face mask or to understand the justification for a mask mandate. Both persuading people and informing them are reasonable goals for health communication. However, those goals can sometimes be in conflict. In this article, we discuss potential conflicts between seeking to persuade or to inform people, the use of spin to persuade people, the ethics of persuasion, and implications for health communication in the context of the pandemic and generally. Decisions to persuade people rather than enable them to make an informed choice may be justified, but the basis for those decisions should be transparent and the evidence should not be distorted. We suggest nine principles to guide decisions by health authorities about whether to try to persuade people.

Keywords: Ethics; Evidence-informed health policy; Health communication; Health education; Health information; Health promotion; Infodemic; Persuasion; Risk communication.

Fig. 1

A continuum from information to coercion

Fig. 2

Factors underlying the justification for persuading people to change their behaviour

Fig. 3

In the United States, an ad campaign compared masks to helmets and seatbelts. The campaign, which was initiated after wearing a mask had been made mandatory in most public places but only 66% of residents said they always wore a mask, was based on a survey that showed this was an effective message