Creating awareness, changing attitudes and helping create systemic change requires effective strategies for outreach and sharing impact. This module will focus on how to:

• Identify and map stakeholders
• Create and use a messaging strategy matrix?
• Engage stakeholders in ongoing dialogue and feedback.

Goal:

This chapter will look at the variety of communication channels you may use to keep stakeholders aware of your efforts and impact, and how to set them up prior to your initial outreach efforts.

Big Idea:

Research shows that people need up to seven exposures to a message before they will act.¹⁸

There are multiple channels you can use to communicate with your stakeholders.  The most effective communication strategies will involvement a combination of these:

• Digital Communication - the use of websites and social media platforms.
• Print Media - the use newspaper and magazine coverage and designed publicity materials for specific audiences and stakeholders.
• Television and Radio coverage - the use of paid or public service announcements.
• Convenings - meetings with current and potential stakeholders to raise awareness and share stories of impact and data.

An overview of each digital channel will be provided to help you be more knowledgeable about which one may be best for you.

Websites are one of the most critical digital channels in that they allow you to communicate impact and connect with prospective members.  Establishing a website starts with procuring a domain name. A domain name is reserved through a domain name registrar like GoDaddy or Namecheap. Once you have a domain name, platforms like Squarespace, Wix, or WordPress, are needed to create the website.  These platforms help simplify the process, are relatively inexpensive. They do not require design or technical experience.  Building a successful website, however, requires more than just these tools. An engaging website needs an intriguing story which can be informed by the messaging matrix and Logic Model that created earlier.

Social Media

Social media channels like Facebook, Instagram, LinkedIn, and YouTube are also useful digital channels.  Each has unique audiences, and it is important to pair the audience and channel to maximize the strengths of each.  In order to bolster your knowledge, each of the digital channels is described in more detail below.

Helping Hand

• Optimally, you should post two to three times per week on the Facebook, LinkedIn, Twitter, and Instagram, but at minimum post regularly and consistently.
• Post at different times to catch different audiences.
• Several platforms let you schedule platforms in advance.
• This keeps your project and message “front and center.”
• Regular updates to your website keep your project and message in front of your audience.

Facebook¹⁹

Facebook is useful for sharing content with individuals as well as for promoting business.  The channel has widespread use regardless of age with 84% of those 30-49 utilizing the channel. Utilization of Facebook remains high for those between 50-64 (72%) and those over 65 (62%). Use is nearly equally distributed between females (52%) and males (48%).  On average, Facebook users spend 35 minutes per day on the platform, and 75% of users spend more than 20 minutes a day.  Facebook provides tools to help organizations boost their audience, and Facebook Live now offers the opportunity to share a video from live events. This aids in streaming large convenings or in reporting important news. The channel is both easy to set-up and easy to use, and instructions for getting started are easy to follow.

LinkedIn²⁰

While Facebook is focused broadly, LinkedIn is most effective at promoting individuals and organizations and creating links between them.  80% of B2B social media leads come from LinkedIn.  While the platform's use is evenly distributed between users 18-64, the gender distribution is more heavily skewed with 54% of users being male and 46% being female. Those who use the channel spend 17 minutes on average per day on the site. Like other channels, the instructions for getting started are easy to follow.

Twitter²¹

Twitter has carved out a unique niche amongst the digital channels in that it is used primarily to share news with stakeholders.  Of its users, 75% check the site daily, and 79% of them retweet. However, the time spent on the website is limited to an average of 2.7 min per day.  Its audience is evenly distributed between age groups 18-64. Like other digital channels, this is relatively easy to set up, and they provide useful technical support.

Instagram²²

Instagram has carved out a unique niche amongst the digital channels in that it is best used to share pictures or video content.  It is rarely used alone and is probably best used as a support tool for one of the other digital channels.  It tends to be mainly used by younger audiences (59% of 18-29) and dominated by women (58% to 42%).  On average, users spend 15 minutes per day using Instagram.

YouTube²³

YouTube is best used to promote an archived video and is probably best used as a support tool for one of the other digital channels.  The channel has a broader reach than cable networks with those 18-49 years old.  Those individuals between 25 and 44 most heavily use it.  On average, users spend 40 minutes per day on the platform.

Blogs, Digital Newsletters, and Emails

Blogs, digital newsletters, and emails are also useful tools that can be used to highlight the work of individuals and organizations and the progress that is made. Blogs allow you to create a running commentary that can be useful to the reader. If your goal is to reach a broad audience, email platforms like Constant Contact and MailChimp can be used for pushing out content and for email blasts to those on your list.

Print Media

Print Media, such as newspaper and magazine articles, can be an excellent means to provide awareness for your project. Reaching out to a local newspaper and or community magazine can be profitable. Newspaper and magazines can highlight your cause through a story of interest or at least share your planning meetings in the public service announcements.

Designed Print Materials

It will be important to create and produce print materials that share your project's purpose, call to action, and intended impact.  These are accomplished with promo folders, graphically rich information sheets or cards. It is beneficial to have these professionally produced with a graphics designer to achieve maximum impact. There are several online or application tools, such as Canva, Adobe Suite, and Publisher that allow you to create and produce low cost, but high-quality print materials

Convenings are useful ways to engage both those who are involved in the efforts and the community at large.  Organizers should consider using a mix of the three types of convenings for effectiveness:

In-person meetings:

• Are extremely useful in creating a sense of community
• Allow for more social interaction, potentially leading to a more robust set of ideas
• Are most effective with a third-party moderator
• Can have the limitations of being geographically and time bound

On-line meetings:

• Can either be implemented using tools like Zoom or Google Docs that allow for discussion and community building, or with Google docs. Note: both have their advantages and disadvantages.
• Allows for live and future collected dialogue.
• Are not geographically limiting

A mix of these methods will allow you to effectively generate ideas and create community.

Convenings are also useful ways to engage both those who are involved in the efforts and the community at large.  Organizers should consider using a mix of the three types of convenings for effectiveness:

• Large-scale public meetings (>100) can be used to generate awareness of your efforts and to share results with the broader community.
• Smaller convenings (15-100) can be used to get input, gain ideas and reinforce why individuals should be involved.
• A task force (5-15) can be used for project related work focused on topics like community-based education, community outreach, healthcare provider education.

Both television and radio reach vast audiences.  The cost to plan, produce, and place an awareness piece on either of these channels will be expensive. Investigate local stations to determine if your project may have free exposure through public service announcements.

STOP

Stop the video and review the Chapter 2.1 Summary. Take to answer the Reflection Questions and begin to complete the listed Action Steps.

Reflection Questions

• What types of communication are we using to reach our target audiences?
• Are there other vehicles that we could be utilizing to reach these audiences?
• Which digital channel is right for the audiences we want to reach?

Actions Steps

• Use the Reflection Questions to help your leadership team determine the modes of communication you might use in your communication strategies.
• Set up social media accounts for the channels you plan to use.
• Seek a communication and marketing volunteer to assist you on your communications strategies.
• Investigate printers and print costs for your printed material needs.

Contact local television and radio stations to determine if there are ways to publicize your project through them.

• Multiple types of communication are necessary to reach different audiences
• Digital channels play a significant role in continually keeping stakeholders aware of your efforts.
• Blogs, Digital Newsletters and Emails are tools that can be used to highlight the work of individual and organizations and the progress that is being made.
• Convenings are ways to engage both those who are involved in the effort and the community at large. They can be used to help those involved in the effort feel rejuvenated and reconnected, provide an opportunity to share input and reinforce why individuals should be involved or help those who are most involved be part of the leadership of the initiative.

Big Idea

The success of your communication strategies is measured by awareness, the number of people who are communicated with, and the number who then engage.  The degree to which stakeholders share the message with others, demonstrate changes in attitudes and actions, and help create change, are also signs of effective outreach.

Goal:

Developing outreach strategies begins with understanding individuals and organizations who have a stake in the outcome and who may benefit from being involved.

Action Step

Complete the Stakeholder Mapping Grid below:

• Identify and list individuals and organizations who are actively involved in advanced illness care. Include their contact information.
• Record their priorities, their values and the resources they can contribute to the overall effort.

Use your completed Present/Future Grid, to add individuals and organizations who play a significant role in patient-centered care.

Please find the Stakeholder Mapping Grid on Pg. 32 of the full Community Engagement Toolkit Companion Guide. To download the guide as a Word document, please click here.

As you consider others to add, key stakeholders could include those individuals and/or organizations who:

• Provide medical care from the time of diagnosis until death.
• Determine what medical care can be provided.
• Provide social support from the time of diagnosis until death.
• Determine what social supports can be provided.
• Provide mental healthcare from the time of diagnosis until death.
• Support the faith of the person with an advanced illness.
• Provide legal counsel.
• Pay for services and supports.
• Consider the role that each stakeholder plays. These include:

The value of stakeholder mapping is that it helps you understand the connections that exist between stakeholders and how they can influence one another to take action. In prioritizing make the following considerations:

• Who can positively impact your goals?
• Who has an interest in advanced illness care?
• Who can influence others to take action?
• Who may have unique knowledge or relationships that can benefit the effort?

Once the relationship column has been completed:

• Rate each stakeholder’s impact, interest, influence, and knowledge on a scale of 1-10 with one being lowest and ten being highest.
• Total the Scores for a priority score.
• Rank the stakeholders in order of priority.
• Analyze the highest scores for individuals and organizations that score the highest, as well as, the stakeholder roles. This will be important later in this chapter as you begin developing your messaging strategy.

Please find the Stakeholder Prioritization Grid on Pg. 32 of the full Community Engagement Toolkit Companion Guide. To download the guide as a Word document, please click here.

Reflection Questions

Who are your key stakeholders?

• Do individuals on the leadership team have existing relationships with them?
• Do these stakeholders already work with one another/have existing relationships with each other?

Action Step

Create a drawing that shows the relationships among your stakeholders.

The Messaging Strategy Matrix helps you determine what and how you will communicate with prioritized stakeholders.  Its structure enables you to look across audiences, and plan messaging, supporting evidence, the call to action and ways to engage.

In creating your Messaging Matrix, you will want to consider:

• The information you wish to share.
• The information you would like to learn.
• The actions that you want to encourage by:
• Identifying the role played by your primary stakeholder group(s).
• Having a clear objective.
• Describing what each of your groups need to know.
• Understanding what supporting evidence may be required for stakeholders to confidently make a decision.
• Knowing the actions, you would like to stakeholders take.
• Using a channel(s) that effectively communicates with your stakeholders.

As you start to develop the messaging matrix, it is important to first determine your primary stakeholder audience. The best approach is to look at the stakeholder grid you completed earlier and choose the one you which is the highest priority. This is also the group you should communicate with most frequently. Most often, those who are represented will include the payor, the provider, the supporter and the influencer. You will also want to include the patient/family and funders. Then order them on the grid based on the level of priority. If a stakeholder group is not a priority, you should omit it from the matrix. It is possible, however, that all of the stakeholder groups could be included.

Please find the Messaging Strategy Matrix on Pg. 35 of the full Community Engagement Toolkit Companion Guide. To download the guide as a Word document, please click here.

Reflection Questions

• What are the different audiences that you identified?
• Which stakeholders would you connect to each audience?
• Do you know of existing patients/family members that would be willing to share their story?

Once you have chosen the primary stakeholder audience, you will want to determine your objective for outreach and communication.  The easiest way to do this is to think about what it is you want those who hear the message to do.  For example, at the outset, your objective could be to generate awareness of your efforts and get others to participate. The audience, the message, and the call to action would be different for this objective than it would be if your aim was to secure funding.

The Present/Future grid and the patient journey, along with your overarching goals, are helpful in guiding your choice of objective.  In the patient journey excerpt below, there seems to be a clear need for a patient navigator.

Edna has been diagnosed with stage-3 metastatic breast cancer. She wants to take an active role in her care and would like to know more about what she can do. Since multiple organizations provide resources, she and her family need help to navigate through the system.

This is reflected in the objective section of the message strategy matrix as well as the patient/family need.

The Present/Future grid and the patient journey will also be helpful as your craft your messages.  The message you choose needs to:

• Connect with your audience on an emotional level.
• Should describe a particular decision point or challenge for the patient, their family or the provider.
• Each message should describe the patient, their family or the provider; the action taken, the result and the impact.

Example:

The following message was designed for a provider and it describes the patient, her goals and the issue she is encountering. For the provider, the objective is to help them recognize and understand the problem and how it is impacting the patient.

Supporting evidence is an important part of the messaging strategy because it brings in data from outside sources to support the claims being made.

• Evidence being drawn upon may help define the concept or be used to demonstrate value.
• Evidence that includes quantitative data and focuses on patient satisfaction or cost reduction is best. When used correctly, qualitative data can also be effective.
• Evidence obtained from well-known healthcare sources like the New England Journal of Medicine may be perceived as being stronger and harder to refute.

In the example you have seen here, Edna needs help navigating the system. The oncology center where she receives care has assigned her a patient navigator. The supporting evidence helps describe what patient navigators are, and what value they provide to the patient, their family, and the provider. Now that you have built the case, with the key message and supporting evidence, you want your target audience to take action. Assume for illustration, that the target audience consists of directors of population health for the health systems in the region.

It is common not to receive a positive response with the initial Call to Action. Receiving no response or a negative response may reveal that the message isn't strong enough, that the supporting evidence is lacking, or that the target audience needs time to consider the ask. Research shows that messages often have to be delivered up to seven times to get traction. ²⁰

Having patients and families tell their story, or showing visuals, will generally help reinforce your case. Providing additional data may also increase your odds of success. When it can be printed and left with the target audience, those odds increase further.

After you go through the message with its intended audience, it is important to be prepared with some follow-up questions. It can be useful to ask:

• Is the issue as a compelling problem?
• What additional information might be helpful?
• Are there are others who could also benefit from hearing the message?

If the response seems positive, it is wise to move to the call for action. Since your goal is to partner with them to improve care, this process should build toward a relationship rather than feel transactional. It is important to thank them for their time and send a note of thanks after.

Engaging communities requires more than messaging:

• Ongoing dialogue and feedback are required through a one-to-one meeting, focus groups, task forces and other convenings.
• Questions should be clear and focused on things that you plan to act upon.
• Have plans for data you gather.
• Establish trust and an ongoing commitment to the community by demonstrating how stakeholder feedback is used.

 STOP

Stop the video and review the Chapter 2.2 Summary. Take time to answer the Reflection Questions and begin to complete the listed Action Steps.

Action Steps

• Map out stakeholders and existing relationships
• Match target audiences with appropriate stakeholders
• Brainstorm ideas of the message the group wants to send
• Narrow the list of possible messages down to 4-5.
• Identify the specifics for each (target audience, which stakeholders might help, type of distribution.

• The first step in developing the outreach strategy is to identify and map these organizations and individuals and their relationships with one another.
• As you begin developing the messaging matrix, it is important to look at your stakeholder grid. The best approach is to look at the roles that are represented there and choose the most frequent for your messaging matrix.
• It is critical to begin with determining your objective for outreach and communication.

The easiest way to think about this is what do you want those who hear the message to do. The message you choose needs to first connect with your audience on an emotional level and describe a particular decision point for the patient, their family or the provider.

• The goal of supporting evidence is to provide data from outside sources that supports the claim being made.
• Growth requires nurturing and patience. Research shows that messages will often have to be delivered multiple times for us to get traction with most messages needing to be delivered 7 times.
• Having patients and families tell their story or showing visuals will generally help reinforce your case.
• After you have gone through the message, it is important to be prepared with some follow-up questions.