The Times They Are a-Changin': Communicating Evolving Health Guidelines

Background:  From statin use to car seat regulations to healthy eating, new research continually prompts health professional groups to develop new guidelines to promote public health. Communicating the value of these changing guidelines, in the face of questions about why the recommendations changed, can be a challenge for health communicators. This presentation explores best practices for managing evolving campaign messages and addressing shifts in guidance in response to the latest supporting research. 

Program background:  This presentation discusses two examples of changing guidelines communicated by health education initiatives of the National Institutes of Health. The Safe to Sleep^® campaign (formerly known as Back to Sleep) began in 1994 to bring awareness to sudden infant death syndrome (SIDS). The campaign educates caregivers on ways to reduce SIDS risk, including the key recommendation to place babies to sleep on their back. Although the campaign has educated consumers for more than 25 years about the elements of a safe sleep environment, outreach efforts continue to face questions about why “the rules keep changing” and must counter anecdotal experiences of those who did not follow safe infant sleep practices and “turned out fine.” Following the American College of Obstetricians and Gynecologists’ Committee Opinion redefining term pregnancy, the Know Your Terms initiative was developed to educate consumers and health providers about the new definition of full-term pregnancy. Although the medical literature had never defined full term, both patients and providers commonly described a pregnancy as “full term” at 37 weeks. Our strategy to communicate these new recommendations included mapping key pregnancy and infant health influencers. We created targeted educational materials specifically for influencers identified through focus group research and environmental scans. To equip health providers, we developed continuing education programs that emphasized strategies for countering common concerns about the changes and produced customizable materials for providers to facilitate patient-provider conversations about the changes. We engaged both existing and newly identified partner organizations to ensure that other organizations’ health resources reflected the latest recommendations. 

Evaluation Methods and Results:  It is difficult to link a knowledge change to a specific initiative when educational messages about back sleeping and full-term delivery are presented through diverse channels. Our presentation speaks to preliminary results from an impact evaluation conducted on the entire Safe to Sleep campaign and data from a program evaluation produced for the U.S. Department of Health and Human Services, assessing knowledge about back sleeping and awareness of full term as 39 weeks. 

Conclusions:  To ensure that all pregnant women and new parents receive consistent messages about evolving recommendations, we adopted a 360^o approach and equipped health providers with the tools to address common concerns about the changes. 

Implications for research and/or practice:  These lessons learned for health communicators not only address broader causes of infant mortality but also serve as models for promoting evidence-based changes in guidelines in other public health programs, from cholesterol to breast cancer screening.