Messaging Matters: Yale School of Public Health expands student communications training

Effective communication is an essential part of the practice of public health.

One of the most important lessons learned during the COVID-19 pandemic was that public health practitioners must be consistent in communicating clear, timely, evidence-based information if they are to properly guide policymakers and maintain public trust. Clear communication is especially important during a crisis when rampant misinformation and disinformation can undermine even the best-intentioned campaigns to improve and protect the public’s health.

In recognition of the volatility of the current health communications environment, the Yale School of Public Health (YSPH) recently expanded its communications training programs to help students become more effective public health communicators.

The latest addition is the course Health Communication and the Media (SBS 577b), which launched in the 2024 spring semester. It is led by Marney White, PhD, MS ’09, professor of social and behavioral sciences (SBS), scientific director of the Initiative for Strategic Health Communications, and a clinical psychologist; and Jackson Higginbottom, MPH ’20, leader of the Initiative for Strategic Health Communications at the Yale-Griffin Prevention Research Center. The course covers op-ed writing, misinformation, visual communications, social media, behavioral theories, entertainment media, persuasive communication and advertising, and risk communications.

“In this era of misinformation, the role of communication in public health has never been more critical,” Higginbottom said.

Higginbottom described health communication as “both a science and an art,” a honed skill that requires “a delicate balance between factual dissemination and persuasive communication to navigate the complex landscape of public health today.”

White summarized it this way:

“Our challenge is to take complicated information and make it accessible to everyone, regardless of their scientific expertise or health literacy, so that they can use it for their own well-being,” said White, whose opinion pieces have been published by The Washington Post, Newsweek, USA Today, and The Chronicle of Higher Education, among many media outlets.

Effective health communication requires nuance and empathy, authenticity, listening, and an understanding of different community needs so that important health information is accessible to all people equally, White and other experts say.

“Sometimes I worry that public health messaging comes across like a loving yet nagging parent: ‘Eat your veggies! Get plenty of exercise! Put on your seatbelt! Don’t text and drive! Don’t smoke! Don’t drink too much! OMG GET VACCINATED!’” White said. “No one wants to hear it, and yet we all need to hear it.”

In launching the new course, White follows in the footsteps of three other YSPH professors – Shelley Geballe, JD ’76, MPH ’95, Mark Schlesinger, and Amy Bei – who have been teaching students effective communications skills as part of their courses for years.

As the practicum portion of her course in public health law (HPM 588a), Geballe requires students to identify a bill pending in the Connecticut General Assembly, research the topic, and write and present oral testimony for or against the bill. She also has them read her Primer on Health Policy Advocacy in Connecticut, which she updates yearly; it includes a 13-page section on how to make your voice heard in the legislative process.

In his health policy course for first-year MPH students (EPH 510), Schlesinger requires students to write an op-ed piece on vaccine policy after scanning the latest news in the U.S. and India. Bei assigns her students to write op-ed pieces as part of her advanced principles of infectious diseases course (EMD 581b).

Schlesinger said that within the vaccine-policy parameters, students can address their op-ed to a wide range of different perspectives across and within the two countries, and can choose among a set of publication venues that they tailor their messaging to match, “so they have a lot of latitude, but all focus on the challenges of addressing the real and important value differences that can underlie public health campaigns.

“It’s not just about clear communication,” he added. “It’s also about recognizing that objections can reflect reasoned, thoughtful perspectives, just ones that are driven by differences in ideologies and values.”

Messaging Matters

YSPH Dean Megan L. Ranney, MD, has identified effective communications as one of four critical pillars that are key to the future of public health, the others being inclusivity, data-driven leadership, and innovation and entrepreneurship.

Over the past year, Ranney has invited national leaders in public health communications to YSPH to share their insight and knowledge with students as part of her Leaders in Public Health speaker series and Dean’s Lecture series. Guests have included such notables as Andy Slavitt, former senior advisor to the Biden administration COVID response; Katelyn Jetelina, a popular epidemiologist, and data scientist whose “Your Local Epidemiologist” newsletter is followed by more than 200,000 subscribers, and Linda Villarosa, a contributing writer for The New York Times magazine who covers race, inequality, and public health.

Effective public health communicators, Geballe said, can help dispel erroneous rumors and widespread misinformation and assist policymakers and members of the public in making informed decisions based on scientific fact.

“Expanding public understanding … could help defuse some of the partisan bickering about the importance of public investment in the diverse programs and services that promote and protect health,” she said. “While finding effective ways to communicate this – accurately and convincingly through trusted messengers – is always essential, it is even more so in the current era of greater disinformation and political polarization.”

Schlesinger said he saw the disinformation wave coming before the pandemic: “When I returned to teaching EPH 510 in 2019, it was already clear that public health in both the U.S. and around the world was facing a communications crisis.”

Likewise, Bei began including op-ed writing in her curriculum just ahead of the pandemic – the first semester she taught Principles of Infectious Diseases II, Spring 2020. Several of her students that semester were able to get their op-eds published on news sites.

“As students navigated a global pandemic, public health communication seemed more relevant than ever,” she said. “I felt like adding an op-ed would give the students a chance to address a pressing topic related to the diseases and infectious disease principles we discussed during the year.” Bei also said that she was “amazed” by the creativity and insight of their writing.

Concurring with White’s and Higginbottom’s views, Bei not only strives to impart the importance of communication, but also being able to take the information from scientific journals and communicate it effectively to the public in a way they can understand.

“We as scientists are often very accustomed to communicating our research for a scientific audience,” she said. “However, developing and refining the skills to communicate science in all its complexity to the public is equally important. This is a skill that takes practice and persistence. I believe that as educators, giving our students every possible opportunity to develop their scientific communication skills for diverse audiences will serve them well in their future careers as public health leaders.”

Collaborating with public health lecturer Dr. James Hamblin, MD, MPH ’18 and a senior writer at The Atlantic, and Leslie Curry, professor of public health (health policy), Schlesinger began requiring his students to write op-eds. “Presciently,” he said, “we chose vaccine policy to be the focus for these op-eds, with students allowed considerable leeway selecting a core message and preferred messaging strategy.”

Leading through experience

Each of the instructors leading YSPH’s communications training is a veteran public health communicator.

Geballe has authored dozens of research reports and op-eds, given many lectures, and testified multiple times before the Connecticut legislature. She is also an author of the book Forgotten Children of the AIDS Epidemic (Yale University Press; 1995). As a Yale Law School student, and as a practicing attorney afterward, she wrote legal briefs for federal and state trial and appellate courts.

Schlesinger is part of an international collaboration of qualitative researchers who use public-facing websites to share the findings of their studies of health experiences. In the U.S., the website is known as the Health Experiences Research Network, or (HERN).

Bei said she had no formal training in communication, but in her own work, she presents her information to a wide range of stakeholders: scientific researchers from national malaria control programs, district medical officers, and the members of the communities participating in her research.

“Science communication is so critical to our research mission, and especially important in building and strengthening trust in science, yet often, the focus of our training is in communicating to scientific audience,” Bei said. These are the reasons she has incorporated writing opinion pieces into her teaching.

“This involves communicating complex concepts in accessible ways, but must be adapted to each specific context and also in appropriate local languages,” she said. “I wanted to give my students an opportunity to practice this critical skill for a topic that they feel strongly about.” Bei added that her students, including recent graduates, are in the process of trying to get op-eds published, and that she expects three to five to come out this summer.

White’s and Higginbottom’s experiences were honed at Yale and YSPH. White is a former Public Voices Fellow, a Yale-sponsored initiative that trains underrepresented scholars to become public health thought leaders by engaging with popular media and the public through op-ed writing, TV and radio interviews, and social media.

“As academic researchers, we learn to write for scientific audiences, but our work seldom reaches a popular audience,” said White, an expert on eating and weight disorders. “Since much of my research has critical educational and policy implications, I was very interested in learning how to frame research in a way to make it accessible to a broader audience.”

Oklahoma native Higginbottom’s first published op-ed, “HPV Vaccine Is a Cancer Vaccine,” appeared in The Oklahoman in December 2019, during his second year at YSPH.

White and Higginbottom begin the op-ed section of their class by reviewing research showing the impact of opinion pieces in shaping opinion and policy. From there, they review published op-ed pieces to identify their structure and to analyze themes and persuasive elements.

“The first piece of advice that I provide to students is to think about what makes them upset or mad,” White said. “What bit of current news or frustration are they experiencing that has public health relevance? What health issues have they debated with distant relatives? Other important points are about readability and ensuring that the piece is easily understood by a lay audience. I also stress word limits and timeliness, since these are so critical in the fast-paced media world.”

Schlesinger has three class sections and assigned readings related to his communications instruction. There is a session on vaccine policy and public attitudes about vaccine mandates and exemptions; a session on how to deliver important health messages to the public; and a session on the role and importance of op-eds.

Last fall, Schlesinger incorporated an experiment that allowed students to use artificial intelligence (AI) assistance in writing their op-eds – though within a strict protocol that required them to first draft the op-ed on their own. The students then itemized each change that they made or rejected in response to the AI-based recommendations. He said about 35 of the 270 students in the course opted for AI assistance.

The initial result?

“Several dozen others experimented with the AI, but in the end rejected its use on the grounds that it undermined their personal ‘voice’ and emotional nuances in their messaging,” Schlesinger said. “Students in the course who did not make personal use of the AI were asked if they felt comfortable with other students using it; about 95% who responded to this inquiry conveyed that they felt that this form of AI assistance was both fair and appropriate for the assignment.”

Student Voices

Participants in the communication training programs have appreciated the targeted instruction.

Nathan Carroll, MPH ’24 (health informatics), was the lead author of a paper, “Hearing the Unheard During the Looming Cicada Apocalypse,” that was published in April in Psychiatry Online, the online platform of American Psychiatric Association Publishing. He said that White and Higginbottom’s class gave him perspective, confidence, and a much deeper understanding of how to effectively communicate.

“Everyone had these fascinating lived personal and professional experiences that challenged my assumptions about how to most effectively communicate,” he said. “I gained a lot of perspective through learning about their experiences. I also gained a sense of what captures people's imagination and attention. Just spouting facts at people is not a great way to get them to take notice. That encouraged me to look for something that addressed a public health need, a mental health need, and at the same time was novel.”

As part of their practicum internships with Connecticut State Senator Saud Anwar, MD, MPH ’98 (chronic disease epidemiology) this spring, Geballe’s students James Lawrence, MPH ’24 (health policy), and Livia Cox, MPH ’25 (health policy), presented oral testimony to legislative committees at the Capitol.

Lawrence, whose parents are deaf, testified before the Public Health Committee in support of HB 5200, a bill to improve health care accessibility for people with disabilities. He also testified before the Human Services Committee in support of bill HB 5241, which would establish a bureau to coordinate services for deaf, hearing-impaired, and deafblind persons. In addition, Lawrence wrote an op-ed piece on why Connecticut needs to fund social deaf services that was published on the CT Mirror online news site in May. Cox gave testimony to the Housing Committee in March supporting legislation to establish an Interagency Council on Homelessness.

Both students said the experience taught them a great deal about how to become better communicators and the importance of communication as a tool to advocate for public health.

Lawrence said that his most important takeaway from the experience was not navigating the legislative process, but learning how to be a better listener.

"Don’t be afraid to ask questions,” he said. “Oftentimes, we step into a space where we aren’t the experts. While we may be familiar with interventions or the epidemiological literature, we don’t necessarily know the nuances of every circumstance, location, or population. So, in a lot of spaces, we’re the outsiders. To ensure you can collect all the information you need, you’ve got to overcome that barrier.”

Cox, for her part, participated in community conversations in public libraries about loneliness and collaborated with international filmmakers on a documentary on homelessness. She also met and collaborated with doctors, social workers, and community advocates, expanding her professional network, and enhancing her ability to work with interdisciplinary teams. Attending press conferences and crafting responses to complex issues for Anwar sharpened her strategic thinking and skills in responding to public concerns. Geballe helped her to overcome her anxiety about speaking in public.

“She told us to think of ourselves as invisible, as a conduit through which the voices of those we represent could be heard,” said Cox, who will continue collaborating with Anwar in the fall through Geballe’s advanced practicum. “This perspective shift helped immensely. Whenever I felt nervous, I would imagine that behind me stood all the clients and patients whose stories and needs I was bringing into the spotlight. This visualization not only kept me calm, but also strengthened my resolve to advocate as effectively as possible.”

For Josiane Alix, MPH ’24, a native of Rwanda, English is a second language, which meant it took longer for her to write her opinion piece than other students. As a student in Schlesinger’s class, she wrote a yet-to-be-published op-ed on the use of a vaccine to combat the Human Papilloma Virus (HPV) – the cause of cervical cancer – in India.

She said that Schlesinger’s course taught her the art of conveying a strategic vision and to think about communications “from the point of view of trying to make a difference and moving the needle on issues I really care about.” Most importantly, she said, the course taught her how to “anticipate concerns of the other side of the audience – the naysayers – and address them.”

YSPH students who used their communications skills in 2023-24

Op-ed writing

Harley Webley, MPH ’24 (health policy), Opinion: Beyoncé, motherhood and Black mental health, CT Mirror, May 7, 2024.

Written testimony for Connecticut House committees

Sydney Perlotto, MPH ’24 (social and behavioral sciences), on HB 5424, An Act Prohibiting Adverse Actions Against Health Care Providers for Providing Certain Health Care Services. Perlotto has been working with State Rep. Jillian Gilchrest and the Connecticut General Assembly caucus focused on reproductive justice.

Hannah James, MPH ’24 (climate change and public health, social and behavioral sciences), on HB 5441, An Act Concerning Utility Shutoffs for Certain Customers. James has been working with New Haven Director of Public Health Maritza Bond and the Connecticut Association of Local Directors of Health, supporting their legislative agendas.

Devin Brown, MPH ’24 (social and behavioral sciences), on HB 5510, An Act Concerning Funding for Student Meals. Brown has been working at the Connecticut Department of Energy and Environmental Protection (DEEP) on its environmental justice planning.