Communication Currents

We recall being together, over a decade ago, at a special symposium held in our graduate program. Voices from the field described their observations about the direction of health communication. E-health, videophone, and online tools were among the opportunities and areas of study they described as the future of health communication research. And a new paradigm shift, namely translational research, which received some attention at this gathering, would indeed play an ever-expanding role as we began to forge our own academic careers in communication.

Fast forward to today. The discipline is feverishly advancing the idea of translating its research ---not just in health communication, but all specialty areas. We now have this outlet, Communication Currents, as well as TRIP (Translating Research Into Practice)--- both accessible online. As the last decade has unfolded, it is clear the extent to which we underestimated the challenges central in making the leap to translational research and how technology would shape or hinder us. Only now are programs around the country including this educational component in their graduate curriculum, focusing on implementation science, translation, and social media. Trial by fire, trial and error, and embedding ourselves in teams of clinicians have been the primary training tools in our own journey. And, to be clear, the journey is still in progress.

The delivery of health care is predicated on effective communication---and all areas of health specialty have included this as a basic competency. We recognize that this is where health communication scholars can play a part in translating their research---bringing context-relevant interventions to light—interventions and practices that are based in theory and evidence. However, the collaboration between communication and health practice still has a long way to go.

We observe that the most exigent demand for health practitioners is time. For communication to be relevant in the context of health care delivery, time constraints have to set the pace and the course of action. This pace is not ours, by trade, but instead by context. Board exams, professional core content and delivery, and competency requirements dominate the training programs for any health specialty. There is little room for our discipline to expect dedicated time and resource commitment for the interventions we can offer. As a reasoned solution to practice interdisciplinary translational research, we opted for a different approach. Adaptation. If we learn about the structures that clinicians must use, and understand demands and needs, we can help achieve healthcare goals using our tools, while relying on their structure. If we truly work to help them, then we find a place for our work and its application. 

We are all working methodically to employ language and structures that are meaningful for our intended audience. But in reality, we see that translating research is not enough---as translation only implies an exchange of meaning and understanding. Implementing ideas from research, and ultimately disseminating the research is what creates the fortified possibility for improvement and change. A part of this dissemination is the delivery of the research intervention. During the last couple of years, we have embarked on finding pathways for dissemination—exploring social media as a tool for translation.

Last spring we began working with an app design agency to help us deliver clinical communication tools to interprofessional health care providers based on our COMFORT Communication Curriculum. COMFORT is an acronym that stands for the seven basic communication principles of palliative care communication. We wanted something providers could use in practice, when faced with challenging interactions with patients, families, and coworkers.

The content is derived from theories in our discipline, but also from several years of research in a variety of health care contexts. In order to create the content, the needs had to be understood. As we have continued to shape our work, advancements in social media have roared along. We have committed to embracing these tools by developing a research website, and using Twitter to spread the word about COMFORT.

In September, our APP called Health Communication became available in the iTunes store as a free download: an attempt to translate COMFORT research for providers. The APP guides the health care professional to provide compassionate and culturally sensitive care to serious and critically-ill patients and their families. The goal of this project was to allow time-compromised clinicians to easily locate communication resources and to feel more comfortable when asked questions about diagnosis, prognosis, spirituality, sexuality, death, and more. The APP features over 100 specific communication strategies, as well as a search by scenario menu drop down list.

Two primary features are included: First, a quick reference guide for what to say and how to say it in a variety of circumstances, and second, a communication toolkit that helps clinicians effectively respond to difficult conversations with patients and caregivers. The toolkit suggests important observations clinicians can make, simple ways of identifying health literacy levels, and basic strategies to improve team collaboration. Common, yet difficult clinical situations in a variety of contexts (e.g., bad news, decision-making, cancer reoccurrence) are easy to find, each with a guide that provides clinicians with appropriate questions to ask, ideas about what to say, and what to observe.

Of course, we are researchers at heart. We can’t get away from using the APP as an opportunity to do research. Thus, there is a feedback pop-up form that the user can choose to complete. This will provide us with data about the APP, its utility, and what changes we should make going forward. In conjunction with these data, conducting focus group research to gather additional feedback on the APP will be vital for its improvement. As we translate, we research-- hoping that translation will in turn inform the research we do, how we do it, how we deliver it, and the problematics we identify.