How the message does not get through.

Jamaica's experience shows how lack of understanding can result in grievous misinterpretation of the communication message. The Ministry of Health initiated a program aimed at reducing the prevalence of childhood malnutrition. 1 aspect of the program was a scheme for changing attitudes and practices related to breastfeeding and infant feeding. Materials and media to be used were slides, booklets, a flannel board and cutouts, and practical demonstrations given by community health workers. The target group was low income mothers attending antenatal and child welfare clinics in 2 parishes of the island. The 1st problem to arise concerned the scripts, which had been written to be read rather than spoken. When they were read aloud to some groups, certain words were not heard correctly. For example, a word like "rarely," sounded like "really." Thus, the statement could have been heard "A breastfed baby really (rarely) gets diarrhea." Other words were unintelligible to the audience because the script had been prepared without an understanding of local idiom. A thorough background knowledge of the audience being addressed is essential. It is only then that the communicator will be able to respond to the specific behavioral needs of the audience and formulate the most appropriate strategies and approaches for delivering messages. This information needs to be collected early in the program planning process, as was done in a baseline survey undertaken before Jamaica's Nutrition Education Program in 1977. This helped in the selection of themes and in the exact content and wording of the messages and in the choice of media. Messages went beyond recognizing and stating the problems to acknowledging existing behavioral constraints. Health and nutrition programs will continue to fail unless communication is made an integral part of the process of change. Successful communication helps ease the transition between old and new ideas by motivating people to accept change and then giving them the tools and skills to deal with new practices. The best way to learn if people will respond to messages and media at the behavioral level is to listen to them.