Communication theory and the search for effective feedback.

If messages transmitted to the public, patients and health professionals could be assured of being received, understood and acted on as intended by the senders of messages, there would be little need to focus on communications and feedback. That the physician's office, the healthcare system and the community are littered with messages that 'never got through' attests to the problem of ineffective communications and the absence of effective feedback. Communication theorists, health psychologists and thoughtful health professionals, particularly those working in community hypertension programmes, have developed approaches that improve the probabilities of 'getting the message through'. Theory-based communications with built-in feedback and 'feed-forward' enhance the probabilities of success considerably. This presentation explores these problems using the SMCR model of communication. Differences between linear models and transactional models are discussed. On the assumption that the health message environments of the future will be increasingly complex with highly differentiated target audiences in a rapid paced computer and electronically driven world, 'getting the message through' will become an even greater challenge than in the recent past. Specific steps to change communication approaches in this setting are proposed.