CHES Area VII: Communication, Advocacy & Health Promotion

Health educators do not work in a vacuum. The programs they design, implement, and evaluate exist within a larger ecosystem of public discourse, media influence, and policy decisions. Area VII of the CHES and MCHES exam focuses on the competencies that allow health educators to communicate effectively, promote health initiatives, and advocate for policies that support population health. These are the skills that extend the reach of health education beyond the classroom or clinic and into the broader public sphere.

Whether you are crafting a public awareness campaign, writing health content for a website, testifying before a local government body, or simply making sure a brochure is understandable to its intended audience, Area VII competencies are at work. This article examines the key concepts within this area and explains how they appear on the certification exam.

For a complete picture of how Area VII relates to the other competency areas, review the overview of all eight Areas of Responsibility.

What Area VII Covers

Area VII encompasses the communication, promotional, and advocacy functions of health education practice. The competencies include assessing audience needs, developing appropriate messages, selecting effective communication channels, using media and technology for health promotion, and engaging in policy advocacy. Health literacy, the ability of individuals to access, understand, and use health information, is a foundational concept throughout this area.

MCHES candidates will encounter more advanced applications of these competencies, including strategic communication planning, media relations, and legislative advocacy at state and national levels. At both certification levels, the emphasis is on creating messages and campaigns that are accurate, culturally appropriate, and designed to produce measurable outcomes.

Key Concepts in Area VII

Health Literacy and Plain Language Principles

Health literacy is the degree to which individuals can obtain, process, and understand the health information they need to make informed decisions. Low health literacy is widespread and contributes to poorer health outcomes, higher hospitalization rates, and reduced use of preventive services. Health educators must be able to assess the literacy demands of their materials and adjust accordingly.

Plain language is the primary tool for improving health literacy. This means using short sentences, common words, active voice, and clear organization. It also means testing materials with members of the target audience before finalizing them. A document that seems clear to a health professional may be confusing to the people it is designed to serve.

Pro Tip: When reviewing health communication materials, apply the "teach-back" concept. Ask yourself whether a reader could explain the key message in their own words after reading the material once. If the answer is uncertain, the material likely needs simplification.

Tailoring Messages for Diverse Audiences

Effective health communication is not one-size-fits-all. Tailored messaging involves adapting content based on the characteristics, needs, preferences, and cultural context of the intended audience. This goes beyond translation into other languages. It includes adjusting tone, imagery, examples, and delivery channels to resonate with specific communities.

Cultural competence plays a significant role here. Messages that ignore cultural values, beliefs, or practices risk being dismissed or misunderstood. Health educators should involve community members in the message development process to ensure that communications are relevant and respectful.

Media Advocacy and Social Marketing

Media advocacy uses media strategically to advance a health-related policy or social change objective. Unlike health communication aimed at individual behavior change, media advocacy targets the broader environment by shaping public discourse and influencing decision-makers. Examples include press conferences about tobacco control legislation, op-eds about food access, and strategic use of news coverage to highlight health disparities.

Social marketing applies commercial marketing principles to promote health behaviors. It involves understanding the target audience, defining the desired behavior change, identifying barriers and motivators, and developing a marketing mix that includes product, price, place, and promotion. Social marketing campaigns are most effective when they are audience-centered and grounded in formative research.

Using Technology and Social Media for Health Promotion

Digital platforms have expanded the channels available for health communication. Websites, mobile applications, email campaigns, and social media all offer opportunities to reach large and diverse audiences. Health educators should understand the strengths and limitations of each platform and be able to select the channels that best match their audience's media habits.

Social media presents unique challenges, including the rapid spread of misinformation, the difficulty of controlling message context, and the need for ongoing engagement. Health educators who use these platforms must be prepared to monitor conversations, respond to inaccurate claims, and maintain a consistent and credible presence.

Policy Advocacy and Legislative Engagement

Policy advocacy involves using evidence and strategic communication to influence laws, regulations, and institutional policies that affect health. Health educators may advocate for increased funding for prevention programs, stronger environmental health regulations, or policies that address social determinants of health.

Legislative engagement can take many forms, from meeting with elected officials and submitting public comments to organizing community testimony and building coalitions around a policy issue. Understanding the legislative process and knowing how to frame health issues in policy-relevant terms are essential skills for health educators who work in advocacy.

Building Coalitions for Advocacy

Advocacy is rarely a solo endeavor. Coalition building brings together organizations and individuals with shared interests to amplify their collective voice. Effective coalitions have clear goals, defined roles for members, and a communication strategy that keeps all partners informed and engaged.

Health educators often serve as coalition facilitators, coordinating activities, resolving conflicts, and ensuring that the coalition's advocacy efforts are evidence-based and strategically focused. The coalition-building skills covered in Area VII complement the partnership competencies addressed in Area V and the networking skills in Area VI.

Exam Application

Area VII questions frequently present communication or advocacy scenarios and ask you to identify the best course of action. You might be asked to select the most appropriate readability level for a patient education brochure, determine which social media strategy would be most effective for reaching young adults, or decide how to frame a health issue for presentation to a city council.

The exam also tests your understanding of communication theory and models. Be prepared to apply concepts such as audience segmentation, message framing, and channel selection in realistic scenarios. Questions may require you to distinguish between approaches aimed at individual behavior change and those aimed at policy or environmental change.

Pro Tip: Pay attention to the goal of each scenario. If the question describes an effort to change a policy or regulation, the answer will likely involve advocacy strategies. If the goal is to change individual behavior, look for answers related to health communication or social marketing. This distinction is a common source of confusion on the exam.

Study Strategies

Review the foundational communication theories covered in your health education coursework, including the Health Belief Model, Social Cognitive Theory, and the Diffusion of Innovations. While these theories appear across multiple areas of the exam, they are especially relevant to Area VII when applied to message design and campaign planning.

Practice writing health messages at different literacy levels. Take a complex health topic and rewrite it for a general audience, then for a low-literacy audience. This exercise builds the practical skill of plain language writing and deepens your understanding of health literacy concepts.

Study real-world examples of media advocacy and social marketing campaigns. Analyze what made them effective or ineffective, and connect your observations to the competencies described in Area VII. For a structured approach to organizing your study time, refer to the CHES study plan guide.

As you complete Area VII, prepare to transition into Area VIII: Ethics and Professionalism, which addresses the ethical principles that guide all health education practice, including communication and advocacy.

Amplifying Your Impact

Communication and advocacy are what transform health education from a behind-the-scenes discipline into a force for visible, measurable change. The ability to craft a clear message, reach the right audience, and mobilize support for health-promoting policies is what separates competent practitioners from truly influential ones.

Area VII prepares you to think strategically about how information flows, how public opinion is shaped, and how policy decisions are influenced. These competencies are tested on the CHES and MCHES exams, but their real value lies in what they enable you to accomplish throughout your career. When you can communicate with clarity, promote with purpose, and advocate with evidence, you multiply the impact of every program you touch.

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