ADD Framework for Health Communication

About ADD

An evidence-based process for message development to support policymakers and health influencers in designing simple messages in a complex world. After all, while all health is complex, the communication about health should not be.


Communication alone is no panacea for our many intractable health challenges. However, every health challenge requires communication. Unfortunatley, too much of the communication we use to inspire and inform people is not translating into action. The ADD framework aims to provide a common foundation that will maximize the effects of health communication.


ADD was developed as part of the World Innovation Summit for Health 2015 Forum "Communicating Complex Health Messages".
ADD aims to guide communication design and decisions in order to improve the efficacy of health communication. It is intended to be beneficial for those who have limited training in the discipline, but can also for experienced health communicators to ensure they have not missed important steps due to over-familiarity.


Scalable to all sizes of problems, budgets, and target populations, and aims to be generalizable to most health issues.
It is not proscriptive and can be supplemented with approaches, theories or channels of communication that are not explicitly mentioned.
Developed based on research, practice and policy evidence about communication development processes and outcomes.
Available online and offline. Written in plan language with easy to follow process questions and checklists. Available in English and other languages are planned.
Unlike most health communication frameworks, ADD is all about the message. It is not about designing programs or campaigns (although it can be used for those purposes). It proivides process of steps, key questions to address at each step and process outcomes for the design of specific messages.

ADD Framework

The framework lays out process steps and key questions that guide the health communicator in producing coherent, understandable and effective messages. It starts with Assess, then Do, then Describe.



Assess sets the requirements and considerations for the function of the communication. This involves understanding the health issue, the aim of the communication and the role communication can play in improving the situation. This includes how the communication will integrate with wider efforts to improve health and influence health behavior. It requires knowing the evidence base about the issue, the causes of the issue, and how communication has been used successfully and unsuccessfully before. Legal and ethical considerations, including any regulations about communication in the specific context will determine what can and cannot be communicated and what might be the unintended consequences of communication. Finally, it means assessing the capabilities and capacity of the human resources available.

  • Evidence base

    What is the evidence about the health topic?
    How has communication been used successfully and unsuccessfully before?
    What is the best practice for this purpose?
  • Function

    What is the role of communication here?
    How does it integrate and support other efforts to improve health and influence health behavior?
    What is the desired outcome?
  • Capacity

    Do you have the right people for the job?
  • Legal and ethical

    What are the legal and ethical issues?
    What are potential unintended effects of the communication?


Do requires conducting a contextual analysis, designing messages, testing and refining, and implementing the communication. The contextual analysis gauges the circumstances in which the communication will be delivered. It includes understanding any political, environmental, or social imperatives affecting the communication, how it may be received, acted on, and how it could be misreported or distorted by others. It incorporates a target audience analysis, including sociodemographic, psychosocial, behavioral characteristics, trusted sources and media channels used, education and health literacy, motives for health, and current knowledge and beliefs. It includes knowing the budget needed or available. Message design involves working through the five Ws of message design. Messages should be pre-tested and improved where warranted. Once messages are implemented they should be monitored and evaluated.

  • Message development

    Have you used the five Ws?
    Are messages consistent with objectives?
    Are they simple to understand and intuitive?
    Have you pretested them and made revisions?
  • Test and refine

    Will your communication actually work?
    What improvements can you make?
  • Implement

    Deliver the communication.


Describe involves an ongoing process of documenting, evaluating and sharing. All steps in the Assess and Do phases should be documented to ensure accountability, transparency, and to improve the breadth and quality of the evidence base. All should be shared electronically in the ADD e-archive (to be released on 18 February 2015 (WISH 2015) to become part of the evidence base for other communicators who are beginning their Assess phase.

  • Document

    Are you capturing key information on the communication?
    Have you inserted it into the ADD reporting template?
  • Evaluate

    Has the communication been evaluated for reach and impact?
  • Share

    Have you added the information and experiences into the ADD e-archive?

Evidence Base

The Share provision of the Describe phase suggests that cases are entered into ADD e-archive. This archive serves as a platform for exchanging practices and their effects. Examples of cases entered into the ADD e-archive thus far are below. More cases to come soon.

ADD Your Case

The ADD e-archive section is now live and functional in a first version. Updates to functionality will come over time and as needed. Add your case now!


Create a free user account here
(coming soon)

Feedback and questions

We want your feedback on this framework. Tell us how you are using it. What challenges you find with it. What suggestions do you have to improve it.