When analysing the impact of a health communication campaign, the wrong victories are often celebrated. Designers of information measure what is easiest, not what is most meaningful. We track exposure rates, comprehension scores, clicks, shares, and, once in a while, a change in behaviour. These conventional metrics offer a sense of rigour and reliability. The numbers can be reassuring. They are tidy, quantifiable and often required by funding bodies or institutional frameworks. However, they tend to focus on surface-level outcomes, whether a message was seen, understood or acted upon, without asking a deeper question: did the information resonate?

Cultural and emotional resonance is the sense that a message feels familiar, respectful or personally meaningful. This is rarely measured in standard evaluations. Most tools are not designed to detect whether a message felt authentic or aligned with lived experience. This creates a blind spot in health communication, especially when working across cultural, linguistic or sociohistorical lines. A message can be clear without being convincing and it can be accurate without it being embraced.

If we want to create health campaigns that genuinely reach people, especially across cultures, identities and histories, designers need to rethink what success looks like. They need to measure resonance and not just reach.

What do we mean by resonance?

Resonance is the emotional and cultural echo that a message leaves behind. It is what happens when someone doesn’t just understand a message but feels seen by it. It is what makes a message memorable not just as a slogan, but as a felt truth.

Traditional metrics ask:

·       Did they see it?

·       Did they share it?

·       Did they act?

Resonance metrics could ask:

·       Did it make sense in their world?

·       Did it touch a nerve or spark a memory?

·       Did it feel like something they could say or believe?

·       Did it show respect for their story?

What about Recall and Talk-Aloud?

 To approach resonance, we don’t need fancier quantitative research methods or dashboards, we need better listening tools. In addition to good old in-depth interviewing, two important tools to measure resonance could be recall and talk-aloud.

Rethinking Recall in Research

Recall is usually about memory. What do people remember from a message? The assumption is that they remember something, at least some of the message worked. But memory without meaning is shallow. It fades quickly.

A resonance-focused recall approach digs deeper:

·       What do you remember most from that message?

·       What part stayed with you and why?

·       What did it remind you of in your own life?

·       Has your understanding of the message changed since you first heard it?

·       What is that message telling you?

·       If you had to repeat that message to a friend or to a family member, how would you say it?

·       Has it made you think differently? If so / if not, in what ways?

These are questions invented off-the-cuff for the purposes of this article that might be included in recall approaches. But they are the kinds of questions that can uncover what really matters in a health promotion message. Maybe it was not the key statistic or the call to action, but a phrase that reminded them of something close to their lives. Maybe the message lingered, not because of how clear it was, but because of the emotional truth it conveyed.

Talk-Aloud: Listening to the Thought Process

Talk-aloud is a method where someone reads or watches a message and speaks their thoughts out loud in real time. In user testing, it is used to spot confusion or design flaws. In health promotion messages, however, it can be a window into how culture, identity and emotion intersect and shape meaning through the message. Alongside recall, it can identify resonance.

Examples of resonance that might emerge in talk-aloud:

·       “I wouldn’t say that word. In my community, we would say it differently.”

·       “This is too formal. It doesn’t feel like it is for us.”

·       “This hits hard. I’ve felt like this before.”

These constitute proof that the message is entering the person’s inner world. The message is either landing well or clashing with what is already there.

Listening for Resonance

When you use recall and talk-aloud methods intentionally, you begin to hear something that normal metrics miss: emotional, cultural and existential meaning. Here are some signs of resonance to listen for:

Resonance Indicator:

·       Emotional echo: “It hit me”

·       Metaphorical translation: “It is like carrying a heavy weight”

·       Cultural alignment: “That’s how we talk about it where I am from”

·       Personal relevance: “This message could be about my family”

·       Reflective response: “It made me think about things differently”

These are signals that the message moved from the surface down into someone’s internal framework, deep under the waterline.

Designing for Resonance

It is important for messages to be designed for clarity and simplicity. But messages also need to be built for interpretation and sense-making. Metaphors, stories, idioms and rhythms that people can claim as their own.

In the testing, recall and talk-aloud phases, specific questions could be asked about resonance, such as “Did this feel true?”, “Did anything make you stop or feel something?”, “Did this reflect your world or feel distant from it?” Recall and talk-aloud prompts could be co-developed by community members. They will know what kinds of questions invite honest reflection, rather than only social desirability or performance.

Also, as with qualitative interviewing, it is important to embrace the tangent. When people drift off-topic in recall or talk-aloud, follow them. They are often leading you to the real context, the one where the health message needs to live if it is going to land, resonate and thrive.

Narrative analysis should be used. Don’t just code for ‘understood’ or ‘not understood’. You need to code for emotional reaction, cultural congruence, symbolic meaning, moral tension and personal story as resonance indicators. These reveal what traditional metrics cannot.

Feeling Seen: Rethinking What Counts

Many well-meaning health campaigns fail, not because people do not care but because they do not see themselves in the message. The language is too clinical, even if there is no jargon and would otherwise be seen as clear. The tone is too distant. The culture is someone else’s. When this happens, people resist and then withdraw. They do not do this out of ignorance or defiance but out of the disconnect.

Researchers need to stop measuring the noise and listening for the echoes.

Culture is vast and overwhelming. It cannot be reduced to a checklist. The same goes for identity and pain and healing. Health communication needs to be felt like a story and not solely read like a manual. Techniques such as recall and talk-aloud help us identify the resonance. It helps measure what was said and what was received, what was learnt and what was kept. This is meaning. And this is what matters.

 Thank you for reading,

Mark Gibson

Leeds, United Kingdom, May 2025