Impacts of a national mass media campaign on walking in Scotland

The promotion of walking as a form of exercise holds considerable potential, both in terms of health benefits and its wide appeal to inactive groups. This paper presents the results of the evaluation of a national mass media walking campaign in Scotland which involved a 40 s television advertisement and a telephone helpline. The target population consisted of people aged 30-55 who are not regular exercisers. The campaign impact was assessed in terms of awareness of the campaign and pre- and post-campaign changes in knowledge and beliefs about walking as a good form of exercise, in motivations and intentions regarding walking/exercise and in walking/exercise behaviour. The evaluation involved two population surveys and baseline and follow-up surveys of the helpline callers. Awareness levels for the television advertisement peaked at 70% of the adult population during the first 4-week burst of advertising, falling to 54% during the non-broadcast period. The evaluation findings show that, at a population level, the campaign had a notable positive impact on knowledge about walking as a form of exercise but no impact on walking behaviour. Among the helpline callers the campaign had a substantial impact at the level of intentions and behaviour: 48% of the callers followed up at 1 year claimed to be more physically active and there was a overall shift from the 'contemplation' stage of change at baseline towards the 'action' stage at the 10-week and 1-year follow-ups. The proportion of adults aware of the telephone helpline rose from 5% at the start of the campaign to 16% 4 months later, but only 5% of these respondents used the service. This level of use represents 0.1% coverage at the start of the campaign rising to 1% 4 months later.     

Effectiveness of a mass media campaign in promoting HIV testing information seeking among African American women

"Take Charge. Take the Test." (TCTT), a media campaign promoting HIV testing among African American women, was piloted in Cleveland and Philadelphia from October 2006 to October 2007. This study assesses TCTT's effectiveness in promoting HIV testing information seeking among target audiences in each pilot city. The authors analyzed data on telephone hotlines promoted by the campaign and the www.hivtest.org Web site to examine trends in hotline calls and testing location searches before, during, and after the campaign. Cleveland hotline data were available from October 1, 2005, through February 28, 2008, for a total of 29 months (N = 126 weeks). Philadelphia hotline data were available from May 1, 2006, through February 28, 2008, for a total of 22 months (N = 96 weeks). The authors assessed the relation between market-level measures of the campaign's advertising activities and trends in hotline call volume and testing location searches. They found a significant relation between measures of TCTT advertising and hotline calls. Specifically, they found that increases in advertising gross ratings points were associated with increases in call volume, controlling for caller demographics and geographic location. The campaign had similar effects on HIV testing location searches. Overall, it appears the campaign generated significant increases in HIV information seeking. Results are consistent with other studies that have evaluated the effects of media campaigns on similar forms of information seeking. This study illustrates useful methods for evaluating campaign effects on information seeking with data on media implementation, hotline calls, and zip code-based searches for testing locations.     

Hepatitis C in Australia: impact of a mass media campaign

BACKGROUND: Hepatitis C affects over 200,000 Australians. This study evaluated the impact of a public education campaign about this disease in New South Wales (NSW), Australia. DESIGN: Cohort and independent cross-sectional telephone surveys before and after the campaign. SETTING/PARTICIPANTS: Random population samples of adults in NSW. INTERVENTION: Television, radio and newsprint advertisements, posters and public display boards, public awareness events and media releases, and dissemination of information to healthcare professionals in April 2000. Data were analyzed in 2000 and 2005. MAIN OUTCOME MEASURES: Campaign recall, and knowledge and attitudes concerning hepatitis C. RESULTS: Recall of information about hepatitis C increased between baseline and follow-up, from 11.1% to 45.5% in the independent samples and 11.8% to 65.3% in the cohort. The proportion of people who knew that there was a low risk of disease transmission by kissing, sharing food utensils, or breastfeeding also increased significantly. In the cohort sample, a higher number of correct knowledge responses was associated with reporting exposure to information about hepatitis C after the campaign, postsecondary education, and a greater level of knowledge at baseline. Most people reported supportive attitudes toward people with hepatitis C and to prevention programs addressing this disease, and there was little apparent improvement in these. CONCLUSIONS: This campaign successfully increased public exposure to information about hepatitis C and improved knowledge about the means of transmission of this disease. There is room for further improvements in community understanding about hepatitis C. Mass media campaigns have a valuable role to play in this endeavor.     

A critical perspective on the drug czar's antidrug media campaign

The US government's Office of National Drug Control Policy (ONDCP) launched its new antidrug media campaign in July 1998. The campaign is likely to increase awareness of the youth drug problem, but shortcomings in the campaign's early implementation raise questions about its potential for changing behavior. Shortcomings include: a) The first wave of ONDCP's television advertisements are focused on reinforcing problem awareness but do not model skills or provide other information necessary for behavior change; b) the campaign provides insufficient focus on promoting drug treatment and citizen involvement in local prevention activities, including political action; c) the campaign is being implemented without a major new investment in drug-treatment programs or community-based prevention programs; d) The campaign does not substantively address alcohol and tobacco, which pose a clear threat to health and serve as a "gateway" to illicit drug use; and e) the first wave of television advertisements use exaggerated fear appeals, a strategy shown by research rarely to be successful. Only time will tell whether the ONDCP media campaign will succeed or fail. Using past research as a guide, there is legitimate reason for concern that the campaign will not live up to expectations.     

Multivariate causal attribution and cost-effectiveness of a national mass media campaign in the Philippines

Cost-effectiveness analysis is based on a simple formula. A dollar estimate of the total cost to conduct a program is divided by the number of people estimated to have been affected by it in terms of some intended outcome. The direct, total costs of most communication campaigns are usually available. Estimating the amount of effect that can be attributed to the communication alone, however is problematical in full-coverage, mass media campaigns where the randomized control group design is not feasible. Single-equation, multiple regression analysis controls for confounding variables but does not adequately address the issue of causal attribution. In this article, multivariate causal attribution (MCA) methods are applied to data from a sample survey of 1,516 married women in the Philippines to obtain a valid measure of the number of new adopters of modern contraceptives that can be causally attributed to a national mass media campaign and to calculate its cost-effectiveness. The MCA analysis uses structural equation modeling to test the causal pathways and to test for endogeneity, biprobit analysis to test for direct effects of the campaign and endogeneity, and propensity score matching to create a statistically equivalent, matched control group that approximates the results that would have been obtained from a randomized control group design. The MCA results support the conclusion that the observed, 6.4 percentage point increase in modern contraceptive use can be attributed to the national mass media campaign and to its indirect effects on attitudes toward contraceptives. This net increase represented 348,695 new adopters in the population of married women at a cost of U.S. $1.57 per new adopter.     

Indirect exposure to a family planning mass media campaign in Nepal

It is often noted that some individuals become aware of a mass media program's messages through discussions with other individuals. However, the extent to which indirect exposure occurs, and its influence on behavior, are somewhat unclear. This study examines the role of indirect exposure in extending the reach of a family planning mass media campaign in Nepal. Sociometric data, gathered from nearly all women between the ages of 15 and 49 years living in six villages in Dang District, Nepal (N = 667), assessed indirect exposure to the radio program. Indirect exposure was extensive; half of all respondents were indirectly exposed to the program's messages and the overall reach of the program increased from 50% to 75% when indirect exposure was considered. Members of community groups had higher levels of direct exposure to the radio program and more extensive and diverse social networks, allowing them to serve as a conduit for these messages into the wider community. While direct exposure to the radio program appeared to influence family planning knowledge, indirect exposure was more strongly associated with contraceptive use. These findings suggest that program evaluations that ignore indirect exposure underestimate the impact of a mass media program on behavior.     

Evaluation of EX: a national mass media smoking cessation campaign

Objectives. We used longitudinal data to examine the relationship between confirmed awareness of a national, branded, mass media smoking cessation campaign and cessation outcomes.Methods. We surveyed adult smokers (n = 4067) in 8 designated market areas (“media markets”) at baseline and again approximately 6 months later. We used multivariable models to examine campaign effects on cognitions about quitting, quit attempts, and 30-day abstinence.Results. Respondents who demonstrated confirmed awareness of the EX campaign were significantly more likely to increase their level of agreement on a cessation-related cognitions index from baseline to follow-up (odds ratio [OR] = 1.6; P = .046). Individuals with confirmed campaign awareness had a 24% greater chance than did those who were not aware of the campaign of making a quit attempt between baseline and follow-up (OR = 1.24; P = .048).Conclusions. A national, branded, mass media smoking cessation campaign can change smokers'' cognitions about quitting and increase quit attempts. We strongly recommend that federal and state governments provide funding for media campaigns to increase smoking cessation, particularly for campaigns that have been shown to impact quit attempts and abstinence.Mass media campaigns can be used to change smoking-related cognitions and to prompt quitting behavior, particularly when combined with other tobacco control efforts.^1,2 Media campaigns at the national, community, and city level have been effectively used to increase smoking cessation among adults.^3–8 The EX campaign (National Alliance for Tobacco Cessation, Washington, DC) was designed as a branded, mass media campaign aimed to encourage adult smokers to quit.^9,10 This campaign was pilot tested in 4 US cities in 2006 and 2007.¹⁰ In a longitudinal pilot study, confirmed campaign awareness was associated with statistically significant change in campaign-related cognitions over approximately 6 months.¹⁰ Given these findings, in the spring of 2008 the National Alliance for Tobacco Cessation (NATC)—a partnership of states, national public health organizations, foundations, and corporations—launched EX as a national campaign.The EX campaign is grounded in behavior change theory^11–13 and the evidence regarding effective mass media campaigns.^1,14–18 Given the evidence that branding can enhance the impact of a public health campaign, all messages are branded “EX.”^19,20 The target audience was defined as “smokers who are open to quitting but may not know how to successfully quit.” The campaign message strategy was based on qualitative data from smokers at various stages in the quitting process, derived from more than 40 focus groups (more than 300 participants), 48 in-depth interviews, and a national survey of more than 1000 smokers. Messages are characterized by an empathetic, smoker-to-smoker voice that encourages smokers to relearn their life without cigarettes. Emphasis is placed on disassociating smoking from common daily activities that would otherwise function as smoking cues, such as driving or drinking coffee.During the 6-month national campaign period, March 31 through September 28, 2008, EX advertisements aired on cable television at 549 average quarterly targeted rating points (TRPs). TRPs are the standard unit of measurement for media delivery and reflect both the reach and the frequency of an advertisement. Reach describes the total percentage of the targeted population that is exposed to the advertisement; frequency describes the number of times individuals in the targeted population saw the advertisement, on average. TRPs are identical to gross rating points (GRPs), except that they are delivered to, and measured within, a specific and defined audience.² EX advertising was not evenly distributed across the campaign period; 68% of the EX TRPs aired in the first 3 months of the campaign. Pfizer''s My Time to Quit campaign aired nationally at 382 average quarterly TRPs during the same period as the national EX campaign. The Phillip Morris campaign, Quit Assist, did not air during the study period; however, because it aired nationally in 2007 awareness of the campaign was measured and was included as a covariate in the present study to control for any residual campaign effects. No local or state-level tobacco control media was airing in 6 of the 8 designated market areas (DMAs) from which the study sample was drawn. In one DMA, occasional public service announcements aired; in another, no information was available as to whether public service announcements would air. Public service announcements generally air at a low TRP level.According to the Centers for Disease Control and Prevention, campaigns that deliver 1200 or more average quarterly TRPs during the introductory year of a campaign can expect to reach 75% to 85% of the target audience, in which case evaluators may expect to detect campaign awareness at 6 months, attitude change at 12 to 18 months, and behavior change at 18 to 24 months.² Given funding constraints, the total media delivery of the EX campaign was approximately 47% of the level recommended by the Centers for Disease Control and Prevention.² Nevertheless, on the basis of the findings noted in the evaluation of the EX pilot campaign we hypothesized that EX awareness would be associated with significant change in campaign-related cognitions and behaviors despite the lower media delivery level. To test this hypothesis, we examined a longitudinal cohort of adult smokers drawn from 8 DMAs, with control for baseline and contextual variables.     

Indicators of response to a mass media CPR recruitment campaign.

Respondents to a mass media cardiopulmonary resuscitation (CPR) recruitment campaign in Harris County, Texas were more likely than non-respondents to be White, female, and under 45 years of age, to have had previous CPR training, experienced an incident in which knowledge of CPR might have been useful, or to have a friend or relative with a relevant medical history. The majority of the respondents were housewives, and professionals or technical workers, particularly in the health field. Findings can be used to identify audiences for future mass media CPR campaigns.     

The public perception of the risks and benefits of alcohol consumption

Abstract: A survey of the community was undertaken in August 1989 to assess the public's perception of the risks and benefits of alcohol use, and their understanding of recommended levels of safe alcohol consumption. A household sample of 500 men and women (18 to 65 years) in metropolitan and rural New South Wales were asked their opinions about the risks and benefits of alcohol use, the health and social consequences of ‘drinking too much’, and the number of standard drinks that would produce a low, medium and high risk to the health of an adult man and woman. The major perceived benefits of alcohol use were relaxation and medication; the major health and social problems attributed to alcohol abuse were brain and liver damage, and domestic violence and family problems. The quantities of alcohol which respondents thought could be consumed with a ‘low’ risk to health were close to National Health and Medical Research Council recommended levels of safe consumption.     

Promoting healthy eating and physical activity short-term effects of a mass media campaign

BACKGROUND: Soaring obesity levels present a severe health risk in the United States, especially in low-income minority populations. INTERVENTION: High-frequency paid television and radio advertising, as well as bus and streetcar signage. SETTING/PARTICIPANTS: A mass media campaign in New Orleans to promote walking and fruit and vegetable consumption in a low-income, predominantly African-American urban population. Messages tailored with consideration of the African-American majority. DESIGN: Random-digit-dial telephone surveys using cross-sectional representative samples at baseline in 2004 and following the onset of the campaign in 2005. MEASURES: Survey items on campaign message recall; attitudes toward walking, snack food avoidance, and fruit and vegetable consumption; and behaviors related to fruit and vegetable consumption, snack food consumption, and utilitarian and leisure walking. RESULTS: From baseline, there were significant increases in message recall measures, positive attitudes toward fruit and vegetable consumption, and positive attitudes toward walking. Behaviors did not change significantly. In 2005, message recall measures were associated with positive levels of each of the outcome variables. CONCLUSIONS: Over 5 months, the media campaign appeared to have stimulated improvements in attitudes toward healthy diet and walking behaviors addressed by the campaign. These findings encourage the continuation of the media campaign, with future evaluation to consider whether the behavioral measures change.     

Development of a media campaign on fetal alcohol spectrum disorders for northern plains american Indian communities

Alcohol-exposed pregnancies are especially of concern for American Indians. The Indian Health Service reported that 47% to 56% of pregnant patients admitted to drinking alcohol during their pregnancy. In addition, rates of Fetal Alcohol Syndrome are estimated to be as high as 3.9 to 9.0 per 1,000 live births among American Indians in the Northern Plains, making prevention of alcohol-exposed pregnancies an important public health effort for this population. The goal of this article is to add to the literature on universal prevention of Fetal Alcohol Spectrum disorders by describing the development, dissemination, and evaluation of a media campaign on Fetal Alcohol Spectrum Disorders that was created by and for American Indian communities in the Northern Plains.     

Factors related to alcohol and drug consumption in Swedish widows

The use of alcohol and medications among Swedish widows was analyzed in relation to various background variables. In Total, 1053 widows (640 widows younger than 65 years and 413 widows older than 65 years) answered the questionnaire. Many reported increased fatigue and sleeping problems. Around one-third of the widows reported drinking alcohol for relief of grief and inadequate support. Association existed between grief and increased intake of sedatives and sleeping pills, and between grief and drinking for relief of grief, as well as increase in intake of sedatives. In widows older than 65 years, perception of bad health, negative outlook for the future, and insufficient support seemed to increase the risk of more sedatives and sleeping pills. Negative outlook for the future also tended to lead to a heightened risk for increased intake of alcohol. There seems to be remaining health problems a long time after bereavement, and counseling may be needed especially when drugs and alcohol are extensively used.