Turning negative into positive: public health mass media campaigns and negative advertising

Literature suggests that 'negative advertising' is an effective way to encourage behavioral changes, but it has enjoyed limited use in public health media campaigns. However, as public health increasingly focuses on non-communicable disease prevention, negative advertising could be more widely applied. This analysis considers an illustrative case from tobacco control. Relying on internal tobacco industry documents, surveys and experimental data and drawing from political advocacy literature, we describe tobacco industry and public health research on the American Legacy Foundation's "truth" campaign, an example of effective negative advertising in the service of public health. The tobacco industry determined that the most effective advertisements run by Legacy's "truth" campaign were negative advertisements. Although the tobacco industry's own research suggested that these negative ads identified and effectively reframed the cigarette as a harmful consumer product rather than focusing solely on tobacco companies, Philip Morris accused Legacy of 'vilifying' it. Public health researchers have demonstrated the effectiveness of the "truth" campaign in reducing smoking initiation. Research on political advocacy demonstrating the value of negative advertising has rarely been used in the development of public health media campaigns, but negative advertising can effectively communicate certain public health messages and serve to counter corporate disease promotion.     

Getting to know the competition: a content analysis of publicly and corporate funded physical activity advertisements

The purpose of this research was to conduct a content analysis of physical activity advertisements in an effort to determine which advertisements were more likely to include features that may attract and maintain attention levels. Fifty-seven advertisements were collected from top circulation Canadian magazines. The advertisements ranged from publicly funded health promotion pieces to corporate sponsored advertisements using physical activity to sell a product. Advertisements were examined for textual and pictorial factors thought to increase attention allocated to advertising of this nature. Only two public health advertisements were found, and the majority of advertisements (57.9%) were from commercial advertisers using physical activity images to sell products or to encourage brand recognition. The advertisements originating with the private sector tended to possess most of the characteristics thought to attract the attention of readers. Once this attention was gained, however, most of these advertisements failed to highlight the benefits of physical activity. As a result, the positive effect of these advertisements may have been compromised. Public health advertisements were so infrequent that we could not compare their characteristics with those originating with the private sector. The characteristics with those we did find were inconsistent with those thought to attract and maintain attention levels. Results are discussed in terms of potential implications for promoting physical activity.     

Alcohol and tobacco advertising in black and general audience newspapers: targeting with message cues?

This study content analyzed 928 tobacco- and alcohol-related advertisements from a 3-year national sample of Black (n?=?24) and general audience (n?=?11) newspapers from 24 U.S. cities. The authors compared the frequency of tobacco and alcohol product and control advertising in Black versus general audience newspapers, as well as the presence of 5 message cues: model ethnicity, presence of health official, referral to resources, personal behavior mobilization, and localization. Results within health issues show that Black newspapers had more alcohol product advertising than did general audience newspapers. In contrast, Black newspapers had less alcohol and tobacco control advertising than general audience newspapers. Black newspapers' tobacco/alcohol product advertisements had more African American models than did general audience newspapers' tobacco/alcohol advertising, whereas general audience newspapers' tobacco control advertisements were significantly more likely to feature public health officials than ads in Black newspapers. Fewer message cues such as personal behavior mobilization, referral to resources, and localization were present in Black versus general audience newspapers. Results suggest that Black newspapers may have greater dependency than do general audience newspapers on these risk-related advertisements that target African American consumers. Given the current advertising environment, public health initiatives are needed to counter unhealthy alcohol product advertising messages that target vulnerable populations.     

Opportunities for improving the nation's health through collaboration with the mass media

Understanding the mass media is a prerequisite to gaining the cooperation of those who control access to media time and space to improve the coverage of health issues about which the public needs, and often wants, to know. To address the complexities of the mass media and how they influence the public's health, a group of Public Health Service agencies, foundations, and research institutions collaborated to review recent changes in the mass media and public health sectors and to recommend steps for increased interaction. These included broadening strategies to include paid advertising, media advocacy, and other tactics beyond public service campaigns; increasing awareness within the public health sector of the media's perspective on health; working collaboratively with media professionals and organizations, including the minority media; and developing guidelines for public-private sector partnerships. These recommendations, and factors affecting the roles of the media and public health communities in informing the public about health, are described in this paper. A complete discussion of these recommendations and related issues can be found in "Mass Media and Health," edited by Caroline McNeil and Elaine Bratic Arkin, a forthcoming publication of the Office of Disease Prevention and Health Promotion, Public Health Service.     

Alcohol and Tobacco Advertising in Black and General Audience Newspapers: Targeting with Message Cues?

This study content analyzed 928 tobacco- and alcohol-related advertisements from a 3-year national sample of Black (n = 24) and general audience (n = 11) newspapers from 24 U.S. cities. The authors compared the frequency of tobacco and alcohol product and control advertising in Black versus general audience newspapers, as well as the presence of 5 message cues: model ethnicity, presence of health official, referral to resources, personal behavior mobilization, and localization. Results within health issues show that Black newspapers had more alcohol product advertising than did general audience newspapers. In contrast, Black newspapers had less alcohol and tobacco control advertising than general audience newspapers. Black newspapers’ tobacco/alcohol product advertisements had more African American models than did general audience newspapers’ tobacco/alcohol advertising, whereas general audience newspapers’ tobacco control advertisements were significantly more likely to feature public health officials than ads in Black newspapers. Fewer message cues such as personal behavior mobilization, referral to resources, and localization were present in Black versus general audience newspapers. Results suggest that Black newspapers may have greater dependency than do general audience newspapers on these risk-related advertisements that target African American consumers. Given the current advertising environment, public health initiatives are needed to counter unhealthy alcohol product advertising messages that target vulnerable populations.     

Public health in Quebec at the dawn of the 21st century

This paper summarises the status of public health in Quebec at the dawn of the 21st century. After introducing the current definition, the author lays out five basic functions of public health in Quebec: knowledge and surveillance of populations health and wellbeing, health protection; prevention of disease, trauma and social problems that influence health; health and wellbeing promotion; and service organization and evaluation. The organization of public health services is then described at the local level (CLSC), regional level (Public health units) and national level (Ministry, Public health directorate and National Institute of Public Health). Finally, the trends and priorities elaborated over the last ten years, as well as the National Public Health Program to be implemented over the next ten years are described.     

Advertising and health education

Health education and advertising have a common aim: to modify human behaviour. Health education tries to induce healthy behaviours. In some occasions Publicity proposes risky behaviours. Ads appearing during a two-month period in magazines of the largest circulation in Spain are analyzed here. A total of 1,726 ads which could have a negative influence on health either because of the product or service offered or for the use of health as a persuasive argument in their text, are considered. The magazines Hola and Lecturas had the highest ratio ads/magazine. Spirits, food and drugs were the most frequently advertised products. And more than 50% of the ads used health and welfare as argument for better selling. Health educators should know and teach the critical analysis of publicity, and use advertisements as a teaching tool to enable people to see through misleading advertising.     

影视公益广告在健康教育中的应用研究

目的了解国内外影视公益广告在健康教育领域中的应用现况,为今后在健康教育中应用影视类公益广告提供参考和建议。方法利用内容分析法对中国公益广告网中全部的健康类影视公益广告进行类目编码,利用2种检验对国内外影视公益广告各类目情况进行比较。结果119则样本中所涉及的健康主题总共有34种,分为日常保健类19则（55．9％）、慢性非传染病类9则（26．5％）、传染病类6则（17．6％）。其中中国制作发行40则（33．6％）;国外制作发行79则（66．4％）。时长主要集中在30s（48则,占30．2％）。国内外在运用影视类公益广告进行健康教育的方法中,在表现主体（）（2=14．184,P=0．001）、表达方式（X。=4．854,P=0．028）、表现手法（X2=12．368,P=0．030）、情感诉求（X2=4．732,P=0．030）和感性诉求（）（2=9．446,P=0．009）方面均有显著性差异。结论影视公益广告策略在健康传播中的应用空间很大,可以借鉴国外成熟的公益广告创作模式,综合考量艺术和科学的结合,进行更加科学、生动和细致的健康传播。     

Health and Nutrition Messages in Food Advertisements: A Comparative Content Analysis of Young and Mature Australian Women's Magazines

Surveys investigating adults’ sources of nutrition information have consistently found magazines to be nominated most frequently, particularly among women. A content analysis was undertaken to compare the advertisements in two magazines with a target audience of young women with those in four magazines oriented towards mature women. Seventy-two magazine issues having a 1992 publication date were sampled, and all food advertisements were coded. In the mature women's magazines, 47% of advertisements were for core (basic) food groups, and all five core food groups were addressed. Food advertisements in the young women's magazines addressed a narrower range of foods, promoted core foods at a significantly lower rate (12% of advertisements), and included only three of the core food groups. The noncore foods most commonly advertised were of low nutrient density and consisted mainly of alcohol, supplements, and cocoa products. Food advertising in young women's magazines frequently used images of lifestyle success and failed to emphasize nutrition or health information messages or dietary recommendations.There is a need to more fully explore attitudes to food and food purchasing behavior in young women and to develop nutrition education strategies to counter the advertising of predominantly nonmeal-type foods with low nutrient density in young women's magazines.     

Ghettoizing Outdoor Advertising: Disadvantage and Ad Panel Density in Black Neighborhoods

This study investigated correlates of outdoor advertising panel density in predominantly African American neighborhoods in New York City. Research shows that black neighborhoods have more outdoor advertising space than white neighborhoods, and these spaces disproportionately market alcohol and tobacco advertisements. Thus, understanding the factors associated with outdoor advertising panel density has important implications for public health. We linked 2000 census data with property data at the census block group level to investigate two neighborhood-level determinants of ad density: income level and physical decay. Results showed that block groups were exposed to an average of four ad spaces per 1,000 residents and that vacant lot square footage was a significant positive predictor of ad density. An inverse relationship between median household income and ad density did not reach significance, suggesting that relative affluence did not protect black neighborhoods from being targeted for outdoor advertisements. Kwate and Lee are with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.     

Was ist New Public Health?

New public health differs from the way health risks and health problems are conventionally handled. Instead of focused individual attention, emphasis is placed on the population, with more thorough analysis of the social factors influencing health and disease, and the factors responsible for inequality. A better assessment of successful/unsuccessful health management in terms of the health resources available characterises New Public Health along with primary prevention as a priority. AIDS prevention and worksite health promotion are two examples worth following in Germany. However economic and medicalization issues are making speedy introduction of New Public Health into general health policy difficult.     

深圳市医疗广告监督情况分析及对策探讨

目的通过分析深圳市医疗广告监督工作的情况，为进一步规范医疗广告提供经验和依据。方法描述分析2010～2011年深圳市发布医疗广告的医疗机构的性质、数量、比例及广告的发布媒介情况。定性分析医疗广告监管的相关文献、专家交流资料和卫生监督工作情况。用Office软件包对数据进行预处理和统计分析。结论通过采取对医疗机构违法发布医疗广告的情况进行通报、行政处罚、约谈医疗机构法人代表、负责人等一系列措施后，深圳市医疗广告违法率呈现大幅下降的趋势。促进深圳市医疗广告的健康发展，必须在加强医疗广告卫生监督综合执法力度和长效机制建设的同时，积极完善医疗保障和医疗广告相关法制体系，实现医疗资源合理分配，引导患者理性就医，加强医疗机构依法执业意识，倡导媒体自律和社会公德，提高群众维权和识别虚假广告能力，才能有效规范医疗广告市场。     

Anti‐smoking advertisements are perceived differently by smokers and individuals with health or advertising knowledge

Objective: Several studies have examined the characteristics of anti‐smoking advertisements that are associated with quitting behaviour. Some studies use researchers or graduate students to code advertisement characteristics, while others recruit smokers or members of the general public. The aim of this study was to assist future campaign development by assessing whether anti‐smoking advertisement characteristics are coded differently by smokers and ‘experts’ (individuals with knowledge of health promotion, public health or advertising). Methods: A total of 49 smokers and 42 experts coded anti‐smoking advertisements according to four key characteristics (emotional/cognitive approach, negative/positive tone, message frame, and main message) and the use of eight executional techniques. Chi‐squared tests were used to measure differences in coding outcomes between smokers and experts. Results: There were significant differences between smokers and experts in the coding of all key characteristics and four of the eight executional techniques. Compared with smokers, experts were more likely to perceive advertisements as negative in tone and as inducing fear. Conclusions: Smokers and experts perceived the characteristics of anti‐smoking advertisements differently. Implications for public health: Differences between smokers and experts may need to be taken into account where studies use either of these groups to code advertisements for campaign development or evaluation purposes.     

Health promotion: convergence between the principles of health surveillance and socially responsible schools

The authors discuss the convergence between health surveillance and socially responsible schools from a health promotion perspective in Porto Alegre, Rio Grande do Sul State, Brazil. The aim of health promotion strategies is to provide the population with the necessary means to improve their health. One of the explanatory paradigms for health surveillance is the social production of health, acknowledging the influence of living conditions on the population's health. The main thrust of schools that promote citizenship is social inclusion, achieved through education by recognizing the needs and possibilities of students and empowering citizens by raising awareness of their rights and duties. The convergence between health surveillance and socially responsible schools is demonstrated in four fields of health promotion: development of personal capacities by providing information and health education to empower people for healthier choices; strengthening of community action for better health; creation of health-friendly public and private environments; and construction of healthy public policies, involving both government and nongovernmental organizations.     

Upstream healthy public policy: lessons from the battle of tobacco.

Many consider public health and politics to be entirely separate worlds. Public health activities are generally well-motivated by public interest, perceived as value-free, scientific, and devoid of partisan preference. Politics, in contrast, can be viewed as a distasteful activity involving self-interested pressure groups, misuse of state power, and influence of money on national decisions. Public health and politics are inappropriate bedfellows if politics is reduced to party politics. Politics, of course, involves more than just party activities; it concerns the structure, distribution, and effects of power in society. Which groups pattern the social order? What are their sources of influence? How do they retain privileged status? What social effects result from the policies these groups shape? Viewed in this broader sense, politics is essential for effective public health and thus is the inescapable context of public health interventions. To disregard sociopolitical determinants of health is to relegate public health to prevention and promotion of individual risk behaviors. If public health is to be more successful in the 21st century, it must comprehend the magnitude of the forces against it and the strategies used to engineer its defeat. Public health interventions in the new millennium must be appropriate to their sociocultural context.     

Do television food advertisements portray advertised foods in a 'healthy' food context?

Exposure to food promotion influences food preferences and diet. As food advertisements tend to promote 'less healthy' products, food advertising probably plays some role in the 'obesity epidemic'. Amid calls for increased regulation, food manufacturers are beginning to engage in a variety of health-promoting marketing initiatives. Positioning products in the context of a 'healthy', balanced diet in television advertisements is one such initiative. We explored whether the wider food context in which foods are advertised on television are 'healthier' than the advertised foods themselves. All foods shown in food advertisements broadcast during 1 week on one commercial UK channel were identified and classified as 'primary' (i.e. the focus of advertisements) or 'incidental'. The nutritional content of all foods was determined and that of primary and incidental foods were compared. Almost two-thirds of food advertisements did not include any incidental foods. When a wider food context was present, this tended to be 'healthier' than the primary foods that were the focus of food advertisements - particularly in terms of the food groups represented. It is not yet clear what effect this may have on consumers' perceptions and behaviour, and whether or not this practice should be encouraged or discouraged from a public health perspective.     

城市外来务工人员的健康促进策略

目的：掌握外来务工人员的卫生KAP水平和主要的健康问题，为进一步制定健康促进策略提供依据。方法：调查采用二阶段随机抽样的方法，用自行设计的问卷共调查了365位外来务工人员的个人状况、家庭状况、卫生习惯、健康促进意识和健康知识等情况。结果：外来务工人员以青壮年为主．具有整体文化程度低。来源地集中，流动性不大。职业不稳定性和多样性，缺乏劳动保障。交流存在障碍，存在歧视现象。基本生活条件极差等社会学特征。同时存在低水平的健康知识，健康行为不良，健康参与意识薄弱．卫生服务公平性差，儿童健康问题突出等健康问题。结论：外来人员的健康促进策略应该立足社区，制定和执行有利于健康的公共政策，创建健康促进支持性环境，开展社区动员与行动，加强教育和培训．发展个人技能，提高社区卫生服务水平。     

Frequency and Types of Foods Advertised on Saturday Morning and Weekday Afternoon English- and Spanish-Language American Television Programs

ObjectiveTo describe food advertised on networks serving children and youth, and to compare ads on English-language networks with ads on Spanish networks.DesignAnalysis of television food advertisements appearing on Saturday morning and weekday afternoons in 2005-2006. A random sample of 1,130 advertisements appearing on 12 networks catering to Spanish-language, children, youth, Black youth, and general audiences were analyzed.Main Outcome MeasuresEach advertisement was coded for the nature of the item promoted, the selling propositions used, and any nutritional claims made.AnalysisCross-tabulations using Fisher's exact test (P < .05 criterion).ResultsOne-fifth of commercials were for food. Food ads were especially prevalent on Saturday programs and children's networks. Seventy percent of food ads were for items high in sugar or fat. More than one fourth of food advertisements were for fast-food restaurants, which were especially common on MTV and Spanish-language networks. Ads for fruits and vegetables were rare (1.7%). One nutrition-related public service announcement was found for every 63 food ads.Conclusions and ImplicationsFood advertisements continue to promote less-healthful items. Until marketing of high calorie, low-nutrient food to children is restricted, education and media literacy remain the best strategies for mitigating advertising effects.     

Why sexual health promotion misses its audience: men who have sex with men reading the texts.

PURPOSE: Sexual health promotion aimed at men who have sex with men (MSM) is not achieving its objective of reducing the incidence of new infections of sexually transmitted diseases, notably HIV/AIDS, in the MSM population. The paper aims to raise awareness of possible unintended consequences when using visual culture and advertising techniques in the field of sexual (and other) health promotion and public health messages. DESIGN/METHODOLOGY/APPROACH: Using critical textual analysis and drawing on visual culture methodology the approach is to critique current practice and suggest alternative ways to approach gay men's sexual health which are not predicated on a "model" gay man. FINDINGS: Men who have sex with men (MSM) are constructed through sexual health promotion (SHP) literature as young, hedonistic and irrational which may serve to distance the very audience it seeks to attract and address. What may at first appear to be a targeted and helpful initiative to raise awareness may inadvertently have the simultaneous and unanticipated effect of "selling" unsafe sex rather than promoting safe sex. This is because, first, the use of sexual imagery designed to attract attention works in unanticipated ways. Second, MSM are constructed through the images and language used in ways that may be at best unhelpful and potentially quite harmful. RESEARCH LIMITATIONS/IMPLICATIONS: There are many different approaches and interventions in this field and the criticisms here may not be applicable to many of the other sources of health promotion awareness campaigns. Future research could certainly be conducted in other fields of health promotion and public health issues such as obesity, drug and alcohol abuse and smoking cessation. PRACTICAL IMPLICATIONS: Health promotion practice should beware of depicting their audience in stereotypical ways. MSM could be constructed far more positively as role models to be followed instead of bad examples to be avoided. ORIGINALITY/VALUE: The methodology is new to this field and the findings provide an original basis for criticism of advertising techniques which have until now formed the basis of this type of public awareness-raising.     

Communal health promotion in child and adolescent health services -- report on the experience with a organisational model for setting up an interdisciplinary network in a socially important area

This report focusses on health promotion for children adolescents und families and on the aspects of organisation and resources. In 1991 the Public Youth Health Care (KJGD), a community health service for children und adolescents, set up a multi-professional "district committee" of distributors in leading positions in a socially important area (social workers, school teachers, kindergarten teachers, councillors, medical personnel, architects and town planners etc.). Medical examinations of all school beginners and children with special educational needs formed the basis of the social paediatric observations and data. Until 2003 the author was responsible for the management and coordination of this local interdisciplinary district committee of leading representatives from local social and educational organisations as well as town councillors who created a local multi-professional network. The district health reports of the discussions in the district committee including the different professional aspects of health promotion were passed on to the local politician actively involved in the discussions with specialists and invested in social and health promotion projects. Social paediatric issues and preventative strategies became part of the work in social and educational organisations in the area und the city. A healthy environment for children und families was promoted. For the KJGD the conceptual work with distributors in leading positions led to initiatives for communal health promotion making time-saving use of existing resources.