Mass Media Health Communication Campaigns Combined with Health-Related Product Distribution: A Community Guide Systematic Review

https://doi.org/10.1016/j.amepre.2014.05.034Get rights and content

Context

Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury.

Evidence acquisition

Using methods previously developed for the Community Guide, a systematic review (search period, January 1980–December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products.

Evidence synthesis

Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns.

Conclusions

Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics.

Section snippets

Context

Preventable hazardous behaviors contribute to injuries, illnesses, and deaths each year in the U.S., from engagement in wheeled sports without proper protective gear (e.g., helmets) to making poor dietary choices that heighten cardiovascular disease risk.1 Over the last several decades, health communication campaigns and social marketing concepts2, 3 have been used widely in the field of public health to disseminate health promotion messages designed to change behaviors and reduce morbidity and

Methods for Conducting the Review

General methods to conduct systematic reviews for the Community Guide and to develop evidence-based recommendations are described in detail elsewhere.28, 29 The conceptual approach and methods specific to this review, including intervention selection and outcome determinations, are described here.

Systematic Review Development Team

The systematic review development team (the team) consisted of scientists and research fellows from CDC’s Community Guide branch collaborating with subject matter experts and consultants, including

Intervention Effectiveness

Initially, 15,941 studies were identified in the search. Of these, 958 were obtained for full-text review. Following the review, 936 articles were excluded after full-text review for not meeting the inclusion criteria.

A total of 23 studies (with 26 study arms)24, 25, 26, 27, 30, 31, 33, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53 evaluating the effectiveness of health communication campaigns that use multiple channels, include mass media, and distribute free or discounted

Applicability

The reviewed studies evaluated intervention effectiveness in a wide range of urban, rural, and suburban settings in the U.S. and Australia,31, 40 Canada,24 Belgium,38 and Israel.25 Many papers did not report details on population demographics, such as race, age, and education. Nonetheless, favorable results were found for interventions targeting a variety of specific demographic groups. Populations addressed included African Americans,41 people of Hispanic origin,27, 43, 45 low-income groups,45

Potential Harms and Additional Benefits

No significant harms of health communication campaigns with product distribution were reported in the reviewed studies or postulated by the review team. However, additional benefits to implementing this intervention were identified through information gathered from reviewing the literature and expert consultation. One benefit, reported in an included study,33 was that targeting condom usage fostered an environment that encouraged dialogue between adults and teenagers, and among teenagers

Considerations for Implementation

Although no common barriers to implementation were reported in the included studies, some unique challenges were mentioned. In one case, retailers sold products that were intended to be free, and in another case there was a lack of community buy-in to the campaign approach.51 For condom promotion and distribution campaigns, community resistance to condom distribution, particularly when targeted to youth, can be a problem.41

Summary of Findings

According to Community Guide rules of evidence,29 there is strong evidence that health communication campaigns that use multiple channels, including at least one mass media channel, combined with promotion and distribution of free or reduced-price health-related products, are effective. The types of behaviors promoted in reviewed studies were use of products that (1) directly protect against behavior-related disease or injury (i.e., condoms, child safety seats, recreational safety helmets, and

Acknowledgments

Points of view are those of the authors and do not necessarily reflect those of the CDC.

No financial disclosures were reported by the authors of this paper.

References (60)

  • H. Mendelsohn

    Mass communication and cancer control

  • A.L. Binnendijk

    A.I.D.׳s experience with contraceptive social marketing: a synthesis of project evaluation findings

    (1996)
  • L.W. Green et al.

    Health education planning: a diagnostic approach

    Mountainview CA: Mayfield Publishing Co

    (1980)
  • W. Griffiths et al.

    The role of mass media in public health

    Am J Public Health/Nations Health

    (1960)
  • M.L. Rothschild

    Carrots, sticks, and promises: a conceptual framework for the management of public health and social issue behaviors

    SMQ

    (2000)
  • D. Glik et al.

    Narrowcasting risks of drinking during pregnancy among African American and Latina adolescent girls

    Health Promot Pract

    (2001)
  • N.I.H. USDHHS

    National Cancer Institute. Making health communication programs work

    (2008)
  • L.B. Snyder et al.

    A meta-analysis of the effect of mediated health communication campaigns on behavior change in the U.S. J

    Health Commun

    (2004)
  • CDC. Gateway to health communication and social marketing practice....
  • N.K. Weinreich

    Hands-on social marketing: a step-by-step guide to designing change for good

    (2010)
  • R. Whitney et al.

    Lessons learned from public health mass media campaigns: marketing health in a crowded media world

    Annu Rev Public Health

    (2004)
  • A history of SunSmart media campaigns....
  • Significant trends

    London: Cancer Research UK

    (2009)
  • Reducing tobacco use: a report of the Surgeon General

    (2000)
  • Best practices for comprehensive tobacco control programs—2007

    (2007)
  • M.C. Farrelly et al.

    Getting to the truth: evaluating national tobacco countermarketing campaigns

    Am J Public Health

    (2002)
  • Social marketing: national benchmark criteria, Inverness Scotland Natural Heritage Social Marketing Centre, 2006....
  • P. Kotler et al.

    Social marketing: influencing behaviors for good

    (2008)
  • Safe Kids U.S....
  • B.A. Morris et al.

    Increasing bicycle helmet use in the community. Measuring response to a wide-scale, 2-year effort

    Can Fam Physician

    (1994)
  • Cited by (80)

    • Health communication campaigns to drive demand for evidence-based practices and reduce stigma in the HEALing communities study

      2020, Drug and Alcohol Dependence
      Citation Excerpt :

      Agenda-setting theory was employed to direct coalition attention to how media coverage influences what people think and talk about with each other, and the opinions they have about topics such as acceptance of naloxone and MOUD as well as stigmatizing attitudes and behaviors (McCombs, 2018; Riley et al., 2016). The analytic framework developed by Robinson et al. (2014) for how media campaigns and health product distribution can be combined to increase behavior change and use of health products was used to guide campaign support of the implementation of EBPs by coalitions in each community. Campaign activities would lead to increased knowledge and self-efficacy, more favorable social norms, greater organizational adoption of EBPs, and improved access to naloxone and MOUD treatment.

    • Similarity Analysis in Understanding Online News in Response to Public Health Crisis

      2022, International Journal of Environmental Research and Public Health
    View all citing articles on Scopus

    The names and affiliations of the Task Force members are listed at www.thecommunityguide.org/about/task-force-members.html

    View full text