1. The Effectiveness of Mass Communication to Change Public Behavior Paper: Lorien C. Abroms and Edward W. Maibach Presenter: Lauralee Woods

2. Presentation  Mutual evolution of Mass Media and Population Health  Proposed People and Places Framework  Components of an effective campaign  Mass Media’s influence on:  Individual-Level  Social Network Level  Community Level  Optimism in Harnessing Mass Media for Public Health  Limits of this Review  Discussion and Questions

3. Mutual Evolution of Mass Media and Public Health  Media:  1980’s broad cast was limited to fewer tools: (Less channels, broader audience)  1990’s “narrow cast/silver cast” (More channels, specific audience)  Specific Demographic/psychographic targets  INTERNET: Information Blast  Radically Alters Business & Information Flow  Lower cost and less gatekeepers  Public Health:  Before: Clinical focus on curing sick individuals  Now: Eocological Model for Population Health

4. Maibach’s People and Places Framework

5. Defining Mass Media and its Components  Mass media: A planned Effort that disseminates old and new messages to produce awareness or behavior change among an intended population through channels that reach a broad audience.  Components: Review of Social Marketing  Well-designed Message (Design)  Target audience  Target behavior  Intended Audience Reached (Exposure)  Frequency of Message (Exposure)

6. Individual-Level Media Campaigns  Extreme Success: “Truth” by Department of Health and American Legacy Foundation  Result: 22% decline in teenage and adolescent smoking  Exception to the Rule  Normal Success: Snyder and Hamiltons meta-analysis of 48 published community-wide mass media health campaigns effects:  9% increase in short-term behavior adoption  17% increase in behavior adoption with enforceable law  5% increase in behavior adoption without enforceable law  Major Players: Reach and Novelty

7. Examples  The “Truth” campaign  Aim at youth feature trendy youth in public demonstration  http://www.youtube.co m/watch?v=Y_56BQmY_e 8 http://www.youtube.co m/watch?v=Y_56BQmY_e 8  CDC’s VERB campaign  CDC’s graphic anti-smoking campaign ad  Tips from former smokers

9. Average Effects of Media Campaigns by Topic – Meta-analytic findings

10. The Collateral Website  Allows for the individually catered message:  “advergames”  Google also sending you specific messages based on your viewing history  Few studies have been done, but promising for customer reach and brand awareness  VERBnow.com

11. Social Network Level  Focuses is on types and degrees of relationship support  Promotes presence of positive health leaders  Target: Friends, Parents, Older Siblings, spouses…  Success: “Talk to your kids about sex, everyone else is.” by North Carolina Department of Health  Results: A Telephone survey showed intention and behavior increased in exposed population

12. Social Network continued:  Less Explored target: Instead of utilizing an already existing social network, building one.  Example: Harvard mentoring project with a three-prong strategy  Public Service Announcements  Outreach to entertainment Community  News Media outreach  Results : Many donations and 700,000 calls to volunteers

13. Mass Media on Community Level  Subcategories: Social norms, social capital, social cohesion, collective self efficacy, income inequality, and racism.  This strategy is used more for youth.  Big Success: http://www.liveearth.org/ promoting Global warming Awarenesshttp://www.liveearth.org/  Results: Most watched televised Concert…Ever  Really successful? Lots of exposure, but are the ones exposed the ones who can and will make change?

14. Place-based Field of Influence: Local and Distal Levels  Range of Opportunities for interventions  The Laws and Policies in the Environment  The availability of products and services increased  Physical structures in the environment  Media and cultural messages in the environment

15. Media Advocacy:  The strategic use of mass media in combination with community organizing to advance healthy public policies  Mobilization of Public and Policy Makers  Lacks established methods for evaluation with environmental interventions  Few studies exist  Success: http://smokefreemovies.ucsf.edu/http://smokefreemovies.ucsf.edu/  Result: Some response from MPAA by considering smoking in R-ratings  An example of this are also all of the ads on the news and on peoples houses during the elections.

16. Optimism in Harnessing Mass Media for Public Health:  Plenty of exposure Opportunities (Institutue of Medicine):  Average adult is exposed 10 hours per day to media  Plenty of studies on Individual level factors  Paper Suggests:  “Big Messy” Programs- Diverse tactics  -Mass media, interpersonal communication, and outreach to policy makers  More studies needed  All should be explored by Public Health field  Okay for groups to choose one focus or the other depending on their need  Limitations: Few studies done on the subject

17. Questions and Concerns:  Are there more examples of successful or limited media campaigns?  Is this framework sufficient for analyzing mass medias role effect on Public Health?  Should we be optimistic about Mass media as a tool for Population health promotion or is it going to create more barriers?

18. 18 DECISIONS/INTENTIONS SOCIAL S ITUATION BIOLOGY/ P ERSONALITY THE THEORY OF TRIADIC INFLUENCE ATTITUDES TOWARD THE BEHAVIOR SOCIAL NORMATIVE BELIEFS Trial Behavior EXPERIENCES: Expectancies -- Social Reinforcements -- Psychological/Physiological SELF-EFFICACY BEHAVIORAL CONTROL Nurture/CulturalBiological/Nature Intrapersonal StreamSocial/Normative StreamCultural/Attitudinal Stream 192021 22 23 Distal Influences Proximal Predictors Levels of Causation Ultimate Causes Social/ Personal Nexus Expectancies & Evaluations Affect and Cognitions Decisions Experiences a b c d e f g h i j k m n o p q r s t u v w x Related Behaviors J K C F I B E H A D G CULTURAL E NVIRONMENT