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Training on Setting-up Awareness Campaigns Prof. dr. Tom Brijs Transportation Research Institute Hasselt University (BE) Disclaimer: Significant parts of the presentation were taken from the European Manual for Designing, Implementing, and Evaluating Road Safety Communication Campaigns (FP6 project CAST)
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Outline 1.Intervention mapping as a stepwise approach for creating awareness campaigns 2.Practical implementation of the stepwise approach
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Part I: Intervention mapping as a stepwise approach for creating awareness campaigns
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Introduction Campaigns are all about changing behavior. So a crucial point is to understand the determinants of behavior –Predisposing factors –Reinforcing factors –Enabling factors
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Predisposing factors: “learning-related factors within the persons of the target population that facilitate or hinder motivation for change” e.g., awareness of the problem, beliefs about the problem, attitudes toward the problem, perceptions about wearing helmets
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Reinforcing factors: “factors that encourage or discourage continuation of the behaviour” e.g., social support, peer pressure, incentives, punishment (fines, demerit points)
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Enabling factors: “factors that can help or hinder the desired behaviours as well as environmental changes” e.g. Skills: how to correctly wear the helmet Resources: money to buy a helmet Barriers: hot weather
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Explaining Human Behaviour Theory of planned behaviour Campaigns Barriers Skills
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Changing needs understanding but Understanding is not sufficient for changing
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Changing behaviour is a science It involves applying theories, learning from earlier empirical studies done on the topic or related topic, and collecting data from your target population and the facilitators of the intervention. Foremost, changing behaviour needs a systematic and planned approach.
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Changing behaviour is a science Evidence-based public health programmes are based on empirical data and theory.
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Theory and Practice Applying theory and research Knowledge of Theory especially knowledge of the process and conditions Example: Fear Appeals
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Theory and Research High Personal Relevance Difficult Behavior Change Fear = Defensive reaction +
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Theory and Research High Personal Relevance Difficult Behavior Change Skills = Constructive reaction +
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Part II: Practical implementation of the stepwise approach
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Intervention Mapping Step 1: Needs Assessment Step 2: Defining Campaign Objectives Step 3: Selecting Methods and Strategies Step 4: Designing the Campaign Step 5: Planning for Campaign Implementation Step 6: Planning for Campaign Evaluation
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Intervention Mapping Step 1: Needs Assessment Step 2: Defining Campaign Objectives Step 3: Selecting Methods and Strategies Step 4: Designing the Campaign Step 5: Planning for Campaign Implementation Step 6: Planning for Campaign Evaluation
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Step 1: Needs Assessment Task 1: Establish a planning group that includes potential program participants and plan the needs assessment Task 2: Conduct the needs assessment to analyze traffic and mobility problems and behavioral and environmental causes Task 3: Define the target population Task 4: Link the needs assessment to evaluation planning by establishing desired program outcomes
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Task 1: Putting together a work group Representatives of the resource group – the program developers and possibly funders Representatives of the potential program adopters and implementers Representatives of the priority population – ultimate end users and managers or leaders from community organizations Step 1: Needs Assessment
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Representatives of the resource group Public authorities –Ministries –National Road Safety Council –World Bank, ADB, … Road authorities Ngo’s: HIB, CRY, GRSP, … Insurance companies Vehicle and safety equipment manufacturers Charities Step 1: Needs Assessment
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Representatives of the potential program adopters and implementers Enforcement authorities –Cambodian National Traffic Police –Local police Schools Driver education training centers Private organizatons, e.g. –Petrol stations –Automobile associations, car manufacturers –Festival and event organizers –Restaurant owners –Supermarkets, … Volunteer organizations Hospitals, doctors Drink producers Step 1: Needs Assessment
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Representatives of the priority population Action groups, e.g. –Motorcycle action groups –Road victims association –Local road safety ambassadors Private organizations –Sport clubs –Youth organizations –Taxi drivers –… A selection of individuals from the target audience Step 1: Needs Assessment
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What we know from the international literature –A strong coalition increases the chances of success of the campaign: public-private partnership involving state organizations (from top level political commitment to local commitment from police departments, local road safety ambassadors), legal departments, insurance companies, … –Early involvement of the different stakeholders is needed –Strong police leadership needed to ensure that strong enforcement is accepted by police officers Step 1: Needs Assessment
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1.What is the problem? Why? Is it a serious problem? What people are involved? 2.What behaviors and environmental conditions are involved? 3.Brainstorm key determinants of behaviors and environmental conditions 4.Build a theory- and evidence-based explanation Task 2: Conduct a needs assessment Step 1: Needs Assessment
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Where do we get the necessary information? - crash statistics (RTAVIS) - hospital data - field observations - field surveys - past campaigns - international literature - interviews with experts - focus group discussions Step 1: Needs Assessment
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Selection of a theoretical model underlying the target behavior in the campaign –Theory of planned behavior –Health-belief model –Protection motivation theory –Deterrence theory Step 1: Needs Assessment
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Behavioural beliefs Normative beliefs Control beliefs Attitude Subjective norm Perceived behavioural control Behavioural intentions Behaviour Theory of Planned Behaviour Step 1: Needs Assessment skills barriers
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Examples –subjective norm, perceived behavioral control (drink driving campaign) http://www.youtube.com/watch?v=qsY_Co-p8Bw http://www.youtube.com/watch?v=qsY_Co-p8Bw –Subjective norm, perceived behavioral control (drink driving) http://www.youtube.com/watch?v=23xr3JF-tz0 Step 1: Needs Assessment
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Intrinsic benefits Extrinsic benefits Self-efficacy Severity Vulnerability Response cost Threat appraisal Coping appraisal Protection motivation Protection Motivation Theory Step 1: Needs Assessment + + = =
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Examples –Severity, vulnerability, response cost (helmet wearing campaign Vietnam) http://www.youtube.com/watch?v=3X46UoXpAME –Self-efficacy (child restraint) http://www.youtube.com/watch?v=j4-zRcm38oM Step 1: Needs Assessment
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Perceived Severity Perceived Susceptibility Perceived Benefits Perceived Barriers Perceived Threat Cost-benefit Analysis Cues to action Likelihood of Action Health Belief Model Step 1: Needs Assessment
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Examples –Benefits (seatbelt wearing campaign) http://www.youtube.com/watch?v=23xr3JF-tz0 –Action cues (campaign on fatigue) http://www.youtube.com/watch?v=LR4NK_xz7y8 http://www.youtube.com/watch?v=LR4NK_xz7y8 –Action cues (call a “responsible young driver”) http://www.youtube.com/watch?v=Vq93NCBp9Ik Step 1: Needs Assessment
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–People tend to change their behavior more easily when campaigns are associated with stronger enforcement. –Communication about enforcement must focus on: Immediacy: you will be fined immediately Severity: you will pay a high fine Likelihood: you have a high chance of being caught –Example drink driving http://www.youtube.com/watch?v=iwKCjIaT_Xs Step 1: Needs Assessment Deterrence Theory
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Task 3: Describing the individuals who are the potential program recipients (target audience) The recipients of campaign benefits may not necessarily be the population at-risk –E.g., car drivers and pedestrians (pedestrian accidents) –E.g. parents and children (child protection) There are often multiple groups targeted by an intervention, some of whom are populations at risk and others, those who influence the environment (e.g. police, school teachers) Program participants could be environmental agents, such as the road safety managers, police, … Step 1: Needs Assessment
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Need for segmentation = separating the audience in distinct, relative homogeneous subgroups, called segments. Why? –The idea is that since a segment shares key characteristics, individuals within a segment will react similarly to the same stimuli (e.g. campaign) –Carefully selecting the target group increases significantly the effect of a campaign Step 1: Needs Assessment
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Criteria for target segment selection –Severity: how much is the target group at risk, what is the potential for improvement? –Accessibility: how can they be identified and reached? –Responsiveness: are they willing to listen and are they responsive to our message? –Segment size: is the segment large enough to be cost-effective? Step 1: Needs Assessment
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Segmentation variables –Demographic: age, gender, education, occupation, family size, social class, … –Geographic: rural versus urban, province, … –Psychographic: personality, beliefs, values, interests, lifestyle –Behavioral: user rate (high offenders versus low offenders) –State of change Step 1: Needs Assessment
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Segmentation variables –State of change: pre-contemplation: individual has no intention to change (believers / non-believers) contemplation: individual starts to become aware of the problem. Highlight discrepancy between individual needs and general public needs (traffic safety) preparation: individual has begun preparations to change. This can be supported by facilitating change. action: change has occurred but risk is still high for fallback. The first actions must be rewarding in order to prevent fallback. Peer pressure, subjective norms play a very important role here. Giving gifts, demerit point systems etc may help. maintenance: new behavior has started to become a habit termination: new behavior is established and return to old behavior is not likely Step 1: Needs Assessment
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Task 4: Objectives from the needs assessment Type of objective Safety outcomes Safety-related behavior outcomes Safety-related environmental outcomes Definition What will change in terms of the safety problem? By how much? Among whom? By when? What safety-related behavior will change? (e.g. helmet wearing) What environmental conditions will change? (e.g. helmet lockers) Step 1: Needs Assessment
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Task 4: Objectives from the needs assessment What will be the target variable of our campaign? –Knowledge about risks associated with not wearing the helmet –Attitudes with respect to helmet wearing –Behavioral intentions with respect to helmet wearing –Changed behavior (helmet wearing) Observed Self-reported -> the closer to behavior, usually the harder it is to prove the effectiveness of the campaign) Step 1: Needs Assessment
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Intervention Mapping Step 1: Needs Assessment Step 2: Defining Campaign Objectives Step 3: Selecting Methods and Strategies Step 4: Designing the Campaign Step 5: Planning for Campaign Implementation Step 6: Planning for Campaign Evaluation
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Step 2: Campaign Objectives At this stage, the general aim of the campaign is translated into specific objectives What are the expected effects of the campaign in terms of the target variable for the specific target group? –E.g. double the helmet use during peak hours for young people between 16-25 years old Other possibilities –The number or severity of accidents involving non-helmet use –The number of offences Alongside the primary objectives, there can also be secondary objectives –E.g. to influence the attitudes towards helmet use –E.g. to influence perceive behavioral control (PBC) by reminding drivers that they are in charge of their own decision to wear the helmet
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Intervention Mapping Step 1: Needs Assessment Step 2: Defining Campaign Objectives Step 3: Selecting Methods and Strategies Step 4: Designing the Campaign Step 5: Planning for Campaign Implementation Step 6: Planning for Campaign Evaluation
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Step 3: Methods and Strategies Theoretical methods –general technique for influencing change –E.g. use of testimonials Practical strategies –Specific technique for the application of the method –E.g. accident victim goes to schools to talk about his/her experiences and makes young people aware of the dangers
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Methods to influence knowledge –Discussion (e.g. in class rooms, on TV, radio, …) –Images –Active learning –… Methods to increase awareness/risk perception –Information about personal risk –Persuasive communication (e.g. role model stories) E.g. 6-12 years old: http://www.vtm.be/zeppezikki/#movie07http://www.vtm.be/zeppezikki/#movie07 –Fear arousal –… Step 3: Methods and Strategies
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Methods to increase self-efficacy –Skill training (e.g. short courses) –Guided practice with feedback (e.g. additional road education courses) –Reinforcement (http://www.youtube.com/watch?gl=NL&hl=nl&v=CBZSF 5Q4B5c)http://www.youtube.com/watch?gl=NL&hl=nl&v=CBZSF 5Q4B5c Methods to change habits –Presenting substitute behaviors –Presenting cues (I buckle up before I start the engine) Step 3: Methods and Strategies
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To change attitudes –Self-reevaluation (discussing about one’s own behavior) –Increasing direct experience (e.g. testimonials) –Anticipated regret (e.g. imagine you are disabled for the rest of your life, how would you feel about that?) To change social influence –Building skills for resistance to social pressure (http://www.youtube.com/watch?gl=NL&hl=nl&v=NTHN 8JguKAU)http://www.youtube.com/watch?gl=NL&hl=nl&v=NTHN 8JguKAU –Showing positive visible expectations Step 3: Methods and Strategies
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Intervention Mapping Step 1: Needs Assessment Step 2: Defining Campaign Objectives Step 3: Selecting Methods and Strategies Step 4: Designing the Campaign Step 5: Planning for Campaign Implementation Step 6: Planning for Campaign Evaluation
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Step 4: Designing the campaign Develop the campaign strategy –Task 1: Define the strategy –Task 2: Develop the message –Task 3: Choose the media and media plan
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Task 1: Define the strategy Isolated campaign: a single campaign Combined campaign: accompanied by increased enforcement, changed legislation and/or educational activities Integrated campaign: –Horizontal integration: across sectors (involvement of different stakeholders) –Vertical integration: across levels (from National to municipal) –E.g. THINK! (UK) & STEP (USA) Multi-year campaign: several waves of the same campaign carried out over a longer period of time Step 4: Designing the campaign
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Task 1: Define the strategy Mass-media communication (non-personal) –TV, radio, newspapers, … Selective communication (reach target groups simultaneously) –Cinema, direct mail, flyers, brochures Interpersonal communication (two or more people communicate directly) –Focus groups –Telephone –Face-to-face Step 4: Designing the campaign
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What we know from international research –Combined and integrated campaigns are more effective than isolated campaigns –Increased enforcement in combination with enforcement awareness campaigns are very successful 2 weeks of advertizing about increased enforcement: 1 week before and 1 week during the increased enforcement period –Campaigns should be accompanied by measures to assist the change process –The use of campaign waves is very successful: 2-3 times per year –Feedback of the results at the end of the campaign towards the general public increases the acceptability of campaigns –Inform road users about intermediate results: information panels indicating the number of offences or the number of correct users Step 4: Designing the campaign
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Task 2: Develop the message General principles about the campaign message –Clear –Consistent –Unambiguous –Well understood by the target audience Content of the message versus style of the message You might want to involve an advertising agency to propose different communication concepts Campaign message ≠ campaign slogan Step 4: Designing the campaign
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The message content: what will be said –Structure of the message One sided message: only arguments in favour of the theme of the campaign are presented –E.g. wear a helmet because it reduces your probability of serious injuries or death in an accident Two-sided message: arguments in favour and against the theme are presented, then arguments to counter the opposing view are included –E.g. wearing a helmet reduces your probability of serious injuries. We know that it is bad for your looks, but do you really think that it is worth driving without a helmet knowing that after having an accident your good looks will be gone forever. Step 4: Designing the campaign
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When to adopt one-sided messages –When the target audience is sympathetic to the message –When the aim is an immediate/short term opinion change When to adopt two-sided messages –When the target audience is unsympathetic to or initially disagrees with the campaign message. I.e. when the negative aspects of the wanted behavior are well known among the target audience –When it is likely that the target audience will be exposed to contradictory messages Step 4: Designing the campaign
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The message style: how it will be said –Emotional and non-factual versus cognitive and rational approach –Emotional messages can be either positive (love, hapiness, pleasure) or negative (fear, anger, sadness) –One must be cautious using fear appeals. Two types of reactions can take place: Cognitive reaction: the respondent wants to reduce the danger by adapting his/her behavior ( = control the danger) Emotional reaction: rejection of the message, i.e. activation of various mechanisms to protect the person from the threat (deny, defensive avoidance or reactance) (= control the fear) Step 4: Designing the campaign
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Examples –Informational approach Drink driving (testimonial, social cost) http://www.youtube.com/watch?v=9kplg8O6GPQ http://www.youtube.com/watch?v=9kplg8O6GPQ Helmet wearing (celebrity endorsement) http://www.youtube.com/watch?v=BmZBDBjCh2o Speed http://www.transport.qld.gov.au/resources/file/eb6d2f00d77fddb/s topping_distances_tvc.mpg –Emotional approach Drink driving (social cost) http://www.youtube.com/watch?v=JdCTxTM_GtU Step 4: Designing the campaign
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Examples –Fear appeal approach Step 4: Designing the campaign
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Message framing –Problem avoidance: the message is directed at avoiding getting into trouble by adopting the correct behavior E.g. (seatbelts) http://www.youtube.com/watch?v=Xx6v9CNcQ04 http://www.youtube.com/watch?v=Xx6v9CNcQ04 –Promotion oriented: the message is directed at showing the benefits of adopting the correct behavior Step 4: Designing the campaign
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Message execution: who’s saying it (crucial for credibility of the message) –Organizations instead of an individual –The use of testimonials –Celebrities Step 4: Designing the campaign
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Campaign identifiers –Mascots –Branding –Logo –Celebrities -> they increase acceptance and/or credibility of the message -> they are useful as a cornerstone of a complete campaign package Step 4: Designing the campaign
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What we know from international research –Persuasive and emotional messages work better than rational and informative (educational) messages –Message must be relevant to the target group in order to increase systematic processing by the target audience. E.g. playing on family values, family e –Systematic processing increases by exposing the audience to the message several times –Fear appeals can work in specific circumstances and when they are not too aggressive. Otherwise, a defensive reaction will take place. Therefore, it is very important to provide efficient mechanisms to avoid the threat and that the target audience finds itself capable of carrying out the recommended actions. Step 4: Designing the campaign
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Intervention Mapping Step 1: Needs Assessment Step 2: Defining Campaign Objectives Step 3: Selecting Methods and Strategies Step 4: Designing the Campaign Step 5: Planning for Campaign Implementation Step 6: Planning for Campaign Evaluation
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Step 5: Planning for campaign implementation Choice of media Media planning Pre-testing (if possible)
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Step 5: Planning for campaign implementation Choice of media and mediators –Depends on campaign budget –Depends on the target audience’s media habits Time most likely to be exposed to the message (e.g. young males watch football matches) Time most likely to adopt the problem behavior (e.g. in bars ~ drink driving) –Depends on geographic coverage of the campaign –Depends on advantages and disadvantages of different media types
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Strengths/weaknesses different media types –TV S: large reach, high frequency, accessible to everyone W: high production cost, short lived messages (seconds) –Radio S: large reach, also local reach, dynamic, low production cost W: low attention, short lived messages, not suitable for complicated messages –Cinema S: selective, high attention, allows for more complexity W: high production cost Step 5: Planning for campaign implementation
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Strengths/weaknesses different media types –Newspapers S: large reach, geographical selectivity, high credibility, high information capacity, short lead time W: short lifespan, poor demographic selectivity, poor reproduction quality, high noise ration –Magazines S: excellent for segmented audience, relatively long lifespan, good reproduction quality W: high insertion cost, low frequency –Flyers, leaflets, brochures S: high selectiveness, allows for complex messages, low cost W: low attention Step 5: Planning for campaign implementation
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Strengths/weaknesses different media types –Direct mailings S: selective communication, for small target groups, high information capacity W: ‘junk mail’, need for address lists –Billboards, small-size posters/banners S: high exposure, on-the-spot presence, geographically selective, long life span W: low attention, low information capacity –Face-to-face contacts S: effective, interaction with target group W: low exposure, high cost per contact Step 5: Planning for campaign implementation
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Media planning = Scheduling the distribution of campaign materials (spots, billboards, website, …) and supportive activities (e.g. education, enforcement, …) –Duration and frequency single-phase versus multi-phase –Time of campaign implementation Seasonal issues (e.g. fatigue in summer period) Event related (e.g. drink driving around Khmer New Year)
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Step 5: Planning for campaign implementation If possible: Pre-testing !! –Is the message appropriate for the target audience? –Is the message understood as intended? –Is the message clearly stated? –Is the message perceived as useful to the target group? –Is the message well recalled or remembered? –Is the message provoking unexpected feelings or reactions in the target group?
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Step 5: Planning for campaign implementation How to pre-test a campaign? –Interviews –Questionnaires –Focus groups –Thought listing task: record immediate verbalised responses
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Intervention Mapping Step 1: Needs Assessment Step 2: Defining Campaign Objectives Step 3: Selecting Methods and Strategies Step 4: Designing the Campaign Step 5: Planning for Campaign Implementation Step 6: Planning for Campaign Evaluation
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Types of evaluation –Process evaluation –Outcome evaluation –Economic evaluation Evaluation designs –Non-experimental –Quasi-experimental –Experimental (randomized control trials) Statistical issues –Sample size –Data analysis Step 6: Planning for program evaluation
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Types of evaluation –Process evaluation: Did the implementation of the campaign take place as planned? Where there any external factors disrupting the campaign process? If yes, what and how to prevent next time? How many paid and unpaid stories came out in the media? Objective exposure –Number of TV/radio spots, audience figures, number of billboards, … –TARP = Target Audience Rating Points (TARP>100) Subjective exposure –Was the target audience aware that the campaign took place (campaign awareness and message recall) –Did the target audience understand the campaign message? Step 6: Planning for program evaluation
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Types of evaluation –Outcome evaluation: Road crashes, injuries, fatalities (e.g. from RTAVIS). However, beware that these may not be the direct result of your campaign! Behavior as outcome measure –V85 speed, median or average speed –BAC levels –Helmet wearing How to measure: Observed behavior, self-reported behavior, number of offences. Beware of confounding factors: use of control group! Step 6: Planning for program evaluation
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Types of evaluation –Economic evaluation: Cost of the campaign –Development of the campaign –Cost of media placement (e.g. TV advertising) –Beware: direct vs. indirect costs Benefits of the campaign –Benefits to the society due to reduced number of fatalities, serious injuries and slight injuries »E.g. willingness-to-pay method »E.g. value of a victim (e.g. in Europe: 2.5 million dollar/fatality) Step 6: Planning for program evaluation
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Types of evaluation –Economic evaluation (continued): Method of evaluation –Cost Effectiveness Analysis (CEA) = when monetary evaluation of the benefits is not possible. –E.g. Campaign or activity ‘X’ is most cost-effective in reducing the speed per km/h –Cost Benefit Analysis (CBA) = when it is possible to value the benefits in a monetary way. –E.g. For each dollar spent in campaign or activity ‘X’ society’s benefits are ‘$’ (cost-benefit ratio) Step 6: Planning for program evaluation
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Evaluation designs –Non-experimental = simple before-after comparison for a specific outcome measure in the treatment group without use of comparison group –Limitations: Several confounding factors: you are not sure that what you measure is really the effect of your campaign Step 6: Planning for program evaluation Target audience BeforeAfterCampaign
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Evaluation designs –Quasi-experimental = a before-after analysis using treatment (exposed to treatment, e.g. 16-25 years old) and comparison group (not exposed to treatment, e.g. 40-45 years old) –Limitations: Individuals are not randomly allocated to either group. Ideally, the comparison group should contain 16-25 years old who were not exposed to the campaign, but sometimes this is practically not possible. Step 6: Planning for program evaluation Target audience BeforeAfterCampaign Comparison group
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Evaluation designs –Experimental (=randomized control design) = before-after study where the subjects are randomly allocated to either the treatment group or control group –Limitations: Theoretically the most powerful evaluation method, however sometimes hard to implement in practice. For instance, when the target audience is the entire population of a particular age group. Step 6: Planning for program evaluation Target audience BeforeAfterCampaign Control group
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Some more comments about evaluation designs –When to evaluate? Immediate after-period analysis Longer-term after-period analysis (e.g. a number of months after the campaign has finished) so evaluate the long-term effect of the campaign –How to isolate effects of several campaign activities? Step 6: Planning for program evaluation Pre/post measurement MediaEnforcementNo program Group 1X Group 2X Group 3XX Group 4X
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Statistical issues –Sample size depends on a number of issues Statistical issues –Power of the test (we want to maximize this probability) »Null hypothesis states there there is no observable difference between the outcome in the treatment group versus the control group »Power = the probability, assuming that the null hypothesis is false (i.e. effect of campaign is significant) of obtaining a result that will allow the rejection of the null hypothesis. So, if there is an effect, we want to maximize the probability of observing it in the data »Typically, power >= 0.8 Step 6: Planning for program evaluation
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Statistical issues –Sample size depends on a number of issues Statistical issues (continued) –Significance of the test (we want to minimize this probability) »Probability to measure an effect if it is not there (false positive) »Typically, significance <=0.05 –Difference: what difference between the treatment group and comparison/control group does the test need to detect? »E.g. we want the test to find a difference of 10% between both groups »Decreasing this number will increase the number of respondents that you need in both groups Practical issues –Budget available for carrying out the evaluation study Step 6: Planning for program evaluation
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Example of sample sizes Step 6: Planning for program evaluation PowerSignificanceDifferenceSample size each group 0.80.055%1,237 0.80.0510%310 0.80.0520%78
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Statistical issues –Data analysis Descriptive statistics –Comparing sample mean, standard deviation –Simple graphs: histograms, box plots, scatter diagrams, line charts Inferential statistics –Hypothesis testing: testing whether the observed difference in the outcome measure between the treatment group and the control group is statistically significant »E.g. T-test –Advanced methodologies »Time series analysis »Structural equation modelling Step 6: Planning for program evaluation
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Example structural equation model
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