Learning from Mass Media Campaigns for HIV/AIDS Prevention
Reviews of mass media campaigns have a special interest for me. They demonstrate what can be done, and as importantly, what cannot be done, by relying on a 1P approach. I have talked about the 5% Solution before, and noted another review of mass media campaigns for changing health behaviors. This post focuses on the findings from a review of recent campaigns to prevent HIV/AIDS. What is interesting in this report are the comparisons it draws to reviews of earlier campaigns in this area as well as the current state of the art and science. The authors used seven principles to guide their analysis: (1) conducting formative research on ...view middle of the document...
the most commonly reported activity was research about campaign messages, including pretesting messages or examining message preferences of members of the target audience. Only two studies used formative research to develop or test their outcome measures (a neglected part of the research process in too many studies).
Using theory - 44% reported using theory, most often the Health Belief Model, Reasoned Action and Planned Behavior, Social Cognitive Theory, the Transtheoretical Model and Stages of Change and the Information-Motivation-Behavioral Skills Model.
Audience segmentation - 94% (all but 2) described an approach to audience segmentation.
Message design – very few campaigns used theory to guide development of persuasive messages. The authors note that while behavioral theories can suggest the type of content to include, HOW that content is formed into messages is often approached without explicit reference to relevant theoretical models such as message framing, emotional appeals, sensation-seeking, elaboration likelihood model and the use of narratives.
Channels – 21% used a single media channel with television, radio and print media being the channel of choice. The remaining campaigns used other channels (billboards, brochures, Internet, newsletters) and a variety of promotional materials such as baseball cards, postcards, condom packs; a variety of interpersonal strategies including peer education and skill-building workshops and hotlines; and some also included community partners, coalitions and community mobilization in their activities.
Process Monitoring – 82% of the campaigns reported audience exposure to messages, with a mean exposure of 77% of the targeted audience (a range of 35% - 100%). There was little reporting of frequency of exposure to campaign messages, and when those data were reported, it was difficult to make comparisons across studies.
Outcomes – Pre-Post test designs using independent sampling were employed by a plurality of the campaigns (13 of the 34, or 38%). Eleven studies used only a post-test measure. The authors note that this means that 70% of the campaigns used weak outcome evaluation designs. In 24 of the campaigns (71%) behavioral outcomes were reported, most often either condom use or HIV/STD testing. Among the studies that used stronger designs (the other 30%), only 2 of the 10 found no statistically significant effects. Six studies reported significant changes in outcomes including talked with others about safer sex, continued abstinence, initiated condom use, increased condom use, reduced number of sexual partners, or were tested for HIV. The other two reported changes in behavioral intentions (for example, to use condoms and shifts in stages of change).
The authors conclude that, when compared to another review of this literature in 2000, HIV/AIDS mass...