Evidence: A Meta-Analysis of the Effect of Mediated Health Communication Campaigns on Behavior Change in the United States
A Meta-Analysis of the Effect of Mediated Health Communication Campaigns on Behavior Change in the United States
Editor's note: Click here for a summary of this evaluation on The CI site.
Name(s) of author(s)?:
Leslie B. Snyder, Mark A. Hamilton, Elizabeth W. Mitchell, James Kiwanuka-Tondo, Fran Fleming-Milici, and Dwayne Proctor
Who published this paper, article, book (chapter) or other publication?:
Journal of Health Communication: International Perspectives, 9:S1, 71-96, DOI: 10.1080/10810730490271548
What are the best extracts that highlight the evidence for the impact of a communication for development, social change, behaviour change, public engagement, or informed citizen strategy on a development issue and priority?:
A meta-analysis was performed of studies of mediated health campaigns in the United States in order to examine the effects of the campaigns on behavior change. Mediated health campaigns have small measurable effects in the short-term. Campaign effect sizes varied by the type of behavior: r=.15 for seat belt use, r=.13 for oral health, r=.09 for alcohol use reduction, r=.05 for heart disease prevention, r=.05 for smoking, r=.04 for mammography and cervical cancer screening, and r=.04 for sexual behaviors. Campaigns with an enforcement component were more effective than those without. To predict campaign effect sizes for topics other than those listed above, researchers can take into account whether the behavior in a cessation campaign was addictive, and whether the campaign promoted the commencement of a new behavior, versus cessation of an old behavior, or prevention of a new undesirable behavior. Given the small campaign effect sizes, campaign planners should set modest goals for future campaigns. The results can also be useful to evaluators as a benchmark for campaign effects and to help estimate necessary sample size.
To which development issue does this evidence and impact data relate?:
Various health topics (seat belt use, oral health, alcohol use reduction, heart disease prevention, smoking, mammography and cervical cancer screening, sexual behaviors)
To which strategic approach(es) does the evidence and impact data relate?:
Mass communication campaigns
What research methodology (ies) was/were used to produce this evidence and impact data?:
Meta-analysis: Studies were included in the meta-analysis if they were published in English in refereed journals or in edited scholarly or professional books and reported on health campaigns using at least one form of community-wide mass media. Campaigns were excluded that only used interpersonal channels, campaigns that were waged within schools or workplaces, and experiments that exposed people to media in small group settings. All campaigns took place in the United States, to control for cultural and media system differences. All studies had to include fully specified measures of campaign effects on at least one type of behavior advocated by the campaign. In a few cases physiological measures were included in the meta-analysis because prior research showed that there were no differences in effect size between behavioral measures and physiological measures (Snyder & Hamilton, 1999). The unit of analysis was the campaign. A total of 48 campaigns were analyzed, with a total N of respondents across all campaigns of 168,362. Effect sizes for campaigns were calculated from reported correlations between program exposure and program outcomes in each study in such a way to create comparable correlations, adjusting for sample sizes. The correlations were then was converted into the average percentage campaign behavior change by first converting r to the d-statistic (Johnson, 1995), which is the average change in behavior divided by the standard deviation (SD) of the average behavior rate.
What is the URL to access this paper, article, book (chapter) or other publication?:
https://www.tandfonline.com/doi/abs/10.1080/10810730490271548
Why was this research evidence found to be useful?:
This study (and other meta-analyses conducted by Snyder and associates on other health topics and in international settings) provides realistic estimates of the impact that can be expected from mass-mediated health campaigns. These estimates can be used to negotiate program targets with donor agencies and program partners who often have unrealistic expectations of what can be achieved through media campaigns. This study and others by Snyder also indicate why some behaviors are harder to change (e.g., addictive behaviors are harder to stop), why it is easier to initiate a new behavior than to replace an old one, as well as what complementary tactics can improve outcomes (e.g., whether the campaign has an enforcement component).
Further comments?:
Other meta-analyses by Snyder, some peer-reviewed and some from conferences, have shown that campaign effect sizes are generally larger in LMICs, that effect sizes for youth-oriented campaigns are smaller than for campaigns targeting adults, and that effect sizes are larger when programs also improve access to resources that audiences need in order to enact promoted behaviors (e.g., pairing a condom distribution campaign with a condom use demand generation campaign).
Participating organisations in the Global Alliance for Social and Behaviour Change - Building Informed and Engaged Societies were asked to identify, in their opinion, the 5 most compelling research and evaluation studies that demonstrate the direct impact of this field of work on a major development issue. This was one of the nominees. For the full compiled list, please click here. For the compilation of the key impact data across all research evidence identified, please click here.