Today’s blog post covers research conducted as part of Policy Evaluation Network (PEN). The research was led by researchers from Amsterdam University Medical Center. Other contributing authors were affiliated with Friedrich-Alexander University, Leibniz Institute for Prevention Research and Epidemiology, Gdansk University of Technology and UL.
To promote physical activity (PA) governments are recommended to ensure mass media campaigns are in place. The International Society for Physical Activity for Health (ISPAH) lists mass media campaigns as one of the eight best investments to promote PA. The World Health Organisation (WHO) has indicated that implementing ‘best practice’ communications campaigns is a key intervention for fostering active societies. There is also evidence to suggest that, globally, just over half of all governments have initiated a PA promoting communications campaign. This makes mass media campaigns one of the more widely implemented PA policy interventions by governments.
However, some political scientists have suggested that mass media campaigns are frequently deployed by governments with little regard for their effectiveness. Rütten and colleagues (2013) have suggested that governments, based on their public relations expertise, may consider the mass media campaign a ‘proven’ solution for policy problems. Therefore, insufficient consideration may be given to the particularities of how mass media can be used as part of a strategy to reduce physical inactivity.
It seems that not all mass media strategies are created equal. Unfortunately, there are presently no authoritative criteria for ensuring the quality of PA-promoting mass media campaigns. So, review of reviews was conducted synthesizing evidence on the effectiveness of mass media campaigns. The review had two aims. The first was to summarise the evidence on the effectiveness of mass-media campaigns in promoting PA or impacting its determinants. The second was to provide policy recommendations for ensuring successful PA-promoting mass media campaigns. Researchers screened 1915 items, identifying 22 studies relevant to the study’s aims.
Figure 1 Flowchart of study selection and in- and exclusion
To synthesis data from these studies a typology was developed by combining frameworks constructed by Brown and colleagues (2012, see figure 2) and Gelius and colleagues (2019). The result was a typology that categorises studies according to their level of enactment (national or subnational level) and their reported effects on three categories of outcome (proximal, intermediate and distal).
The quality of the evidence supporting mass media campaign effectiveness was assessed and generally found to be critically low (so you should take the findings with a major pinch of salt). But, with that proviso out of the way, it was found that effects of mass media campaigns were easier to detect for the so-called ‘proximal’ outcomes identified by Brown than for distal ones. This means that it’s easier for a mass media campaign to change people’s awareness of a message than it is to change their attitudes or intentions. Knowledge, Attitudes and intentions are, in turn, easier to influence than actual PA behaviour.
Figure 2 The framework of mass-media campaigns by Brown and colleagues with proximal, intermediate and distal outcomes.
Another finding from the research is that campaigns that focused on social norms were more effective than campaigns that focused on risks. In essence, campaigns that promote the message that PA is enjoyable or socially desirable are more effective than campaigns that inform the audience that PA will reduce their risk of diabetes.
A further interesting finding from the review is that successful campaigns had the following features: audience segmentation and multiple media channels were utilised and the campaigns were embedded in broader multicomponent PA programmes.
There are various factors that influence the reported effectiveness of mass media campaigns: different effects between subgroups within the audience (especially motivated subgroups versus vulnerable subgroups), the combination of mass media campaigns with other interventions (confusing the identification of the most active ingredient) and a general lack of solid monitoring or evaluation frameworks in the mass media campaigns under study. In spite of these reporting drawbacks, a number of policy-relevant recommendations were drawn up based on the study findings.
1 An effective mass media campaign should be sustained over an extended period of time to influence social norms. Sustained evaluation of campaigns should utilise proximal outcomes to demonstrate impact.
2 Mass media campaigns should be combined with other interventions. This highlights a need for joined up thinking in the implementation of policy interventions.
3 Mass media campaign should consider audience segmentation. This is important as the evidence identifying which strategies work best in vulnerable demographics is still wafer thin.
If you are interested in learning more about these research findings the review was published as part of a PEN special issue in the European Journal of Public Health. It is accessible here.
Dr. Kevin Volf is a research postgraduate student in the Department of Physical Education and Sport Sciences in the University of Limerick.