Public service announcements (PSAs) emerged after World War II in the United States as a promising strategy for increasing awareness of important social issues and changing beliefs, attitudes, and behavior. Research at that time showed that PSA campaigns had limited success in changing attitudes and behavior. Even so, both in the U.S. and internationally, sponsoring agencies and organizations continued to produce PSAs, hoping they would create significant behavior change.
In the 1980s, a more informed view of what PSAs can achieve began to emerge as practitioners of social marketing demonstrated that media campaigns can produce behavior change when they are designed and executed according to the principles and best practices followed by the advertising industry. Beginning in the 1990s, PSA-based campaigns to promote public action through programs and policy change became more common. Research has shown that such campaigns can play a key role in shaping the public agenda, changing perceptions of social norms, reinforcing school- and community-based programs, and building support for and then publicizing changes in public policy, all of which can foster individual behavior change.
PSAs and other media executions are best designed using a planning scheme that is grounded in advertising best practices and behavior change theory and that uses those media executions as part of a broader intervention effort. These various elements can be brought together by using a media planning guide that outlines how the campaign will work in sync with other intervention activities and what its key messages will be.
In the United States, federal regulations that outlined broadcasters’ public service obligations were loosened in the 1980s, making it increasingly difficult to get donated time for PSAs and other public service messages. More broadly, the increased focus of broadcasters, cable networks, and print publications on generating revenue has magnified this problem. Faced with strong competition, campaign planners need a strategy for convincing media gatekeepers to give priority to their messaging.
The rise of social media (e.g., Facebook, Instagram, Twitter) has opened up a new means of putting PSAs before the public. For example, once a message is posted on a video-sharing website such as YouTube, it can be linked to the sponsoring organization’s website, where additional intervention-related material can be found, as well as to websites hosted by other groups. Promotional efforts through national, state, and community organizations can draw an initial audience, with the hope that they will share the link with their social media and email contacts and that eventually the message will “go viral.”
PSAs remain a viable media alternative for public communication campaigns, despite the fact that major media outlets do not often provide donated time or space for such advertising. In some cases, a PSA-driven campaign will be supported by a large budget, but while such campaigns have a better chance of success, the resources required are seldom available. The emergence of social media has created a new way to build an audience. Successful examples of social media campaigns are emerging, but why some campaigns take off and others do not requires additional study.
The reasoned action approach is a behavioral theory that has been developed since the 1960s in a sequence of reformulations. It comprises the theory of reasoned action; the theory of planned behavior; the integrative model of behavioral prediction; and its current formulation, the reasoned action approach to explaining and changing behavior. Applied to health messages, reasoned action theory proposes a behavioral process that can be described in terms of four parts. First, together with a multitude of other potential sources, health messages are a source of beliefs about outcomes of a particular health behavior, about the extent of social support for performing that behavior from specific other people, and about factors that may hamper or facilitate engaging in the behavior. Second, these beliefs inform attitude toward performing the behavior, perceptions of normative influence, and perceptions of control with respect to performing the behavior. Third, attitude, perceived norms, and perceived control inform the intention to perform the behavior. Fourth, people will act on their intention if they have the required skills to do so and if there are no environmental obstacles that impede behavioral performance.
The theory’s conceptual perspective on beliefs as the foundation of behavior offers a theoretical understanding of the role of health messages in behavior change. The theory also can be used as a practical tool for identifying those beliefs that may be most promising to address in health messages, which makes the theory useful for those designing health message interventions. Reasoned action theory is one of the most widely used theories in health behavior research and health intervention design, yet is not without its critics. Some critiques appear to be misconceptions, such as the incorrect contention that reasoned action theory is a theory of rational, deliberative decision making. Others are justified, such as the concern that the theory does not generate testable hypotheses about when which variable is most likely to predict a particular behavior.
Marieke L. Fransen and Saar Mollen
During the past few decades we have witnessed increased academic attention on resistance to persuasion. This comes as no surprise, as people are often persuaded by external forces when making important decisions that may affect their health. Public health professionals, scholars, and other concerned parties have developed numerous trainings, interventions, and regulations to teach or assist people to resist unwanted persuasion, deriving from media exposure (e.g., advertising) or social pressure. The extant literature on resistance induction encompasses strategies such as inoculation, media literacy interventions, trainings on specific persuasive techniques, warnings, and social influence interventions. Although the research findings of the discussed strategies vary in how straightforward they are, they do offer promising avenues for policymakers and health communication professionals. Furthermore, several avenues worthy of further study can be identified.
R. Craig Lefebvre and P. Christopher Palmedo
Many ideas about best practices for risk communication share common ground with social marketing theory and practice: for example, segmentation, formative research, and a focus on behavioral outcomes. Social marketing first developed as a methodology to increase the public health impact of programs and to increase the acceptability and practice of behaviors that improve personal and social well-being. The core concepts of this approach are to be people-centered and to aim for large-scale behavior change. An international consensus definition of social marketing describes it as an integration of theory, evidence, best practices, and insights from people to be served. This integrated approach is used to design programs that are tailored to priority groups’ needs, problems, and aspirations and are responsive to a competitive environment. Key outcomes for social marketing efforts are whether they are effective, efficient, equitable, and sustainable.
The 4P social marketing mix of Products, Prices, Places, and Promotion offers both strategic and practical value for risk-communication theory and practice. The addition of products, for example, to communication efforts in risk reduction has been shown to result in significantly greater increases in protective behaviors. The Cover CUNY case demonstrates how full attention to, and consideration of, all elements of the marketing mix can be used to design a comprehensive risk-communication campaign focused on encouraging college student enrollment for health insurance. The second case, from the drug safety communication arena, shows how a systems-level, marketplace approach is used to develop strategies that focus on key areas where marketplace failures undermine optimal information-dissemination efforts and how they might be addressed.
Kristin Page Hocevar, Miriam Metzger, and Andrew J. Flanagin
Our understanding and perceptions of source credibility significantly drive how we process health and risk messages, and may also influence relevant behaviors. Source credibility is believed to be impacted by both perceptions of source trustworthiness and expertise, and the effect of credibility on changes in attitudes and behavior has been studied for decades in the persuasion literature. However, how we understand and define source credibility—particularly the dimension of expertise—has changed dramatically as social media and other online platforms are increasingly used to design and disseminate health messages. While earlier definitions of source credibility relied heavily on the source’s credentials as indicators of expertise on a given topic, more recent conceptualizations must also account for expertise held by laypeople who have experience with a health concern. This shifting conceptualization of source credibility may then impact both why and when people select, as well as how they perceive, process, and judge, health messaging across both novel and more traditional communication contexts.
The spiral of silence theory provides insight into the ways in which perceptions of public opinion can lead to changes in opinion expression behavior. Conceptualized in a political communication context, the central claim of the theory is that individuals’ fear of social isolation motivates them to continuously evaluate the climate of opinion through both experiences with the media and interpersonal communication. Upon assessment, individuals either find themselves in a situation where their opinion aligns with the majority or minority. Accordingly, those who find their opinion does not align with the dominant opinion are likely to conceal their opinions while those who find their opinion aligns with the majority are more likely to express them.
Empirical research testing the spiral of silence theory has predominately focused on measurement of focal variables and methods of empirical testing. Advances have been made in regard to micro-level factors, such as creating universally applicable measures of psychological attributes. However, limited work has explored macro-level factors, such as appropriateness of issues, application to computer-mediated communication environments, and tools used to identify circumstances vulnerable to spiral of silence effects. Nonetheless, the practical value of the spiral of silence theory for health and risk communicators can be utilized by modifying campaign efforts to anticipate and counteract fluxes in public opinion.
Helena Sofia Rodrigues and Manuel José Fonseca
In the context of epidemiology, an epidemic is defined as the spread of an infectious disease to a large number of people, in a given population, within a short period of time. When we refer to the marketing field, a message is viral when it is broadly sent and received by the target market through person-to-person transmission. This marketing communication strategy is currently assumed to be an evolution by word of mouth, with the influence of information technologies, and called Viral Marketing. This stated similarity between an epidemic and the viral marketing process is notable yet the critical factors to this communication strategy’s effectiveness remain largely unknown. A literature review specifying some techniques and examples to optimize the use of viral marketing is therefore useful.
Advantages and disadvantages exist to using social networks for the reproduction of viral information. It is very hard to predict whether a campaign becomes viral. However, there are some techniques to improve advertising/marketing communication, which viral campaigns have in common and can be used for producing a better communication campaign overall. It is believed that the mathematical models used in epidemiology could be a good way to model a marketing communication in a specific field. Indeed, an epidemiological model SIR (Susceptible-Infected-Recovered) helps to reveal the effects of a viral marketing strategy. A comparison between the disease parameters and the marketing application, as well as simulations using Matlab software explores the parallelism between a virus and the viral marketing approach.