**1. Introduction**

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The mass media are intensively employed in public health. Vast sums are spent annually for materials and salaries that have gone into the production and distribution of booklets, pamphlets, exhibits, newspaper articles, and radio and television programs. These media are employed at all levels of public health in the hope that three effects might occur: the learning of correct health information and knowledge, the changing of health attitudes and values and the establishment of new health behavior.

Mass media campaigns have long been a tool for promoting public health (Noar, 2006) being widely used to expose high proportions of large populations to messages through routine uses of existing media, such as television, radio, and newspapers. Communication campaigns involving diverse topics and target audiences have been conducted for decades. Some reasons why information campaigns fail' is an early landmark in the literature. Exposure to such messages is, therefore, generally passive (Wakefield, 2010). Such campaigns are frequently competing with factors, such as pervasive product marketing, powerful social norms, and behaviours driven by addiction or habit.

Mass media campaigns have generally aimed primarily to change knowledge, awareness and attitudes, contributing to the goal of changing behaviour. There has not normally been a high expectation that such campaigns on their own would change people's behaviour. Theory suggests that, as with other preventive health efforts, mass media campaigns are most likely to reduce unhealthy attitudes if their messages are reinforced by other efforts. Reinforcing factors may include law enforcement efforts, grassroots activities, and other media messages.

There is a vast literature relating to public health information campaigns. Much theoretical literature is devoted to the topic of effectiveness of health communication strategies. Mass media campaigns have usually been one element of broader health promotion programmes with mutually reinforcing components:


The Role of Mass Media Communication in Public Health 401

Elliott (1987), one of Australia's leading communication practitioners, offers a particularly informative look at the differences between advertising and communication campaigns. His literature review and analyses of campaigns are especially relevant because they are based largely on experience. He defines a set of parameters for considering and planning for a

Elliott's (1987) basic premise is that the objectives and processes that are appropriate for commercial advertising are usually inappropriate for health promotion. The essential differences between advertising and health campaigns lie in the nature of the product, the processes involved in promotion and, of course, in the nature of audiences. Elliott argues that advertising by itself will not result in fundamental changes in behaviour: "Commercial products are regarded by many as trivial and superficial, not as central and ego-involving to the individual as ill health. They are positive and attractive and can be relatively easily obtained. By contrast, health publicity is largely negative: it preaches the avoidance of something negative (which is enjoyable), often involving short-term unpleasantness, for the

Elliott (1987) draws on previous research to demonstrate once again that advertising does not have massive effects on potential consumers, as many might believe. However, he notes that small changes in market share for a particular product that are achieved as a consequence of advertising may result in greatly increased sales and profits. In this regard, it is useful to recall Rogers and Storey's (1987) assertion that a health promotion campaign might be considered successful if five percent of the target audience make long–term

Commercial advertising techniques are but one element of a communication campaign using mass media. The following table is comparing communication campaigns and

wants.

need.

opinions.

opinion.

benefit.

Focus on feelings and perceptions toward

Based on the idea of satisfying desires and

May be designed to create desire and

Usually, if not exclusively, a personal

Plays on prevailing attitudes and

product. Not attitude change.

**Typical Communication Campaign Typical Advertising Campaign** 

Usually against the tide of public opinion. Tries to stay with the tide of public

**3. Advertising and communication campaigns** 

sake of benefits that are long-term, probabilistic and not guaranteed".

campaign's realistic outcomes.

changes in overt health behaviour.

Persuasive focus involving response shaping, reinforcement attitude change;

Difficult to specify individual desires and

Designed to meet societal or individual

Not usually seen as a personal benefit as such and may be designed to create a social

May not be in line with prevailing

advertising.

wants.

benefit.

behavioural change.

needs in face of risk.

attitudes and opinions.

4. Encouraging local and national policy changes so as to create a supportive environment within which people are more able to change their behaviour.

This book chapter will first focus on some key concepts such as communication campaigns *vs* mass media campaigns, advertising *vs* communication campaigns, the concept of risk and risk communication campaigns. Later on, the chapter will focus on the effectiveness of public health campaigns using mass media communication.
