Evan K. Perrault
Due to their sheer scope in trying to reach large sections of a population, and the costs necessary to implement them, evaluation is vital at every stage of the health communication campaign process. No stage is more important than the formative evaluation stage. At the formative stage, campaign designers must determine if a campaign is even necessary, and if so, determine what the campaign’s focus needs to be. Clear, measurable, and realistically attainable objectives need to be a primary output of formative evaluation, as these objectives help to guide the creation of all future campaign efforts. The formative stage also includes pilot testing any messages and strategies with the target audience prior to full-scale implementation. Once the campaign is implemented, process evaluation should be performed to determine if the campaign is being implemented as planned (i.e., fidelity), and also to document the dose of campaign exposure. Identifying problem areas during process evaluation can ensure they get fixed prior to the completion of the campaign. Detailed process evaluation also allows for greater ease in replicating a successful campaign attempt in the future, but additionally can provide potential reasons for why a campaign was not successful. The last stage is outcome evaluation—determining if the objectives of the campaign were achieved. While it is the last stage of campaign evaluation, campaign designers need to ensure they have planned for it in the formative stages. If even just one of these stages of evaluation is minimized in campaign design, or relegated to an after-thought, developers need to realize that the ultimate effectiveness of their campaigns is likely to be minimized as well.
Yvonnes Chen and Joseph Erba
Media literacy describes the ability to access, analyze, evaluate, and produce media messages. As media messages can influence audiences’ attitudes and behaviors toward various topics, such as attitudes toward others and risky behaviors, media literacy can counter potential negative media effects, a crucial task in today’s oversaturated media environment. Media literacy in the context of health promotion is addressed by analyzing the characteristics of 54 media literacy programs conducted in the United States and abroad that have successfully influenced audiences’ attitudes and behaviors toward six health topics: prevention of alcohol use, prevention of tobacco use, eating disorders and body image, sex education, nutrition education, and violent behavior. Because media literacy can change how audiences perceive the media industry and critique media messages, it could also reduce the potential harmful effects media can have on audiences’ health decision-making process.
The majority of the interventions have focused on youth, likely because children’s and adolescents’ lack of cognitive sophistication may make them more vulnerable to potentially harmful media effects. The design of these health-related media literacy programs varied. Many studies’ interventions consisted of a one-course lesson, while others were multi-month, multi-lesson interventions. The majority of these programs’ content was developed and administered by a team of researchers affiliated with local universities and schools, and was focused on three main areas: reduction of media consumption, media analysis and evaluations, and media production and activism. Media literacy study designs almost always included a control group that did not take part in the intervention to confirm that potential changes in health and risk attitudes and behaviors among participants could be attributed to the intervention. Most programs were also designed to include at least one pre-intervention test and one post-intervention test, with the latter usually administered immediately following the intervention. Demographic variables, such as gender, age or grade level, and prior behavior pertaining to the health topic under study, were found to affect participants’ responses to media literacy interventions.
In these 54 studies, a number of key media literacy components were clearly absent from the field. First, adults—especially those from historically underserved communities—were noticeably missing from these interventions. Second, media literacy interventions were often designed with a top-down approach, with little to no involvement from or collaboration with members of the target population. Third, the creation of counter media messages tailored to individuals’ needs and circumstances was rarely the focus of these interventions. Finally, these studies paid little attention to evaluating the development, process, and outcomes of media literacy interventions with participants’ sociodemographic characteristics in mind. Based on these findings, it is recommended that health-related media literacy programs fully engage community members at all steps, including in the critical analysis of current media messages and the production and dissemination of counter media messages. Health-related media literacy programs should also impart participants and community members with tools to advocate for their own causes and health behaviors.
Shirley S. Ho and Andrew Z. H. Yee
Health communication research has often focused on how features of persuasive health messages can directly influence the intended target audience of the messages. However, scholars examining presumed media influence on human behavior have underscored the need to think about how various audience’s health behavior can be unexpectedly influenced by their exposure to media messages. Two central theoretical frameworks have been used to guide research examining the unintended effects: the third-person effect and the influence of presumed media influence (IPMI). The theoretical explanations for presumed media influence is built on attribution bias, self-enhancement, perceived exposure, perceived relevance, and self-categorization. Even though both the third-person effect and the IPMI share some theoretical foundations, and are historically related, the IPMI has been argued to be better suited to explaining a broader variety of behavioral consequences. One major way that presumed media influence can affect an individual’s health behavior is through the shifting of various types of normative beliefs: descriptive, subjective, injunctive, and personal norms. These beliefs can manifest through normative pressure that is theoretically linked to behavioral intentions. In other words, media have the capability to create the perception that certain behaviors are prevalent, inculcating a normative belief that can lead to the uptake of, or restrain, health behaviors. Scholars examining presumed media influence have since provided empirical support in a number of specific media and behavioral health contexts. Existing findings provide a useful base for health communication practitioners to think about how presumed media influence can be integrated into health campaigns and message design. Despite the proliferation of research in this area, there remains a need for future research to examine these effects in a new media environment, to extend research into a greater number of health outcomes, to incorporate actual behavioral measures, and to ascertain the hypothesized causal chain of events in the model.