Young people's response to death threat appeals: do they really feel immortal?
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Threat appeals are used frequently in health promotion, with threats of (premature) death common in some areas, e.g. 'quit smoking or you'll die'. There is a common notion that young people feel they are immortal. Accordingly, we investigated whether young people would respond less to threats of death than to non-death threats and whether younger people would respond less to death threats than older people. This study was conducted with smokers in two age groups (16-25 and 40-50 years). Each respondent was exposed to one message about the threat of emphysema, either a death or non-death message. Younger smokers did not respond more to non-death threats than death threats and expressed a higher level of response to all threats than older smokers. It would appear that death threats are effective with young people and so we conclude that they do not feel immortal. An additional finding was that older females responded significantly more to non-death threats than older males. Death threats may not be effective with older females and a segmentation approach may be advisable when targeting older people using death threats in health promotion campaigns. (+info)
Reconsidering community-based health promotion: promise, performance, and potential.
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Contemporary public health emphasizes a community-based approach to health promotion and disease prevention. The evidence from the past 20 years indicates, however, that many community-based programs have had only modest impact, with the notable exception of a number of HIV prevention programs. To better understand the reasons for these outcomes, we conducted a systematic literature review of 32 community-based prevention programs. Reasons for poor performance include methodological challenges to study design and evaluation, concurrent secular trends, smaller-than-expected effect sizes, limitations of the interventions, and limitations of theories used. The effectiveness of HIV programs appears to be related in part to extensive formative research and an emphasis on changing social norms. (+info)
Development and testing of promotion materials on tissue and organ donation.
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AIM: To develop leaflets that would promote and increase tissue and organ donation and to test their persuasive value. METHOD: The study was carried out in two parts. In Study 1, we assessed attitudes, knowledge, and intentions about tissue and organ donation of 200 randomly chosen persons from the population of the capital of Croatia, Zagreb, as well as of 108 health professionals in different hospitals in Zagreb. We also assessed the willingness of health care professionals to ask their patients whether they were willing to donate their tissue and/or organs. Dependent variables in this study were attitudes, knowledge, and intentions. On the basis of attitude and knowledge analyses, two types of tissue and organ donation promotional leaflet were developed: one intended for the community sample and the other for health professionals. The leaflets were used as independent variable. In Study 2, performed a year later, the leaflets were presented to another group of 184 persons from Zagreb population and 50 health professionals. We compared attitudes, knowledge, and intentions of community sample and health professionals presented with leaflets vs those not presented with leaflets, and assessed the persuasive power of the two types of promotional material developed. RESULT: The community sample presented with the leaflet in Study 2 showed significantly more positive attitudes towards organ donation when compared with the group not presented with a leaflet in Study 1 (t=2.26; p=0.025), but there was no significant improvement in attitudes towards tissue donation or intention to either donate or receive tissues and organs for transplantation. For health professionals, the Study 2 group presented with a leaflet showed a tendency toward less positive attitudes but significantly more positive intention than those in Study 1 not presented with a leaflet to donate bone marrow (t=2.39; p=0.021) and one's own organs (t=2.24; p<0.027), and to ask others about blood donation (t=2.1; p=0.037). CONCLUSION: Presentation of leaflets succeeded in producing a tendency toward more positive attitudes and intentions toward tissue and organ donation. Still, a single presentation is clearly insufficient to produce significant change in all variables - attitudes, knowledge, and intentions. (+info)
Working with the private sector for child health.
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Private sector providers are the most commonly consulted source of care for child illnesses in many countries, offering significant opportunities to expand the reach of essential child health services and products. Yet collaboration with private providers presents major challenges - the suitability and quality of the services they provide is often questionable and governments' capacity to regulate them is limited. This article assesses the actual and potential contributions of the private sector to child health, and classifies and evaluates public sector strategies to promote and rationalize the contributions of private sector actors. Governments and international organizations can use a variety of strategies to collaborate with and influence private sector actors to improve child health - including contracting, regulating, financing and social marketing, training, coordinating and informing the public. These mutually reinforcing strategies can both improve the quality of services currently delivered in the private sector, and expand and rationalize the coverage of these services. One lesson from this review is that the private sector is very heterogeneous. At the country level, feasible strategies depend on the potential of the different components of the private sector and the capacity of governments and their partners for collaboration. To date, experience with private sector strategies offers considerable promise for children's health, but also raises many questions about the feasibility and impact of these strategies. Where possible, future interventions should be designed as experiments, with careful assessment of the intervention design and the environment in which they are implemented. (+info)
Targeted subsidy for malaria control with treated nets using a discount voucher system in Tanzania.
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During the last decade insecticide-treated nets have become a key strategy for malaria control. Social marketing is an appealing tool for getting such nets to poor rural African communities who are most afflicted by malaria. This approach usually involves subsidized prices to make nets and insecticide more affordable and help establish a commercial market. We evaluated a voucher system for targeted subsidy of treated nets in young children and pregnant women in two rural districts of southern Tanzania. Qualitative work involved focus group discussions with community leaders, male and female parents of children under 5 years. In-depth interviews were held with maternal and child health clinic staff and retail agents. Quantitative data were collected through interviewing more than 750 mothers of children under 5 years during a cluster sample survey of child health. The voucher return rate was extremely high at 97% (7720/8000). However, 2 years after the start of the scheme awareness among target groups was only 43% (45/104), and only 12% of women (12/103; 95% CI 4-48%) had used a voucher towards the cost of a net. We found some evidence of increased voucher use among least poor households, compared with the poorest households. On the basis of these results we renewed our information, education and communication (IEC) campaign about vouchers. Discount vouchers are a feasible system for targeted subsidies, although a substantial amount of time and effort may be needed to achieve high awareness and uptake - by which we mean the proportion of eligible women who used the vouchers - among those targeted. Within a poor society, vouchers may not necessarily increase health equity unless they cover a high proportion of the total cost: since some cash is needed when using a voucher as part-payment, poorer women among the target group are likely to have lower uptake than richer women. The vouchers have two important additional functions: strengthening the role of public health services in the context of a social marketing programme and forming an IEC tool to demonstrate the group at most risk of severe malaria. (+info)
The effectiveness of gateway communications in anti-marijuana campaigns.
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Successful anti-marijuana messages can be hypothesized to have two types of effects, namely persuasion effects, that is, a change in people's beliefs about using marijuana, and priming effects, that is, a strengthened correlation between beliefs and associated variables such as attitude and intention. This study examined different sets of anti-drug advertisements for persuasion and priming effects. The ads targeted the belief that marijuana is a gateway to stronger drugs, a belief that is often endorsed by campaign planning officials and health educators. A sample of 418 middle and high school students was randomly assigned to a control video or one of three series of ads, two of which included the gateway message in either an explicit or implicit way. Results did not support the use of the gateway belief in anti-marijuana interventions. Whereas no clear persuasion or priming effects were found for any of the ad sequences, there is some possibility that an explicit gateway argument may actually boomerang. In comparison to the control condition, adolescents in the explicit gateway condition tended to agree less with the gateway message and displayed weaker correlations between anti-marijuana beliefs and their attitude toward marijuana use. The results suggest that the gateway message should not be used in anti-drug interventions. (+info)
Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania.
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OBJECTIVE: To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. METHODS: Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. FINDINGS: The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. CONCLUSION: The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria. (+info)
Advertising strategies to increase public knowledge of the warning signs of stroke.
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BACKGROUND AND PURPOSE: Public awareness of the warning signs of stroke is important. As part of an educational campaign using mass media, the Heart and Stroke Foundation of Ontario conducted public opinion polling in 4 communities to track the level of awareness of the warning signs of stroke and to determine the impact of different media strategies. METHODS: Telephone surveys were conducted among members of the general public in 1 control and 3 test communities before and after mass media campaigns. The main outcome measure used to determine effectiveness of the campaigns was the ability to name > or =2 warning signs of stroke. RESULTS: In communities exposed to television advertising, ability to name the warning signs of stroke increased significantly. There was no significant change in the community receiving print (newspaper) advertising, and the control community experienced a decrease. Television increased the knowledge of both men and women and of people with less than a secondary school education but not of those > or =65 years of age. Intermittent, low-level television advertising was as effective as continuous, high-level television advertising. CONCLUSIONS: Results of this survey can be used to guide mass media-buying strategies for public health education. (+info)