Theoretical foundation of health campaign messages

IfKW • Simona Fodor & Raluca Piteiu

Theoretical foundation of health
campaign messages

Key Points

1. Relevance of behavioral theory
2. Theories of behavior change
2.1 Theories of Reasoned Action & Planned Behavior
2.2 The Health Belief Model
2.3 An Integrative Model
3. Conclusion
4. Application of theories
4.1 Florida‘s „truth“ campaign
4.2 HIV Prevention in Zimbabwe
4.3 Childhood obesity
11.Conclusion
12.References


• messages: thought-out communications based on theory and
research

• theories to understand how behavior change occurs

• theory as “the support beam on which everything else is hung”
(Weinreich, 1999, p. 91)

• theories of behavior change as a framework to help identify the
determinants of any given behavior

IfKW • Simona Fodor & Raluca Piteiu 3


2.1 Theories of Reasoned Action (TRA) & Planned Behavior (TPB)

• behavioral intention as the best predictor of a behavior

• direct determinants:
TRA: attitude
subjective norm

TPB: + perceived control

• major strength: causal chain  causal relationships



(Montano & Kasprzyk, 2008, p. 70)




• necessary conditions for behavior change to occur

• primary concepts predict reasons for action



(Champion & Skinner, 2008, p. 49)



• weak point: undefined relationships  ambiguity in HBM applications





• unites several theoretical perspectives

• most important determinant: intention to perform a behavior



(Fishbein & Cappella, 2006, p. 2)


3. Conclusions

• complementary theories with significant degrees of overlap

• “the central issue is not which model is superior to other models
or which variables may be more important but the relative utility
and changes in relative utility with different behaviors and
situations over time”
(Maddux, Ingram & Desmond, 1995; cited after Champion & Skinner, 2008, p. 61)

• key factors: population and behavior specific

• link between: theories of behavioral prediction and change &
theories of communication


Theoretical foundation of health campaign messages

APPLICATIONS


Key Points
2.1 Theories of Reasoned Action & Planned Behavior
3. Conclusion
4. Application of theories:
4.1 Florida‘s „truth“ campaign
4.2 HIV Prevention in Zimbabwe
4.3 Childhood obesity
11.Conclusion
12.References

Florida’s “truth” anti-tobacco
campaign

WHO?

WHERE?
Truth
TV, radio, HOW?
billboard, Anti- Counter-
print, tobacco marketing
events,
website campaign

WHY?
Alert youth
of tobacco
marketing
strategies


campaign

IT DID NOT TELL YOUTH
TO STOP SMOKING


campaign


campaign

Targeted
beliefs
Quitting smoking does
less harm to others

Quitting shows
independence

Quitting shows youth
are not manipulated by
tobacco companies


campaign

Campaign effects were consistent with hypotheses derived from
The Theory of Reasoned Action (Hersey&Co, 2005)

- more negative beliefs about
tobacco industry practices

Higher level of
exposure to the - negative attitudes toward the
campaign were industry
associated with:

- lower receptivity to tobacco
advertising


campaign
Results

Success in changing
Reach and results
tobacco-related
• 6 months – 92%
• Beliefs target group
awareness
• Attitudes
• 1 year – high school
• Smoking prevalence smoking rate: down
among youth by 8% and by 19.4%
in middle school


HIV Prevention in Zimbabwe
(Montano, Kasprzyk, 2008)

Identify • Using condoms all the time with steadyall the time with
Using
(ACTION) condoms (TARGET)
partners in
steady partners (CONTEXT) in the next three months
the next three months
behavior (TIME)

Elicitation • 8 people aged 18-30 in each village (½ males, ½
interviews females) in Shone or Ndebele (local languages)

• Questionnaire was tested in 2 villages
• N=5,546 (185 residents in each of the 32 villages)
Survey
instrument • N’= 2,212 had steady partners and could answer the
questionnaire

• Identify which beliefs (behavioral,
Analyze normative, efficacy) to target through
persuasive communication
• Behaviors (e.g. use the
Develop condom) are easier to
persuasive change than behavioral
arguments categories (safe sex) or goals
(not get HIV).


Communication approach for
changing sexual behavior

Community Popular Opinion Leader (CPOL) model

identifies and trains popular opinion leaders
(POLs) to have conversations with peers
and to model themselves as having
adopted the behaviors that are being
promoted (Montano, Kasprzyk, 2008, 90)


Reframing childhood obesity in USA
The Framing theory

“To frame is to select some
aspects of a perceived reality
“The agenda setting
and make
process is an ongoing
them more salient in a
competition among issue
FRAMING
communication context, in AGENDA
proponents to gain the
such a way as to
THEORY
promote a particular problem
SETTING
attention of media
professionals, the public,
definition, causal
and policy elites.”
interpretation, moral
(Dearing and Rogers,
evaluation, and/or treatment
1996)
recommendation for the item
described.” (Entmann, 1993)


Woodruff, Dorfman, Berends, and Agron
(2003)

Research Goal
to find out how childhood obesity has been framed in the media

Method
Content analyzed all major newspapers in California from 1998-2000
Upstream public health issue (policy solutions) or individual and family
responsibility?

Framing
1/3 of the articles proposed a solution with only “individual responsibility”–
children and parents need to change their eating and exercise habits


Woodruff, Dorfman, Berends, and Agron
(2003)

Action
Publish an article which aims at equipping health practitioners and advocates
with skills to reframe news coverage of public health issues, including
childhood obesity

Reframing
influence the public agenda setting and the policy agenda setting
Advocate childhood obesity solutions as a shared responsibility

Result
Substantial more news articles and opinion pieces found in Californian
newspapers reflecting the frame shared in the article


Conclusions

• Theories of behavioral prediction and behavioral
change – identify which beliefs to target trough
persuasive communication techniques

• Further research needs:
• focus the efforts towards developing comprehensive
theories of message effectiveness


References
• Champion, V. L. & Skinner, C. S. (2008). The Health Belief Model. In K. Glanz, B. K. Rimer & K. Viswanath (eds.),
Health Behavior and Health Education: Theory, Research, and Practice (S. 45-65), San Francisco, CA: Wiley & Sons.

• Earl, S., Lloyd, C., Sidell, M., Spurr, S. (2007). Theory and Research in Promoting Public Health (S. 129-160), Sage
Publications, Thousand Oaks.

• Finnegan, J. R. & Viswanath, K. (2008). Communication Theory and Health Behavior Change. The Media Studies
Framework. In K. Glanz, B. K. Rimer & K. Viswanath (Hrsg.), Health Behavior and Health Education: Theory,
Research, and Practice (S. 363-387), San Francisco, CA: Wiley & Sons.

• Fishbein, M. & Cappella, J. N. (2006). The role of theory in developing effective health communications. Journal of
Communication, 56, S. 1-17.

• Montano, D. E. & Kasprzyk, D. (2008). Theory of reasoned action, theory of planned behavior, and the integrated
behavioral model. In K. Glanz, B. K. Rimer & K. Viswanath (Hrsg.), Health behavior and health education: Theory,
research, and practice (S. 67-96). San Francisco, CA: Wiley & Sons.

• Rossmann, C. (2010). Zur theorie-und evidenzbasierten Fundierung massenmedialer Gesundheitskampagnen.
Public Health Forum, 18, S. 16-17.

• Weinreich, Klein, Kendra (1999). Hands-on Social Marketing: A step by step guide (S. 91-96), Sage Publications,
Thousand Oaks.

• http://www.tobaccofreedom.org/msa/articles/truth_review.html, 22.04.2012

• http://www.gwumc.edu/sphhs/departments/pch/phcm/casesjournal/volume1/sponsored/cases_1_14.pdf, 23.04.2012


Many thanks for your attention!


Theoretical foundation of health campaign messages

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