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Omoloso, Aisha Imam: Lessons and Implications of Public Health Television Campaigns
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Lessons and Implications of Public Health
Television Campaigns: A Review
OMOLOSO, AISHA IMAM*
Abstract
Campaigns through the mass media serve as reliable means of inducing people to
act in certain ways. Thus government and other relevant agencies often engage in
various media campaigns geared at protecting and improving public health. Such
campaigns, due to a variety of factors, often record success or otherwise. While
most of these campaigns reach the populace via a combination of two or more
channels, this study singles out television as a channel of disseminating campaign
messages. Reviewing lessons learned from past public health campaigns, the study
explores strategies that can be adopted for optimal utilization of the powers of
television in the production and dissemination of televised public health campaigns
in Nigeria.
Key words: Public Health, Communication Campaign, Televised Campaign
Introduction
Due to the significance of health to the over all performance of every entity, public health
has, over the years, become an issue of priority to nations across the globe. To tackle
heath concerns, governments the world over have often resolved to the use of
communication campaigns to reach out to the people, with the aim of influencing them
into carrying out desired healthy practices.
These campaigns are carried out through several channels of communication such as
interpersonal channels and the mass mediated channels. The mass media have however
gained popularity because of their ability to reach a vast majority of people within a short
time. As such government and other relevant agencies invest huge amounts on public
health campaigns through the media.
This can only be with the view that such campaigns are capable of inducing the
required behavior in the people they are targeted at. Consistent with this view, Dejong
(2002) remarks that; “Television, radio and print advertising can entice people to buy a
wide range of products and services, and television entertainment programs and movies
exert enormous influence over our ideas, values and behavior. Therefore, according to
conventional wisdom, it should be possible to use mass communications to get people to
act on behalf of their own health and well-being or to "do right" by important social
causes. Based on this assumption, since World War II, federal, state and local
governments, private foundations and other nongovernmental organizations have
sponsored hundreds of public service campaigns to promote social rather than
commercial "goods"
Abone (2008) equally describes the mass media as the key component of the global
strategy for sustainable health development through adequate information and education
on various health issues. The role played by the mass media is also a vital one such that
without the media, it would be absolutely impossible for health promoters and
stakeholders to disseminate information as well as monitor and coordinate the activities
of the various countries on health issues (Mustapha, 2008).
*Omoloso, Aisha Imam, Department of Mass Communication, University of Ilorin, Ilorin.
Journal of Communication and Media Research, Vol. 1, No. 2, October 2009, 181 – 189.
©Delta Publications Ltd.
JCMR
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Journal of Communication and Media Research Vol. 1, No. 2, October 2009
Although most campaigns are often transmitted to the populace via a combination of
channels such as the media and interpersonal means, television, due to its unique nature
of transmitting visuals and audio in what appears to be a readily accessible means to the
audience, usually emerges as a tool for disseminating most public health campaign
messages.
In Nigeria for instance, Public health campaigns shown regularly on television
include those by various agencies such as the Federal and States Ministries of Health,
National Agency for Food and Drug Administration and Control (NAFDAC), National
Agency for the Control of AIDS and States Action Committees on AIDS, National
Orientation Agency as well as other non-governmental organisations. Such campaigns
take the form of Jingles/advertisements, public service announcements and education
entertainment (edutainments) like dramas or soap operas. (It is important to note though
that most of these campaigns also make use of additional channels of communication).
The question however is: “whether it is sufficient for campaign planners to simply
include television as a channel of message dissemination” The answer is NO. As the
popular saying goes, “whatever is worth doing is worth doing well”. If one must harness
the powers of television or any medium at all to succeed in a campaign, efforts must be
made to ensure optimal use of such an opportunity.
This study within the framework of available literature and lessons from past public
health campaigns, explores the use of television in public health campaigns with a view
to proposing a model on how televised Nigerian public health campaigns can be scaled
up to achieve optimal success. To this end, the paper is organised under he following
headings: The communication campaign: features and process, Television: a popular
medium, Television and public health campaigns, The Nigerian Situation, and Strategies
for harnessing television power: lessons from past campaigns
The Communication Campaign: Features and Process
A communication campaign can be described as an organised set of communication
activities geared towards generating specific effects in a relatively large number of people
within a prescribed period of time. (Rogers and Storey, cited in Jeffres and Perloff, 1997).
Such campaign can take the form of public information campaign meant to benefit the
public on health or safety issues; election campaigns for political parties or candidates,
advocacy campaigns for a particular cause or campaigns meant for commercial
advertising (McQuail, 2005).
Generally, campaigns originate from a collective source (like the government or any
other organisation); they are designed to meet certain socially approved objectives,
transmitted through several channels and consist of many messages. McQuail (2005:474477). Still describing the key features of the general campaign process, McQuail however
points out that the degree to which the target audience of campaigns is actually reached
should be considered, while other factors such as filter conditions (attention, perception
and motivation) and information processing also determine the public reached and the
campaign’s success. Other aspects of the process include the kind of effects (interests
campaigns seek to serve) and evaluation (assessment) of the campaign effort.
A guideline that can be used to stimulate ideas, manage the process of campaign
development and implementation as well as evaluate campaign results involves;
launching a strategic planning process, selecting a strategic objective (of which media
campaign is one part), selecting a target audience, developing a staged approach, defining
a key promise, avoiding fear appeals, selecting the right message source, selecting a mix
of media channels, maximizing media exposure conducting formative research with
target audience and conducting process and outcome evaluation (Dejong, 2002).
Omoloso, Aisha Imam: Lessons and Implications of Public Health Television Campaigns
185
Consistent with Dejong’s guideline Salem, Bernstein and Sullivan (2008) also
provide a 5-step check list that can be used for behavior change communication
programmes. This situates the programmes as beginning with an analysis, which is done
through formative research, to gain an understanding of the issues at stake, the audience
and other potential participants. Results of this analysis are then used for the strategic
design of the campaign (which has to do with developing the programme objective and
deciding on how to achieve it). After this is done, development of messages and materials
to be used takes place, and then a pilot study is conducted on the audience with a view to
revising the messages and materials based on the findings of the study. With all
preparation complete, actual development and implementation of the programme plan,
monitoring of such and finally, an evaluation of programme outcomes and impacts take
place.
It would be observed from the reviews above that communication campaigns are
multi-staged and carefully planned programmes carried out to achieve stated objectives
of influencing the recipients towards holding certain views or taking certain actions.
Research can also be identified as fundamental to virtually every aspect of the campaign
process.
Television: A Popular Medium
Regardless of the products of latest technological advancements such as the new media
and the various advantages of such, television, a product of the late 1920s still appears to
be a popular medium found in and used by most households the world over.
Despite condemnation on its presumed negative effects, television upon arrival
fascinated people due to its ability to broadcast moving pictures over the air and into
people’s homes. (DeFleur and Dennis, 1994:213). Its combination of sight, sound and
motion creates the most powerful and effective marketing platform for products, services,
events and the advocacy of issues while the accessibility of free over-the-air broadcast
programming will continue to make it the most effective and cost efficient choice to
reach consumers. (Poulios, n.d.). This medium’s arrival made it possible for families to
have fun and carry out leisure activities right inside their homes. (Croteau and Hoynes,
2000).
Annan (2003) describes television as a tremendous force for good as it can educate
great numbers of people about the world around them; show us how much we have in
common with our neighbors, near and far and shed light on the dark corners, where
ignorance and hatred fester.
In a similar vein, Akpan (1988) contends that; “Television is more than just another
public resource. It is the greatest communication mechanism ever designed and operated
by man. It pumps into our brains an unending stream of information, opinion, moral
value and aesthetic taste. It cannot be a neutral influence. Every minute of television
programming teaches us something. These days what people think about nearly every
issue; be it politics, religion, government, fashion, culture is almost exclusively
influenced by television” (13).
That television can influence some into carrying out undesirable or anti- social
behavior is a fact that cannot be contested as people react to and are influenced by media
messages based on several factors. However it can be adjudged from the views above that
television does have the potential to influence people’s attitudes or behaviors. Therefore,
this advantage of the medium can be tapped and used for the good of the society at large.
In other words, the effects of television can be capitalized on in order to disseminate
intentional and positive messages.
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Television and Public Health Campaigns
While most public health campaigns certainly do not rely on television alone, research
such as Palmgreen, Donohew, Lorch, Hoyle& Stephenson (2001), Dejong (2002), La’aro
(2002), Keating, Meekers and Adewuyi (2006) show that combined with other channels,
this medium still plays a significant role in disseminating health related information.
According to Christenson and Ivancin (2006:3), “Television has long served as a
source of information for viewers on health-related topics. Television news, clearly, often
contains information on personal health and health care policy. But in addition,
entertainment shows — including soap operas, dramas and even sitcoms — often include
content that, whether intentionally or not, communicate health messages to viewers”.
Similarly, due to its powers of imprinting messages on the mind, this medium
performs an important function in dealing with social change especially attitudinal
change that could bring about healthy living. (Abone, 2008:175).
However, while Dejong (2002) remarks that it would be a mistake to assume that a
campaign must use television to be successful, he adds all the same, that, this medium is
excellent in providing short uncomplicated messages, evoking emotional reactions,
establishing evidence of new social norms, and modeling behaviors that can be easily
taught.
What the above views indicate is that television has the potential to disseminate
health related or any type of information such that the recipient of the information will be
influenced into displaying the desired attitudinal or behavioral change prescribed or
contained in the message received. However, plausible as television could be as a
campaign medium for public health communication, not all public health campaigns
necessarily need to be disseminated through television. Also, the use of television does
not imply automatic success. This means that not all television campaigns are successful
and not even all the successful ones are absolutely effective.
Available literature indicates the ineffectiveness of some campaigns due to various
reasons. Kim (2006) for instance, analyzing two public service announcements promoting
breastfeeding in the United States, submits that the campaign conveys “guilt- ridden
rhetorical message capable of misinforming the target audience while it also fails to
promote breast feeding thus making the campaign ineffective. Trafton (2006) also
identifies another campaign “KNOW HIV/AIDS” (which has television as one of its
message channels) as failing to change the behavior and increase the knowledge of many
deaf and hard of hearing Americans contrary to its motive of using the media’s power to
impact positively on the people. This is due to the fact that the campaign message did not
cater adequately for this category of recipient. According to Trafton, changing a person’s
behavior goes beyond simply disseminating information. Thus basing a campaign solely
on this premise would render it ineffective. Egger (cited in Trafton, 2006) writes that;
“…the adoption of health-enhancing behavior is “a function of the level of knowledge,
attitudes and skills that the person possesses in relation to the health risk and the extent to
which individual or socio environmental incentives or barriers exist that facilitate or
inhibit ceasing the risky behavior”
Example of yet another failed campaign which included the use of television is the
“5 a Day for Better Health” aimed at increasing the number of fruits and vegetables
servings consumed by all Americans daily (Truhe, 2006). Truhe posits that for a
campaign to be successful, it should boost people’s perceptions that its goal is achievable.
Factors identified for the failure of this campaign include its failure to improve people’s
accessibility to stores where they can get the fruits and vegetables, its failure to tackle the
promotion of competing and readily available but less healthy foods, setting of a standard
(for fruits and vegetable consumption) which may deter people from complying after all,
especially when they cannot meet up to this standard.
Omoloso, Aisha Imam: Lessons and Implications of Public Health Television Campaigns
187
The Nigerian Situation
Issues on public health have become regular features in the messages of Nigerian media.
Hardly does a day pass by without at least one form of public health message or the other
either on TV or radio broadcasts or on the pages of the print media. Campaigns
safeguarding public health are also conducted through community moblisations, posters,
handbills and stickers among others.
Televised public health campaigns transmitted in the country include
Advertisements/jingles and public service announcements by The National Agency for
Food and Drugs Administration and control (NAFDAC), Roll Back Malaria Initiative (an
effort at combating malaria by the Federal Ministry of Health), National Programme on
Immunization campaigns and various anti HIV/AIDS campaigns, also in form of jingles
as well as other forms of education entertainment (edutainments) and soap operas. An
example is “I Need to Know”, a 30 minutes television series on the Nigerian Television
Authority and other TV stations across the country. Images and Sweet Angels, aired on
Galaxy Television and Proudly African on MITV are also enlightenment programmes on
HIV/AIDS (Amobi, 2008).
In general however, studies conducted on some Nigerian public health campaigns
which have made use of television (although in combination with other communication
channels) found some of the campaigns to be effective while others are not. For instance,
La’aro (2002), studying rural-urban exposure (in Ilorin and Oyun local governments of
Kwara State) to NAFDAC public health campaigns found that the population of study
acknowledged compliance to the campaign messages.
Also, in Bauchi, Enugu and Oyo States, evaluation findings of a VISION project
mass media campaign that focused on reproductive health and HIV/AIDS confirmed the
media’s effectiveness in increasing awareness about HIV and AIDS (Keating, Meekers
and Adewuyi, 2006)
Similarly, while previous programmes on HIV/AIDS had failed, “I Need to Know” a
30-minute 52 episode Television series on adolescent health issues is successful due to its
detailed content (UNFPA, 2002)
Other scholars in the field of mass communication seem to believe there is a lot of
room for improvement. Udoakah and Iwokwagh (2008) describe several communication
strategies such as the use of radio and television jingles, drama, enlightenment
programmes and multi-media materials as not effective enough and leaving too much to
be desired in the sphere of HIV/AIDS prevention.
Examining the communicative effectiveness of selected HIV/AIDS public
awareness/sensitization texts at the Keffi local government of Nassarawa state, Raj
(2008) found that such texts, to a large extent, lack potency of communicative efficiency.
He submits that communicating through language should go beyond mere information
exchange. Rather, attempt should be made to anticipate the background, mood and
psyche of the decoder(s) i.e. the recipient of the message.
Survey findings by Ufuophu-Biri (2008) also show that adequate exposure to
broadcast campaign messages on HIV/AIDS by students of the higher institutions of
learning in Delta State failed to change the students’ sex lifestyle.
The fore-going literature confirms that not all campaigns that make use of television
succeed after all. It also brings to fore the fact that to succeed, several factors have to be
put into consideration in the design and implementation of the campaigns.
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Strategies for Harnessing Television Power: Lessons from Past Campaigns
Campaign originators/planners, who decide to make use of television (either as a major or
supplementary channel) because of its potentials of audience reach and influence, would
only do justice to their campaign when they attempt to utilize the medium’s powers
optimally. This can be achieved by taking full cognizance of a variety of factors that can
facilitate or hinder a campaign’s success.
According to Jeffres and Perloff (1997), “ the success of any campaign will depend
on diverse factors: the subject it addresses, preconceived attitudes about the subject, the
magnitude of the campaign, the duration of the campaign, its visual appeal, and the
nature of competing views…”
Relying on available literature and lessons from past public health campaigns,
strategies that can be adopted towards ensuring an optimal use of television as a public
health campaign tool will be discussed under the following key aspects of the campaign
process: Formative Research, The Campaign Message, Implementation, Monitoring and
Evaluation.
Formative Research
According to Keller (1997); “Before any campaign begins, the message and objectives of
the campaign must be tailored to fit both the audience and the setting. This process should
begin with a careful review of the audience, an assessment of current policies and
programs that affect the reproductive health services available, and an evaluation of
communication resources. Focus group research and pre-testing materials can reveal
specific audience needs and help gauge the effectiveness of new materials before they are
reproduced and widely distributed”.
Salem, Bernstein, and Sullivan (2008) also identify the need for an understanding of
the target audience and other potential participants in a communication programme. This,
according to them, can be achieved through formative research by identifying the primary
audience and collecting relevant information about them. Such information includes their
attitudes and beliefs about the health issue as well as factors affecting such attitudes and
beliefs among others. Armed with relevant information, it should then be determined
whether the programme would be able to meet the needs of the audience. Thereafter, an
audience profile should be created to help in the development of effective campaign
messages and materials.
The foregoing indicates that research is a fundamental part of campaign planning and
implementation. “Many failed campaigns are understood to have been seriously flawed in
design and execution due to poor planning and inadequate formative research.” (Dejong,
2002: 8). It is through research that campaign planners would be able identify a problem,
people affected or at risk of this problem, their attitudes towards this problem, factors
affecting these, ways of solving the problem as well as the best medium and approach to
adopt.
The Campaign Message
Since the message is the end product of the campaign effort (which eventually gets to the
audience), it is only logical that this aspect of the process be done strategically. Usdin
(cited in Coulson, n.d) identifies important features which should be considered in
developing heath messages to include; having an understanding of the target audience
and barriers hindering the practice of the issue in question so that messages can be
structured in a way that would be meaningful to them; relying on Judgments of health
experts in identifying the key issues that the target audience should know as well as
ensuring that messages are accurately designed. Other factors include determining the
suitability of a medium to the message that is to be conveyed; making use of positive
Omoloso, Aisha Imam: Lessons and Implications of Public Health Television Campaigns
189
messages as opposed to laying emphasis on the negative (which has the tendency to
arouse in the audience, fear, helplessness or even refusal to change) and avoiding the
blaming of victims as a means of spurring people to action.
Usdin further notes that messages containing immediate benefits for the audience
when they comply with desired behaviour have been shown to be successful and that
messages should be appropriate to the target audience in terms of the language, style or
format to be used. They should also be kept short, simple and free of technical or
scientific terms not common to the audience.
Production of quality campaign messages can also be ensured by taking into
consideration accuracy and clarity of messages; consistency, appeal and relevance of
messages and materials to the audience as well as credibility of communication channels.
(Salem, Bernstein and Sullivan, 2008). These scholars also note the importance of the
sensitivity of messages and materials to gender differences: messages should not be
gender biased or reinforce such. They note that messages should be appropriate for the
needs and circumstances of both women and men.
In the aspect of message content, Ferguson (1999), discussing the results of
persuasion studies, points out that certain factors can be more effective when used in
messages. These include the use of supporting campaign message materials like case
studies (which are more specific) as opposed to generalizations, the use of two- sided as
opposed to one-sided arguments, specifying what actions should be taken by the
audience, making effective use of visuals, making use of positive as opposed to negative
contents and the strategic use of emotional and fear appeal as well as humor and
reference groups (groups to which people belong or long to belong).
Ferguson’s points as well as those of Usdin, Salem, Bernstein and Sullivan can thus
be adapted to televised public health campaigns as may be suitable to given campaign
objectives, messages and audience.
Generally, however, the various discussions on the campaign message so far, imply
that messages need to be carefully designed using findings from formative research on
the audience so that these messages can be carefully tailored not only to meet the needs
of the audience, but to achieve the desired effects.
Implementation, Monitoring and Evaluation
Implementing the campaign message, monitoring of the campaign during implementation
as well as evaluating the entire programme are also key areas that determine the over all
success of public health campaigns.
According to Salem, Bernstein and Sullivan (2008), implementation and monitoring
involves developing and implementing a plan for disseminating the message, following
up the progress of the programme and making adjustments (where need be) based on
monitoring findings. They further describe evaluation as involving the measurement of
outcomes and assessment of impacts; dissemination of results to people such as partners,
key stakeholders, the news media, and funding agencies; recording of lessons learned and
documenting research findings for future purpose; and revision or redesigning of the
programme based on evaluation findings.
“Formative evaluation sets realistic parameters for progress assessment and identifies
key variables that impinge on the adoption of a recommended behavior” (Anderson-Wik,
2002: 40)
Dejong (2002) points out that failure to evaluate campaigns is a common factor that
prevents campaign planners from assessing and correcting errors made, thereby serving
as an impediment towards learning more appropriate strategies. He suggests the
incorporation of evaluation activities of both the campaign process and outcome, into
early programme planning, so as to monitor the campaign’s progress and demonstrate the
overall impact of the project.
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Journal of Communication and Media Research Vol. 1, No. 2, October 2009
Three types of evaluation strategies according to this writer are; community studies
(which evaluates impacts by comparing treatment areas exposed to the campaigns and
control areas where there has been no campaign), exposure campaigns (which involves
comparing knowledge, attitude and behaviours of people who have been exposed to a
campaign and those who have not) and time-series studies i.e. assessment done over an
extended period of time both before and after the campaign introduction.
Conclusion and Recommendations
It is clear from literature reviewed in this paper that with so many campaigns and public
health communication programmes in place in Nigeria, if lack of strict and thorough
adoption of tested campaign principles and techniques (such as the ones discussed in this
paper) would merely render majority of such campaign efforts producing slight
behavioral change (achieve fair success) or make them a complete waste of time and
resources all together. Therefore, the powers of television can only be fully utilized for
the purpose of public health campaigns if the campaign designers follow sound principles
and techniques guiding the campaign process.
This study recommends that the medium should be used for such campaign purposes
and similar types of communication only after formative research has shown that it is a
suitable medium for the type of health communication and the intended audience of its
message. The message should then be carefully and strategically tailored to meet the
needs of this audience.
Further more, the role of thorough research, monitoring and evaluation should never
be overlooked.
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