Economics of Mass Media Health Campaigns with Health-Related Product Distribution

A Community Guide Systematic Review


      The objective of this systematic review was to determine the costs, benefits, and overall economic value of communication campaigns that included mass media and distribution of specified health-related products at reduced price or free of charge.

      Evidence acquisition

      Economic evaluation studies from a literature search from January 1980 to December 2009 were screened and abstracted following systematic economic review methods developed by The Community Guide. Data were analyzed in 2011.

      Evidence synthesis

      The economic evidence was grouped and assessed by type of product distributed and health risk addressed. A total of 15 evaluation studies were included in the economic review, involving campaigns promoting the use of child car seats or booster seats, pedometers, condoms, recreational safety helmets, and nicotine replacement therapy.


      Economic merits of the intervention could not be determined for health communication campaigns associated with use of recreational helmets, child car seats, and pedometers, primarily because available economic information and analyses were incomplete. There is some evidence that campaigns with free condom distribution to promote safer sex practices were cost-effective among high-risk populations and the cost per quit achieved in campaigns promoting tobacco cessation with nicotine replacement therapy products may translate to a cost per quality-adjusted life-year less than $50,000. Many interventions were publicly funded trials or programs, and the failure to properly evaluate their economic cost and benefit is a serious gap in the science and practice of public health.
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        • Community Preventive Services Task Force
        Combination of mass media health campaigns and health-related product distribution is recommended to improve healthy behaviors.
        Am J Prev Med. 2014; 47: 372-374
        • Robinson M.N.
        • Tansil K.A.
        • Elder R.W.
        • et al.
        Mass media health communication campaigns combined with health-related product distribution: a Community Guide systematic review.
        Am J Prev Med. 2014; 47: 360-371
      1. Special issue on cost-effectiveness analysis.
        J Health Commun. 2006; 11: S1-S73
      2. U.S. Department of Labor, Bureau of Labor Statistics. Consumer Price Index—all urban consumers.

      3. World Bank. World development indicators.

        • Alstead M.
        • Campsmith M.
        • Halley C.S.
        • Hartfield K.
        • Goldblum G.
        • Wood R.W.
        Developing, implementing, and evaluating a condom promotion program targeting sexually active adolescents.
        AIDS Educ Prev. 1999; 11: 497-512
        • Bauer J.E.
        • Carlin-Menter S.M.
        • Celestino P.B.
        • Hyland A.
        • Cummings K.M.
        Giving away free nicotine medications and a cigarette substitute (Better Quit) to promote calls to a quitline.
        J Public Health Manag Pract. 2006; 12: 60-67
        • Bergman A.B.
        • Rivara F.P.
        • Richards D.D.
        • Rogers L.W.
        The Seattle children’s bicycle helmet campaign.
        Arch Pediatr Adolesc Med. 1990; 144: 727-731
        • Brown W.J.
        • Mummery K.
        • Eakin E.
        • Schofield G.
        10,000 Steps Rockhampton: evaluation of a whole community approach to improving population levels of physical activity.
        J Phys Act Health. 2006; 3: 1-14
        • Cummings K.M.
        • Fix B.
        • Celestino P.
        • Carlin-Menter S.
        • O’Connor R.
        • Hyland A.
        Reach, efficacy, and cost-effectiveness of free nicotine medication giveaway programs.
        J Public Health Manag Pract. 2006; 12: 37-43
        • Eakin E.G.
        • Mummery K.
        • Reeves M.M.
        • et al.
        Correlates of pedometer use: results from a community-based physical activity intervention trial (10,000 Steps Rockhampton).
        Int J Behav Nutr Phys Act. 2007; 4: 31
        • Fellows J.L.
        • Bush T.
        • McAfee T.
        • Dickerson J.
        Cost effectiveness of the Oregon quitline “free patch initiative”.
        Tob Control. 2007; 16: Si47-Si52
        • Kahn J.G.
        • Kegeles S.M.
        • Hays R.
        • Beltzer N.
        Cost-effectiveness of the Mpowerment Project, a community-level intervention for young gay men.
        J Acquir Immune Defic Syndr. 2001; 27: 482-491
        • Kennedy M.G.
        • Mizuno Y.
        • Seals B.F.
        • Myllyluoma J.
        • Weeks-Norton K.
        Increasing condom use among adolescents with coalition-based social marketing.
        AIDS. 2000; 14: 1809-1818
        • Levy A.S.
        • Hawkes A.P.
        • Rossie G.V.
        Helmets for skiers and snowboarders: an injury prevention program.
        Health Promot Pract. 2007; 8: 257-265
        • Rebchook G.M.
        • Kegeles S.M.
        • Huebner D.
        Translating research into practice: the dissemination and initial implementation of an evidence-based HIV prevention program.
        AIDS Educ Prev. 2006; 18: S119-S136
        • Rouzier P.
        • Alto W.A.
        Evolution of a successful community bicycle helmet campaign.
        J Am Board Fam Pract. 1995; 8: 283-287
      4. Smith PK. Increasing bicycle helmet use in Michigan: A school-based intervention pilot program. Evaluation Report. Lansing MI: Michigan State Department of Public Health, 1991.

        • St Louis R.M.
        • Parow J.E.
        • Eby D.W.
        • Bingham C.R.
        • Hockanson H.M.
        • Greenspan A.I.
        Evaluation of community-based programs to increase booster seat use.
        Accid Anal Prev. 2008; 40: 295-302
        • Tinkelman D.
        • Wilson S.M.
        • Willett J.
        • Sweeney C.T.
        Offering free NRT through a tobacco quitline: impact on utilisation and quit rates.
        Tob Control. 2007; 16: Si42-Si46
        • Wood T.
        • Milne P.
        Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia.
        Accid Anal Prev. 1988; 20: 177-185
        • Miller N.
        • Frieden T.R.
        • Liu S.Y.
        • et al.
        Effectiveness of a large-scale distribution programme of free nicotine patches: a prospective evaluation.
        Lancet. 2005; 365: 1849-1854
        • Cummings K.M.
        • Hyland A.
        • Fix B.
        • et al.
        Free nicotine patch giveaway program: 12-month follow-up of participants.
        Am J Prev Med. 2006; 31: 181-184
        • Hutchinson P.
        • Wheeler J.
        The cost-effectiveness of health communication programs: what do we know?.
        J Health Commun. 2006; 11: S7-S45