Mass Media Health Communication Campaigns Combined with Health-Related Product Distribution

A Community Guide Systematic Review


      Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury.

      Evidence acquisition

      Using methods previously developed for the Community Guide, a systematic review (search period, January 1980–December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products.

      Evidence synthesis

      Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns.


      Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Danaei G.
        • Ding E.L.
        • Mozaffarian D.
        • et al.
        The preventable causes of death in the U.S.: comparative risk assessment of dietary, lifestyle, and metabolic risk factors.
        PLoS Med. 2009; 6: e1000058
        • Wiebe G.D.
        Merchandising commodities and citizenship on television.
        Public Opin Q. 1951; 15: 679
        • Kotler P.
        • Zaltman G.
        Social marketing: an approach to planned social change.
        J Mark. 1971; 35: 3-12
        • Mendelsohn H.
        Mass communication and cancer control.
        in: Cullen J.W. Fox B.H. Isom R.N. Cancer: the behavorial dimensions. Raven, New York1976
        • Binnendijk A.L.
        A.I.D.׳s experience with contraceptive social marketing: a synthesis of project evaluation findings.
        U.S. Agency for International Development, Washington DC1996
        • Green L.W.
        • Kreuter M.W.
        • Deeds S.G.
        • Partridge K.
        Health education planning: a diagnostic approach.
        Mountainview CA: Mayfield Publishing Co. 1980
        • Griffiths W.
        • Knutson A.L.
        The role of mass media in public health.
        Am J Public Health/Nations Health. 1960; 50: 515-523
        • Rothschild M.L.
        Carrots, sticks, and promises: a conceptual framework for the management of public health and social issue behaviors.
        SMQ. 2000; 6: 86-114
        • Glik D.
        • Halpert-Schilt E.
        • Zhang W.
        Narrowcasting risks of drinking during pregnancy among African American and Latina adolescent girls.
        Health Promot Pract. 2001; 2: 222-232
        • USDHHS N.I.H.
        National Cancer Institute. Making health communication programs work.
        USDHHS, Washington DC2008
        • Snyder L.B.
        • Hamilton M.A.
        • Mitchell E.W.
        • Kiwanuka-Tondo J.
        • Fleming-Milici F.
        • Proctor D.
        A meta-analysis of the effect of mediated health communication campaigns on behavior change in the U.S. J.
        Health Commun. 2004; 9: S71-S96
      1. CDC. Gateway to health communication and social marketing practice.

        • Baron R.C.
        • Melillo S.
        • Rimer B.K.
        • et al.
        Intervention to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers: a systematic review of provider reminders.
        Am J Prev Med. 2010; 38: 110-117
        • Weinreich N.K.
        Hands-on social marketing: a step-by-step guide to designing change for good.
        2nd ed. Sage, Thousand Oaks CA2010
        • Whitney R.
        • Viswanath K.
        Lessons learned from public health mass media campaigns: marketing health in a crowded media world.
        Annu Rev Public Health. 2004; 25: 419-437
      2. A history of SunSmart media campaigns.

        • Sun Smart survey 2003–2008
        Significant trends.
        London: Cancer Research UK. 2009 (
        • USDHHS
        Reducing tobacco use: a report of the Surgeon General.
        USDHHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta GA2000
        • CDC
        Best practices for comprehensive tobacco control programs—2007.
        USDHHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta GA2007
        • Farrelly M.C.
        • Healton C.G.
        • Davis K.C.
        • Messeri P.
        • Hersey J.C.
        • Haviland M.L.
        Getting to the truth: evaluating national tobacco countermarketing campaigns.
        Am J Public Health. 2002; 92: 901-907
      3. Social marketing: national benchmark criteria, Inverness Scotland Natural Heritage Social Marketing Centre, 2006.

        • Kotler P.
        • Lee N.R.
        Social marketing: influencing behaviors for good.
        3rd ed. Sage, Thousand Oaks CA2008
      4. Safe Kids U.S.

        • Morris B.A.
        • Trimble N.E.
        • Fendley S.J.
        Increasing bicycle helmet use in the community. Measuring response to a wide-scale, 2-year effort.
        Can Fam Physician. 1994; 40: 1126-1131
        • Ressler W.H.
        • Toledo E.
        Kasdah B’Rosh Tov: a description and evaluation of the Israeli bicycle helmet campaign.
        Health Educ Behav. 1998; 25: 354-370
        • Rouzier P.
        • Alto W.A.
        Evolution of a successful community bicycle helmet campaign.
        J Am Board Fam Pract. 1995; 8: 283-287
        • Martinez-Donate A.P.
        • Zellner J.A.
        • Fernandez-Cerdeno A.
        • et al.
        Hombres Sanos: exposure and response to a social marketing HIV prevention campaign targeting heterosexually identified Latino men who have sex with men and women.
        AIDS Educ Prev. 2009; 21: S124-S136
        • Zaza S.
        • Wright-De Aguero L.K.
        • Briss P.A.
        • et al.
        Data collection instrument and procedure for systematic reviews in the Guide to Community Preventive Services. Task Force on Community Preventive Services.
        Am J Prev Med. 2000; 18: S44-S74
        • Briss P.A.
        • Zaza S.
        • Pappaioanou M.
        • et al.
        Developing an evidence-based Guide to Community Preventive Services—methods. The Task Force on Community Preventive Services.
        Am J Prev Med. 2000; 18: S35-S43
        • Ebel B.E.
        • Koepsell T.D.
        • Bennett E.E.
        • Rivara F.P.
        Use of child booster seats in motor vehicles following a community campaign: a controlled trial.
        JAMA. 2003; 289: 879-884
        • 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
      5. Louisiana Public Health Institute. Media and communications.

        • Alstead M.
        • Campsmith M.
        • Halley C.S.
        • Hartfield K.
        • Goldbaum G.
        • Wood R.W.
        Developing, implementing, and evaluating a condom promotion program targeting sexually active adolescents.
        AIDS Educ Prev. 1999; 11: 497-512
        • Green L.W.
        • Kreuter M.W.
        Health promotion planning: an educational and ecological approach.
        3rd ed. Mayfield Publishing Co., Mountain View CA1999
        • Evans W.D.
        Social marketing campaigns and children’s media use.
        Future Child. 2008; 18: 181-203
        • Dearing J.W.
        • Kreuter M.W.
        Designing for diffusion: how can we increase uptake of cancer communication innovations?.
        Patient Educ Couns. 2010; 81: S100-S110
        • Jacob V.
        • Chattopadhyay S.K.
        • Elder R.W.
        • et al.
        Economics of mass media health campaigns with health-related product distribution: a Community Guide systematic review.
        Am J Prev Med. 2014; 47: 348-359
        • De Cocker K.A.
        • De Bourdeaudhuij I.M.
        • Brown W.J.
        • Cardon G.M.
        Effects of “10,000 steps Ghent”: a whole-community intervention.
        Am J Prev Med. 2007; 33: 455-463
        • O’Leary A.
        • Jemmott L.S.
        • Goodhart F.
        • Gebelt J.
        Effects of an institutional AIDS prevention intervention: moderation by gender.
        AIDS Educ Prev. 1996; 8: 516-528
        • Roberts D.C.
        • Black D.
        Comparison of interventions to reduce sun exposure.
        Behav Med. 2009; 35: 67-76
        • Ross M.W.
        • Chatterjee N.S.
        • Leonard L.
        A community level syphilis prevention programme: outcome data from a controlled trial.
        Sex Transm Infect. 2004; 80: 100-104
        • DiGuiseppi C.G.
        • Rivara F.P.
        • Koepsell T.D.
        • Polissar L.
        Bicycle helmet use by children. Evaluation of a community-wide helmet campaign.
        JAMA. 1989; 262: 2256-2261
        • Burns E.K.
        • Levinson A.H.
        Reaching Spanish-speaking smokers: state-level evidence of untapped potential for QuitLine utilization.
        Am J Public Health. 2010; 100: S165-S170
        • Kegeles S.M.
        • Hays R.B.
        • Pollack L.M.
        • Coates T.J.
        Mobilizing young gay and bisexual men for HIV prevention: a two-community study.
        AIDS. 1999; 13: 1753-1762
        • 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
        • Campbell S.L.
        • Lee L.
        • Haugland C.
        • Helgerson S.D.
        • Harwell T.S.
        Tobacco quitline use: enhancing benefit and increasing abstinence.
        Am J Prev Med. 2008; 35: 386-388
        • 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
        • 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
        • Pendergrast R.A.
        • Ashworth C.S.
        • DuRant R.H.
        • Litaker M.
        Correlates of children’s bicycle helmet use and short-term failure of school-level interventions.
        Pediatrics. 1992; 90: 354-358
        • Smith P.K.
        Increasing bicycle helmet use in Michigan: a school-based intervention pilot program. Evaluation report.
        Michigan State Department of Public Health, Lansing MI1991 (
        • Wood T.
        • Milne P.
        Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia.
        Accid Anal Prev. 1998; 20: 177-185
        • de Vroome E.M.
        • Sandfort T.G.
        • de Vries K.J.
        • Paalman M.E.
        • Tielman R.A.
        Evaluation of a safe sex campaign regarding AIDS and other sexually transmitted diseases among young people in the Netherlands.
        Health Educ Res. 1991; 6: 317-325
      6. Gold J, Goller J, Hellard M, et al. Evaluation of the Victorian “You’ll Never Know Who You’ll Meet” youth awareness campaign. Australian Sexual Health Conference; 2008 Sept 15; Perth, Australia. Sex Health 2008;5:381–404.

        • Romer D.
        • Sznitman S.
        • DiClemente R.
        • et al.
        Mass media as an HIV-prevention strategy: using culturally sensitive messages to reduce HIV-associated sexual behavior of at-risk African American youth.
        Am J Public Health. 2009; 99: 2150-2159
        • Rosser S.
        The effects of using fear in public AIDS education on the behaviour of homosexually active men.
        J Psychol Human Sex. 1991; 4: 123-134
        • Traeen B.
        Learning from Norwegian experience: attempts to mobilize the youth culture to fight the AIDS epidemic.
        AIDS Educ Prev. 1992; Fall(1S): S43-S56
        • Schooler C.
        • Chaffee S.H.
        • Flora J.A.
        • Roser C.
        Health campaign channels: tradeoffs among reach, specificity, and impact.
        Hum Commun Res. 1998; 24: 410-432
        • Wakefield M.A.
        • Loken B.
        • Hornik R.C.
        Use of mass media campaigns to change health behaviour.
        Lancet. 2010; 376: 1261-1271