OCR psychology - Methods of health promotion

Background: Yale's Model of Communication

Hovaland started a series of studies to find out how to get people to respond better to health promotional campaigns

The model focuses on 3 apsects of a campaign:

• The Communicator - has to be creditable (trustworthy & possess expertise).
• The Message - if complicated, it should be one sided (state what to do) or if it is simple, it should be two sided (allow the audience to make up their own minds).
• Audience Participation - The audience are more likely to maintain attitude and behaviour change if they have actively participated in the message rather than passively received it.

* Hovland et al found that people with low self-esteem or depressive tendencies were more easily influenced.

* People with a strong sense of group conformity are less susceptible to media persuasion.

* The model also suggests that fear arousal is often necessary as a starting point, but that it will not work by itself. 

Aim: To test the effectveness of an advertising campaign about chip-pan fires

Methodology: A Quasi Experiment

Participants: People living in the TV area (in Yorkshire)

Procedure:

• The media campaign was shown on TV in 10 UK regional television areas from 1976 & 1984
• There were two 60 second commericials (called 'Inattendance' and 'Overfilling') - these showed the initial cause of the fire and the actions required to put it out.
• Each region was shown the chip-pan campaign.
• 3 areas - (Granada, Harlech & Tyne Tees) were shown reminders in another year.
• An analysis of the number of chip-pan fires reported from 1976 & 1982 was carried out for each area.
• 2 quantitative consumer surveys in 1976 and 1983 was also used to gather the data

Findings:

• The largest reduction of chip-pan fires was during the campaign (e.g. Tyne Tees - reduction of 33%)
• The net decline in each area over the 12 month period of the campaign was between 7% and 25%.
• Overlap areas showed less impact - (i.e. Granada & Central) probably due to reduced imapct of seeing campaign more than once .
• Questionnaire showed an increase in the awareness of chip-pan fires advertising from 62% to 90%
• People mentioning chip-pan fires as a danger in the kitchen also increased from 12% before the campaign to 28% after the campaign in the Yorkshire tv area.

Conclusions:

• Viewers are less likely to be influenced by the campaign if overexposed to it, such as in the overlap areas.
• The advertising proved effective as shown by the reduction in chi-pan fires
• The most behaviour change is seen during the campaign

Validity:

• High in mundane realism & ecological validity - Real chip-pan fires were reported, real advert shown. Most people own a tv and see adverts everyday in their homes.
• Low validity - Other factors which could have affected awareness of chip-pan fires wasn't considered. E.g. a leaflet campaign which people could have received in the post, other adverts on the tv, an educational campaign etc.
• Questionnaires - not everyone would have answered them & also allows for social desirability bias.
• Problems with reports of chip-pan fires - some people may not have reported if they had put out a chip-pan fire (underemphasis of advert effectiveness).

Reliability:

• Standardised procedure - All participants saw the same advert over the same period of time, each the same length etc. therefore can be easily replicated in different countries etc (to give us a higher external validity).

• Unreliable as overlap in some areas meant some people saw the advert more than once (low internal validity).

What is Legislation? - A law which has been produced by a governing body in order to regulate, authorise, sanction, declare or restrict. In terms of events, Legislation defines the governing legal principles outlining the responsibilities of event organisers etc. to protect the safety of the public.

Examples of Legislation that are health related:

• The smoking ban (England 1st July 2007)
• Drinking driving - alcohol limit laws.

Why is Legislation effective in behaviour change?

• Acts as a external reminder/cue --> linking to the health belief model (HBM).
• Forces people to follow a particular behaviour change.

Aim: To review the impact of the passing of the law in Maryland, USA, requiring children under the age of 16 to wear a helmet when cycling on roads & paths.

Methodology: A Natural Experiment

Participants:

• Children from 47 schools in Howard County
• 2 control groups - one from Montgomary County & one from Baltimore County.
• Aged 9-10, 12-13, and 14-15 years
• 7322 children were sent questionnaires

Procedure:

• Questionnaires containing a 4-point Likert scale were sent - topics included bicycle & helmet use, awareness of laws and peer pressure.
• Parents were also asked to help with the questionnaire so that informed consent was obtained

Findings:

• Response rates were between 41-53% across the 3 age groups and counties.
• Howard County reported helmet usage had increased from 11.4% to 37.5%
• Montgomary County " " "  8.4% to 12.6%
• Baltimore County " " " 6.7% to 11.1%
• Most children (87%) were aware of the law, in Howard County
• 14% of the children didn't know about the law (4% of the respondants)
• Also this study correlated with an observational study by Cote (1992) which found similar rates of cycle helmet usage.

Conclusions:

• The Howard County legislation showed a large increase in the reported rate of cycle helmet wearing.
• The slight rise in the area where ther was an educational programme campaign was not significantly different from the area where ther was no campaign
• Therefore we might conclude that this passing legislation has more effect than the ed. campaign alone & that ed. campaigns are not neccessarily effective at all in increasing health behaviours.

Fear Arousal/Appeal:

A persuasive message which emphasises the harmful physical/social consequences of failing to comply with the recommendations of the message.

--> links to HBM

by increasing perception of serioueness & susceptability.

HBM also suggest that a perceived threat is neccessary for a person to change their behaviour.

Aim: To study the motiveationa effects of fear arousal in health promotion.

Methodology: A Laboratory Experiment using independant measures.

IV - Level of fear arousal

DV - measure of change in oral hygine and perception pre & post lecture (self report).

Participants:

• An entire year of a large Conneticut high school - approx. 200 Students
• Average ages of 15 years

Procedure:

• 4 groups of participants
• 3 were given a 15 minute lecture of tooth decay and oral hygine
• Group 1 - Strong fear appeal -> graphic pictures & very serious consquences
• Group 2 - Moderate fear appeal -> pictures with less graphic descriptions/consequence
• Group 3 -> Minimal fear arousal -> no pictures, only diagrams & not referring to serious consquences.

Findings:

• There was no significant difference between groups in the amount of newly aquired information on oral hygine.
• The strong fear arousal has the greatest increase in anxiety (42% vs. 24% for min. fear arousal).
• Participants in the minimum fear arousal group showed the biggest change in healthcare (36% vs. 8% for strong fear arousal).

Conclusions:

The overall effectiveness of a health promotion campaign is likely to be reduced by the use of strong fear appeal ---> This may be because, altough it creates the most anxiety, participants feel that the serious consequences of not adopting the promoted health behaviour is so far removed from where they're at in their lives & that they aren't susceptible to it.

Evaluative points:

• Only Students - may be more affected by fear appeal (as they're young) or less ('young people feeling like they'll live forever') -> low population validity (ethnocentric/USA).
• Self report - allows social desireability bias