An evaluation of a national mass media campaign to raise public awareness of possible lung cancer symptoms in England in 2016 and 2017

Background A two-phase ‘respiratory symptoms’ mass media campaign was conducted in 2016 and 2017 in England raising awareness of cough and worsening shortness of breath as symptoms warranting a general practitioner (GP) visit. Method A prospectively planned pre–post evaluation was done using routinely collected data on 15 metrics, including GP attendance, GP referral, emergency presentations, cancers diagnosed (five metrics), cancer stage, investigations (two metrics), outpatient attendances, inpatient admissions, major lung resections and 1-year survival. The primary analysis compared 2015 with 2017. Trends in metrics over the whole period were also considered. The effects of the campaign on awareness of lung cancer symptoms were evaluated using bespoke surveys. Results There were small favourable statistically significant and clinically important changes over 2 years in 11 of the 15 metrics measured, including a 2.11% (95% confidence interval 1.02–3.20, p < 0.001) improvement in the percentage of lung cancers diagnosed at an early stage. However, these changes were not accompanied by increases in GP attendances. Furthermore, the time trends showed a gradual change in the metrics rather than steep changes occurring during or after the campaigns. Conclusion There were small positive changes in most metrics relating to lung cancer diagnosis after this campaign. However, the pattern over time challenges whether the improvements are wholly attributable to the campaign. Given the importance of education on cancer in its own right, raising awareness of symptoms should remain important. However further research is needed to maximise the effect on health outcomes.

The cost-effectiveness of a mass media campaign to promote smartphone apps for weight loss: an updated modeling study (Preprint)

UNSTRUCTURED Background Evidence suggests that smartphone apps can be effective in the self-management of weight. Given the low cost, broad reach, and apparent effectiveness of apps at promoting weight loss, governments may seek to encourage the uptake of such apps as an opportunity for reducing excess weight among the population. However, the cost and potential cost-effectiveness are important considerations. Our study used a modeling approach to assess the health impacts, health system costs, cost-effectiveness, and health equity of a mass media campaign to promote high quality smartphone apps for weight loss in New Zealand. Methods We used an established proportional multistate life table model that simulates the 2011 New Zealand (NZ) adult population over the lifetime, sub-grouped by age, sex, and ethnicity (Māori [Indigenous]/non-Māori). The key risk factor was BMI. The model compared business-as-usual to a one-off mass media campaign intervention, which included the pooled effect size from a recent meta-analysis of smartphone weight loss apps. The resulting impact on BMI and BMI-related diseases was captured through changes in health gain (quality-adjusted life years; QALYs) and in health system costs (health system perspective). The difference in total health system costs was the net sum of interventions costs and downstream cost offsets due to altered disease rates. A discount rate of 3% was applied to health gains and health system costs. Multiple scenario and sensitivity analyses were also conducted, including an equity adjustment. Results Across the remaining lifetime of the modeled 2011 NZ population, the mass media campaign to promote weight loss apps usage had an estimated overall health gain of 181 (95% uncertainty interval [UI]: 113, 270) QALYs and health care costs of NZ$ -606,000 (95%UI: -2,540,000, 907,000). The mean health care costs were negative, representing an overall savings to the health system and a likely cost-saving intervention. Across the outcomes examined in this study, the modeled mass media campaign to promote weight loss apps among the general population would be expected to provide higher per capita health gain for Māori and hence reduce health inequalities arising from high BMI. Conclusions A modeled mass media campaign to encourage the adoption of smartphone apps to promote weight loss among the NZ adult population is expected to yield an overall gain in health and to be cost-saving to the health system. While other interventions in the nutrition and physical activity space are even more beneficial to health and produce larger cost-savings (eg, fiscal policies, food reformulation), governments may choose to include strategies to promote health app usage as complementary measures.

Avaliação de campanhas de saúde: uma revisão integrativa sobre a construção de indicadores

O presente estudo tem o objetivo de mapear indicadores de avaliação de campanhas de comunicação com foco em saúde, através de uma revisão integrativa da literatura, realizada a partir da busca de artigos científicos nas bases de dados da capes, SciELO e anais da compós. A pesquisa considerou o período entre 2009 e 2019 e utilizou os seguintes descritores: ‘communication’ + ‘indicators’; ‘health campaign’ + ‘sti’; ‘communication’ + ‘aids’; ‘health promotion’ + ‘mass media’ + ‘campaign’. Foram analisados dez artigos científicos, após a aplicação dos filtros, resultando na identificação dos seguintes indicadores: 1) alcance; 2) grp; 3) percepção de campanha; 4) efeito da campanha; 5) compreensão; 6) impacto; 7) efetividade; e 8) aceitabilidade. Dentre os indicadores mapeados, identificaram-se estudos com relatos e avaliações de diferentes tipos de campanhas de comunicação pública voltadas para a promoção da saúde, sendo elas: campanhas de prevenção ao hiv/aids, combate ao tabagismo, conscientização ambiental e contra a proliferação da dengue.

“Follow the Whistle: Physical Activity Is Calling You”: Evaluation of Implementation and Impact of a Portuguese Nationwide Mass Media Campaign to Promote Physical Activity

To raise perceived capability (C), opportunity (O) and motivation (M) for physical activity (PA) behaviour (B) among adults, the Portuguese Directorate-General of Health developed a mass media campaign named “Follow the Whistle”, based on behaviour change theory and social marketing principles. Comprehensive formative and process evaluation suggests this media-led campaign used best-practice principles. The campaign adopted a population-wide approach, had clear behavioural goals, and clear multi-strategy implementation. We assessed campaign awareness and initial impact using pre (n = 878, 57% women) and post-campaign (n = 1319, 58% women) independent adult population samples via an online questionnaire, comprising socio-demographic factors, campaign awareness and recall, and psychosocial and behavioural measures linked to the COM-B model. PA was assessed with IPAQ and the Activity Choice Index. The post-campaign recall was typical of levels following national campaigns (24%). Post-campaign measures were higher for key theory-based targets (all p < 0.05), namely self-efficacy, perceived opportunities to be more active and intrinsic motivation. The impact on social norms and self-efficacy was moderated by campaign awareness. Concerning PA, effects were found for vigorous activity (p < 0.01), but not for incidental activity. Overall the campaign impacted key theory-based intermediate outcomes, but did not influence incidental activity, which highlights the need for sustained and repeated campaign efforts.

Impact of a mass media campaign on breast cancer symptoms awareness and screening uptake in Malaysia: findings from a quasi-experimental study

ObjectiveTo evaluate the impact of a mass media campaign in terms of improving breast cancer (BC) symptoms awareness and screening uptake.DesignBefore—and after—study with comparator groups.SettingSelangor State, Malaysia.ParticipantsMalaysian women aged >40 years (n=676) from randomly selected households.InterventionA culturally adapted mass media campaign (TV, radio, print media and social media).Primary and secondary outcome measuresThe primary endpoint was BC symptoms awareness, which was assessed with the Breast Cancer Awareness Measure precampaign and postcampaign. Secondary outcomes included campaign reach, self-efficacy to notice BC symptoms and clinical outcomes. Clinical breast examination and mammogram screening data were collected from hospitals and clinics.ResultsMost participants recognised at least one of the campaign materials (65.2%). The odds of seeing the campaign were lowest for Chinese women (adjusted OR 0.25, 95% CI 0.15 to 0.40) compared with Malays and for women aged >70 years (adjusted OR 0.47, 95% CI 0.23 to 0.94) compared with younger women. Participants who recognised the campaign were significantly more likely to have improved awareness postcampaign compared with non-recognisers particularly for key symptoms such as ‘a lump or thickening in your breast’ (88.9% vs 62.1%) and ‘discharge or bleeding from nipple’ (79.7% vs 55.3%). Improvement in symptoms awareness scores was not associated with sociodemographic variables.ConclusionsImplementation in Malaysia of an evidence-based mass media campaign from the UK that was culturally adapted appeared to lead to improved awareness about some BC symptoms, though various modes of media communication and perhaps other health education approaches may be required to extend the reach to diverse, multiethnic populations and all age groups.