How health communication campaigns affect behaviour & the role mass media plays in it.

1. India – Building Scalable
communications’ models…
S.Shankar Narayanan
Director, Programs,
PSI India

2. Why mass media?
• India is a developed media market
– 80%+ of the TG are reached through mass media -
comprising TV, print, radio, outdoor, mobile, social media
– TV is the main medium for entertainment
• Opportunity to build an emotional connect and
aspiration
– The target audience believes mass media is a credible
source for information
– Mass media builds quick awareness
– Anecdotal evidence suggests mass media results in people
seeking more information about products and services

3. Stages of readiness and media
effectiveness
Adapted from “Stages of Buyer Readiness”, Philip Kotler, Marketing
Management, 11th Ed, 2003.

4. Effects of Health Communication
Campaigns on Behavior
Campaign Effect Size on Behavior (d)
Adapted from Snyder, Leslie 2007b and Snyder et al. 2009

5. Selection of media
Case study 1- People seeking treatment for STIs from
Key Clinics
% of men seeking treatment
25% 23%
21%
18%
20% 18%
14% 13%
15% 12% 12%
10% 10% 10% 10%
10%
5%
0%
IPC Street Outdoor Ads Electronic
Baseline-May 06
Theatre Ads
Dec 06 Not-exposed Dec 06 Exposed

6. Selection of Media
Case study 2- Emergency Contraceptive
Use of EC
12 10.1
8.1
10
8
3.9
% Use 6
3.2 2.4
4 1.4
2
0
Baseline Endline - Not Endline -Mass Media
exposed
Ev er use of EC Use of regular contraceptiv e after use of EC

7. 3 models… Pilot and take to scale
Other geography – MM only
Program focus Other program
geography: geography:
MM + PBCC + MM + PBCC
IPC
Legend: MM- Mass Media; PBCC – Provider Behaviour Change
Communications; IPC – Inter-personal communications

8. The process - Research to Action
Build an archetype
Identify key determinants of behavior
w.r.t. the prioritized determinant identify:
•beliefs to reinforce (perceived benefits)
and/or
•beliefs to change (perceived barrier)
Create a brand or campaign personality
State the brand/campaign promise
Position relative to competing behaviors or
brands

9. Process – Research to Action
IUCD - Freedom5
• Archetype:
– Poonam – the happy homemaker
All her aspirations revolve around her children and
her husband. She wants to free herself from the
fear of pregnancy so that she can respond to her
husband sexually, without holding back
• Determinants of Behaviour:
– Poonam will adopt Freedom5 if she was convinced
it is as good as sterilization with the added benefit
of reversibility*
* 2010 TRaC Study
• Reinforce core benefit:
– Freedom5 will give me ‘peace of mind’

10. Results – Reach and Recall of TV Ad
• Implementation:
– On air in end December 2010 and JuIy 2011
– Results of the Reach & recall study in January 2011
• Reach of the campaign - 59.4% of TG
• Of those reached:
– 59.5% agreed with the statement, ‘Freedom 5 can
prevent pregnancy for up to 5 years’
– 33.4% agreed with the statement, ‘Freedom 5 is a
reversible method’
– 22.9% agreed with the statement, ‘Freedom 5 is better
than other methods’
– 7.9% visited a provider to seek information about
Freedom 5 and 41.6% discussed Freedom 5 with their
husband

11. Take Home # 1 Weight of the evidence
• Mass media have had measurable and
consistent positive effects in FP & HIV
programming.
• The effects of mass media are greater in
developing countries.
• Longer interventions have had greater impact

12. Take Home # 2 Mass Media operates
in 2 ways
• Stand alone:
– Increase knowledge, self-efficacy, risk-perception
– Promote behaviors (e.g., condom use, fewer partners)
• Service-linked:
– Create demand for services (e.g., FP,STI/male
circumcision)
– Establish community norms (e.g., use of ART, PMTCT)
– Enhance compliance through counseling (FP,ICTC,MC,
ART, PMTCT)

13. Take Home # 3 Cost Effective
• Mass media are cost effective
• For any statistically significant effect size, mass media
interventions are generally more cost-effective than
alternative interventions
• They reach such a large % of the population.

14. Take Home # 4 Policy implications
• Mass media are essential to future Health
interventions programming:
 Changes behaviors – outside clinic
 Change community norms
 Increase service utilization (USE)

15. What we think works well
• Evidence lead – Consumer insights ( difference
between lead & decide)
• Tight brief – Audience segmentation
• 360 Surround and engage – execution
discipline
• Private sector techniques – aspirational,
emotional connect and the ‘ zeigarnic effect’
• Partnerships – sustainability