Leslie B. Snyder

A Meta-Analysis of the Effect of Mediated Health Communication Campaigns on Behavior Change in the United States

A meta-analysis was performed of studies of mediated health campaigns in the United States in order to examine the effects of the campaigns on behavior change. Mediated health campaigns have small measurable effects in the short-term. Campaign effect sizes varied by the type of behavior: r¯ = .15 for seat belt use, r¯ = .13 for oral health, r¯ = .09 for alcohol use reduction, r¯ = .05 for heart disease prevention, r¯ = .05 for smoking, r¯ = .04 for mammography and cervical cancer screening, and r¯ = .04 for sexual behaviors. Campaigns with an enforcement component were more effective than those without. To predict campaign effect sizes for topics other than those listed above, researchers can take into account whether the behavior in a cessation campaign was addictive, and whether the campaign promoted the commencement of a new behavior, versus cessation of an old behavior, or prevention of a new undesirable behavior. Given the small campaign effect sizes, campaign planners should set modest goals for future campaigns. The results can also be useful to evaluators as a benchmark for campaign effects and to help estimate necessary sample size

The SAGE Sourcebook of Advanced Data Analysis Methods for Communication Research

Chapter 1: Overview - Michael D. Slater, Andrew F. Hayes, Leslie B. Snyder Chapter 2: Contemporary Approaches to Assessing Mediation in Communication Research - Kristopher J. Preacher, Andrew F. Hayes Chapter 3: Studying Change and Intraindividual Variation: Longitudinal Multilevel and Structural Equation Modeling - Kimberly Henry, Michael D. Slater Chapter 4: Time Series Analysis: Traditional and Contemporary Approaches - Itzhak Yanovitzky, Arthur Vanlear Chapter 5: Event History Analysis for Communication Research - Leslie B. Snyder, Ann O?Connell Chapter 6: Estimating Causal Effects in Observational Studies: The Propensity Score Approach - Itzhak Yanovitsky, Robert Hornik, Elaine Zanutto Chapter 7: Commentary on the Uses and Misuses of Structural Equation Modeling in Communication Research - R. Lance Holbert, Michael T. Stephenson Chapter 8: Multilevel Modeling: Studying People in Contexts - Hee Sun Park, William P. Eveland Jr., Robert Cudeck Chapter 9: Communication Network Analysis - Thomas W. Valente Chapter 10: Scaling and Cluster Analysis - David Roskos-Ewoldsen, Beverly Roskos-Ewoldsen Chapter 11: Contemporary Approaches to Meta-Analysis in Communication Research - Blair T. Johnson, Lori A. J. Scott-Sheldon, Leslie B. Snyder, Seth M. Noar, Tania B. Huedo-Medina Chapter 12: Handling Missing Data in Communication Research - Ofer Harel, Rick Zimmerman, Olga Dekhtyar

Agenda-Setting Effects of Television News Coverage and the Effects Decay Curve:

Some fundamental concepts in agenda-setting are related to a simple cognitive memory decay process. Accounting for issue obtrusiveness and amounts of prior coverage, predictions for the size of the relationship between declining accumulated television coverage and issue salience are derived. Levels of declining accumulated coverage are estimated by applying an exponential decay function to the prominence of daily television coverage. This function presumably models simple forgetting of coverage that occurs within individual audience members. Three issues (inflation, Iran, and the Soviet Union) were investigated over an 1,826-day period, using the daily prominence of television coverage obtained from television news archives and daily salience of the issues interpolated from monthly archived poll data. The size of the relationship between accumulated coverage and issue salience was found to decrease with the amount of coverage of an issue prior to the beginning of the study period. A new unobtrusive issue (Iran) was found to have the strongest agenda-setting effects and more rapidly declining coverage effects than other issues.

Pathways to posttraumatic growth versus posttraumatic stress: coping and emotional reactions following the September 11, 2001, terrorist attacks.

Exposure to trauma can lead to both posttraumatic growth and posttraumatic stress, but little is known about the commonalities and differences in the pathways through which they occur. The authors examined coping and emotional reactions as mediators of the effect of television exposure on both posttraumatic growth and posttraumatic stress in a nationally representative sample of 1,004 U.S. adults approximately 6 weeks after the September 11, 2001, terrorist attacks. Although posttraumatic growth and posttraumatic stress symptoms were moderately positively related, the pathways from coping and emotions to the outcomes differed: Positive coping and anger were more strongly related to posttraumatic growth than to posttraumatic stress, and pathways of negative coping and feeling depressed regarding the attacks were more strongly related to stress than to growth. Comparison of models suggested that emotions are both outcomes of and motivators for coping and that patterns of coping and emotions relate differentially to posttraumatic stress and posttraumatic growth.

Caution: Alcohol Advertising and the Surgeon General's Alcohol Warnings May Have Adverse Effects on Young Adults.

Abstract Government mandated warnings are becoming more common. However, studies have not compared the effect of warnings, meant to increase perception of risk, to advertising, which aims to decrease perceptions of risk and enhance perceptions of product benefits. We conducted an experiment to test the effects of the newly introduced Surgeon Generals alcohol warnings and advertisements on college students. Surprisingly, the warnings boomeranged, causing drinkers to perceive greater benefits from the alcoholic beverages. The advertisements had powerful effects on both drinkers and nondrinkers, increasing perceptions of benefits and decreasing risks. In part, the ads worked by causing people to perceive fewer risks communicated by the stimulus materials, and reducing peoples ability to recall the content of the warning. The results suggest that, for young people, the warning labels in their present form may be counterproductive, and advertisements make drinking more attractive. Implications for warning an...

Mass media health communication campaigns combined with health-related product distribution: a community guide systematic review

CONTEXT 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. CONCLUSIONS 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.

Effectiveness of mass media interventions for HIV prevention, 1986-2013: a meta-analysis.

Objectives:This meta-analysis was conducted to synthesize evaluations of mass media–delivered HIV prevention interventions, assess the effectiveness of interventions in improving condom use and HIV-related knowledge, and identify moderators of effectiveness. Study Selection:We systematically searched electronic databases, relevant Web sites, related journals, and reference lists of previous reviews and included studies. Studies that quantitatively evaluated the effectiveness of mass media–delivered HIV prevention using pre-/post-campaign assessments, targeted the general population, reported outcomes of interest, and were available as of September 30, 2013 were eligible for inclusion. Data Extraction and Synthesis:Raters coded report, intervention, and sample characteristics. The standardized mean difference, d, comparing pretest and posttest assessments was calculated for each study sample. Effect sizes were analyzed incorporating random-effects assumptions. Results:Of the 433 obtained and screened reports, 54 reports containing evaluations of 72 interventions using 93 samples (N = 142,196) met the selection criteria and were included. Campaigns were associated with increases in condom use [d+ = 0.25, 95% confidence interval (CI) = 0.18 to 0.21], transmission knowledge (d+ = 0.30, 95% CI = 0.18 to 0.41), and prevention knowledge (d+ = 0.39, 95% CI = 0.25 to 0.52). Increases in condom use were larger for longer campaigns and in nations that scored lower on the human development index. Increases in transmission knowledge were larger to the extent that respondents reported greater campaign exposure, for more recent campaigns, and for nations that scored lower on the human development index. Conclusions:Mass media interventions may be useful in reducing global HIV/AIDS disparities because of their reach and effectiveness.

The Influence of Organizational Characteristics and Campaign Design Elements on Communication Campaign Quality: Evidence from 91 Ugandan AIDS Campaigns

This research proposes and tests a model of the relationship between organizational factors, campaign design elements, and campaign quality of communication campaigns. It is the first quantitative study to test these relationships across many organizations. The context for the study was AIDS education and outreach campaigns in Uganda, during a time of successful decrease in the spread of HIV infection. Ninety-one organizations were surveyed. Since only 14% of the organizations collected exposure or outcome data, the study focused on the factors affecting campaign quality. Quality was examined by measuring goal specificity, execution quality, and message quality. The results show that financial resources, professional training, participation of outreach workers in planning the campaign, and audience participation in planning and executing the campaign were key organizational variables affecting the quality of the campaigns. The important campaign design elements affecting campaign quality were conducting research, using multiple channels, targeting only a few groups, and pretesting messages. The results have import for campaign planners, managers of organizations conducting campaigns, and funders. In addition, it is vital that organizations collect exposure and outcome data in the future to provide feedback on each campaign.

Effect of Graphic Cigarette Warnings on Smoking Intentions in Young Adults

Introduction Graphic warnings (GWs) on cigarette packs are widely used internationally and perhaps will be in the US but their impact is not well understood. This study tested support for competing hypotheses in different subgroups of young adults defined by their history of cigarette smoking and individual difference variables (e.g., psychological reactance). One hypothesis predicted adaptive responding (GWs would lower smoking-related intentions) and another predicted defensive responding (GWs would raise smoking-related intentions). Methods Participants were an online sample of 1,169 Americans ages 18–24, who were randomly assigned either to view nine GWs designed by the FDA or to a no-label control. Both the intention to smoke in the future and the intention to quit smoking (among smokers) were assessed before and after message exposure. Results GWs lowered intention to smoke in the future among those with a moderate lifetime smoking history (between 1 and 100 cigarettes), and they increased intention to quit smoking among those with a heavy lifetime smoking history (more than 100 cigarettes). Both effects were limited to individuals who had smoked in some but not all of the prior 30 days (i.e., occasional smokers). No evidence of defensive “boomerang effects” on intention was observed in any subgroup. Conclusion Graphic warnings can reduce interest in smoking among occasional smokers, a finding that supports the adaptive-change hypothesis. GWs that target occasional smokers might be more effective at reducing cigarette smoking in young adults.

Meaning making coping, making sense, and post-traumatic growth following the 9/11 terrorist attacks

According to the meaning making model, traumatic events disrupt global meaning systems, and meaning making coping helps restore congruency between global meaning and appraisals of traumatic events. We examined the contextual and coping predictors of two specific meanings made: having made sense and perceiving post-traumatic growth in a nationally representative sample of 1004 adults approximately six weeks after the September 11th terrorist attacks in the United States. Although the two meanings made were positively correlated, they had very different predictors: having made sense was primarily predicted by some aspects of meaning focused coping as well as other typically adaptive coping (e.g., active coping), but perceived growth was predicted by nearly all types of coping. Further, having made sense was related to less distress, but perceived growth was related to more distress. These results suggest that having made sense is a product of meaning focused and active coping and appears adaptive, while post-traumatic growth reflects a mix of positive functioning and continued distress and coping efforts.