-

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RTI Pr ject N . 0215472.001.001 

March 7, 017 

F d Safety C nsumer Research 

Literature Review 

Rep rt 

Prepared For Prepared By 

Chris Bernstein and Tracy Legall J nathan L. Blitstein 

USDA, FSIS, OPACE, Catherine L. Viat r 

F d Safety Educati n Jenna E. Br phy 

1400 Independence Ave., S.W. Katherine M. K sa 

Washingt n, DC 20250 3700 Car line B. Rains 

Ellen M. Th mas 

Chi ma L. W k 

RTI Internati nal 

3040 E. C rnwallis R ad 

Research Triangle Park, NC 27709 2194 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

_________________________________ 

RTI Projec Number 

0215472.001.001 

Food Sa ety Consumer Research: 

Literature Review 

Dra t Report 

March 27, 2017 

Prepared for 

Chris Bernstein and Tracy Legall 

USDA, FSIS, OPACE, 

Food Safe y Educa ion 

1400 Independence Ave., S.W. 

Washing on, DC 20250-3700 

Prepared by 

Jonathan L. Blitstein 

Catherine L. Viator 

Jenna E. Brophy 

Katherine M. Kosa 

Caroline B. Rains 

Ellen M. Thomas 

Chioma L. Woko 

RTI In erna ional 

3040 E. Cornwallis Road 

Research Triangle Park, NC 27709 

RTI In erna ional is a regis ered rademark and a rade name of Research Triangle Ins i u e. 
 

 

 

 

 

 

 

 

 

 

 

 

 

1 

2 

3 

Contents 

Section Page 

Executive Summary ES-1 

Introduction 1-1 

1.1 Purpose..................................................................1-2 

Methods 2-1 

2.1 Da abase Search .....................................................2-1 

2.2 Ti le Review ............................................................2-2 

2.3 Abs rac Review.......................................................2-3 

2.4 Da a Abs rac ion......................................................2-3 

Results 3-1 

3.1 Campaign Charac eris ics Repor ed............................3-1 

3.1.1 Campaign Loca ion ........................................3-1 

3.1.2 Se ing .........................................................3-8 

3.1.3 Audience Charac eris ics.................................3-9 

3.1.4 Sponsorship..................................................3-9 

3.2 Campaign and Forma ive Developmen .....................3-10 

3.2.1 Food Safe y ................................................3-18 

3.2.2 Public Safe y ...............................................3-19 

3.2.3 Chronic Disease Preven ion...........................3-19 

3.3 Campaign Message Charac eris ics...........................3-21 

3.3.1 Food Safe y ................................................3-23 

3.3.2 Public Safe y ...............................................3-23 

3.3.3 Chronic Disease Preven ion...........................3-23 

3.4 Campaign Dissemina ion Charac eris ics ...................3-24 

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4 

5 

3.4.1 Food Safe y ................................................3-34 

3.4.2 Public Safe y ...............................................3-34 

3.4.3 Chronic Disease Preven ion...........................3-34 

3.5 Campaign Evalua ion Charac eris ics ........................3-35 

3.5.1 Food Safe y ................................................3-36 

3.5.2 Public Safe y ...............................................3-37 

3.5.3 Chronic Disease Preven ion...........................3-38 

Key Findings and Lessons Learned 4-1 

4.1 Campaign Developmen ............................................4-1 

4.2 Forma ive Research ...............................................4-32 

4.3 Message Charac eris ics..........................................4-32 

4.4 Campaign Dissemina ion ........................................4-33 

4.5 Audience ..............................................................4-34 

4.6 Evalua ion Charac eris ics .......................................4-34 

Conclusions 5-1 

Re erences R-1 

Appendixes 

A Search Terms..........................................................A-1 

B Coding Manual ........................................................B-1 

iv 
 

 

 

Figures 

Number Page 

2-1. Inclusion/Exclusion Cri eria Flow Diagram ..........................2-4 

3-1. Deeper Dive: Emo ional Appeals .....................................3-22 

3-2. Deeper Dive: Social Media..............................................3-32 

v 
 

 

 

 

 

 

 

Tables 

Number Page 

3-1. Campaign Charac eris ics .................................................3-2 

3-2. Addi ional Sponsorship Informa ion .................................3-10 

3-3. Types of Forma ive Research Suppor ing Campaign 

Developmen ................................................................3-12 

3-4. Types of Dissemina ion Channels ....................................3-25 

3-5. Evalua ion Measures of Food Safe y Campaigns (n = 5) .....3-37 

3-6. Evalua ion Measures of Public Safe y Campaigns (n = 5)....3-37 

3-7. Evalua ion Measures of Chronic Disease Preven ion 

Campaigns (n = 94) ......................................................3-38 

4-1. Key Findings and Lessons Learned.....................................4-2 

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Executive Summary 

Public heal h communica ion campaigns employ mass media 

channels o inform or persuade an audience abou he value of 

engaging in heal h-promo ing behaviors. In suppor of he U.S. 

Depar men of Agricul ure’s Food Safe y and Inspec ion 

Service’s (FSIS’s) in eres in public heal h communica ion 

campaigns, RTI In erna ional conduc ed a sys ema ic review of 

 he peer-reviewed li era ure o cap ure informa ion on elemen s 

and charac eris ics of consumer-focused public heal h 

campaigns. This research provides insigh in o consumers’ 

diverse food safe y needs and he messaging and 

accompanying ma erials needed o improve consumers’ food 

safe y behavior. 

We iden ified food safe y–rela ed heal h behaviors and relevan 

public heal h behavior ou comes for our search. The primary 

cri eria for selec ing relevan public heal h behaviors included 

low-cos behaviors, behavioral adop ion, and behaviors ha are 

carried ou frequen ly or repea edly. Elec ronic da abase 

searches wi h an agreed upon se of key words yielded 

approxima ely 1,200 peer-reviewed published ar icles.1 Ar icles 

were reviewed and re ained based on he following decision 

cri eria: 

 The s udy presen s a public heal h or risk 

communica ion campaign. 

 The campaign addresses one of he selec ed heal h 

domains. 

 The campaign is consumer focused. 

 The campaign was conduc ed in he Uni ed S a es, 

Uni ed Kingdom, Europe, Aus ralia/New Zealand, 

Canada, or Mexico. 

1 No e, we use he erms “ar icle” and “s udy” in erchangeably in his 

repor . 

ES-1 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

 The s udy repor s measured ou comes of he campaign 

(e.g., behavior, a i ude, knowledge, awareness). 

 The s udy is no a review or edi orial or limi ed o 

quali a ive findings. 

The abs rac review resul ed in he inclusion of 124 ar icles for 

da a abs rac ion. Nex , he full ex for each s udy was 

subjec ed o a sys ema ic coding process ha ex rac ed 

informa ion on s udy and campaign charac eris ics, campaign 

developmen and forma ive research, message charac eris ics, 

campaign dissemina ion charac eris ics, audience 

charac eris ics, and evalua ion charac eris ics. The following 

summarizes he opline findings of he da a abs rac ed from he 

ar icles. 

 Across all campaigns in he review, 42% were 

implemen ed a a na ionwide or s a ewide level. 

 More han half of he campaigns in he review (55%) 

were implemen ed for a general audience, while he 

remaining 45% arge ed a priori y audience. 

 Of he 104 ar icles, be ween 75% and 90% did no 

men ion any of he forma ive research me hods 

measures. Of he ar icles ha did men ion forma ive 

research, inpu from s akeholders and message es ing 

were mos of en men ioned (25% and 29%, 

respec ively). 

 The channel used by he grea es number of campaigns 

was radio/ elevision (71%), followed by prin (64%) and 

In erne (35%). Six ar icles used social media as a 

campaign channel. 

 Behavior change (i.e., self-repor ed) was he mos 

commonly repor ed evalua ion ou come (87%) followed 

by awareness (62%), a i udes (48%), and knowledge 

(39%). 

The findings in his repor provide an overview of he li era ure 

on public heal h communica ion campaigns conduc ed over he 

las 36 years. The 1042 ar icles cover a range of public heal h 

 opics. The larges number of ar icles are abou campaigns 

focused on chronic disease preven ion; only five of he ar icles 

focused on food safe y. 

2 During da a abs rac ion, wen y ar icles were removed based on he 

inclusion / exclusion cri eria described above, leaving 104 ar icles in 

 he review. 

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Executive Summ ry 

Campaign evalua ion 

resul s include he 

following: 

 87% measured 

behavior and 61% 

of he resul s were 

s a is ically 

significan 

 48% measured 

a i udes and 56% 

of he resul s were 

s a is ically 

significan 

 39% measured 

knowledge and 

76% of he resul s 

were s a is ically 

significan 

 62% measured 

awareness and 

56% of he resul s 

were s a is ically 

significan 

This repor provides limi ed informa ion on campaign 

developmen or he use of forma ive research. Those planning 

public heal h communica ion campaigns should recognize ha 

 he inves men of ime and resources in campaign planning and 

forma ive research could increase message recep ivi y and 

campaign effec iveness. 

Mos of he ar icles included good descrip ions of 

communica ion channels bu li le informa ion on exposure or 

popula ion reach. Evidence of campaign recall was reasonably 

good. Al hough radio/ elevision was he mos commonly 

employed channel for dissemina ing campaign messages, his 

finding needs o be considered in ligh of he ime span of he 

campaigns and ar icles included in his repor . Given he 

compara ively low cos s and increased reach of social media, i 

would no be surprising o see radio/ elevision begin o decline 

in erms of i s impac as a message delivery channel. 

This repor includes lessons learned from he field. The key 

lessons from his body of li era ure include he following: 

 Using sound behavior heory is a key fac or in arge ing 

mo iva ion o change. 

 Par nerships and collabora ion are an essen ial 

componen of campaign planning ha should be 

considered af er assessing readiness among po en ial 

par ners. 

 Messages should be carefully developed o resona e wi h 

priori y audiences. Recognizing and apping in o 

psychosocial charac eris ics of priori y audiences can 

help develop messages ha are more likely o be 

received favorably. 

 Reinforcemen can include he use of differen 

communica ion channels and dissemina ion a mul iple 

levels of he socio-ecological framework. 

 I is necessary o ma ch dissemina ion plans wi h 

message charac eris ics such as complexi y. Using one 

simple, focused message can be more effec ive han 

mul iple, complex messages ha may have limi ed long-

 erm effec iveness. 

 Television is credi ed wi h he grea es abili y o 

genera e audience awareness, bu i comes a a very 

high cos . Campaign planners should carefully consider 

balanced media purchases ha allow for he grea es 

po en ial for exposure. 

ES-3 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1 Introduction 

The U.S. Depar men of Agricul ure’s Food Safe y and 

Inspec ion Service’s (USDA’s/FSIS’s) Office of Public Affairs and 

Consumer Educa ion (OPACE) s rives o con inuously increase 

consumer awareness of recommended food safe y prac ices 

wi h he in en o improve food-handling behaviors a home. 

Through i s consumer educa ion programs, OPACE educa es he 

public on recommended food safe y prac ices o enable 

consumers o make safe food handling and prepara ion 

decisions when cooking a home, hus helping reduce he 

incidence of foodborne illnesses, hospi aliza ions, and dea hs. 

OPACE shares i s messages hrough 

 he Food Safe Families campaign, 

 o her adver ising, 

 social media, 

 he USDA web si e and FoodSafe y.gov 

 he Mea and Poul ry Ho line and Ask Karen (an online 

guide o answer food safe y ques ions), 

 publica ions, and 

 even s. 

These messages are focused on he four core food safe y 

behaviors: clean, separa e, cook, and chill. Addi ionally, 

OPACE’s public educa ion and ou reach ini ia ives place an 

emphasis on reaching vulnerable and underserved popula ions, 

such as adul s aged 60 or older, pregnan women, paren s of 

children 5 years of age or younger, diabe es pa ien s, cancer 

pa ien s, individuals wi h compromised immune sys ems, and 

 he underserved. 

FSIS con rac ed wi h RTI In erna ional o es new and ailored 

consumer messages, which will enable FSIS o effec ively 

communica e wi h he public and work o improve consumer 

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Food S fety Consumer Rese rch: Liter ture Review 

food safe y prac ices. As par of his projec , RTI conduc ed a 

sys ema ic review of he peer-reviewed li era ure o de ermine 

 hema ic elemen s of consumer public heal h campaigns. This 

research will provide insigh in o consumers’ diverse food safe y 

needs and he messaging and accompanying ma erials needed 

 o improve consumers’ food safe y behavior. 

1.1 PURPOSE 

The purpose of he li era ure review was o review and 

summarize findings from public heal h communica ion 

campaigns and provide recommenda ions on how campaign 

prac ices can be rela ed o food safe y and o her heal h and 

safe y behaviors. Public heal h communica ion campaigns 

a emp o inform or persuade an audience abou he value of 

engaging in heal h-promo ing behavior. They use mass media 

channels ha are open o he public o dissemina e messages. 

This places hem in a separa e ca egory from in erven ions or 

o her public heal h approaches ha arge specific individuals. 

This review includes campaigns ha address food safe y 

behaviors (e.g., clean, separa e, cook, and chill) and o her 

safe y and heal h-promo ing behaviors (e.g., heal hy ea ing, 

firearm safe y). The repor cap ures lessons learned from he 

broad li era ure on public heal h communica ion ha can be 

applied o food safe y campaigns. OPACE can use his review o 

inform he design of FSIS communica ion campaigns. 

This repor describes he resul s of he li era ure review and is 

organized as follows: 

 Sec ion 2 describes he me hods used for he sys ema ic 

li era ure review. 

 Sec ion 3 describes he resul s, wi h subsec ions for 

each componen of campaign developmen , 

implemen a ion, and evalua ion. 

 Sec ion 4 highligh s he key findings and lessons learned 

from he li era ure reviewed. 

 Sec ion 5 concludes he repor . 

In addi ion, he appendices provide he following: 

 Appendix A: Search Terms 

 Appendix B: Coding Manual 

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2 Methods 

RTI conduc ed a sys ema ic li era ure review in four s eps: 

(1) searched academic da abases using specific search erms, 

(2) reviewed ar icle i les for inclusion in he s udy, 

(3) reviewed abs rac s, and (4) abs rac ed da a from he full-

 ex ar icles included in his sys ema ic review. This sec ion 

describes hese s eps in more de ail. 

2.1 DATABASE SEARCH 

The li era ure review 

iden ified ar icles ha 

repor ed on public 

heal h communica ion 

campaigns on he 

following opics: 

 Food safe y 

 Poison con rol 

 Smoke 

alarms/home 

safe y 

 Oral heal h/hygiene 

 Exercise 

 Heal hy ea ing 

 Condom use/sexual 

behavior 

 Secondhand smoke 

 Firearm s orage 

RTI and FSIS collabora ively iden ified five food safe y–rela ed 

heal h behaviors: 

1. Food safe y (general, safe food handling, preven ion of 

foodborne illness) 

2. Clean—handwashing (rela ed o food prepara ion), 

cleaning surfaces, no washing poul ry o avoid crosscon amina ion in he ki chen 

3. Separa e—using separa e cu ing boards 

4. Cook—using a food hermome er and cooking o 

recommended empera ures 

5. Chill—cooling foods, properly s oring lef overs, hawing 

mea /poul ry 

We recognized ha he li era ure on public heal h 

communica ion campaigns ha focus on safe food handling 

prac ices may be limi ed. Addi ionally, FSIS wan ed o learn 

abou effec ive campaigns in o her areas ha improved 

consumer behavior. To bols er he li era ure review, we also 

included he following rela ed public heal h domains because 

 hey may provide useful informa ion on he role of na ional 

public heal h campaigns in changing consumer behavior: 

1. Poison con rol 

2. Smoke alarms/home safe y 

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Food S fety Consumer Rese rch: Liter ture Review 

3. Oral heal h/hygiene 

4. Exercise 

5. Heal hy ea ing 

6. Condom use/sexual behavior 

7. Secondhand smoke (preven ion) 

8. Safe firearm s orage 

The primary cri eria for selec ing rela ed public heal h domains 

included low-cos behaviors, behavioral adop ion, and 

behaviors ha are carried ou frequen ly or repea edly. 

RTI crea ed a se of search erms ha could be applied o each 

selec ed behavior: 

[beh vior of interest3] AND [(communica ion OR 

risk OR media OR heal h) AND campaign] AND 

[consumer OR public] AND [behavior OR a i ude 

OR knowledge OR awareness] AND [evalua ion OR 

impac OR ou come OR change] 

We hen conduc ed bibliographic searches by public heal h 

domain o increase our abili y o sor and arge he se of 

iden ified abs rac s. We searched PubMed, Web of Science, 

CINAHL, and Food Science & Technology Abs rac s da abases. 

Using RTI’s Library and Informa ion Services, we searched for 

ar icles published in English be ween he years of 1980 and 

2016. The search yielded 1,205 ci a ions. 

2.2 TITLE REVIEW 

To de ermine he relevance of iden ified peer-reviewed s udies, 

a eam of four experienced RTI researchers independen ly 

reviewed he i le and ci a ion of each ar icle. The aim of his 

process was o exclude s udies ha clearly did no mee he 

review’s inclusion cri eria. Accordingly, we excluded s udies 

wri en in languages o her han English, s udies conduc ed in 

coun ries o her han hose of in eres (Uni ed S a es, Canada, 

Aus ralia/New Zealand, he European Union, or Mexico), and 

s udies ha did no ma ch he iden ified behavior domain or did 

no include a public heal h communica ion campaign. The i le 

3 Search erms for each safe food handling behavior and public heal h 

domain of in eres are provided in Appendix A. 

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Section 2 — Methods 

review resul ed in he re en ion of 289 s udies for he abs rac 

review. 

Of he 1,205 ar icles 

ini ially iden ified in he 

da abase search: 

 289 abs rac s were 

reviewed 

 124 ar icles were 

reviewed 

 104 ar icles were 

included in he final 

review. 

2.3 ABSTRACT REVIEW 

Figure 2-1 provides a flow diagram for our approach o 

iden ifying relevan s udies o include in he sys ema ic 

li era ure review. Two rained researchers independen ly 

reviewed each remaining abs rac based on he following 

inclusion cri eria: 

 The ar icle repor s an evalua ion of a public heal h/risk 

communica ion campaign. 

 The campaign addresses one of he selec ed public 

heal h domains. 

 The campaign arge ed a consumer audience. 

 The campaign was conduc ed in he Uni ed S a es, 

Uni ed Kingdom, Europe, Aus ralia/New Zealand, 

Canada or Mexico. 

 The ar icle repor s ou comes rela ed o behavior, 

a i ude, knowledge, or awareness. 

We excluded review and edi orial s udies, as well as s udies 

limi ed o quali a ive findings from focus groups or in erviews, 

because he li era ure review focused on publica ions ha 

repor ed ou comes. 

Any discrepancies be ween he decisions of he wo reviewers 

were resolved hrough discussion un il an agreemen was 

reached for each abs rac . 

The abs rac review resul ed in he inclusion of 124 ar icles for 

da a abs rac ion. 

2.4 DATA ABSTRACTION 

Af er reviewing he abs rac s, we ob ained he full- ex original 

ar icles for hose s udies ha me he inclusion cri eria. Five 

reviewers independen ly coded he ar icles based on a defined 

se of cri eria o ensure consis ency (see Appendix B for he 

coding manual). Reviewers par icipa ed in hree 1-hour raining 

mee ings where he coding manual and da a abs rac ion 

approach were explained. In addi ion, he lead au hor (JLB) 

anno a ed wo ar icles and walked he reviewers hrough he 

coding process on an i em-by-i em basis. Approxima ely 10% 

of he ar icles were double-coded for quali y con rol by he 

2-3 
 

 

Peer-reviewed literature (1980 -

2016) 

YES 

Does the article report an evaluation No I 

I of a public health/risk I 

Exclude 

communication campaign? 

YES 

Does the campaign address one No _I of the selected health - I Exclude 

behaviors? 

YES 

,, 

Is the campaign No _I Exclude 

I consumer focused? - I 

YES 

Was the campaign 

conducted in the US, No I 

I EU, UK, AU, NZ, I 

Exclude 

Canada, or Mexico? 

YES 

~ Is the article limited 

No to qualitative No Does the article report 

Is the article a - findings from campaign impacts 

review? - interviews or focus (behavior, attitude, 

groups? knowledge, awareness)? 

~ YES 

~ YES YES 

Exclude Exclude 

1 

Retain for 

systematic 

literature review 

Food S fety Consumer Rese rch: Liter ture Review 

Figure 2-1. Inclusion/Exclusion Criteria Flow Diagram 

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Section 2 — Methods 

primary reviewer and he lead au hor. This process was par of 

a raining exercise designed o ensure ha all coders 

unders ood he erminology and concep s associa ed wi h he 

coding cri eria. Agreemen be ween he wo coders averaged 

76.4%, ranging from 100.0% o 64.1%. As par of he raining 

process, discrepancies were discussed and resolved so ha 

bo h coders achieved comple e agreemen on all variables. 

During he da a abs rac ion process, reviewers iden ified 20 

ar icles ha did no mee he inclusion cri eria shown in 

Figure 2-1. These ar icles were elimina ed, resul ing in 104 

ar icles in he final review. 

Reviewers coded he following charac eris ics for all ar icles: 

 Study and campaign characteristics: public heal h 

domain, loca ion of campaign (coun ry), se ing where 

campaign was dissemina ed, and he funding source of 

 he evalua ion 

 Campaign development and ormative research: 

 heore ical basis, social marke ing/branding, and 

forma ive research 

 Message characteristics: message framing, focus, call 

 o ac ion, and visual cues 

 Campaign dissemination: channels, media exposure, 

and reach 

 Evaluation characteristics: evalua ion design, 

measured period of exposure, recall, ou come(s) 

repor ed, and s a is ical significance 

Addi ional informa ion on he i ems describing each 

charac eris ic and heir se of coding op ions is presen ed in 

Appendix B. Following da a abs rac ion, we cleaned, 

summarized, and analyzed he coded da a. Based on hema ic 

similari ies, we condensed he original 13 public heal h domains 

in o hree public heal h domains: 

 Food safe y: general food safe y, clean, separa e, cook, 

and chill 

 Public safe y: poison con rol, smoke alarms, and firearm 

s orage 

 Chronic disease preven ion: oral heal h, exercise, 

heal hy ea ing, condom use, and secondhand smoke 

preven ion 

2-5 
 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Frequencies were repor ed for each charac eris ic, and he 

mean, minimum, and maximum were repor ed for selec 

charac eris ics. All analyses were performed using SAS and 

impor ed in o Excel. 

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3 Results 

This sec ion presen s he resul s of he li era ure review on 

public heal h campaigns. We repor on he campaign 

charac eris ics, campaign and forma ive developmen , message 

charac eris ics, and dissemina ion charac eris ics, and 

campaign evalua ions. The resul s are presen ed overall and by 

 hree public heal h domains: food safe y (n = 5), public safe y 

(n = 5), and chronic disease preven ion (n = 94). 

3.1 CAMPAIGN CHARACTERISTICS REPORTED 

Table 3-1 highligh s he campaign charac eris ics ha were 

repor ed for each s udy in he review. These charac eris ics 

include he year he campaign began, he coun ry in which he 

campaign was conduc ed, he ype of se ing in which he 

campaign was implemen ed, he in ended audience, and he 

source of sponsorship or funding. 

Approxima ely half of hese ar icles (51%) focused on 

campaigns based in he Uni ed S a es. The mos common level 

of implemen a ion for he campaigns was a he na ionwide or 

s a ewide level (42%), and 55% of all campaigns discussed in 

 he ar icles arge ed he general popula ion. A federal or 

na ional governmen agency was he mos common source of 

campaign funding across all ar icles (25%). 

3.1.1 Campaign Location 

Loca ion indica es he coun ry where he public heal h 

communica ion campaign was conduc ed. Op ions included he 

Uni ed S a es, he Uni ed Kingdom, Europe (no UK), 

Aus ralia/New Zealand, Canada, and Mexico. 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 3-1. Campaign Characteristics 

First Author and Year 

Year o Campaign Priority General 

Publication Began Country Setting Audiencea Audience Sponsor 

Food Sa ety (n = 5) 

Abbo (2012) NR Uni ed S a es U Gran funded 

(clean, cook, chill, 

lef overs) 

Dharod (2004) 2000 Uni ed S a es C (S) Gran funded 

(Figh BAC) 

James (2013) NR Uni ed S a es N/S Federal governmen 

(lef overs) 

Ra napradipa 2005 Uni ed S a es N/S Public–priva e 

(2009) par nership 

(mercury in fish) 

Tiozzo (2011) 2007 Europe (no Uni ed C (G) Federal governmen 

(S lmonell ) Kingdom) 

Public Sa ety (n = 5) 

Greene (2015) 2004 Uni ed S a es C (G) Gran funded 

(lead poisoning) 

Henry (2003) 1998 Uni ed S a es C (S) Public–priva e 

(air quali y) par nership 

McLaughlin (2004) NR Uni ed S a es C (G) Federal governmen 

(lead poisoning) 

Rober o (2002) NR Uni ed S a es C (G) S a e governmen 

(firearm safe y) 

Robinson (2014) 2007 Uni ed Kingdom C (G) Public–priva e 

(suicide preven ion) par nership 

Chronic Disease Prevention (n = 94) 

Acharya (2006) 2000 Uni ed S a es C (G) S a e governmen 

(heal hy ea ing) 

Albarracin (2003) NR Uni ed S a es NR Gran funded 

(alcohol 

abs inence) 

Arikan (2014) NR Europe (no Uni ed N/S Federal governmen 

Kingdom) (obesi y) 

Bauman (2001) 1998 Aus ralia/New N/S S a e governmen 

Zealand (exercise) 

Bauman (2003a) 1999 Aus ralia/New N/S Federal governmen 

Zealand (exercise) 

Bauman (2003b) 1998 Aus ralia/New N/S Federal governmen 

Zealand (exercise) 

Bell (2013) 2007 Aus ralia/New C (G) No repor ed 

Zealand (heal hy ea ing and 

exercise) 

(con inued) 

3-2 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

Table 3-1. Campaign Characteristics (continued) 

First Author and Year 

Year o Campaign Priority General 

Publication Began Country Setting Audiencea Audience Sponsor 

Chronic Disease Prevention (n = 94) (cont’d) 

Berry (2009) 2007 Canada N/S S a e governmen 

(heal hy ea ing and 

exercise) 

Bli s ein (2012) 2007 Uni ed S a es N/S Federal governmen 

(sexual behavior) 

Boles (2014) 2011 Uni ed S a es C (G) Federal governmen 

(heal hy ea ing) 

Boo h-Bu erfield NR Uni ed S a es C (S) Public–priva e 

(2004) par nership 

(heal hy ea ing) 

Bove (2011) 2010 Europe (no Uni ed C (G) S a e governmen 

Kingdom) (heal hy ea ing and 

exercise) 

Brorsson (1988) 1987 Europe (no Uni ed N/S Public–priva e 

Kingdom) (sexual behavior) par nership 

Bull (2008) 2004 Uni ed S a es C (G) Public–priva e 

(condom use) par nership 

Cagampang (1997) 1992 Uni ed S a es N/S S a e governmen 

(sexual behavior) 

Campbell (1987) 1987 Uni ed Kingdom N/S Federal governmen 

(sexual behavior) 

Chen (2002) NR Uni ed S a es C (S) S a e governmen 

(sexual behavior) 

Cochrane (2008) NR Uni ed Kingdom C (S) Gran funded 

(exercise) 

Craig (2006) 2003 Canada N/S Public–priva e 

(exercise) par nership 

Craig (2007) 2004 Canada N/S Public–priva e 

(exercise) par nership 

Darrow (2008) 2003 Uni ed S a es C (S) S a e governmen 

(sexual behavior) 

de Vroome (1990) 1987 Europe (no Uni ed N/S Federal governmen 

Kingdom) (condom use) 

Dixon (1998) 1992 Aus ralia/New N/S Public–priva e 

Zealand (heal hy ea ing) par nership 

Dona e (2010) 2006 Uni ed S a es C (S) Gran -funded 

(sexual behavior) 

Dooley (2010) NR Canada O Federal governmen 

(heal hy ea ing) 

(con inued) 

3-3 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 3-1. Campaign Characteristics (continued) 

First Author and Year 

Year o Campaign Priority General 

Publication Began Country Setting Audiencea Audience Sponsor 

Chronic Disease Prevention (n = 94) (cont’d) 

DuRan (2006) 1999 Uni ed S a es N/S Public–priva e 

(sexual behavior) par nership 

Eves (2012) NR Uni ed Kingdom C (G) Gran funded 

(exercise) 

Fernandez Cerdeno 2006 Uni ed S a es C (S) Gran funded 

(2012) 

(condom use) 

Foers er (1995) 1988 Uni ed S a es N/S Gran funded 

(heal hy ea ing) 

Gase (2015) 2012 Uni ed S a es C (G) O her 

(heal hy ea ing) 

Gee (2007) 2003 Uni ed S a es C (G) Public–priva e 

(sexual behavior) par nership 

Gibson (2010) NR Uni ed S a es C (G) Gran funded 

(drug use 

preven ion) 

Gilber (2013) 2009 Canada C (S) Gran funded 

(sexual behavior) 

Glasson (2013) 2008 Aus ralia/New N/S Federal governmen 

Zealand (heal hy ea ing) 

Goodwin (2014) 2007 Uni ed Kingdom C (G) Nonprofi / 

(exercise) philan hropic 

Guy (2009) 2004 Aus ralia/New C (G) Public–priva e 

Zealand (sexual behavior) par nership 

Ha field (2016) NR Uni ed S a es C (S) Gran funded 

(heal hy ea ing) 

Hlavinkova (2014) 2008 Europe (no Uni ed C/S Federal governmen 

Kingdom) (sexual behavior) 

Ho a (2010) NR Europe (no Uni ed C (G) No repor ed 

Kingdom) (heal hy ea ing) 

Howle (2012) 2001 Uni ed S a es N/S S a e governmen 

(heal hy ea ing) 

Huhman (2010) 2002 Uni ed S a es N/S Federal governmen 

(exercise) 

James (2015) 2008 Uni ed S a es N/S Gran funded 

(secondhand 

smoke exposure) 

(con inued) 

3-4 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

Table 3-1. Campaign Characteristics (continued) 

First Author and 

Year o 

Publication 

Year 

Campaign 

Began Country Setting 

Priority 

Audiencea 

General 

Audience Sponsor 

Chronic Disease Prevention (n = 94) (cont’d) 

King (2013) 

(exercise) 

2008 Aus ralia/New 

Zealand 

N/S Federal governmen 

Leavy (2013) 

(exercise) 

2008 Aus ralia/New 

Zealand 

N/S S a e governmen 

Lim (2015) 

(sexual behavior) 

2009 Aus ralia/New 

Zealand 

N/S Gran funded 

Maddock (2007) 

(heal hy ea ing) 

2004 Uni ed S a es NR Public–priva e 

par nership 

Mann (2013) 2011 Canada C (G) S a e governmen 

(sexual 

behavior/condom 

use) 

Mar ensson (2004) 

(oral heal h) 

1999 Europe (no Uni ed 

Kingdom) 

N/S O her 

Mar inez-Dona e 

(2009) 

2006 Uni ed S a es C (S) Gran funded 

(sexual 

behavior/condom 

use) 

McMahon (2004) 

(sexual behavior) 

2000 Aus ralia/New 

Zealand 

N/S Federal governmen 

Merom (2005) 

(exercise) 

2003 Aus ralia/New 

Zealand 

N/S Federal governmen 

Miles (2001) 

(heal hy ea ing and 

exercise) 

1999 Uni ed Kingdom N/S Commercial/ 

priva e indus ry 

Moa i (1992) 

(condom use) 

1987 Europe (no Uni ed 

Kingdom) 

N/S No repor ed 

Mon oya (2005) 2002 Uni ed S a es C (S) S a e governmen 

(sexual behavior) 

Mork (2015) 

(heal hy ea ing) 

NR Europe (no Uni ed 

Kingdom) 

N/S Federal governmen 

Mur omaa (1984) 

(oral heal h) 

1981 Europe (no Uni ed 

Kingdom) 

N/S Public–priva e 

par nership 

Nigg (2005) 2002 Uni ed S a es N/S O her 

(exercise) 

O’Hara (2011) 

(heal hy ea ing and 

exercise) 

2009 Aus ralia/New 

Zealand 

NR No repor ed 

Parker (2004) 

(cancer awareness) 

2002 Uni ed S a es N/S Public–priva e 

par nership 

(con inued) 

3-5 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 3-1. Campaign Characteristics (continued) 

First Author and Year 

Year o Campaign 

Publication Began Country Setting 

Priority 

Audiencea 

General 

Audience Sponsor 

Chronic Disease Prevention (n = 94) (cont’d) 

Pedrana (2012) 2008 Aus ralia/New 

Zealand (sexual behavior) 

Pivonka (2011) 2007 Uni ed S a es 

(heal hy ea ing) 

Plan (2010) 2002 Uni ed S a es 

(sexual behavior) 

Plan (2014) 2007 Uni ed S a es 

(sexual behavior) 

Pollard (2008) 2002 Aus ralia/New 

Zealand (heal hy ea ing) 

Po er (2008) 2002 Uni ed S a es 

(exercise) 

Reger (1999) 1996 Uni ed S a es 

(heal hy ea ing) 

Reger (2000) 1997 Uni ed S a es 

(heal hy ea ing) 

Reger (2002) 2001 Uni ed S a es 

(exercise) 

Reger-Nash (2005) 2001 Uni ed S a es 

(exercise) 

Reger-Nash (2008) 2005 Uni ed S a es 

(exercise) 

Rise (1988) 1981 Europe (no Uni ed 

Kingdom) (oral heal h) 

Rogers (2013) 2006 Uni ed S a es 

(heal hy ea ing) 

Rogers (2014) NR Uni ed S a es 

(heal hy ea ing and 

exercise) 

Romer (2009) 2006 Uni ed S a es 

(sexual behavior) 

Ross (1993) 1987 Uni ed Kingdom 

(sexual behavior) 

Schmid (2009) 2006 Canada 

(smoking) 

Singer (1991) 1988 Uni ed S a es 

(condom use) 

Siska (1992) 1990 Uni ed S a es 

(sexual behavior) 

C (S) 

N/S 

C (S) 

C (S) 

C (G) 

NR 

C (G) 

C (G) 

C (S) 

C (S) 

C (S) 

N/S 

C (G) 

C/S 

C (S) 

C (G) 

N/S 

N/S 

C (G) 





















Nonprofi / 

philan hropic 

Public–priva e 

par nership 

Public–priva e 

par nership 

O her 

S a e governmen 

Federal governmen 

Public–priva e 

par nership 

Gran funded 

Gran funded 

No repor ed 

No repor ed 

O her 

Public–priva e 

par nership 

Gran funded 

Federal governmen 

No repor ed 

Public–priva e 

par nership 

Federal governmen 

Federal governmen 

(con inued) 

3-6 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

Table 3-1. Campaign Characteristics (continued) 

First Author and Year 

Year o Campaign Priority General 

Publication Began Country Setting Audiencea Audience Sponsor 

Chronic Disease Prevention (n = 94) (cont’d) 

Smi h (2009) 2002 Canada C (G) O her 

(secondhand 

smoke exposure) 

Solorio (2016) 2014 Uni ed S a es C (S) Gran funded 

(sexual behavior) 

Sou hco e (2016) 2013 Uni ed S a es U S a e governmen 

(heal hy ea ing) 

S ekler (2013) 2009 Uni ed S a es C (S) Public–priva e 

(sexual behavior) par nership 

Su herland (2013) 2004 Uni ed Kingdom N/S Federal governmen 

(heal hy ea ing) 

Thrasher (2013) 2005 Mexico C (G) No repor ed 

(smoking) 

Trussell (2001) 1997 Uni ed S a es N/S Nonprofi / 

(sexual behavior) philan hropic 

Turrell (1997) NR Aus ralia/New N/S Federal governmen 

Zealand (heal hy ea ing) 

Wagman (1993) NR Canada C (G) O her 

(sexual behavior) 

Wammes (2007) 2002 Europe (no Uni ed N/S Federal governmen 

Kingdom) (heal hy ea ing and 

exercise) 

Wardle (2001) 1998 Uni ed Kingdom N/S Nonprofi / 

(heal hy ea ing and philan hropic 

exercise) 

Wechem (1997) 1992 Europe (no Uni ed C (G) No repor ed 

Kingdom) (heal hy ea ing) 

Wechem (1998) 1991 Europe (no Uni ed N/S Public–priva e 

Kingdom) (heal hy ea ing) par nership 

Whi e (2015) 2008 Uni ed S a es N/S S a e governmen 

(secondhand 

smoke exposure) 

Whi ingham NR Europe (no Uni ed C/S Federal governmen 

(2008) Kingdom) 

(condom use) 

Zimmerman (2007) 2003 Uni ed S a es C (G) No repor ed 

(condom use) 

C (G) = Communi y (general); C (S) = Communi y (specific); C/S = Child care/school; N/S = 

Na ionwide/s a ewide; O =O her; NR = No repor ed; U = Universi y 

a Priori y audiences include subgroups of he general popula ion wi h special needs (e.g., pregnan women, children 

below he age of 5 years, he elderly, and persons who are immunocompromised). 

3-7 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

3.1.2 

Approxima ely half of he campaigns in he review were 

conduc ed in he Uni ed S a es (51%). Nine percen were based 

in he Uni ed Kingdom, 15% were in Europe, 15% were in 

Aus ralia/New Zealand, 9% were in Canada, and 1% were 

based in Mexico. 

For he five food safe y campaigns included in his review, four 

were based in he Uni ed S a es and one in Europe. This finding 

is similar o he five public safe y campaigns, of which four 

were based in he Uni ed S a es and one was based in he 

Uni ed Kingdom. For he chronic disease preven ion campaigns, 

almos half of he s udies were based in he Uni ed S a es 

(48%). The remaining chronic disease campaigns were 

conduc ed in he Uni ed Kingdom (9%), Europe (16%), 

Aus ralia/New Zealand (17%), Canada (10%), and Mexico 

(1%). 

Setting 

The se ing describes he level a which he campaign was 

implemen ed. Se ings could be classified as na ionwide or 

s a ewide; wi hin a communi y (general or ailored o a specific 

group); or a a childcare, school, or universi y. The se ing has 

an impac on how he campaign is designed and evalua ed, 

par icularly in erms of channels, sample size, and o her 

measures. 

Across all campaigns in he review, 42% were implemen ed a 

a na ionwide or s a ewide level. Of he remaining s udies, 28% 

focused generally in a communi y; 20% focused on a specific 

group wi hin a communi y; 5% focused on childcare, school or 

universi y se ings; and 1% focused on o her se ings. Four 

percen of he s udies did no repor a campaign se ing. 

Focusing on each campaign domain: 

 Of he five food safe y campaigns, wo were ei her 

implemen ed a a na ionwide or s a ewide level, one was 

focused generally in a communi y, one was aimed a a 

specific group or groups in a communi y, and one was 

implemen ed a he universi y level. 

 Of he five public safe y campaigns, four were focused 

generally in a communi y, and one ook place in a 

specific communi y se ing. This campaign, rela ed o air 

pollu ion, was conduc ed in a workplace se ing and 

focused on drivers in he A lan a area. 

3-8 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

 Of he chronic disease preven ion campaigns, 45% were 

implemen ed a ei her a na ionwide or s a ewide level; 

26% were implemen ed generally in a communi y; 20% 

were focused in a specific communi y se ing; 4% 

occurred wi hin childcare, school, or universi y se ings; 

1% occurred wi hin o her se ings; and 4% were no 

repor ed. 

3.1.3 Audience Characteristics 

Campaigns can reach a general audience (e.g., everyone wi hin 

 he se ing) or a specific group. For public heal h campaigns, 

specific groups of in eres o FSIS included popula ions who are 

mos vulnerable o foodborne illness, such as children, he 

elderly, pregnan women, and minori ies. 

More han half of he campaigns in he review (55%) were 

implemen ed for a general audience, while he remaining 45% 

 arge ed a priori y audience. By campaign domain, wo of he 

food safe y campaigns focused on a general audience and hree 

on a priori y audience; four of he public safe y campaigns 

 arge ed a general audience and one arge ed a priori y 

audience; and 51 of he chronic disease preven ion campaigns 

 arge ed a general audience, while 43 focused on a priori y 

audience. 

Among he 45% of s udies ha arge ed specific subgroups 

(n = 51), 24% focused on homosexual men or men who have 

sex wi h men (MSM), 20% on paren s, 16% each on eens and 

e hnic minori ies, 10% on women, 8% on children, and 2% 

each on pregnan women and he elderly. 

3.1.4 Sponsorship 

The mos common source of funding or sponsorship for 

campaigns across all s udies was a federal or na ional 

governmen agency (25%). The nex mos common source of 

funding was public–priva e par nerships (21%), where he 

governmen and an indus ry or commercial en i y collabora ed 

 o develop and implemen a campaign. Eigh een percen of he 

s udies were gran funded, 14% were s a e governmen 

funded, and less han 1% were funded by he 

commercial/priva e indus ry alone (0.96%). O her sources, 

such as indus ry rade associa ions and ci y governmen s, 

funded 7% of he s udies. The remaining 10% of s udies did 

no repor a source of sponsorship or funding. 

3-9 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Addi ional informa ion on sponsorship informa ion is provided 

according o he campaign ype (Table 3-2). For his 

assessmen , we broke he chronic disease preven ion ca egory 

in o hree groups: heal hy ea ing and physical ac ivi y, condom 

use, and o her chronic disease preven ion. Propor ionally, 

public-priva e par nership was he mos common among public 

safe y campaigns, while federal governmen funding is more 

common for food safe y heal hy ea ing and physical ac ivi y, 

and condom use. O her chronic disease preven ion was mos 

commonly funded suppor ed by gran funding. Food safe y was 

 he only heal h behavior no suppor ed by s a e governmen 

funding. 

Table 3-2. Additional Sponsorship In ormation 

State 

Government 

N (%) 

Federal 

Government 

N (%) 

Nonpro it/ 

Philanthropic 

N (%) 

GrantFunded 

N (%) 

Commercial/ 

Private 

Industry 

N (%) 

Public/ 

Private 

Partnership 

N (%) 

Other 

N (%) 

Not 

Reported 

N (%) 

Food safe y 0 (0%) 2 (40%) 0 (%) 2 (40%) 0 (0%) 1 (20%) 0 (0%) 0 (0%) 

Public safe y 1 (20%) 1 (20%) 0 (0%) 1 (20%) 0 (0%) 2 (40%) 0 (0%) 0 (0%) 

Heal hy ea ing 

& physical 

ac ivi y 

7 (14.6) 14 (29.2) 2 (4.2%) 6 (12.5%) 1 (2.1%) 10 (20.8%) 2 (4.2%) 6 (12.5%) 

Condom use 5 (15.6%) 8 (25%) 2 (6.25%) 6 (18.75%) 0 (0%) 6 (18.75%) 2 (6.25%) 3 (9.4%) 

O her chronic 

disease 

preven ion 

2 (14.3%) 1 (7.1%) 0 (0%) 4 (28.6%) 0 (0%) 3 (21.4%) 3 (21.4%) 1 (7.1%) 

To al 15 26 4 19 1 22 7 10 

3.2 CAMPAIGN AND FORMATIVE DEVELOPMENT 

Table 3-3 de ails he ypes of forma ive research suppor ing 

campaign developmen by each domain. Forma ive 

developmen included he use of focus groups, in erviews wi h 

 he priori y popula ion, exper elici a ion, inpu from 

s akeholders, and message es ing4. Of he 104 ar icles, 

be ween 75% and 90% did no men ion any of he forma ive 

research me hods lis ed above; his is a mos likely a func ion 

of he inclusion and exclusion cri eria used o selec peerreviewed s udies. Inpu from s akeholders and message es ing 

were mos of en men ioned (25% and 29%, respec ively). 

4 This s udy does no include consumer surveys conduc ed prior o a 

campaign as par of forma ive developmen . 

3-10 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

The following heories 

were commonly used 

by he campaigns in 

 his review: 

 Theory of Planned 

Behavior/Reasoned 

Ac ion: a 

persuasion model, 

used o predic how 

individuals will 

behave based on 

preexis ing 

a i udes, 

behavioral 

in en ions, and 

subjec ive norms 

 Social Cogni ive 

Theory: based on 

 he idea ha 

people learn by 

observing o hers 

In erviews wi h he priori y popula ion and exper elici a ion 

were leas men ioned (11% and 14%, respec ively). 

Theories used o guide campaign developmen were also 

iden ified. The mos frequen ly used heories were Theory of 

Planned Behavior/ Reasoned Ac ion/In egra ed Theory of 

Behavior Change (TPB/TRA) (12%) and Social Cogni ive Theory 

(SCT) (8%). Agenda Se ing and Ex ended Parallel Process 

Model were no men ioned in any ar icle. Over 60% of he 

ar icles did no men ion any heory. 

We also examined social marke ing and branding of he 

campaigns. Social marke ing uses a marke ing mix (produc , 

price, placemen , and promo ion) in campaign developmen o 

encourage a specific behavior. More han half of he ar icles did 

no men ion social marke ing a all (54%); hose ha did were 

evenly spli be ween no well described and very well 

described5 (23% for each, respec ively). Branding— he process 

of crea ing an impression in consumers’ minds ha promo es a 

favorable a i ude oward he arge behavior—was men ioned 

in 13% of he s udies reviewed. Of hese, 5% described heir 

branding very well. 

5 The level of descrip ion is based on coder judgmen . The coding 

manual ins ruc ed he coder o mark a fea ure as “very well 

described” if he s udy provided enough informa ion o unders and 

 he au hor’s posi ion and o mark he fea ure as “no well 

described” if he fea ure is briefly men ioned. 

3-11 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 3-3. Types o Formative Research Supporting Campaign Development 

Type o Formative Research 

First Author and Year o Interviews Expert Message 

Publication Focus Group (priority pop.) Elicitation Stakeholders Testing 

Food Sa ety (n = 5) 

Abbo , 2012   

(clean, cook, chill, 

lef overs) 

Dharod, 2004      

(Figh BAC) 

James, 2013      

(lef overs) 

Ra napradipa, 2009      

(mercury in fish) 

Tiozzo, 2011     

(S lmonell ) 

Public Sa ety (n = 5) 

Greene, 2015    

(lead poisoning) 

Henry, 2003      

(air quali y) 

McLaughlin, 2004      

(lead poisoning) 

Rober o, 2002      

(firearm safe y) 

Robinson, 2014      

(suicide preven ion) 

Chronic Disease Prevention 

Acharya, 2006 

(heal hy ea ing) 

Albarracin, 2003 

(alcohol abs inence) 

Arikan, 2014 

(obesi y) 

Bauman, 2001 

(exercise) 

Bauman, 2003 

(exercise) 

(n = 94) 

     

    

     

     

     

(con inued) 

3-12 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

Table 3-3. Types o Formative Research Supporting Campaign Development (continued) 

Type o Formative Research 

First Author and Year o Interviews Expert Message 

Publication Focus Group (priority pop) Elicitation Stakeholders Testing 

Chronic Disease Prevention (n = 94) (cont’d) 

Bauman, 2003      

(exercise) 

Bell, 2013      

(heal hy ea ing and 

exercise) 

Berry, 2009      

(heal hy ea ing and 

exercise) 

Bli s ein, 2012     

(sexual behavior) 

Boles, 2014      

(heal hy ea ing) 

Boo h-Bu erfield, 2004      

(heal hy ea ing) 

Bove , 2011      

(heal hy ea ing and 

exercise) 

Brorsson, 1988      

(sexual behavior) 

Bull, 2008      

(condom use) 

Cagampang, 1997      

(sexual behavior) 

Campbell, 1987      

(sexual behavior) 

Chen, 2002      

(sexual behavior) 

Cochrane, 2008      

(exercise) 

Craig, 2006      

(exercise) 

Craig, 2007      

(exercise) 

Darrow, 2008      

(sexual behavior) 

(con inued) 

3-13 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 3-3. Types o Formative Research Supporting Campaign Development (continued) 

Type o Formative Research 

First Author and Year o Interviews Expert Message 

Publication Focus Group (priority pop) Elicitation Stakeholders Testing 

de Vroome, 1990      

(condom use) 

Dixon, 1998      

(heal hy ea ing) 

Dona e, 2010      

(sexual behavior) 

Dooley, 2010   

(heal hy ea ing) 

DuRan , 2006      

(sexual behavior) 

Eves, 2012     

(exercise) 

Fernandez Cerdeno,   

2012 

(condom use) 

Foers er, 1995      

(heal hy ea ing) 

Gase, 2015      

(heal hy ea ing) 

Gee, 2007      

(sexual behavior) 

Gibson, 2010      

(drug use preven ion) 

Gilber , 2013      

(sexual behavior) 

Glasson, 2013      

(heal hy ea ing) 

Goodwin, 2014     

(exercise) 

Guy, 2009      

(sexual behavior) 

Ha field, 2016      

(heal hy ea ing) 

Hlavinkova, 2014      

(sexual behavior) 

(con inued) 

3-14 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

Table 3-3. Types o Formative Research Supporting Campaign Development (continued) 

Type o Formative Research 

First Author and Year o Interviews Expert Message 

Publication Focus Group (priority pop) Elicitation Stakeholders Testing 

Ho a, 2010      

(heal hy ea ing) 

Howle , 2012      

(heal hy ea ing) 

Huhman, 2010      

(exercise) 

James, 2015      

(second-hand smoke 

exposure) 

King, 2013      

(exercise) 

Leavy, 2013      

(exercise) 

Lim, 2015      

(sexual behavior) 

Maddock, 2007      

(heal hy ea ing) 

Mann, 2013      

(sexual 

behavior/condom use) 

Mar ensson, 2004      

(oral heal h) 

Mar inez-Dona e, 2009      

(sexual 

behavior/condom use) 

McMahon, 2004      

(sexual behavior) 

Merom, 2005      

(exercise) 

Miles, 2001      

(heal hy ea ing and 

exercise) 

Moa i, 1992      

(condom use) 

Mon oya, 2005     

(sexual behavior) 

(con inued) 

3-15 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 3-3. Types o Formative Research Supporting Campaign Development (continued) 

Type o Formative Research 

First Author and Year o Interviews Expert Message 

Publication Focus Group (priority pop) Elicitation Stakeholders Testing 

Chronic Disease Prevention (n = 94) (cont’d) 

Mork, 2015      

(heal hy ea ing) 

Mur omaa, 1984      

(oral heal h) 

Nigg, 2005      

(exercise) 

O’Hara, 2011      

(heal hy ea ing and 

exercise) 

Parker, 2004    

(cancer awareness) 

Pedrana, 2012      

(sexual behavior) 

Pivonka, 2011 

(heal hy ea ing) 

Plan , 2010   

(sexual behavior) 

Plan , 2014     

(sexual behavior) 

Pollard, 2008      

(heal hy ea ing) 

Po er, 2008      

(exercise) 

Reger, 1999      

(heal hy ea ing) 

Reger, 2000      

(heal hy ea ing) 

Reger, 2002     

(exercise) 

Reger-Nash, 2005      

(exercise) 

Reger-Nash, 2008      

(exercise) 

Rise, 1988      

(oral heal h) 

(con inued) 

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Section 3 — Results 

Table 3-3. Types o Formative Research Supporting Campaign Development (continued) 

Type o Formative Research 

First Author and Year o Interviews Expert Message 

Publication Focus Group (priority pop) Elicitation Stakeholders Testing 

Chronic Disease Prevention (n = 94) (cont’d) 

Rogers, 2013      

(heal hy ea ing) 

Rogers, 2014  

(heal hy ea ing and 

exercise) 

Romer, 2009     

(sexual behavior) 

Ross, 1993      

(sexual behavior) 

Schmid , 2009      

(smoking) 

Singer, 1991      

(condom use) 

Siska, 1992      

(sexual behavior) 

Smi h, 2009      

(secondhand smoke 

exposure) 

Solorio, 2016      

(sexual behavior) 

Sou hco e, 2016      

(heal hy ea ing) 

(S ekler, 2013      

(sexual behavior) 

Su herland, 2013      

(heal hy ea ing) 

Thrasher, 2013      

(smoking) 

Trussell, 2001      

(sexual behavior) 

Turrell, 1997      

(heal hy ea ing) 

Wagman, 1993      

(sexual behavior) 

(con inued) 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 3-3. Types o Formative Research Supporting Campaign Development (continued) 

Type o Formative Research 

First Author and Year o Interviews Expert Message 

Publication Focus Group (priority pop) Elicitation Stakeholders Testing 

Chronic Disease Prevention (n = 94) (cont’d) 

Wammes, 2007      

(heal hy ea ing and 

exercise) 

Wardle, 2001    

(heal hy ea ing and 

exercise) 

Wechem, 1997      

(heal hy ea ing) 

Wechem, 1998      

(heal hy ea ing) 

Whi e, 2015      

(secondhand smoke 

exposure) 

Whi ingham, 2008     

(condom use) 

Zimmerman, 2007     

(condom use) 

 = No specified 

 = Yes, bu no well described 

= Yes, described very well 

3.2.1 Food Sa ety 

Three of he five ar icles under he food safe y domain repor ed 

using he following heories: one each for he TPB/TRA, Heal h 

Belief Model (HBM), and Diffusion of Innova ions Model 

 heories. One s udy used wha was described as 

“Communica ion” heory, al hough i is unclear wha his 

means. One s udy did no repor a heory. 

Social marke ing was men ioned in wo of he five s udies, 

al hough he use of social marke ing was no well described. 

James e al. (2013) described he developmen and evalua ion 

of he “4 Day Throw Away” social marke ing campaign. Tiozzo 

e al. (2011) described how social marke ing concep s were 

reviewed before he developmen of heir campaign. None of 

 he food safe y campaigns were branded. 

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Section 3 — Results 

Examining he forma ive research ha led o he developmen 

of he campaigns, we found ha none of he five food safe y 

campaigns repor ed in erviews wi h he priori y popula ion or 

inpu from s akeholders. Two described heir me hods using 

focus groups very well. Only one s udy we reviewed, Abbo e 

al. (2012), described heir me hods using focus groups, exper 

elici a ion, and message es ing very well. This par icular s udy 

described he developmen of a universi y campus–based food 

safe y media campaign for young adul s in he Uni ed S a es. 

3.2.2 Public Sa ety 

Two of he five s udies under he public safe y domain repor ed 

using he SCT and HBM heories (one each). The remaining 

 hree s udies did no specify a heory. Greene e al. (2015), 

described in de ail he use of Bandura’s SCT o help preven 

childhood lead exposure. 

The social marke ing componen was described in four of he 

five s udies; wo were no well described and he o her wo 

were very well described. Greene e al. (2015), who based heir 

campaign on SCT, also described how hey used Bandura’s 

social marke ing model. None of he public safe y campaigns 

were branded. 

In erviews wi h he priori y popula ion and exper elici a ion 

were no used in any of he public safe y campaigns. 

S akeholder inpu was men ioned in one s udy, al hough i was 

no well described. Message es ing was also described in only 

one s udy, al hough i was very well described. As par of he 

social marke ing model Greene e al. (2015) used, planning and 

 racking measures were implemen ed o revise he campaign if 

necessary. Using focus groups also resul ed in changes o he 

original campaign o be er resona e wi h he arge audience, 

in his case young children who resided in neighborhoods wi h 

high ra es of childhood lead poisoning. 

3.2.3 Chronic Disease Prevention 

The 94 s udies under he chronic disease preven ion domain 

used a varie y of heories, al hough he majori y were no 

specified (66%). The mos repor ed were TPB/TRA, SCT, and 

ecological models (e.g., Social Ecological Model [SEM], 

Behavioral Ecological Model) (12%, 7%, and 6%, respec ively). 

Huhman e al. (2010) men ioned bo h TPB/TRA and SCT in 

 heir evalua ion of he Cen ers for Disease Con rol and 

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Food S fety Consumer Rese rch: Liter ture Review 

Preven ion’s (CDC’s) VERB campaign, which was designed o 

promo e physical ac ivi y among weens (i.e., children be ween 

 he ages of 10 and 13 years). Campaign messages were 

designed using componen s of bo h heories such as selfefficacy and social influences. In he Uni ed S a es, Rogers e 

al. (2013) a emp ed o address childhood obesi y using he 

SEM a each level: individual, in erpersonal, organiza ional, and 

policy. The campaign dissemina ed messages arge ed oward 

increasing knowledge among children and heir families while 

implemen ing ini ia ives and policies a local schools ha 

par icipa ed. 

Social marke ing was used in almos half of he campaigns in 

 he chronic disease preven ion domain (n = 42). Of hese, 20 

ar icles did no describe his componen well and 22 described 

i very well. Branding was men ioned less frequen ly han social 

marke ing; 85% of he s udies did no repor using his 

campaign ool. Five s udies ha included branding described i 

very well and also described social marke ing very well. Four of 

 he five were campaigns focused on sexually ransmi ed 

disease/HIV preven ion. One of hese evalua ions, Mon oya e 

al. (2005) used branding in heir social marke ing campaign o 

increase syphilis es ing and knowledge in men who have sex 

wi h men (MSM). These researchers hired a social marke ing 

company o help brand and implemen he campaign. 

Exploring he forma ive research ha led o he developmen of 

 he chronic disease preven ion campaigns, we found ha 

be ween 70% and 90% of he s udies did no men ion any of 

 he me hods we considered for his componen : focus groups, 

in erviews wi h he priori y popula ion, exper elici a ion, inpu 

from s akeholders, or message es ing. Twen y campaigns used 

focus groups, and ar icles on eigh of hose s udies described 

 heir me hods and design very well. Eleven s udies conduc ed 

in erviews wi h he priori y popula ion. Of he 14 s udies 

men ioning exper elici a ion, only 2 described hese me hods 

very well. The wo ypes of forma ive research used mos of en 

were inpu from s akeholders and message es ing (27% and 

30%, respec ively). Ar icles on 18 s udies ha used s akeholder 

inpu and message es ing did no describe hese well; of hese 

7 and 10, respec ively, described hese me hods very well. 

Across his domain, Pivonka e al. (2011) was he one s udy 

 ha consis en ly described all five me hods very well, including 

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Section 3 — Results 

social marke ing and branding of he campaign. These au hors 

developed he Frui s & Veggies—More Ma ers campaign, which 

replaced he 5 A Day Program crea ed in he la e 1980s. A 

brand developmen agency was hired o help crea e his 

campaign. S akeholder inpu was evalua ed by gaining he 

perspec ives of 20 governmen , nonprofi , grower, grocery, and 

foodservice organiza ions on he old 5 A Day Program. 

In erviews wi h mo hers and children were held before he 

campaign was developed o unders and knowledge, a i udes, 

beliefs, facili a ors, and barriers of consumers. Message es ing 

consis ed of several rounds of focus groups and a survey for 

each fac or of he campaign. Focus groups were held in hree 

ci ies wi h mo hers o choose a s a emen o serve as a brand 

pla form; hen bo h men and women par icipa ed in a se of 

groups in Maryland o choose graphics and logos for he 

campaign; finally, an online survey was conduc ed o assess 

 he campaign’s slogan. A ask force was selec ed for his 

campaign developmen ; members included governmen 

agencies, nonprofi agencies, and indus ry marke ers. This ask 

force reviewed and made changes o each campaign fac or 

before consumers provided inpu hrough he focus groups and 

online survey. For our purposes, we consider his me hod an 

exper elici a ion. 

3.3 CAMPAIGN MESSAGE CHARACTERISTICS 

The campaign message charac eris ics ha we examined in 

each s udy included message framing; message focus; a call o 

ac ion; and he use of visual cues or icons o promo e he 

campaign, a se of visual images (logo, masco , use of color) 

used consis en ly o promo e he campaign. 

Reviewers coded for he mos common frames, which are gain 

frame and loss frame. A gain-framed message sugges s added 

benefi s from engaging in he desired behavior (e.g., increase 

your exercise for be er heal h; qui smoking and you’ll live 

longer). Loss-framed messages emphasize he cos s or risks 

associa ed wi h behaviors (e.g., oo much added sugar in your 

die can lead o diabe es; washing poul ry can spread bac eria). 

The vas majori y of he campaigns (97%) did no repor 

message framing. 

Reviewers also looked for explici informa ion on whe her he 

campaign employed messages ha appealed o logic (ra ional 

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Food S fety Consumer Rese rch: Liter ture Review 

focus) or emo ion (emo ional focus). Among he examined 

s udies, 98% did no repor a ra ional or emo ion focus for he 

campaign. Figure 3-1 provides addi ional informa ion on he 

s udies ha discussed emo ion-focused campaigns. 

Figure 3-1. Deeper Dive: Emotional Appeals 

Many public heal h campaigns seek o change behavior by using persuasive messaging. These 

campaigns are based on appeals ha are ei her logical or emo ional. Logical appeals are based on 

fac s and rely on logical (i.e., if- hen) hinking. They are associa ed wi h more delibera ive and 

purposeful cogni ive processing. In con ras , emo ional appeals a emp o ac iva e subjec ive, 

experien ial hinking. Emo ional appeals are associa ed wi h more shallow or peripheral cogni ive 

processing. Emo ional appeals can evoke nega ive emo ions (e.g., fear, anger) or posi ive emo ions 

(e.g., pride, love). As described below, 2 of he 104 s udies summarized in his review used 

emo ional appeals. 

The Use o Emotion to Rebrand a Healthy Eating Campaign (Pivonka et al., 2011). In 2005, 

 he Produce for Be er Heal h (PBH) Founda ion sough o revive he 5-A-Day for Be er Heal h 

Program, a social marke ing program designed o promo e ea ing a leas 5 servings of frui and 

vege ables every day. To reinvigora e he 5-A-Day brand, PHB, in collabora ion wi h he Na ional 

Cancer Ins i u e and CDC, conduc ed ex ensive forma ive research wi h individuals from he priori y 

audience (i.e., mo hers). In erviews sugges ed ha using emo ional appeals o mo iva e consumers. 

There was no ques ion ha frui and vege ables were viewed as an impor an par of a heal hy die , 

bu he forma ive research sugges ed ha mos consumers did no see any benefi o increasing heir 

in ake of frui and vege ables. Using a marke ing research approach, PHB developed wo emo ional 

appeals: 

• Serve Up he Passion: Food is one of he world’s grea es deligh s and is an incredible source of 

crea ivi y, imagina ion, and self-expression. As a mom, you ake grea pleasure in preparing meals 

your family enjoys. 

• Thrive: As a mom, you are happies when you see your family happy, ac ive, and vi al. You seek 

 o give hem every advan age o help hem hrive. So if you wan your mind and body, as well as 

 hose of your family, o flourish, you need o nourish hem inside and ou . 

The 5-A-Day for Be er Heal h Program was rebranded as he Frui s and Veggies – More Ma ers 

program. Awareness of he revamped program increased from 12% in 2007 o 18% in 2010. Of he 

mo hers who were aware of he Frui s and Veggies – More Ma ers logo, he percen age who said i 

mo iva ed hem o help heir families ea more frui and vege ables increased from 23% in 2007 o 

38% in 2010. 

The Use o Emotion to Encourage Syphilis Testing (Plant et al., 2010). In 2001, several local 

organiza ions in Los Angeles developed a social marke ing campaign o ry o curb rising ra es of 

syphilis among MSM. The S op he Sore Campaign was based on an exis ing campaign ha had been 

well received in San Francisco. The Los Angeles S op he Sore’s campaign branding used humor o 

break hrough he “HIV preven ion fa igue” and se i apar from o her sexual heal h messages. The 

campaign “sold” syphilis es ing by appealing o he emo ional a ribu es of peace of mind and desire 

for heal h. This approach emo ionally reinforced he idea ha ge ing a syphilis es is in he bes 

in eres of MSM. Survey resul s indica e ha a majori y of responden s (71%) was aware of he 

campaign, and 27% spon aneously men ioned he campaign (i.e., unaided awareness). 

A call o ac ion is a messaging device designed o provoke an 

audience response. Calls o ac ion are usually expressed in he 

form of an impera ive, such as “ge ou and vo e” or “ea your 

five-a-day.” Approxima ely 33% of he campaigns repor ed 

using a call o ac ion in he campaign. In one example, Bli s ein 

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Section 3 — Results 

e al. (2012) evalua ed he Paren s Speak Up na ional 

campaign ha urged paren s o communica e wi h heir 

children abou sexual behavior. In hese call- o-ac ion 

campaigns, 35% used visual cues or icons. 

3.3.1 Food Sa ety 

There was li le informa ion describing he campaign message 

charac eris ics for he five food safe y campaigns. None 

repor ed message framing or a message focus. Only one of he 

five s udies repor ed using a call o ac ion, bu i was no well 

described. 

Four of he five s udies repor ed using a visual cue or icon o 

promo e he campaign. Two of hese were well described. The 

firs used a ‘#4’ masco as a visual icon o signify he campaign 

message of discarding lef overs; he s udy included pho os of 

 he masco , pos er, and magne used in he “4 Day Throw 

Away” campaign (James e al., 2013). The second used a 

s ylized and anima ed illus ra ion of a S lmonell bac erium 

 ha was crea ed for a S lmonell awareness campaign in I aly 

(Tiozzo e al., 2011). 

3.3.2 Public Sa ety 

None of he public safe y campaigns repor ed using a message 

frame or message focus. Similar o he food safe y campaigns, 

one of he five public safe y campaigns repor ed a call o 

ac ion, bu i was no well described. One of he five ar icles 

repor ed using visual cues or icons for promo ion, bu i oo was 

no well described. 

3.3.3 Chronic Disease Prevention 

Overall, he s udies repor ing chronic disease preven ion 

campaigns provided more de ailed informa ion han he s udies 

repor ing food safe y or public safe y campaigns. 

Three of he campaigns provided message framing; all hree 

presen ed messages as gain frames. Two campaigns described 

a message focus; bo h campaigns employed an emo ional 

appeal. 

Thir y-four percen of he chronic disease preven ion campaigns 

included a call o ac ion; of hese, 58% were described well. For 

example, Dixon e al. (1998) described he 2 Frui ‘n’ 5 Veg 

Every Day campaign, and Plan e al. (2014) described he call 

 o ac ion o ge es ed for syphilis. 

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Food S fety Consumer Rese rch: Liter ture Review 

Thir y-four of he chronic disease campaigns used visual cues 

or icons o promo e he campaign; 18 of hese were well 

described, while 14 were no described very well. 

3.4 CAMPAIGN DISSEMINATION 

CHARACTERISTICS 

Campaign dissemina ion charac eris ics included channel, 

exposure, popula ion reach, and recall. Al hough no par of our 

a priori coding scheme, reviewers no ed a number of s udies 

 ha repor ed using earned media o heigh en exposure. Earned 

media refers o ins ances where he program receives a en ion 

in he media hrough press releases and o her news s ories, 

where paid adver ising or marke ing is no occurring. Seven of 

 he 104 s udies repor ed earned media. 

Message channels are he differen media ha can be used o 

deliver message con en . Channels were coded o include he 

ca egories of public spaces (buses, billboards), prin 

(newspapers, magazines), radio/ elevision, In erne /social 

media, unspecified mass media, o her, or no specified. 

Table 3-4 displays he channels used for each of he public 

heal h campaigns in he review. The channel used by he 

grea es number of campaigns was radio/ elevision a 71%, 

followed by prin channels a 64%. Six s udies used social 

media as a campaign channel (see Figure 3-2). Three of he 

s udies did no specify he channel used o implemen he 

campaign, and 13 referred o unspecified mass media. 

Exposure is a measure ha quan ifies he propor ion of a given 

popula ion ha is likely o view a par icular message. Exposure 

is based on a media provider’s es ima e ra her han self-repor . 

For radio and elevision, exposure is of en repor ed as GRPs 

(Gross Ra ing Poin s), TARPs (To al Audience Ra ing Poin s), or 

“media share”; for prin media, exposure is of en repor ed as 

“impressions”; for billboards and o her media, exposure may be 

repor ed as he number of “views” or “looks.“ These repor s are 

an assessmen of po en ial exposure among he popula ion, no 

 he s udy sample. The majori y of s udies (88%) did no repor 

a measure of exposure. 

3-24 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 3 — Results 

Table 3-4. Types o Dissemination Channels 

Public 

Spaces Print Internet/ 

First Author and (buses, (newspaper, Radio/ Social Mass Media Not 

Year o Publication billboards) magazines) TV Media (unspeci ied) Othera Reported 

Food Sa ety 

Abbo , 2012 • • • • 

(clean, cook, 

chill, lef overs) 

Dharod, 2004 • • • • 

(Figh BAC) 

James, 2013 • • • • 

(lef overs) 

Ra napradipa, • 

2009 

(mercury in fish) 

Tiozzo, 2011 • 

(S lmonell ) 

Public Sa ety 

Greene, 2015 • 

(lead poisoning) 

Henry, 2003 • • • 

(air quali y) 

McLaughlin, 2004 • • • • 

(lead poisoning) 

Rober o, 2002 • 

(firearm safe y) 

Robinson, 2014 • • • • • 

(suicide 

preven ion) 

Chronic Disease Prevention 

Acharya, 2006 • • • 

(heal hy ea ing) 

Albarracin, 2003 • • 

(alcohol 

abs inence) 

Arikan, 2014 • • • • • 

(obesi y) 

Bauman, 2001 • • 

(exercise) 

Bauman, 2003 • • • 

(exercise) 

(con inued) 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 3-4. Types o Dissemination Channels (continued) 

Public 

Spaces Print Internet/ 

First Author and (buses, (newspaper, Radio/ Social Mass Media Not 

Year o Publication billboards) magazines) TV Media (unspeci ied) Othera Reported 

Chronic Disease Prevention (n = 94) (cont’d) 

Bauman, 2003 • 

(exercise) 

Bell, 2013 • • • 

(heal hy ea ing 

and exercise) 

Berry, 2009 • 

(heal hy ea ing 

and exercise) 

Bli s ein, 2012 • • • 

(sexual behavior) 

Boles, 2014 • • • • 

(heal hy ea ing) 

Boo h-Bu erfield, • • • • 

2004 

(heal hy ea ing) 

Bove , 2011 • • • • 

(heal hy ea ing 

and exercise) 

Brorsson, 1988 • • • 

(sexual behavior) 

Bull, 2008 • 

(condom use) 

Cagampang, • • • 

1997 

(sexual behavior) 

Campbell, 1987 • • 

(sexual behavior) 

Chen, 2002 • • • • 

(sexual behavior) 

Cochrane, 2008 • • 

(exercise) 

Craig, 2006 • • 

(exercise) 

Craig, 2007 • 

(exercise) 

(con inued) 

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Section 3 — Results 

Table 3-4. Types o Dissemination Channels (continued) 

Public 

Spaces Print Internet/ 

First Author and (buses, (newspaper, Radio/ Social Mass Media Not 

Year o Publication billboards) magazines) TV Media (unspeci ied) Othera Reported 

Chronic Disease Prevention (n = 94) (cont’d) 

Darrow, 2008 • • • • 

(sexual behavior) 

de Vroome, 1990 • • • • 

(condom use) 

Dixon, 1998 • • 

(heal hy ea ing) 

Dona e, 2010 • • • 

(sexual behavior) 

Dooley, 2010 • 

(heal hy ea ing) 

DuRan , 2006 • • 

(sexual behavior) 

Eves, 2012 • 

(exercise) 

Fernandez • 

Cerdeno, 2012 

(condom use) 

Foers er, 1995 • • • • 

(heal hy ea ing) 

Gase, 2015 • • • 

(heal hy ea ing) 

Gee, 2007 • • • 

(sexual behavior) 

Gibson, 2010 • • • 

(drug use 

preven ion) 

Gilber , 2013 • • 

(sexual behavior) 

Glasson, 2013 • • 

(heal hy ea ing) 

Goodwin, 2014 • 

(exercise) 

Guy, 2009 • • • • 

(sexual behavior) 

Ha field, 2016 • • 

(heal hy ea ing) 

(con inued) 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 3-4. Types o Dissemination Channels (continued) 

Public 

Spaces Print Internet/ 

First Author and (buses, (newspaper, Radio/ Social Mass Media Not 

Year o Publication billboards) magazines) TV Media (unspeci ied) Othera Reported 

Chronic Disease Prevention (n = 94) (cont’d) 

Hlavinkova, 2014 • • 

(sexual behavior) 

Ho a, 2010 • 

(heal hy ea ing) 

Howle , 2012 • 

(heal hy ea ing) 

Huhman, 2010 • • • • 

(exercise) 

James, 2015 • • • • 

(second-hand 

smoke exposure) 

King, 2013 • • • 

(exercise) 

Leavy, 2013 • • • • • 

(exercise) 

Lim, 2015 • • • 

(sexual behavior) 

Maddock, 2007 • • • • • 

(heal hy ea ing) 

Mann, 2013 • 

(sexual 

behavior/condom 

use) 

Mar ensson, 2004 • • 

(oral heal h) 

Mar inez-Dona e, • • • 

2009 

(sexual behavior/ 

condom use) 

McMahon, 2004 • • • 

(sexual behavior) 

Merom, 2005 • • • 

(exercise) 

Miles, 2001 • • • 

(heal hy ea ing 

and exercise) 

(con inued) 

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Section 3 — Results 

Table 3-4. Types o Dissemination Channels (continued) 

Public 

Spaces Print Internet/ 

First Author and (buses, (newspaper, Radio/ Social Mass Media Not 

Year o Publication billboards) magazines) TV Media (unspeci ied) Othera Reported 

Chronic Disease Prevention (n = 94) (cont’d) 

Moa i, 1992 • • • 

(condom use) 

Mon oya, 2005 • • • • 

(sexual behavior) 

Mork, 2015 • 

(heal hy ea ing) 

Mur omaa, 1984 • • • 

(oral heal h) 

Nigg, 2005 • • • 

(exercise) 

O’Hara, 2011 • • 

(heal hy ea ing 

and exercise) 

Parker, 2004 • • • • 

(cancer 

awareness) 

Pedrana, 2012 • • • • • 

(sexual behavior) 

Pivonka, 2011 • 

(heal hy ea ing) 

Plan , 2010 • • • • 

(sexual behavior) 

Plan , 2014 • • • • 

(sexual behavior) 

Pollard, 2008 • • 

(heal hy ea ing) 

Po er, 2008 • 

(exercise) 

Reger, 1999 • • • 

(heal hy ea ing) 

Reger, 2000 • • • 

(heal hy ea ing) 

Reger, 2002 • • • • 

(exercise) 

Reger-Nash, • • 

2005 

(exercise) 

(con inued) 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 3-4. Types o Dissemination Channels (continued) 

Public 

Spaces Print Internet/ 

First Author and (buses, (newspaper, Radio/ Social Mass Media Not 

Year o Publication billboards) magazines) TV Media (unspeci ied) Othera Reported 

Chronic Disease Prevention (n = 94) (cont’d) 

Reger-Nash, • • • 

2008 

(exercise) 

Rise, 1988 • • 

(oral heal h) 

Rogers, 2013 • • • 

(heal hy ea ing) 

Rogers, 2014 • • 

(heal hy ea ing 

and exercise) 

Romer, 2009 • 

(sexual behavior) 

Ross, 1993 • 

(sexual behavior) 

Schmid , 2009 • • • • • 

(smoking) 

Singer, 1991 • • 

(condom use) 

Siska, 1992 • 

(sexual behavior) 

Smi h, 2009 • • • 

(second-hand 

smoke exposure) 

Solorio, 2016 • • • 

(sexual behavior) 

Sou hco e, 2016 • • 

(heal hy ea ing) 

S ekler, 2013 • • • 

(sexual behavior) 

Su herland, 2013 • 

(heal hy ea ing) 

Thrasher, 2013 • 

(smoking) 

Trussell, 2001 • • • • 

(sexual behavior) 

(con inued) 

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Section 3 — Results 

Table 3-4. Types o Dissemination Channels (continued) 

Public 

Spaces Print Internet/ 

First Author and (buses, (newspaper, Radio/ Social Mass Media Not 

Year o Publication billboards) magazines) TV Media (unspeci ied) Othera Reported 

Chronic Disease Prevention (n = 94) (cont’d) 

Turrell, 1997 • 

(heal hy ea ing) 

Wagman, 1993 • 

(sexual behavior) 

Wammes, 2007 • • • • 

(heal hy ea ing 

and exercise) 

Wardle, 2001 • • • 

(heal hy ea ing 

and exercise) 

Wechem, 1997 • 

(heal hy ea ing) 

Wechem, 1998 • • • 

(heal hy ea ing) 

Whi e, 2015 • • • • 

(second-hand 

smoke exposure) 

Whi ingham, • 

2008 

(condom use) 

Zimmerman, • 

2007 

(condom use) 

a Includes promo ional i ems (such as coloring books or prin ed bags), direc mailings, or public rela ion even s. 

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Food S fety Consumer Rese rch: Liter ture Review 

Figure 3-2. Deeper Dive: Social Media 

Compu ers and digi al media have changed he way we connec wi h he public and 

dissemina e public heal h communica ion campaigns. In he firs decade of he 21s cen ury, 

 he In erne provided a pla form for expanded or enhanced informa ion. Because he amoun 

of informa ion one can include in a prin ad or 30-second PSA is limi ed, many public heal h 

campaigns included an In erne address (i.e., URL) wi h promp s o drive raffic oward heir 

websi es where consumers could ob ain addi ional, more de ailed informa ion. This ype of 

media use is s ill highly prevalen bu limi ed in ha i is ypically uni-direc ional, which limi s 

user in erac ion, and i is difficul for users o encourage o her po en ial audience members 

 o par icipa e. 

The adven of social media—including Facebook, Twi er, YouTube, and blogging websi es— 

provides ano her, more immersive oppor uni y for engaging he public. We define social 

media as in erac ive compu er-media ed pla forms ha allow for informa ion sharing in an 

open ( ypically public) access forma . Key charac eris ics include user-genera ed con en , he 

abili y o dissemina e informa ion o a large group, and oppor uni y for o her ne work 

members o provide feedback. Communica ion on social media can be charac erized as 

having po en ially high reach, high frequency, immediacy, and permanence. 

Among he 104 ar icles reviewed for his repor , 36 repor ed using he In erne as a 

dissemina ion channel. Of hese, 34 included a websi e in heir campaign dissemina ion, 12 

men ioned he use of radi ional online ads (e.g., banner ads), and 6 included social media 

ac ivi ies. Implemen a ion of he six campaigns ha repor ed using social media ranged from 

2008 o 2014. Three of he s udies (Boles e al., 2014; Gase e al., 2015; Whi e e al., 2015) 

provided limi ed informa ion. They no ed ha social media was par of a larger campaign 

dissemina ion effor and men ioned a few specific de ails such as he use of Facebook, 

Twi er, or a blog, bu he au hors provided no de ails on he social media ou reach or effec s 

of social media ac ivi y. This is no surprising, because he s udies included in his review 

varied subs an ially in he amoun and quali y of informa ion provided on specific 

dissemina ion ac ivi ies. The o her hree s udies ha included social media are de ailed 

below. 

Using Social Media to Encourage HIV Testing (Solorio et al., 2016). The Tu Amigo 

Pepe social marke ing campaign was fielded in Sea le, Washing on, in 2014. The campaign 

 arge ed La ino MSM who do no iden ify as gay. The campaign’s primary aim was o 

encourage young, sexually ac ive men o ge es ed for HIV. The campaign used a mix of 

marke ing channels bu relied heavily on he In erne . As no ed in he s udy, “All 

engagemen was viral or direc ed from media par ner si es and social pos s” (Solorio e al., 

2016). The campaign includes social media messaging, a campaign websi e, and social 

media adver ising. I also included he es ablishmen of campaign-specific hash ags (#), a 

device ha can be used o share, promo e, and rack messages and communica ions. The 

campaign also included a “reminder” app (reminder o ge es ed) and a web-based zip-code 

loca ion finder o help individuals loca e es ing si es. 

(con inued) 

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Section 3 — Results 

Figure 3-2. Deeper Dive: Social Media (continued) 

The campaign used Google insigh and analy ics and o her mobile pla form racking ools o 

assess communi y engagemen . As he au hors no e, his fea ure allowed he 

implemen a ion eam o quickly adap he campaign o increase response ra e and user 

engagemen (Solorio e al., 2016). For example, he campaign s aff was able o increase he 

number of communi y members using he zip-code loca or by moving i o a more prominen 

place on he web page. The campaign achieved a 10% engagemen ra e on Facebook; he 

au hors poin ou ha ypical direc social media engagemen averages 2%. The campaign 

also received 68,300 impressions from Facebook users (e.g., likes, shares). Fur hermore, he 

campaign genera ed 79 new Twi er followers. These numbers should be viewed as highly 

encouraging o o hers consider his approach in ligh of he fac ha he campaign relied on 

user-driven dissemina ion ra her han radi ional media purchases. 

Using Social Media to Get Consumers to Throw Away Le t-Overs (James et al., 

2013). The 4-Day Throw Away social marke ing campaign was conduc ed as a pilo s udy in 

 hree communi ies in he Midwes . The campaign used bo h radi ional media and social 

media o deliver he message ha lef overs should no be kep for longer han 4 days. Social 

media ac ivi ies included a Facebook page and Twi er accoun . O her digi al elemen s 

included a websi e, YouTube videos, and an iPad/iPhone app. The campaign also included a 

hash ag and a hash ag-based masco , #4, who was por rayed as a superhero. For racking 

purposes, he campaign included wo web si e addresses. Including wo addresses allowed 

 he au hors o rack whe her users accessed he websi e from radi ional media or social 

media sources. During he 6-mon h campaign period, approxima ely 60% of he websi e 

 raffic came from radi ional media and 40% came from social media. 

The campaign’s social media reach was es ima ed a 53,463. This number included 11,759 

YouTube views, 166 Facebook users and 21,240 Facebook impressions, 51 Twi er followers, 

4,679 mobile app users wi h 13,592 logged app sessions, and 1,976 websi e visi s. Al hough 

 he preponderance of campaign awareness was driven by radi ion media, hese numbers 

reflec a subs an ial level of engagemen hrough social media ou le s. 

Using Social Media to In orm Youth about Type-II Diabetes (Rogers et al., 2014). 

The Bigger Pic ure social marke ing campaign was designed o reframe he discussion of 

 ype 2 diabe es from one ha emphasized individual behavior change o a focus on he 

social and environmen al de erminan s ha increase ype 2 diabe es risk fac ors, par icularly 

in dis ressed communi ies. The campaign was fielded in he San Francisco, California, area. 

The campaign developed an innova ive communi y ou reach (i.e., local you h poe s who 

developed con en and dissemina ed messages in local public schools) and social media 

ac ivi ies. The campaign planners decided ha a social media presence was a necessary 

communica ion medium because of he heavy use of social media among heir priori y 

audience—school-aged children (Rogers e al., 2014). Social media ac ivi ies included a 

websi e ha was available in English and Spanish. The websi e provided appealing, clear, 

and reliable informa ion abou diabe es. O her digi al con en included YouTube-like video 

public service announcemen s and downloadable educa ional ma erials. To increase 

campaign dissemina ion, he campaign developed a Facebook page and a Twi er accoun . 

No informa ion on he effec s of he social media ac ivi ies is provided, bu he s udy au hors 

repea edly no ed he impor ance of leveraging social media o engage young priori y 

audiences. 

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Food S fety Consumer Rese rch: Liter ture Review 

The average period of 

exposure to the public 

health campaigns in the 

review was 15 months. 

3.4.1 

3.4.2 

3.4.3 

Popula ion reach is a measure of po en ial global exposure 

among he popula ion. Unlike media exposure, which is specific 

 o a ype of medium, reach is more commonly repor ed as a 

measure for he en ire campaign dissemina ion plan. Only 7% 

of he s udies repor ed popula ion reach. 

The average period of exposure o he public heal h campaigns 

in he review was 15 mon hs, wi h a median of 7 mon hs, 

minimum of 1 week, and a maximum of 5 years. 

Food Sa ety 

Three of he five food safe y campaigns were implemen ed 

 hrough public spaces and prin , hree were implemen ed by 

radio/ elevision, and wo by In erne /social media. 

One food safe y campaign repor ed exposure, which was 

repor ed for o al social media reach a 53,463 (YouTube video 

views, Facebook users and pos s, Twi er followers, mobile app 

users, and websi e visi s) and o al radi ional media reach a 

28,508 (magne s, pos ers, and no ecards dis ribu ed). 

Similarly, one of he food safe y campaigns repor ed popula ion 

reach, which was es ima ed a 21%. This ar icle defined reach 

as he percen age of households ha repor ed receiving he 

informa ion ma erial (Tiozzo e al., 2011). 

Public Sa ety 

Four of he five public safe y campaigns were implemen ed 

 hrough public spaces and radio/ elevision, and hree were 

prin -based campaigns. None of he public safe y campaigns 

repor ed he use of In erne /social media. No public safe y 

campaigns repor ed exposure. Only one public safe y campaign 

repor ed campaign reach, which was averaged a 42% across 

all channels used (McLaughlin e al., 2004). 

Chronic Disease Prevention 

The majori y of he chronic disease campaigns used 

radio/ elevision as he dissemina ion channel (71%), followed 

by prin (64%). For y-eigh percen used public spaces as par 

of heir campaign, and 36% used In erne /social media. Twelve 

percen of he chronic disease campaigns repor ed using mass 

media, bu he medium was unspecified. Six percen of he 

chronic disease campaigns did no specify a delivery channel. 

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Section 3 — Results 

Seven of he chronic disease campaigns repor ed earned 

media. These campaigns were rela ed o drinking 1% milk, 

increasing physical ac ivi y, main aining oral heal h, and 

preven ing HIV. Twelve of he chronic disease campaigns 

repor ed a measure of exposure, primarily repor ed as GRPs 

(ranged from 15.5 GRPs o 8,565 GRPs). Two campaigns, on 

obesi y and physical ac ivi y, repor ed TARPs (ranged from 150 

 o 800). One s udy on he 5 A Day campaign repor ed 80 

million media impressions, while ano her on heal hy ea ing and 

exercise repor ed 3,664 new incoming service calls and 389 

visi ors per week. 

Chronic disease campaigns repor ed he highes reach. Five 

campaigns repor ed a 75% mean reach, wi h he highes a 

92% (increasing physical ac ivi y) and he lowes a 62% 

(preven ing obesi y). 

3.5 CAMPAIGN EVALUATION CHARACTERISTICS 

The effec s of a campaign can be measured wi h one group or 

mul iple groups, once or mul iple imes. The campaigns 

included in he review collec ed evalua ion da a wi h one group 

a one ime (pos -campaign) (21%) and over mul iple ime 

periods (43%) and wi h mul iple groups a one ime (16%) and 

over mul iple ime periods (21%). 

To evalua e he effec iveness of campaigns, a li le more han 

 wo hirds of all s udies used an observa ional design (69%), 

and almos one hird used a compara ive design (30%). A 

compara ive design is one ha measures he effec s of he 

campaign by comparing a group ha was exposed o he 

campaign o a con rol or comparison group ha was no 

exposed o he campaign. An observa ional design, on he o her 

hand, surveys one group of people, usually in a par icular 

marke or geographic area, who may have been exposed o he 

campaign. 

Possible ou comes of public heal h campaigns include increases 

in knowledge or awareness and changes in a i ude or 

behavior.6 The s udies in he review measured he following 

ou comes: 

6 In he evalua ion of public heal h communica ion campaigns, da a 

are collec ed via survey, and behavior is based on self-repor . 

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Food S fety Consumer Rese rch: Liter ture Review 

3.5.1 

Four of the five food 

safety campaigns 

measured behavior, 

knowledge, and 

awareness, with nearly 

all of these showing 

statistically significant 

changes. 

 39% measured knowledge, of which 76% showed a 

s a is ically significan resul ; 

 48% measured a i udes, of which 56% showed a 

s a is ically significan resul ; 

 62% measured awareness, of which 56% showed a 

s a is ically significan resul ; and 

 87% measured behavior, of which 61% showed a 

s a is ically significan resul . 

These ou comes are mos commonly measured using 

frequencies (number of people or even s), bu hey can also be 

measured using odds ra ios ( he probabili y of an even ), 

means (con inuous measures), or s a us (change from one 

ca egory o ano her). The average sample size for a campaign 

evalua ion was 2,947 people, wi h a minimum of 33 and a 

maximum of 80,192. 

In he following sec ions (Sec ions 3.5.1 hrough 3.5.3) we 

presen a series of ables (Tables 3-5 hrough 3-7) wi h 

descrip ive informa ion on campaign evalua ion ou comes. 

These ables are summa ive across he public heal h domain 

(i.e., food safe y, public safe y, chronic disease preven ion) and 

display he propor ion of s udies ha repor ed each ype of 

evalua ion ou come (i.e., behavior, a i ude, knowledge, 

awareness), he propor ion of hose repor s ha were 

s a is ically significan , and he scale of measure used for he 

repor ed measure. Addi ional informa ion on he behaviors 

addressed in each s udy can be found in he relevan sec ion of 

Table 4-1. 

Food Sa ety 

Of he five food safe y campaigns, hree used observa ional 

designs (i.e., measuring he effec s of he campaign wi h one 

group) wi h pre- and pos -in erven ion measuremen s. The 

remaining wo s udies used compara ive designs. 

Table 3-5 provides an overview of campaign evalua ion 

ac ivi ies for he food safe y campaigns. Four of he five food 

safe y campaigns measured behavior, knowledge, and 

awareness. A i ude was measured in one s udy. Mos of he 

repor ed ou comes indica ed s a is ically significan change or 

difference. Some of he behaviors measured in hese s udies 

were rela ed o hand washing, proper food s orage and 

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Section 3 — Results 

 hawing, and speaking o medical professionals abou 

preven ing foodborne illness. 

Table 3-5. Evaluation Measures o Food Sa ety Campaigns (n = 5) 

Number o Studies with 

Number o Studies Reporting Statistically Signi icant 

Campaign Outcome Outcomea Outcome 

Behavior 4 4 

A i ude 1 1 

Knowledge 4 4 

Awareness 4 3 

a Number of s udies ha repor each ype of campaign ou come. 

3.5.2 Public Sa ety 

Of he five public safe y campaigns, four used observa ional 

designs (i.e., measuring he effec s of he campaign wi h one 

group) wi h pre- and pos -in erven ion measuremen s. The 

remaining s udy used a compara ive design. 

Table 3-6 provides an overview of campaign evalua ion 

ac ivi ies for he public safe y campaigns. All five s udies 

measured behavior, four measured awareness, hree measured 

knowledge, and wo measured a i udes. However, few of hese 

repor ed ou comes indica ed s a is ically significan change or 

difference. Behaviors measured in hese s udies were rela ed o 

repor ing peeling pain and o her lead poisoning preven ion 

 ac ics, reducing driving ime (for air quali y), ob aining a gun 

 rigger-lock, and preven ing suicide. This able indica es ha 

measures of behavior and awareness are common, while 

measures of a i udes are uncommon, among public safe y 

campaigns. 

Table 3-6. Evaluation Measures o Public Sa ety Campaigns (n = 5) 

Number o Studies with 

Number o Studies Reported Statistically Signi icant 

Campaign Outcome Outcomea Outcome 

Behavior 5 2 

A i ude 2 0 

Knowledge 3 2 

Awareness 4 1 

a Number of s udies ha repor each ype of campaign ou come. 

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Food S fety Consumer Rese rch: Liter ture Review 

3.5.3 Chronic Disease Prevention 

Of he 94 chronic disease preven ion campaigns, 65 used an 

observa ional design me hod (i.e., measuring he effec s of he 

campaign wi h one group) wi h pre- and pos -in erven ion 

measuremen s. The o her 28 s udies used compara ive designs. 

Table 3-7 provides an overview of campaign evalua ion 

ac ivi ies for he chronic disease preven ion campaigns. Among 

 he 94 chronic disease preven ion campaigns, 76 measured 

behavior, 67 measured awareness, 44 measured knowledge, 

and 37 measured a i udes. Be ween half and hree-four hs of 

 he repor ed ou comes indica ed s a is ically significan change 

or difference. Behaviors measured in hese s udies include 

increases in self-pro ec ive behaviors (e.g., condom use, 

physical ac ivi y, heal h screening), reduc ion in heal h risk 

behaviors (e.g., prema ure sexual debu , drug use), and 

reduc ion of communi y heal h risks (e.g., air pollu ion, secondhand smoke). 

Table 3-7. Evaluation Measures o Chronic Disease Prevention Campaigns (n = 94) 

Statistically Signi icant 

Outcome Type Measured Outcomea Outcome 

Behavior 76 46 

A i ude 37 22 

Knowledge 44 33 

Awareness 67 37 

a Number of s udies ha repor each ype of campaign ou come. 

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4 Key Findings and 

Lessons Learned 

The 104 ar icles included in his repor included a large and 

diverse se of lessons learned ha OPACE can use o guide he 

developmen of fu ure public heal h and risk communica ion 

campaigns. These lessons learned are presen ed in Table 4-1 

along wi h key findings by s udy. The following sec ions 

summarize lessons learned by opic. 

4.1 CAMPAIGN DEVELOPMENT 

Lessons learned and sugges ions rela ed o campaign 

developmen emphasize he impor ance of using credible 

 heories and frameworks in planning communica ion 

campaigns. Some of he heories specifically iden ified include 

diffusion of innova ion (Dharod e al., 2004), gain frame and 

exchange heory (Goodwin e al., 2014), and social marke ing 

approaches (Plan e al., 2010). The use of sound behavior 

 heory is recommended as a key fac or in arge ing mo iva ion 

 o change. 

Several au hors emphasized he benefi s of par nership and 

collabora ion. Au hors alked abou he impor ance of 

es ablishing par nerships (Foers er e al., 1995) and developing 

alliances bo h wi hin and be ween organiza ions. Several no ed 

 he impor ance of collabora ing wi h communi y groups 

(Fernandez Cerdeno e al., 2012; Ha field e al., 2016; Miles e 

al., 2001). As a cau ionary no e, Cochrane & Davey (2008) 

poin ed ou ha he behavior change aims of public heal h 

communica ion campaigns can be undermined when po en ial 

par ner groups are recrui ed wi h insufficien prepara ion. This 

sugges s ha assessing readiness among po en ial par ners 

could be a valuable par of planning effor s. 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Food Sa ety 

Abo , 2012 

(clean, cook, chill, 

lef overs) 

 Campaign increased self-ra ings of 

food safe y knowledge and skill, 

ac ual food safe y knowledge, food 

safe y self-efficacy, s age of change 

for safe food handling, and repor ed 

hand-washing behaviors. 

 Long- erm follow-up may be needed 

 o de ermine he ex en o which 

 he changes in knowledge, selfefficacy, and s age of change are 

sus ained. 

Dharod, 2004 

(Figh BAC) 

 Campaign improved food safe y 

awareness and knowledge bu no 

behaviors. 

 The use of mul iple media channels 

can help maximize exposure 

campaign messages. 

 I is essen ial o ake heory (e.g., 

diffusion of innova ion) in o accoun 

 o explain campaign rela edchanges. 

 Social marke ing campaigns ha 

 ake advan age of mul iple 

cul urally relevan media channels 

are likely o improve food safe y 

awareness and bring abou changes 

in food safe y knowledge and 

a i udes among La ino consumers. 

James, 2013 

(lef overs) 

 Individuals from he pilo es 

communi ies were significan ly 

more aware of he campaign han 

 hose from he con rol communi ies. 

 Pilo es communi ies also had a 

 Large social marke ing campaigns 

should use an appropria e mix of 

 radi ional media and social media 

me hods when focusing on food 

safe y opics. 

grea er percen age of individuals 

 hrowing lef overs away af er 4 

days compared wi h con rol 

communi ies. 

Ra napradipa, 2009 

(mercury in fish) 

 Consumers did no exhibi an 

increase in general knowledge nor 

did hey indica e any a i udinal or 

behavioral changes. 

 None repor ed 

(con inued) 

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Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Food Sa ety (cont’d) 

Tiozzo, 2011 

(S lmonell ) 

 Percen age of households ha 

received ma erial was 21%. 

 Of he persons who received 

ma erial, 

– 89% remembered he opic of he 

campaign; 

– 7% only remembered ha he 

campaign focused on food-rela ed 

heal h or good food-handling 

prac ices; and 

– 4% gave no answer or a 

comple ely wrong answer. 

 Of he people who read he 

ma erial, 

– 45% hung i in he ki chen; 

– 20% discussed i wi h household 

members; 

– 12% discarded i af er reading; 

and 

– 14% did no remember wha hey 

did wi h i . 

 For all 10 ques ions, he percen age 

of correc responses was higher for 

 he people who had read he 

ma erial han for hose who had no 

received i . 

 Campaign developmen is 

s reng hened when based on 

explici principles of communica ion 

 heory and he use of forma ive 

research o define he campaign’s 

charac eris ics. 

 Pos al channel seems o have been 

less efficien in he larger own han 

in smaller owns, indica ing ha 

al erna ive and be er arge ed 

forms of communica ion may be 

needed. 

Public Sa ety 

Greene, 2015 

(lead poisoning) 

Henry, 2003 

(air quali y) 

 Increased propor ion of responden s 

who repor ed seeing informa ion on 

lead poisoning. 

 Significan ly fewer miles were 

driven on days when ozone levels 

were expec ed o exceed he 

s andards. 

 Governmen workers reduced he 

number of rips hey ook on aler 

days, bu he overall reduc ion in 

 rips was no significan . 

 I is difficul o con rol surrounding 

media or even s ha may produce 

similar or con radic ory informa ion 

during a campaign. 

 None repor ed 

(con inued) 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Public Sa ety (cont’d) 

McLaughlin, 2004  Recall of campaign componen s  None repor ed 

(lead poisoning) ranged from 22% o 63%. 

 Approxima ely 45% of responden s 

repor ed hey ook specific s eps o 

learn more abou or preven lead 

poisoning because of a leas one of 

 he componen s of he campaign. 

– 73% repor ed hey asked heir 

doc or abou blood es s for lead 

poisoning. 

– 21% repor ed hey called a 

phone number o learn more 

abou lead poisoning. 

– 76% repor ed hey changed he 

way hey cooked or cleaned. 

– 43% repor ed hey changed he 

kinds of foods hey feed heir 

families. 

– 41% repor ed hey spoke o heir 

landlord. 

– 60% repor ed hey ook o her 

s eps o preven lead poisoning. 

 Among hose repor ing hey ook 

specific s eps o learn more abou 

or preven lead poisoning 

– 51% indica ed hey ook s eps 

because of he newspaper 

adver isemen s. 

– 35% were promp ed by a 

billboard. 

– 24% were promp ed by a sign on 

a bus or bus shel er. 

– 14% were promp ed by a sign on 

a sani a ion ruck. 

– 12% were promp ed by he 

video. 

– 11% were promp ed by he 

hardware s ore display. 

– 7% were promp ed by ei her he 

pos mark or he ar work display. 

(con inued) 

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Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Public Sa ety (cont’d) 

Rober o, 2002 

(firearm safe y) 

 Approxima ely 20% of individuals 

heard he PSA. 

 None repor ed 

 Af er he campaign here was a 

significan increase in uncued 

knowledge of he locking-rela ed 

gun-safe y prac ices in he 

 rea men coun y. 

Robinson, 2014 (suicide 

preven ion) 

 Among he 28% of responden s 

who were aware of he campaign, 

39% said i made hem more 

aware of suicide preven ion 

services. 

 In large-scale campaigns, differen 

communica ion effor s may be 

needed because regional 

differences can influence ou comes 

in behavior and awareness. 

 Changes in a i ude were 

associa ed wi h hose who were 

already aware of he in erven ion. 

 There was no s a is ically 

significan impac on behavior, bu 

31% of women compared wi h 

19% of men who recognized he 

campaign said hey would alk o 

someone hinking abou suicide. 

Chronic Disease Prevention 

Acharya, 2006 (heal hy 

ea ing) 

 The campaign significan ly 

increased he probabili y of a 

consumer purchasing a heal hy 

menu i em by 4%. 

 None repor ed 

 By improving consumer a i udes 

 oward heal hy menu i ems, he 

campaign indirec ly increased 

purchases of hese i ems by 4%. 

Albarracin, 2003 

(alcohol abs inence) 

 Par icipan s repor ed s ronger 

in en ions o drink when hey 

ini ially received he abs inence 

message han when hey received 

 he modera ion message. 

 Theory provides useful guidelines 

regarding message fac ors ha 

influence beliefs, a i udes, and 

in en ions. 

 Among par icipan s who ried he 

produc , hose exposed o he 

abs inence message had s ronger 

in en ions o use i han hose 

exposed o he modera ion 

message. 

(con inued) 

4-5 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Arikan, 2014 (obesi y)  85% of par icipan s repor ed 

receiving informa ion hrough TV 

ads, 28% hrough radio ads, 11% 

from newspapers, 11% from family 

and/or friends, 6% from billboards, 

and 8% from he In erne and 

o her sources. 

 29% of par icipan s repor ed 

desired behavioral changes af er 

 he campaign. 

Bauman, 2001  This in egra ed campaign posi ively 

(exercise) influenced shor - erm physical 

ac ivi y message recall, knowledge, 

and behavior of he arge 

popula ion compared wi h he 

popula ion in he region ha was 

no exposed. 

Bauman, 2003  Promp ed recogni ion of he 

(exercise) campaign agline increased from 

14% o 42%. 

 Knowledge increased as a resul of 

 he campaign, from 2% o 7% 

depending on he ques ion. 

 Adul par icipa ion in physical 

ac ivi y declined by 6%, al hough 

 he decline was less in s a es wi h 

 he campaign. 

Bauman, 2003  The Push Play ini ia ive increased 

(exercise) awareness of physical ac ivi y and 

in en ion o be ac ive among adul s 

in New Zealand. 

Bell, 2013  Par icipan s were significan ly more 

(heal hy ea ing and likely o have seen, read, or heard exercise) abou he program in he media. 

 Program awareness remained 

significan ly higher a each 

subsequen survey wi h awareness 

peaking a 59%. 

 Par icipan s were significan ly more 

likely o iden ify all hree key 

messages. 

 Television genera ed a large share 

of he campaign’s awareness, 

emphasizing i s impor ance as a 

media channel for heal h 

promo ion. 

 Wi hin-individual analyses may 

provide a differen perspec ive in 

assessing media campaigns, when 

compared wi h analyses based on 

independen samples. 

 Campaigns can only produce shor -

 erm effec s and need o be se 

agains he pervasive influences of 

social and s ruc ural fac ors ha 

 end o promo e unheal hy 

behavior. 

 Addi ional inves men s in s ra egic 

planning may be beneficial. 

 None repor ed 

 None repor ed 

(con inued) 

4-6 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Berry, 2009 

(heal hy ea ing and 

exercise) 

Bli s ein, 2012 

(sexual behavior) 

Boles, 2014 

(heal hy ea ing) 

Boo h-Bu erfield, 2004 

(heal hy ea ing) 

 Unpromp ed recall was very poor: 

0.4% par icipan s recalled he 

heal hy ea ing adver isemen , and 

0.5% recalled he physical ac ivi y 

adver isemen . 

 Promp ed recall was somewha 

be er: 19% par icipan s recalled 

 he heal hy ea ing adver isemen , 

and 17% par icipan s recalled he 

physical ac ivi y adver isemen . 

 Fa hers exposed o campaign 

messages demons ra ed an 

increasing rajec ory of fa her-child 

communica ion compared wi h 

con rol fa hers. 

 Mo her-child communica ion did 

no differ be ween mo hers 

exposed o campaign messages 

and con rol mo hers. 

 80% of people who saw, heard, or 

read abou he campaign said hey 

in ended o reduce he amoun of 

soda or sugary drinks hey offered 

 o a child. 

 Abou half said hey in ended o 

reduce he amoun of soda or 

sugary drinks hey consume 

 hemselves. 

 No change in soda consump ion 

behavior af er he campaign was 

observed. 

 Campaign significan ly increased 

in en ion and a i ude. 

 Campaign posi ively changed 

beliefs abou he heal hiness, as e, 

and cos of low-fa milk. 

 Resul s of quali a ive da a indica e 

 ha governmen messages may 

no be considered credible. 

 Repea ed exposure offers mul iple 

oppor uni ies for learning and 

persuasion, repea ed exposure 

increases he likelihood ha a 

person will receive he message 

when hey are recep ive, and 

repea ed messaging increases he 

social expec a ions (i.e., norma ive 

value) associa ed wi h he 

message. 

 None repor ed 

 None repor ed 

(con inued) 

4-7 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Bove , 2011 

(heal hy ea ing and 

exercise) 

Brorsson, 1988 

(sexual behavior) 

Bull, 2008 (condom 

use) 

Cagampang, 1997 

(sexual behavior) 

Campbell, 1987 

(sexual behavior) 

 Campaign was recalled by 7% of 

adul s spon aneously and by 46% 

of adul s passively (i.e., wi h aid), 

hence by a o al of 53% of all 

adul s. 

 33% of all adul s were sensi ized o 

 he heal h-promo ing messages 

and 25% o he impor ance of 

undergoing screening. 

 General public awareness abou 

how he HIV virus is carried and 

 ransmi ed increased over he 

period s udied. 

 Responden s who were celiba e he 

mon h before surveys increased 

from 28 o 36%. 

 Responden s who indica ed hey 

would avoid ouching a s ranger 

who was bleeding and needed help 

increased in each successive 

survey. 

 Responden s who indica ed hey 

would avoid close con ac wi h an 

infec ed work colleague decreased. 

 No differences be ween 

neighborhoods wi h and wi hou 

 he POWER campaign wi h regard 

 o primary ou comes were found. 

 Pos hoc analyses showed ha 

women exposed o POWER pos ers 

were 1.50 imes as likely o have 

used a condom a las sex. 

 Majori y of you hs and heir 

paren s hough i was a valuable 

program. 

 Resul s sugges ha , even before 

 he governmen ’s leafle and 

 elevision campaigns, he publici y 

surrounding AIDS had increased 

 he public level of knowledge abou 

 he disease. 

 Campaigns wi h shor ime frames 

may resul in low urnou ra es. 

 Communi y members (i.e., 

pharmacis s) can play impor an 

role in communica ing heal h 

issues. 

 None repor ed 

 If campaign and comparison 

neighborhoods are si ua ed oo 

close o one ano her, 

con amina ion can reduce 

measured impac s. 

 Researchers should consul wi h 

s a is icians and conduc a priori 

power calcula ions. 

 Before a large, complex, and high 

profile campaign is launched, 

preliminary research mus ensure 

 ha he core elemen s of he 

campaign will have heir in ended 

effec . 

 None repor ed 

(con inued) 

4-8 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Chen, 2002 (sexual 

behavior) 

 Weekly calls o ho line increased by 

600% during he ou break. 

 80% of surveyed individuals ci ed 

 he media as he source of 

awareness. 

Cochrane, 2008 

(exercise) 

 Increased up ake of physical 

ac ivi y in urban communi y of lowincome s a us. 

 Compared wi h he con rol group, 

 he in erven ion sample repor ed 

an increase in physical ac ivi y and 

be er overall heal h. 

Craig, 2006 (exercise)  Ini ia ive increased awareness and 

usage of pedome ers in he 

Canadian popula ion. 

 None repor ed 

 Alignmen of ins i u ional policy is 

impor an , and sus ained collec ive 

effec iveness can only be achieved 

when all con ribu ions are made in 

 he same direc ion and a he same 

 ime. 

 Po en ially frui ful in eragency 

collabora ions can be foiled when 

professionals or organiza ions are 

no in an appropria e s age of 

readiness o suppor change. 

 The key requiremen s for 

sus ainable programs are ha he 

ac ivi ies hemselves should be 

available, accessible, affordable, 

and appropria e. 

 None repor ed 

(con inued) 

4-9 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Craig, 2007 (exercise)  There was 2.4% and 2.3% higher 

prevalence of sufficien walking 

among hose recognizing he 

campaign brand and i s general 

message. 

 The prevalence of sufficien walking 

among hose recognizing he 

 agline was higher han ha among 

 hose aware of he campaign brand 

and i s general message and was 

associa ed wi h 23% higher 

adjus ed odds of sufficien walking 

compared wi h hose who did no 

recognize ha specific agline. 

 Sufficien walking was also 

associa ed wi h pedome er 

ownership; hose owning a 

pedome er were 14% more likely 

 han hose no owning one o 

engage in sufficien walking. 

 Being aware of he specific agline 

and owning a pedome er had an 

addi ive impac on he odds of 

sufficien walking; hose repor ing 

 his combina ion were 1.52 imes 

more likely o repor sufficien 

walking han hose who did no 

mee his condi ion, which was 

associa ed wi h a significan ly 

higher prevalence of sufficien 

walking be ween hese wo groups. 

Darrow, 2008  Exposure o campaign ma erials 

(sexual behavior) increased over he 6-mon h s udy 

period. 

 Syphilis knowledge scores 

remained unchanged. 

 No s a is ically significan increases 

in clinic visi s, es ing for syphilis, 

or rea men of syphili ic infec ions 

occurred as a resul of he 

campaign. 

 Achievemen of public heal h goal 

migh only be observed hrough 

ongoing surveillance of con inuous 

longer erm campaigns. 

 The effec iveness of campaign 

messages may be improved by 

combining mo iva ional and explici 

heal h-rela ed messages wi h a 

user-friendly and affordable ool for 

self-moni oring purposes. 

 Repea ed and las ing popula ion 

effec s may require a public heal h 

commi men o provide con inuous 

message delivery, suppor ed by 

ancillary services and programs. 

 None repor ed 

(con inued) 

4-10 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

de Vroome, 1990  From he firs exposure o HIV  None repor ed 

(condom use) mass media campaigns, by 1989, 

knowledge abou he preven ion of 

HIV ransmission wi h condoms 

reached 98% of he s udy sample. 

 Surveys conduc ed from 1987 o 

1989 indica ed s a is ically 

significan changes in knowledge, 

a i udes, and sexual behaviors 

wi h regard o condom use as a 

means of HIV preven ion. 

Dixon, 1998  When promo ional ac ivi y was  Campaigns may need o be long 

(heal hy ea ing) mos in ense and he elevision erm if sus ained change is o be 

adver ising buys were highes , achieved. 

rela ively high levels of campaign 

awareness were es ablished, and 

spon aneous recall of heal hy die 

ads promo ing frui and/or 

vege ables peaked. 

 As he elevision adver ising budge 

decreased in la er years of he 

campaign, here were significan 

declines in awareness and 

knowledge of he slogan. 

Dona e, 2010  Campaign was effec ive in reaching  Evalua ion can be limi ed by he 

(sexual behavior) bo h he erosexually iden ified lack of comparison communi ies, 

La ino men who have sex wi h small sample size, and differences 

women and men who have sex in he sociodemographic profiles of 

wi h men and women (MSMW). he s udy samples. 

 Campaign was associa ed wi h a 

significan reduc ion in he number 

of male par ners wi h whom 

he erosexually iden ified La ino 

MSMW had unpro ec ed anal sex. 

 Campaign did no seem o have 

any significan impac on o her 

cogni ive and behavioral variables, 

such as knowledge of HIV es ing 

loca ions, knowledge of he clinic 

 ha offered he male heal h exam, 

percep ion of HIV risk, and condom 

carrying. 

(con inued) 

4-11 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Dooley, 2010  A pre-pos experimen revealed  None repor ed 

(heal hy ea ing) ha body-image public service 

adver isemen s (PSAs) may 

increase anxie y compared wi h 

unrela ed PSAs. 

 Heal h benefi PSAs were more 

readable han all o her PSA groups 

and showed higher heal hy ea ing 

planning compared wi h unrela ed 

ones. 

 No significan weigh a i udes, 

self-es eem, and s ages of change 

differences were found by message 

 ype. 

DuRan , 2006  Among paren s living in coun ies  TV messages seem o have he 

(sexual behavior) where billboards or ci y bus signs s ronges effec s on behaviors and 

were displayed, 27% repor ed a i udes in heal h campaigns. 

seeing he message one or more 

 imes compared wi h 21% of 

paren s who lived ou side hese 

coun ies. 

 Among paren s who repor ed 

seeing he billboards or ci y bus 

signs, paren s living in coun ies 

where he billboards were 

displayed were much more likely o 

have recalled he message 

correc ly han paren s living 

ou side hese coun ies. 

 Paren s living in a coun y where 

 he TV PSAs were aired were 

equally as likely o repor having 

seen he PSAs one or more imes 

as paren s living ou side he 

viewing areas. 

 Among paren s who repor ed 

seeing a TV PSA abou sex, correc 

knowledge abou he message in 

 he PSA was higher among paren s 

living in coun ies where he PSAs 

were aired han paren s living 

ou side of hese coun ies and was 

associa ed wi h he frequency of 

seeing he PSA. 

(con inued) 

4-12 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

DuRan , 2006  Paren s living in a coun y where 

(sexual behavior) he TV PSAs were aired were 

(con ’d) equally as likely o repor having 

seen he PSAs one or more imes 

as paren s living ou side he 

viewing areas. 

 Among paren s who repor ed 

seeing a TV PSA abou sex 

educa ion, correc knowledge abou 

 he message in he PSA was higher 

among paren s living in coun ies 

where he PSAs were aired han 

paren s living ou side of hese 

coun ies and was associa ed wi h 

 he frequency of seeing he PSA. 

 The scale assessing he frequency 

 ha paren s had alked o heir 

children abou sexual issues during 

 he previous 6 mon hs was 

associa ed significan ly wi h he 

repor ed frequency of seeing 

billboards or bus signs, TV PSAs, 

and hearing radio PSAs abou bo h 

sexual issues and eenage 

pregnancy. 

Eves, 2012  Campaign increased s air climbing,  None repor ed 

(exercise) wi h grea er effec s a he Pos er + 

S airwell messages si e han 

Pos ers alone. 

 Follow-up revealed higher 

agreemen wi h wo s a emen s 

abou caloric ou comes of s air 

climbing in he si e where hey 

were ins alled in he s airwell. 

(con inued) 

4-13 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Fernandez Cerdeno, 

2012 (condom use) 

Foers er, 1995 (heal hy 

ea ing) 

Gase, 2015 

(heal hy ea ing) 

Gee, 2007 

(sexual behavior) 

 Par icipan s who repor ed exposure 

 o he campaign were significan ly 

more likely o have been es ed for 

HIV, in end o be es ed during he 

nex 6 mon hs, and know where o 

ge es ed. 

 Significan and posi ive changes in 

percep ion of HIV risk, knowledge 

of es ing loca ions, and condom 

carrying among he erosexually 

iden ified La inos. 

 Significan reduc ion in ra es of 

recen unpro ec ed sex wi h women 

and men among he erosexually 

iden ified La ino MSMW. 

 Campaign genera ed nearly 80 

million media impressions. From 

January 1990 o March 1991, a 

 o al of 137 prin ar icles on die 

and cancer preven ion appeared in 

California newspapers, of which 

88% were a ribu able o or 

men ioned he 5 A Day campaign. 

 Highly significan associa ions were 

found be ween in ermedia e 

variables and he amoun of frui 

and vege ables consumed. 

 Campaign had rela ively broad 

reach and limi ed bu posi ive 

impac s on knowledge, a i udes, 

behavioral in en ions, and 

behaviors. 

 91% of he women knew abou 

emergency con racep ion, 

compared wi h 82% a he 

beginning. 

 49% knew i s mechanism of ac ion 

compared wi h 39%. 

 38% discussed i wi h a provider 

compared wi h 25%. 

 22% received an advance 

prescrip ion for i compared wi h 

12%. 

 79% were more likely o use i 

compared wi h 63%. 

 More effor should have been 

direc ed o forge alliances and 

involve local ins i u ions in he 

communi y during he planning 

s age o sensi ize hem o he 

public heal h needs of he arge 

popula ion. 

 Dual s ra egy ha ar icula es bo h 

broad and narrow approaches 

allowed developmen of a 

non hrea ening, socially and 

cul urally accep able campaign. 

 Public resources can be leveraged 

by working wi h he indus ries o 

provide consumers wi h 

informa ion and services. 

 Fac ors like in ensi y and dura ion 

need o be ma ched o popula ion 

charac eris ics o suppor 

widespread behavior shif s. 

 The fac ha 10% of responden s 

repor ed seeing he ad in 

newspapers and 6.8% repor ed 

seeing he ad in he mail (al hough 

 he ads were no dissemina ed 

 hrough hese channels) sugges s 

some issues wi h recall. 

 Grassroo s communi y educa ion 

campaigns can be effec ive 

me hods on improving knowledge 

on a par icular heal h opic. 

(con inued) 

4-14 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Gibson, 2010 

(drug use preven ion) 

Gilber , 2013 

(sexual behavior) 

Glasson, 2013 (heal hy 

ea ing) 

Goodwin, 2014 

(exercise) 

 56% had seen a preven ion-rela ed 

pos er, 45% had seen 2 or more 

copies of he newsle er, 29% had 

seen he elevision show, and 41% 

had seen he s ress grip. 

 Exposure o he narrowcas ing 

pos ers and newsle er significan ly 

increased he odds of pos -

in erven ion low-risk injec ion 

s a us. 

 Significan ly improved de ec ion 

among MSM a clinic si es wi h 

preexis ing high HIV de ec ion 

ra es. 

 Among paren s who were aware of 

campaign, here was a ne increase 

of 0.5 servings of frui and 

vege ables daily compared wi h 

 hose who were unaware. 

 84% of responden s had no seen 

 he campaign image. 

 21% of responden s had heard of 

 he campaign and rela ed physical 

ac ivi y schemes. 

 67% of responden s indica ed ha 

 hey were no likely o ge involved 

wi h campaign ac ivi ies in he 

fu ure. 

 36% of responden s gave a 

nega ive response surrounding he 

image, ex , design and/or 

informa ion con en , wi h 24% 

giving an incorrec in erpre a ion of 

ei her he image or message. 

 Social marke ing may be a cos -

effec ive s ra egy for con rolling 

 he spread of HIV among injec ion 

drug users. 

 None repor ed 

 Adequa e funding for local 

programs ha deliver communi ybased educa ion and “below he 

line” social marke ing needs o be 

provided o allow a grea er reach 

and a higher dosage of program 

s ra egies. 

 Planners need o develop prac ices 

 ha ensure communica ion among 

key s akeholders concerning he 

design concep s. 

 Incorpora ing key heories like gain 

frame, exchange heory, and TPB 

in o he planning and design of a 

heal h promo ion campaign raises 

 he odds of influencing a arge ed 

popula ion’s mo iva ion for 

behavior change. 

(con inued) 

4-15 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Guy, 2009  No evidence ha HIV es ing ra es 

(sexual behavior) increased following a heal h 

promo ion campaign. 

Ha field, 2016  In erven ion decreased BMI z- (heal hy ea ing) scores among children in he 

in erven ion communi y rela ive o 

con rol communi ies. 

 Campaigns may fail o influence 

behavior when media spending is 

no well ma ched o he arge 

audience. 

 Campaigns may fail if hey do no 

adequa ely resona e wi h he 

 arge popula ion. For example, 

messages may no have caugh he 

a en ion of hose who saw hem, 

or if hey were received, he 

messages may no have been 

in erpre ed by hose arge ed as 

sufficien ly mo iva ing. 

 Campaign messages and 

corresponding environmen al 

changes mus be aligned and 

mu ually reinforcing. 

 Communica ions mus be grounded 

in comprehensive forma ive 

research, including ac ive 

collabora ion wi h local par ners, o 

inform message ailoring. 

 Time required for forma ive 

research— and incorpora ion of 

insigh s genera ed—should be 

included in projec planning and 

budge ing. 

 Messaging should reinforce effor s 

a mul iple levels wi hin a wholesys ems framework, sa ura ing he 

environmen hrough diverse 

channels. 

 Local alliances can s reng hen 

communica ions campaigns. 

 Local par nerships may enhance 

program sus ainabili y. 

 Communica ions should be 

developed collabora ively wi h 

s akeholders, designed o engage 

communi y members a mul iple 

levels and hrough mul iple 

channels, and suppor ed and 

sus ained hrough local 

par nerships. 

(con inued) 

4-16 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease 

Hlavinkova, 2014 

(sexual behavior) 

Ho a, 2010 

(heal hy ea ing) 

Prevention (cont’d) 

 Campaign significan ly increased 

young people’s knowledge of 

HIV/AIDS. 

 Perceived “child friendliness” of he 

Frui PSA significan ly influenced 

children’s a i udes oward i . 

 Children’s a i ude oward he Frui 

PSA was influenced by heir 

a i ude oward frui af er exposure 

 o he PSA for bo h ypes of PSAs. 

 Children’s a i ude oward frui 

af er exposure o he Frui PSA was 

influenced by children’s percep ions 

of he persuasiveness of he PSA. 

 Children’s a i ude oward frui 

af er exposure o he Frui PSA had 

a similar influence on he 

persuasiveness of he PSA. 

 Children’s a i ude oward frui 

af er exposure o he Frui PSA 

influenced heir hypo he ical choice 

of snack foods for he evening. 

 Children’s a i ude oward frui 

af er exposure o he Frui PSA had 

a similar influence on heir 

hypo he ical choice of snack foods 

for he evening. 

 Children’s a i udes oward he 

Frui PSA direc ly influenced heir 

percep ions of he persuasiveness 

of he PSA for bo h PSAs. 

Howle , 2012 (heal hy 

ea ing) 

 Across s a es, weekly consump ion 

of frui and vege ables was grea er 

in s a es wi h marke ing programs 

 han in s a es wi hou marke ing 

programs. 

 In s a es wi h marke ing 

campaigns, hose mee ing he five 

or more daily frui and vege able 

serving cri erion wen from 24% o 

27% a pos - es . 

 In s a es wi hou he campaign, he 

percen age mee ing he five-a-day 

recommenda ion was mos ly 

unchanged, going from 23.2 o 

23.7%. 

 Forma ive research should evalua e 

key differences among he 

in ended audience and allow for 

message ailoring. 

 Appropria ely designed, programleng h elevision ma erial can 

influence children’s behavior more 

effec ively han shor 

adver isemen s. 

 The use of a special anima ed 

charac er or spokesperson could be 

used o convey posi ive public 

service messages. 

 Program planners should consider 

 he role of cul ural con ex in he 

developmen of effec ive pro-heal h 

communica ion campaigns. 

 None repor ed 

(con inued) 

4-17 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Huhman, 2010 

(exercise) 

James, 2015 (secondhand smoke exposure) 

King, 2013 

(exercise) 

 28% of children had unpromp ed 

recall of VERB, and 47% recalled 

VERB af er promp ing, for a o al 

awareness level of 75%. To al 

awareness of VERB among he 

 arge audience increased 

significan ly from 2003 o bo h 

la er cohor s, as did unpromp ed 

recall of he campaign. 

 Higher percen ages of children 

were physically ac ive he more 

 hey saw he campaign, ranging 

from 62.4% wi h no campaign 

exposure o 68.4% for hose who 

saw i every day. 

 The more frequen ly children were 

exposed o he campaign, he more 

 hey believed in he benefi s of 

physical ac ivi y, heir self-efficacy 

 o be physically ac ive, and social 

influences on heir physical ac ivi y. 

 As frequency of exposure o VERB 

increased, adolescen s repor ed 

more free- ime physical ac ivi y 

sessions, ranging from 2.02 

sessions for hose unexposed o 

 he campaign o 4.9 sessions for 

 hose exposed every day. 

 Daily users of obacco who were 

exposed o he campaign were 

 wice as likely o make a qui 

a emp compared wi h hose no 

exposed o he campaign. 

 There was a highly s a is ically 

significan effec of campaign 

exposure on awareness of a 

helpline or websi e for qui ing 

 obacco use. 

 Campaign exposure had a 

significan impac on nonusers’ 

desire o curb obacco use and 

 obacco adver ising. 

 Campaign awareness was higher 

among women han men and 

among more educa ed and more 

affluen adul s. 

 None repor ed 

 None repor ed 

 None repor ed 

(con inued) 

4-18 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Leavy, 2013 (exercise)  Awareness of he campaign 

increased from 30% o 49% from 

baseline o second follow-up. 

 In en ion o engage in physical 

ac ivi y doubled o 21% a second 

follow-up. 

 Significan median increases were 

seen in self-repor ed walking, 

vigorous physical ac ivi y, and o al 

physical ac ivi y. 

Lim, 2015  Low recogni ion and message recall 

(sexual behavior) for he campaign among young 

people surveyed a a music 

fes ival. 

Maddock, 2007 (heal hy  Consump ion of low-fa milk 

ea ing) significan ly increased from pos -

campaign and a 3-mon h followup. 

 A i ude significan ly increased 

from baseline o pos - es and a 3-

mon h follow-up. 

 20.5% repor ed changing he way 

 hey hink abou milk because of 

 he campaign. 

 25.3% repor ed being mo iva ed o 

swi ch o low-fa milk. 

Mann, 2013  There were a o al of 13,385 

(sexual behavior/ websi e hi s, 82% of which were condom use) unique visi ors. On average, he 

websi e received 732 hi s per 

mon h. 

 A o al of 104 requisi ions were 

submi ed for chlamydia and 

gonorrhea es ing. 

 53% of responden s repor ed hey 

would change one or more 

behaviors as a resul of visi ing he 

websi e. 

 When asked abou wha ac ions 

 hey would under ake, 31% s a ed 

 hey would ask heir par ner o ge 

 es ed, 30% s a ed hey would 

increase he frequency of es ing, 

and 24% s a ed hey would use 

condoms more of en. 

 The ype of media, i s dose, and 

reach all have he abili y o affec 

campaign awareness. 

 High levels of campaign awareness 

can be genera ed hrough he use 

of concen ra ed media purchased 

 ha arge ed priori y groups. 

 Heal h campaigns arge ing young 

people should consider appropria e 

message s yle and media channels 

 o maximize campaign reach and 

impac . 

 For sus ained effec s, boos er 

sessions may be needed o firmly 

es ablish behavior change. 

 Par nerships can be a key o he 

success of communica ion 

programs. 

 None repor ed 

(con inued) 

4-19 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Mar ensson, 2004 (oral 

heal h) 

Mar inez-Dona e, 2009 

(sexual behavior/ 

condom use) 

McMahon, 2004 (sexual 

behavior) 

Merom, 2005 (exercise) 

 There was a significan increase in 

 he number of correc answers 

regarding diagnosis, symp oms, 

and rea men s of periodon i is. 

 Almos 86% of he erosexual La ino 

men and he erosexually iden ified 

(HI) La ino MSMW had seen or 

heard abou he campaign and 

 heir componen s. 

 Survey resul s documen ed posi ive 

behavioral responses o he 

campaign among bo h he erosexual 

La inos and HI La ino MSMW. 

 Almos one ou of hree survey 

responden s exposed o he 

campaign repor ed having enac ed 

a leas one of several po en ial 

risk reduc ion measures as a resul 

of he campaign. 

 There was no significan increase in 

 he propor ion of HIV es s 

performed ha could be a ribu ed 

 o he campaign. 

 Significan reduc ions in car-only 

 rips o work replaced by walking 

or cycling or rips combining 

walking and public ranspor . 

 None repor ed 

 The use of aided recall can resul in 

an overes ima ion of he reach of 

 he campaign and incorrec 

classifica ion of subjec s’ exposure 

s a us. 

 When implemen ing a shor ( woweek) campaign wi h limi ed 

funding across e hnically diverse 

groups, i could be more beneficial 

 o focus on a smaller range of 

e hnici ies o ensure a more 

successful implemen a ion and 

evalua ion. 

 None repor ed 

(con inued) 

4-20 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Miles, 2001  The average pos -campaign weigh  Campaigns should follow 

(heal hy ea ing and was 2.3 kg lower han before he recommenda ions like broadcas ing exercise) campaign, wi h 44% losing weigh . he campaign message over years 

 Frui and vege able in ake ra her han weeks or mon hs o 

significan ly increased by 0.8 increase he likelihood of long- erm 

por ions per day. change. 

 Percen age ea ing 5 por ions of  Mass-media heal h campaigns 

frui and vege ables a day should form s rong links 

significan ly increased by 13%. communi y and heal h cen ers. 

 Number of par icipan s ea ing fried 

food less han once a week 

significan ly increased by 16%. 

 Propor ion consuming whole milk 

significan ly decreased from 10 o 

7%. 

 There were significan increases in 

brisk walking, modera e ac ivi y, 

and vigorous ac ivi y. 

 39% of par icipan s increased heir 

ac ivi y levels following he 

campaign. 

 To al number of minu es spen in 

ac ivi y per week significan ly 

increased by 94 min per week. 

Moa i, 1992 (condom  Respec ively, 25%, 12%, and 11%  None repor ed 

use) repor ed ha he campaigns have 

made hem more concerned abou 

individual risk of HIV infec ion and 

promp ed hem o use condoms 

and be es ed for HIV. 

Mon oya, 2005 (sexual  Significan increases in syphilis  None repor ed 

behavior) awareness, knowledge, and 

 es ing. 

 80% of gay and bisexual men 

surveyed were aware of he 

campaign. 

 One hird of he sample 

spon aneously men ioned (unaided 

awareness) he campaign when 

asked o “recall any ads or public 

even s ha provided informa ion 

abou sexual heal h issues.” 

Mork, 2015  The campaign had a posi ive effec  None repor ed 

(heal hy ea ing) on he number of produc s sold 

wi h he fron -of-package label. 

(con inued) 

4-21 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Mur omaa, 1984 (oral 

heal h) 

Nigg, 2005 

(exercise) 

O’Hara, 2011 

(heal hy ea ing and 

exercise) 

Parker, 2004 

(cancer awareness) 

Pedrana, 2012 

(sexual behavior) 

 In 1980, 54% if he in erviewees 

had visi ed he den is in he las 

12 mon hs. 

 In 1983, 65% of he in erviewees 

had visi ed he den is in he las 

12 mon hs. 

 Ini ial resul s of workshops o rain 

 eachers in heal h s andards and 

physical educa ion s andards are 

very posi ive, and he public 

educa ion componen is being 

successfully dissemina ed. 

 Newspaper con en analysis 

revealed an increase in coverage of 

 he ini ia ive opic areas. 

 Paid elevision adver ising shows a 

dose-response rela ionship o he 

campaign goal. 

 The survey resul s showed ha 

nega ive a i udes decreased 

among women who wen 

unscreened, heir confidence in 

cancer screening and rea men 

increased, and fewer viewed a 

diagnosis of cancer as a dea h 

sen ence. 

 A small overall change ook place 

in he knowledge and behaviors of 

Georgians aged 45–74 regarding 

cancer screenings be ween he 

Oc ober 2002 and March 2003 

survey. 

 High levels of campaign awareness 

among he arge popula ion, bo h 

unaided (43%) and aided (86%), 

were found up o 14 mon hs 

following he launch of campaign. 

 Mass media channels are effec ive 

in reaching a large sec or of he 

popula ion, bu each channel has 

unique charac eris ics ha 

program planners should be 

familiar wi h in order o achieve 

behavior change. 

 None repor ed 

 A grea er volume of sus ained 

adver ising is necessary o achieve 

higher levels of behavior change. 

 None repor ed 

 Campaigns ha use da a sources 

no explici ly designed o 

evalua ion campaign ou comes 

may be limi ed in heir abili y o 

make causal a ribu ions. 

(con inued) 

4-22 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Pivonka, 2011 (heal hy 

ea ing) 

Plan , 2010 

(sexual behavior) 

Plan , 2014 

(sexual behavior) 

 Campaign awareness increased 

from 12% o 18%. 

 Percen age of mo hers who said 

 hey were more likely o buy a 

produc wi h he campaign logo 

rose from 40% o 45%. 

 38% of mo hers aware of he logo 

said i mo iva ed hem o help heir 

families ea more frui and 

vege ables. 

 Campaign was significan ly 

associa ed wi h syphilis es ing in 

 he pas 6 mon hs and wi h syphilis 

awareness and knowledge among 

MSM in Los Angeles Coun y. 

 A majori y (71%) of gay and 

bisexual men were aware of 

campaign. 

 Syphilis knowledge was higher 

among hose wi h unaided 

campaign awareness. 

 There was no significan correla ion 

be ween campaign awareness and 

syphilis es ing in he las 6 

mon hs. 

 Conduc ing forma ive research of 

campaigns and messages is cri ical 

for effec iveness. 

 If campaign resources are limi ed, 

adop ing es ed campaigns and 

messages, and delivering hem 

consis en ly and repea edly o 

consumers could be a cos -

effec ive al erna ive. 

 Adherence o social marke ing 

principles, including produc , price, 

place, and promo ion, in addi ion 

 o marke research, audience 

segmen a ion, and branding, can 

help ensure ha campaign 

objec ives are me . 

 Using unpromp ed ques ions o 

assess campaign awareness and 

knowledge should become a 

s andard in social marke ing 

evalua ion. 

 None repor ed 

(con inued) 

4-23 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Pollard, 2008 (heal hy  62% of responden s were 

ea ing) spon aneously aware of campaign 

and 90% were aware when 

promp ed wi h a descrip ion. 

 Correc knowledge of he 

recommended number of servings 

of frui and vege ables increased 

significan ly over he campaign 

period. 

 Mean daily frui and vege able 

in ake increased by 0.8 servings 

over he campaign period, an 

increase of 0.2 servings of frui 

(no significan ) and 0.6 servings of 

vege ables (significan ). 

 Overall, he propor ion of he 

popula ion who repor ed ea ing wo 

or more servings of frui and five or 

more of vege ables daily increased 

significan ly. 

Po er, 2008 (exercise)  There was no significan effec on 

behavioral variables assessing 

physical ac ivi y. 

 There was a sligh effec on some 

cogni ive variables rela ed o 

physical ac ivi y. 

 Al hough here was a subs an ial 

effec on awareness of he 

campaign, here was no effec on 

 he frequency of awareness 

variable. 

Reger, 1999  34% of high-fa milk drinkers 

(heal hy ea ing) swi ched o low-fa milk compared 

wi h 4% in he comparison ci y. 

Reger, 2000  Campaign was effec ive in 

(heal hy ea ing) encouraging high-fa milk drinkers 

 o swi ch o low-fa milk. 

 Well-execu ed social marke ing 

campaigns are an effec ive me hod 

 o increase awareness of die ary 

recommenda ions and o mo iva e 

behavior change. 

 Resul s demons ra e he 

impor ance of implemen ing social 

marke ing campaigns over an 

ex ended period so ha 

incremen al grow h in knowledge, 

in en ions, and behavior can occur 

and be main ained. 

 None repor ed 

 A media-only approach may no be 

effec ive in elici ing behavior 

change, depending on he 

complexi y of he behavior. 

 Paid adver ising alone was no an 

effec ive long- erm s ra egy for 

promo ing behavior change. 

(con inued) 

4-24 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Reger, 2002 (exercise)  Observa ion da a of walking 

showed a significan effec wi h a 

23% increase in walking 

observa ions in he in erven ion 

versus a 6% decrease in he 

comparison. 

 32% of he baseline seden ary 

popula ion in he in erven ion 

repor ed mee ing he 

recommenda ion for modera ein ensi y physical ac ivi y versus 

18% in he comparison. 

 While comparison responden s 

repor ed no change in in en ion, 

in erven ion responden s repor ed 

significan changes in heir 

in en ion. 

Reger-Nash, 2005  92%, 85%, and 89% of residen s 

(exercise) knew abou he campaign a 3 

mon hs, 6 mon hs, and 12 mon hs. 

 Responden s repor ed higher 

propor ions of sufficien ly ac ive 

walkers han did hose in he 

con rol ci y. For he mos seden ary 

nonwalkers, his difference was 

significan ly higher a 3 mon hs 

and 12 mon hs. 

 Compared wi h he con rol ci y, 

one in erven ion group was almos 

 wice as likely o have made any 

increase in heir daily walking ime 

and significan ly more likely o 

have achieved sufficien ly ac ive 

walking s a us. 

 In comparing he median minu es 

walked per week, he significan 

gains for he in erven ion group 

were 0, 75, 50, and 80 compared 

wi h he con rol group gains of 0, 

0, 0, and 5. 

 None repor ed 

 Using one simple, focused message 

in communi y in erven ions may be 

more efficacious han more cos ly 

and complex mul i-message 

communi y campaigns. 

(con inued) 

4-25 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Reger-Nash, 2008  The campaign resul ed in a  None repor ed 

(exercise) significan increase in walking 

behavior among he arge 

popula ion compared wi h he 

con rol popula ion. 

 No o her significan increases in 

o her modera e- o-vigorous 

physical ac ivi ies were observed. 

Rise, 1988  An increase in preven ive  None repor ed 

(oral heal h) knowledge and behavior rela ed o 

periodon al diseases was observed 

 hroughou he whole s udy period. 

Rogers, 2013 (heal hy  There were significan increases in  Communi y-level effor s can resul 

ea ing) frui and vege able consump ion in a mul iyear branding behavior 

and in paren al awareness of he change campaign ha is appealing 

program af er he 5-year and memorable. 

campaign.  Building on exis ing communi y 

rela ionships is a viable approach 

 o es ablishing he par nerships 

essen ial for successful and 

sus ained communi y-based 

behavior change. 

Rogers, 2014  Shor - erm changes in knowledge  Campaign developers should 

(heal hy ea ing and of and a i udes abou ype 2 consider a range of po en ial exercise) diabe es were observed, wi h wo developmen models and behavior 

of he hree measures being heories. 

s a is ically significan . 

Romer, 2009  The mean repor ed exposure ra e  None repor ed 

(sexual behavior) o HIV preven ion messages was 

significan ly higher in he media 

ci ies han in he nonmedia ci ies. 

Ross, 1993  Television-based media campaigns  Television-based media campaigns 

(sexual behavior) produced he grea es increase in appear o be he mos effec ive 

 es ing ra es, wi h an average 46% way of increasing awareness. 

increase over 2 mon hs compared 

wi h newspapers and pos er 

campaigns (average 6% increase 

over 2 mon hs). 

 Regional HIV es ing ra es 

correla ed significan ly wi h clinic 

 es ing ra es. 

 No increase in posi ive HIV es s 

was seen following media 

campaigns. 

(con inued) 

4-26 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Schmid , 2009  60% of par icipan s remembered  S akeholders may experience 

(smoking) he campaign slogan. difficul ies wi h implemen a ion 

 52% remembered hearing or processes and working imelines if 

seeing he adver isemen s on radio he demands of campaign 

and/or elevision. developmen are no fully 

 80% who had been exposed o he explained o hem. 

pos ers indica ed hey liked hem  Campaigns can benefi from 

and 85% said hey liked he arge ing specific segmen ed 

campaign PSAs. audiences beyond age group (e.g., 

 A higher propor ion of responden s arge ing you h from differen 

e hnic and socioeconomic ried o convince an older 

experimen ing sibling o qui backgrounds). 

smoking a he ime of he pos -

 es compared wi h he pre es . 

 A pos - es , mos responden s 

were more likely o ell o her 

experimen ers no o smoke, 

suppor smokers o qui obacco 

use, and lis en o people who old 

 hem abou he benefi s of being 

abs inen from obacco. 

 Al hough here was li le change in 

responden s’ a i udes and 

behaviors, here were a grea er 

number of s uden s who became 

involved in delivering obacco 

reduc ion/preven ion programming 

a heir schools a pos - es . 

Singer, 1991 (condom  Effec s of he campaign were  None repor ed 

use) minimal; here was a small bu 

s a is ically significan increase in 

repor ed condom use. 

(con inued) 

4-27 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Siska, 1992  Propor ion of exposed par icipan s  The es ing of finished public 

(sexual behavior) recalling “an AIDS message” was heal h media ma erial is beneficial 

significan ly higher in Tennessee for prac ical decision-making. 

 han in Illinois. 

 59% of hose in Tennessee 

assigned o he exposure group 

could correc ly recall specific 

elemen s of he PSA. 

 21% of hose in Illinois assigned o 

 he exposure group could correc ly 

recall specific elemen s of he PSA. 

 Propor ion of par icipan s 

men ioning AIDS as an impor an 

issue increased a bo h si es from 

recrui men o follow-up for he 

exposed groups, bu no for he 

unexposed groups. 

Smi h, 2009 (second-  In erven ion si e showed no  None repor ed 

hand smoke exposure) grea er improvemen han he 

con rol si e in smoke-free homes 

s a us. 

Solorio, 2016  High exposure ra e among he  None repor ed 

(sexual behavior) arge popula ion. 

 Significan changes in in en ions 

 oward HIV es ing and HIV es ing 

behavior. 

Sou hco e, 2016  No evidence of behavior change  When implemen ing a heal h 

(heal hy ea ing) following he in erven ion. campaign in a universi y se ing, 

 88% of par icipan s a follow-up messaging should no be 

repor ed no icing he campaign, au hori a ive while conveying he 

wi h 55% believing i o be abou in ended heal h message. 

disease preven ion.  I is impor an o be aware of 

vulnerable popula ions. 

 Social media marke ing migh have 

a grea er impac among young 

adul s han prin media or poin -ofpurchase labeling. 

(con inued) 

4-28 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

S ekler, 2013 

(sexual behavior) 

Su herland, 2013 

(heal hy ea ing) 

Thrasher, 2013 

(smoking) 

Trussell, 2001 (sexual 

behavior) 

 23% of men repor ed seeing he 

campaign. 

 25% knew wha he slogan 

referred o. 

 72% who saw he campaign 

recognized symp oms. 

 Diagnosis of cases decreased from 

51% pre-campaign o 44% pos -

campaign. 

 Reduc ion in sal use a he able 

was significan ly grea er af er 

campaign. 

 Grea er knowledge and qui -rela ed 

psychosocial responses and 

behaviors among smokers exposed 

 o pic orial heal h warning labels 

compared wi h hose exposed o 

 ex -only heal h warning labels. 

 The media campaign was 

associa ed wi h addi ive effec s 

rela ed o higher campaign-rela ed 

knowledge and s ronger 

psychosocial responses o pic orial 

heal h warning labels. 

 Significan increase occurred in he 

propor ion of women who knew 

pregnancy can be preven ed af er 

sex. 

 Among women who knew 

some hing can be done af er sex o 

preven pregnancy, here were 

significan increases in he 

propor ions knowing he erm 

“emergency con racep ive pills.” 

 The frac ion of women knowing he 

72-h ime limi rose significan ly 

only in Philadelphia and Sea le. 

 Significan increases in he 

propor ion of women who had 

heard of he Emergency 

Con racep ion Ho line. 

 None repor ed. 

 I is par icularly impor an for 

public heal h in erven ions ha 

require behavior changes o be 

effec ive in reaching socially 

disadvan aged popula ions o avoid 

increasing already presen 

dispari ies be ween socioeconomic 

groups. 

 None repor ed 

 News media coverage can be an 

invaluable addi ion o PSA 

placemen . 

 Local spokespeople—par icularly 

physicians and nurse 

prac i ioners—can be invaluable 

messengers. 

 Clinicians can be par icularly 

impor an in ar icula ing heal h 

informa ion in a knowledgeable 

and nonjudgmen al manner. 

(con inued) 

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Food S fety Consumer Rese rch: Liter ture Review 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Turrell, 1997 

(heal hy ea ing) 

Wagman, 1993 (sexual 

behavior) 

Wammes, 2007 

(heal hy ea ing and 

exercise) 

Wardle, 2001 

(heal hy ea ing and 

exercise) 

Wechem, 1997 (heal hy 

ea ing) 

 Be ween 40% and 60% of 

responden s regularly engaged in 

food behaviors ha were consis en 

wi h guideline recommenda ions. 

 High pre es level of knowledge 

and awareness of HIV 

 ransmission, al hough a biased 

unders anding of risk associa ed 

wi h “risk group” was very 

common. 

 A pos - es , only a small number 

of people recalled seeing he 

ou door promo ion. Of hose who 

did, 25% re ained he primary 

message. 

 Campaign awareness ranged from 

61% af er he ini ial campaign o 

88% af er he final campaign. 

 Message recall ranged from 42% o 

68%. 

 There were no ed differences in 

changes of a i ude and in en ions 

for preven ion of weigh gain. 

 More han half of responden s 

heard of he campaign. 

 30% recalled he heal hy lifes yle 

messages. 

 56% of he responden s were 

aware of campaign. 

 As opposed o he con rol 

communi y, here was a significan 

decrease in ac ual fa consump ion 

be ween pre- and pos - es . 

 Af er he campaign, significan ly 

more responden s in he 

experimen al communi y in ended 

 o ea lower-fa food produc s and 

repor ed a behavioral change in he 

las 6 mon hs. 

 Campaigns should develop 

s ra egies ha are specifically 

designed and arge ed oward 

groups ha are difficul o reach. 

 None repor ed 

 Campaign ma erials and ac ivi ies 

should be pilo es ed in con rolled 

se ings for heir efficacy before 

na ionwide implemen a ion o 

avoid implemen a ion of ineffec ive 

ma erials. 

 Differen approaches migh be 

needed o maximize par icipa ion 

from groups mos in need of 

lifes yle change. 

 None repor ed 

(con inued) 

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Section 4 — Key Findings nd Lessons Le rned 

Table 4-1. Key Findings and Lessons Learned (continued) 

First Author and Year 

o Publication 

(Behavior) Key Findings Lessons Learned 

Chronic Disease Prevention (cont’d) 

Wechem, 1998 (heal hy 

ea ing) 

Whi e, 2015 (secondhand smoke exposure) 

Whi ingham, 2008 

(condom use) 

Zimmerman, 2007 

(condom use) 

 A en ion for heal hy or unheal hy 

food produc s was significan ly 

higher in he firs and second pos -

 es s han in he pre es . 

 No significan improvemen in 

a i udes was found af er 6 

mon hs. 

 29% of all pos - es responden s 

repor ed seriously considering 

buying lower fa food produc s in 

 he nex 6 mon hs, which was a 

significan increase rela ive o he 

pre es . 

 In en ion o lower die ary fa in ake 

increased significan ly a pos - es . 

 Comparing pre- and pos -campaign 

resul s, Oklahomans demons ra ed 

significan increases in: 

suppor ing smoke-free bars 

(24% o 55%); 

repor ing beliefs ha 

secondhand smoke causes 

hear disease (59% o 73%), 

is very harmful (64% o 

71%), and causes sudden 

infan dea h (24% o 34%); 

and 

repor ing hey are very likely 

 o ask someone no o smoke 

nearby (45% o 52%). 

 Exposure o he elevision 

commercial produced a posi ive 

effec on risk percep ion. 

 There was also a posi ive effec on 

 he in en ion o buy and carry 

condoms and on he in en ion o 

 ake ini ia ive in discussing condom 

use before having sex. 

 Campaign was effec ive in 

increasing he condom-use beliefs 

and behaviors in arge popula ion. 

 Television appears o be he mos 

effec ive channel of mass 

communica ion in general. 

 None repor ed 

 None repor ed 

 Campaigns can leverage 

psychosocial charac eris ics for 

segmen a ion and message 

 arge ing and his can be highly 

effec ive when he psychosocial 

charac eris ics is correla ed wi h 

 he in ended behavior change. 

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Food S fety Consumer Rese rch: Liter ture Review 

4.2 FORMATIVE RESEARCH 

Lessons learned and sugges ions rela ed o forma ive research 

emphasized he impor ance of projec planning and message 

 es ing. Au hors poin ed ou ha very of en hey fel hey 

should have allowed more ime for planning and forma ive 

research (Ha field e al., 2016). O hers highligh ed he 

impor ance of pilo ing messages in con rolled se ings before 

 ackling broad, media-based dissemina ion (Wammes e al., 

2007). For example, Greene and colleagues (2015) sugges 

 ha informa ion ga hered from focus groups was ins rumen al 

improving campaign messages abou preven a ive ac ion in a 

campaign designed o reduce household exposure o sources of 

lead poisoning. 

4.3 MESSAGE CHARACTERISTICS 

Lessons learned and sugges ions rela ed o message 

charac eris ics address credibili y, sensi ivi y, and 

reinforcemen . Wi h respec o credibili y, Berry and colleagues 

(2009) no ed ha many consumers view source credibili y as a 

rela ive phenomenon. Specifically, public heal h messages from 

governmen sources may be viewed as more credible han 

public heal h messages from commercial sources, bu ha does 

no mean ha governmen sources are necessarily viewed as 

credible. 

Several au hors provided insigh s o he way messages should 

be carefully developed o resona e wi h priori y audiences. For 

example, messages developed for young adul audiences 

should avoid s rong au hori arian language (Sou hco e e al., 

2016). Similarly, recognizing psychosocial charac eris ics of 

priori y audiences can lead o messages ha are more likely o 

be received favorably (Zimmerman e al., 2007). Ho a and 

colleagues (2010) highligh ed he need for public heal h 

message developers o be aware of he cul ural con ex of he 

popula ions hey hope o affec . Several au hors provided 

sugges ions rela ed o reinforcing messages. Reinforcemen can 

include he use of differen communica ion channels and 

dissemina ion a mul iple levels of he socio-ecological 

framework. Highligh ing he impor ance of reinforcemen , 

Bli s ein and colleagues (2012) showed ha repea ed 

messaging offers mul iple oppor uni ies for learning and 

persuasion ha increase he likelihood ha a person will 

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Section 4 — Key Findings nd Lessons Le rned 

receive he message when hey are recep ive. Echoing he 

value of repe i ion, several au hors recommended developing 

campaigns wi h longer dissemina ion plans o increase he 

likelihood of long- erm change (Miles e al., 2001) and allow for 

incremen al grow h in knowledge, in en ions, and behavior 

(Pollard e al., 2008). I is, of course, necessary o ma ch 

dissemina ion plans wi h message charac eris ics such as 

complexi y. The s udy by Reger-Nash and colleagues (2005) 

highligh ed he efficacy of using one simple, focused message 

ra her han more cos ly and complex messages ha may have 

had limi ed long- erm effec iveness. McMahon and colleagues 

(2004) sugges ed ha when resources are limi ed, arge ing 

messages o cul ural groups may help ensure successful 

message dissemina ion. 

4.4 CAMPAIGN DISSEMINATION 

Lessons learned and sugges ions rela ed o campaign 

dissemina ion primarily address he use of differen 

communica ion channels, bu also highligh issues rela ed o 

campaign reach. Several au hors indica ed he benefi s of 

mul ichannel approaches, which are credi ed wi h maximizing 

exposure (Dharod e al., 2004; James e al., 2013). Mur omaa 

and colleagues (1984), while encouraging he use of mul iple 

communica ion channels, cau ioned program planners o 

unders and he charac eris ics, s reng hs, and limi a ions of he 

differen channels in heir media mix. For example, several 

au hors emphasized he impac of elevision (Arikan e al., 

2014; DuRan e al., 2006; van Wechem e al., 1998). This 

medium is credi ed wi h he grea es abili y o genera e 

audience awareness. However, he capaci y of elevision o 

reach audiences comes a a very high cos , and campaign 

planners should carefully consider balanced media purchases 

 ha allow for he grea es po en ial for exposure. Trussell and 

colleagues (2001) demons ra ed he value of news coverage, or 

earned media, which is ypically free and can have mul iplier 

effec s when s ories genera ed by one source are picked up and 

carried by o hers. O her au hors provided sugges ions for 

improving campaign reach. Cochrane and Davey (2008) s a ed 

 ha for programs o be successful, campaign messages and 

ma erials have o be available, accessible, affordable, and 

appropria e. In o her words, he campaign has o mee he 

audience where hey live, in a way ha can be grasped by he 

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Food S fety Consumer Rese rch: Liter ture Review 

audience members, a a reasonable cos (including fac ors such 

as ime and convenience), and in a form ha resona es wi h 

 he audience’s previously held beliefs and unders anding. 

4.5 AUDIENCE 

Lessons learned and sugges ions rela ed o audience emphasize 

 he impor ance of segmen ing and main aining heal h equi y. 

Segmen ing, he process of dividing audiences in o smaller, 

homogeneous groups, can allow for arge ed messages wi h 

grea er resonance. Schmid and colleagues (2009) sugges ed 

ex ending segmen a ion beyond radi ional demographic 

charac eris ics like age and race/e hnici y. Segmen a ion can be 

applied o ensure ha public heal h campaigns do no 

inadver en ly con ribu e o heal h dispari ies. I is impor an for 

public heal h in erven ions, especially hose promo ed by 

governmen agencies, o effec ively reach socially 

disadvan aged popula ions o avoid increasing already presen 

dispari ies among socio-economic groups (Su herland e al., 

2013). For example, messages like “ea more frui and 

vege ables” may be more accessible and affordable for groups 

wi h more household resources. Program planners should 

consider ha differen approaches migh be needed o 

maximize par icipa ion from groups mos in need of lifes yle 

change. 

4.6 EVALUATION CHARACTERISTICS 

Lessons learned and sugges ions rela ed o evalua ion 

charac eris ics involve considering fac ors ha may confound or 

influence evalua ion ou comes, including issues rela ed o 

measuring and assessing change. O her sugges ions involve 

me hods for assessing campaign awareness. Several au hors 

no ed plausible explana ions for why evalua ion findings did no 

mee expec a ions. These include regional differences ha 

could have influenced (i.e., confounded) behavior and 

campaign awareness (Su herland e al., 2013), spillover effec s 

due o he proximi y of campaign and comparison communi ies 

(Bull e al., 2008), secular even s ha influence arge 

behaviors in a manner ha is similar o he proposed campaign 

messages (Greene e al., 2015), and s a is ical power (Bull e 

al., 2008). O her commen s refer o measuremen issues 

rela ed o assessing change. Bauman and colleagues (2001), 

discussing a campaign designed o promo e physical ac ivi y, 

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Section 4 — Key Findings nd Lessons Le rned 

poin ed ou ha examining wi hin-person change (i.e., over 

 ime) ra her han differences be ween independen popula ions 

can yield differen resul s. Al hough his is undoub edly rue, i 

should also be no ed ha each of hese approaches yields a 

differen inference regarding campaign effec s. Specifically, 

assessing wi hin-person change addresses evalua ion ques ions 

abou person-level change, or individual grow h, while 

measuring campaign effec s be ween independen groups 

addresses evalua ion ques ions abou popula ion differences. 

There seems o be a consis en message regarding he 

assessmen of campaign awareness among he s udies included 

in his review: aided, or promp ed, recall measures yield 

spuriously high ra es of awareness (Mar inez-Dona e e al., 

2009). In fac , Gase and colleagues (2015) no ed ha 10% of 

responden s indica ed seeing ads in sources where hey were 

no placed. This ype of phan om awareness has been no ed by 

o her researchers (Bli s ein e al., 2016). One au hor wen as 

far as o call for unpromp ed recall o be adop ed as he 

s andard in all social marke ing campaigns (Plan e al., 2010). 

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5 Conclusions 

Li era ure review is a his orical process wi h resul s ha should 

be considered in ligh of he ime span of he campaigns and 

s udies examined. The findings of his repor provide an 

overview of he li era ure on public heal h communica ion 

campaigns conduc ed over he las 36 years. The 104 ar icles 

cover a range of public heal h opics. No surprisingly, he 

larges number of s udies are from campaigns focused on 

chronic disease preven ion, wi h HIV preven ion and obesi y 

preven ion (i.e., die and physical ac ivi y) represen ing he 

majori y. Only five of he s udies focused on food safe y. This 

breakdown suppor s he prior assump ion ha we would have 

found limi ed informa ion had we focused solely on consumer 

food safe y public heal h communica ion campaigns. To some 

ex en , his dis ribu ion reflec s he perceived impor ance and 

available resources across addressable public heal h issues. 

Accordingly, i is no surprising ha he mos common source 

of funding was a federal or na ional governmen . However, as 

no ed in he lessons learned sec ion, governmen s may no be 

seen as credible sources. Thus, governmen agencies planning 

public heal h communica ion campaigns should consider 

carefully heir repu a ion wi h he general public and find 

par ners who can bols er audience accep abili y of campaign 

messages. 

This repor provides limi ed informa ion on campaign 

developmen or he use of forma ive research. This limi ed 

informa ion does no mean ha hese campaigns were no 

based on good scien ific heory and prac ices. On he con rary, 

some of he campaigns included in his review are wellrespec ed public heal h effor s (e.g., 1% or Less; CDC’s Verb 

campaign) known o have influenced public heal h ou comes. I 

is, in fac , more likely ha he limi ed amoun of informa ion on 

campaign developmen is a func ion of he inclusion and 

5-1 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

exclusion cri eria used o selec peer-reviewed s udies. In 

par icular, we excluded quali a ive s udies and s udies limi ed 

 o da a from focus groups in favor of s udies ha repor ed 

ou comes such as behaviors, a i udes, knowledge, and 

awareness. In fac , he s udies ha provided more informa ion 

on campaign developmen , forma ive research, and message 

charac eris ics were also he s udies ha ended o provide less 

evidence on campaign ou comes. Never heless, forma ive 

research and campaign developmen approaches, such as he 

use of behavior heory, are bes prac ices ha need o be given 

careful and considerable a en ion. Those planning public heal h 

communica ion campaigns should recognize ha he 

inves men of ime and resources in campaign planning and 

forma ive research can increase message recep ivi y and 

campaign effec iveness. As Noar (2006, p. X) poin ed ou over 

a decade ago in a review of mass media campaigns, “Forma ive 

research ... can enable campaign planners o ruly unders and 

 heir arge audience in erms of he problem behavior a hand, 

 heir message preferences, and he mos promising channels 

 hrough which hey can be reached.” 

Mos of he s udies we reviewed included good descrip ions of 

 heir communica ion channels bu rela ively li le informa ion on 

exposure or popula ion reach. Evidence of campaign recall, 

collec ed from sample par icipan s and of en used as a gauge of 

campaign awareness, was reasonably good. Al hough we see 

 ha radio/ elevision was he mos commonly employed channel 

for dissemina ing campaign messages, his finding needs o be 

considered in ligh of he ime span of he campaigns and 

s udies included in his repor . Consider, for example, ha of 

 he 36 ar icles ha describe using he In erne as a 

communica ion channel, he only ones ha specifically used 

social media were published in he las 3 years, represen ing 

campaigns ha were in he field be ween 2008 and 2014. 

Rogers and colleagues (2014) no ed he impor ance of reaching 

children and young adul s hrough social media. In fac , many 

people now—bo h young and old—use social media as a 

primary source of news and o her informa ion abou he world 

around hem. Given he compara ively low cos and increased 

reach of his medium, i would no be surprising o see 

radio/ elevision begin o fall in erms of i s impac as a message 

delivery channel. 

5-2 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Section 5 — Conclusions 

A review of he repor ed findings from he ar icles included here 

indica es ha behavior and awareness are he wo mos 

commonly measured ou comes. For example, self-repor ed 

behavior change was measured in all five ar icles ha focused 

on food safe y, and all five demons ra ed s a is ically significan 

behavior change in he frequency of performing safe food 

handling behavior. Cau ion is urged in in erpre ing his 

informa ion given he small number of ar icles in his group and 

 he large and recognized bias oward publishing ar icles wi h 

s a is ically significan findings. Behavior change was measured 

in abou 80% of he ar icles ha focused on chronic disease 

preven ion wi h jus less han half of hese ar icles 

demons ra ing s a is ically significan resul s. In some respec s, 

 he use of public heal h communica ion campaigns can be 

considered a more ma ure prac ice in chronic disease 

preven ion, and his more balanced finding likely reflec s he 

fac ha acknowledging bo h posi ive (i.e., significan ) and 

nega ive (i.e., nonsignifican ) resul s con ribu es o he 

developmen of a ma ure body of evidence. 

Given he range of public heal h domains included in his s udy 

and he fac ha effec ive messages need o be ailored bo h o 

 he heal h behavior and he priori y audience, summarizing and 

dis illing a clear pic ure from he s udies’ key findings are 

difficul . Clearly, assessing campaign awareness is common and 

an impor an par of campaign evalua ion. Because campaigns 

are dissemina ed in he public space, a person randomly 

surveyed may or may no have been exposed o he campaign, 

and measures of awareness can serve as an impor an 

manipula ion check for program evalua ors. I is wor h no ing 

 ha many ar icles concluded ha effec ive campaigns can 

increase awareness of a public heal h problem, bu awareness 

does no consis en ly ransla e in o behavior change (e.g., 

[Boles e al., (2014); Bull e al. (2008); Darrow & Biers eker 

(2008)]) I is also wor h no ing ha none of he ar icles in his 

review examined knowledge or a i ude as a media or of 

behavior. I may be ha he inclusion/exclusion cri eria omi ed 

ar icles wi h his ype of analysis. However, remembering ha 

behavior change heories posi a sor of “pa hway” for behavior 

change is impor an . Campaign evalua ors should be 

encouraged o plan heir evalua ions wi h he key s epping 

s ones along ha pa hway in mind. In par icular, campaign 

evalua ors should consider measuring cogni ive and behavior 

5-3 
 

 

 

Food S fety Consumer Rese rch: Liter ture Review 

cons ruc s ha ma ch he heory used during campaign 

planning and message developmen . 

5-4 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Acharya, R. N., Pa erson, P. M., Hill, E. P., Schmi z, T. G., & 

Bohm, E. (2006). An evalua ion of he "TrEAT Yourself 

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 nd Beh vior, 33(3), 309-324. 

doi:10.1177/1090198105284875 

Albarracin, D., Cohen, J. B., & Kumkale, G. T. (2003). When 

communica ions collide wi h recipien s' ac ions: Effec s 

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message recommenda ion. Person lity nd Soci l 

Psychology Bulletin, 29(7), 834-845. 

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Arikan, I., Karakaya, K., Era a, M., Tuzun, H., Baran, E., 

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Bauman, A., Arms rong, T., Davies, J., Owen, N., Brown, W., 

Bellew, B., & Vi a, P. (2003a). Trends in physical ac ivi y 

par icipa ion and he impac of in egra ed campaigns 

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Ze l nd Journ l of Public He lth, 27(1), 76-79. 

Bauman, A., McLean, G., Hurdle, D., Walker, S., Boyd, J., van 

Aals , I., & Carr, H. (2003b). Evalua ion of he na ional 

'Push Play' campaign in New Zealand—Crea ing 

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Bauman, A. E., Bellew, B., Owen, N., & Vi a, P. (2001). Impac 

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Turrell, G. (1997). Compliance wi h he Aus ralian die ary 

guidelines in he early 1990's: Have popula ion-based 

heal h promo ion programs been effec ive? Nutrition nd 

He lth, 11(4), 271-288. 

van Wechem, S. N., Brug, J., van Assema, P., Kis emaker, C., 

Rieds ra, M., & Loewik, M. R. H. (1998). Fa Wa ch: A 

na ionwide campaign in he Ne herlands o reduce fa 

in ake – effec evalua ion. Nutrition nd He lth, 12(2), 

119-130. 

van Wechem, S. N., van Assema, P., Brug, J., Kis emaker, C., 

Rieds ra, M., Hardeman, W., & Lowik, M. R. H. (1997). 

Resul s of a communi y-based campaign o reduce fa 

in ake. Nutrition nd He lth, 11(3), 207-218. 

Wagman, L. M. (1993). A heal h depar men 's response o 

AIDS. Condomania: A public educa ion in erven ion. 

C n di n Journ l of Public He lth. Revue C n dienne de 

S nte Publique, 84 Suppl 1, S62-65. 

Wammes, B., Oenema, A., & Brug, J. (2007). The evalua ion of 

a mass media campaign aimed a weigh gain 

preven ion among young du ch adul s. Obesity, 15(11), 

2780-2789. doi:10.1038/oby.2007.330 

Wardle, J., Rapopor , L., Miles, A., Afuape, T., & Duman, M. 

(2001). Mass educa ion for obesi y preven ion: he 

pene ra ion of he BBC's 'Figh ing Fa , Figh ing Fi ' 

campaign. He lth Educ tion Rese rch, 16(3), 343-355. 

Whi e, A. H., Brown-Johnson, C. G., Mar inez, S. A., Paulson, 

S., & Beebe, L. A. (2015). Oklahoma "Tobacco S ops 

wi h Me" media campaign effec s on a i udes oward 

R-12 
 

 

 

 

 

 

 

 

 

 

 

References 

secondhand smoke. The Journ l of the Okl hom St te 

Medic l Associ tion, 108(11), 450-454. 

Whi ingham, J., Rui er, R. A., Zimbile, F., & Kok, G. (2008). 

Experimen al pre es ing of public heal h campaigns: A 

case s udy. Journ l of He lth Communic tion, 13(3), 

216-229. doi:10.1080/10810730701854045 

Zimmerman, R. S., Palmgreen, P. M., Noar, S. M., Lus ria, M. 

L., Lu, H. Y., & Lee Horosewski, M. (2007). Effec s of a 

 elevised wo-ci y safer sex mass media campaign 

 arge ing high-sensa ion-seeking and impulsivedecision-making young adul s. He lth Educ tion nd 

Beh vior, 34(5), 810-826. 

doi:10.1177/1090198107299700 

R-13 

 

 

Appendix A: 

Search Terms 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1. FOOD SAFETY campaign and behavior search terms 

[food safe y OR consumer food handling OR food safe y 

behavior OR food safe y prac ices OR improper food handling 

OR food con amina ion OR foodborne disease preven ion] AND 

[(communica ion OR risk OR media OR heal h) AND campaign] 

AND [consumer OR public] AND [behavior OR a i ude OR 

knowledge OR awareness] AND [evalua ion OR impac OR 

ou come OR change]. 

2. CLEAN campaign and behavior search terms 

[Clean OR cleaning OR hand washing OR handwashing OR wash 

OR rinse OR soap OR hand hygiene OR sani ize] AND 

[(communica ion OR risk OR media OR heal h) AND campaign] 

AND [consumer OR public] AND [behavior OR a i ude OR 

knowledge OR awareness] AND [evalua ion OR impac OR 

ou come OR change]. 

3. SEPARATE campaign and behavior search terms 

[separa e OR cross con amina ion OR cross-con amina e OR 

cu ing boards OR separa ion OR separa e OR (bac eria OR 

bac erial) ransfer] AND [(communica ion OR risk OR media OR 

heal h) AND campaign] AND [consumer OR public] AND 

[behavior OR a i ude OR knowledge OR awareness] AND 

[evalua ion OR impac OR ou come OR change]. 

4. COOK behavior search terms 

[cook OR cooking OR hermome er OR food hermome er OR 

food empera ures OR empera ure moni oring] AND 

[(communica ion OR risk OR media OR heal h) AND campaign] 

AND [consumer OR public] AND [behavior OR a i ude OR 

knowledge OR awareness] AND [evalua ion OR impac OR 

ou come OR change]. 

5. CHILL campaign and behavior search terms 

[Cold s orage OR refrigera e OR room empera ure OR defros 

OR defros ed cooling foods OR food holding OR holding food 

 empera ures OR s oring foods OR food s orage OR hawing] 

AND [(communica ion OR risk OR media OR heal h) AND 

campaign] AND [consumer OR public] AND [behavior OR 

a i ude OR knowledge OR awareness] AND [evalua ion OR 

impac OR ou come OR change]. 

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Food S fety Consumer Rese rch: Liter ture Review 

6. POISON CONTROL campaign and behavior search 

terms 

[poison con rol OR poison exposure OR oxic exposure OR 

poisonous hazards OR hazardous poison OR poisoning OR 

poison informa ion] AND [(communica ion OR risk OR media OR 

heal h) AND campaign] AND [consumer OR public] AND 

[behavior OR a i ude OR knowledge OR awareness] AND 

[evalua ion OR impac OR ou come OR change]. 

7. SMOKE ALARMS/HOME SAFETY campaign and 

behavior search terms 

[home safe y OR smoke alarm OR smoke de ec or OR fire 

alarm OR fire de ec or OR carbon monoxide de ec or OR Fire 

Safe y] AND [(communica ion OR risk OR media OR heal h) 

AND campaign] AND [consumer OR public] AND [behavior OR 

a i ude OR knowledge OR awareness] AND [evalua ion OR 

impac OR ou come OR change]. 

8. ORAL HEALTH/HYGIENE campaign and behavior 

search terms 

[oral heal h OR oral hygiene OR oral disease OR den al heal h 

OR den al hygiene] AND [(communica ion OR risk OR media OR 

heal h) AND campaign] AND [consumer OR public] AND 

[behavior OR a i ude OR knowledge OR awareness] AND 

[evalua ion OR impac OR ou come OR change]. 

9. EXERCISE campaign and behavior search terms 

[exercise OR physical ac ivi y OR physical fi ness OR fi ness OR 

recrea ion OR spor s] AND [(communica ion OR risk OR media 

OR heal h) AND campaign] AND [consumer OR public] AND 

[behavior OR a i ude OR knowledge OR awareness] AND 

[evalua ion OR impac OR ou come OR change]. 

10. HEALTHY EATING campaign and behavior search 

terms 

[heal hy ea ing OR heal hy die OR nu ri ion OR frui and 

vege able consump ion OR obesi y preven ion] AND 

[(communica ion OR risk OR media OR heal h) AND campaign] 

AND [consumer OR public] AND [behavior OR a i ude OR 

knowledge OR awareness] AND [evalua ion OR impac OR 

ou come OR change]. 

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Appendix A — Se rch Terms 

11. CONDOM USE/SEXUAL BEHAVIOR campaign and 

behavior search terms 

[condom OR con racep ion OR con racep ive OR sexual 

behavior OR sexual prac ices OR sexual ac ivi y OR sexually 

 ransmi ed diseases OR sexually ransmi ed infec ions OR HIV 

OR AIDS OR abs inence OR safe sex] AND [(communica ion OR 

risk OR media OR heal h) AND campaign] AND [consumer OR 

public] AND [behavior OR a i ude OR knowledge OR 

awareness] AND [evalua ion OR impac OR ou come OR 

change]. 

12. SECONDHAND SMOKE (PREVENTION) campaign and 

behavior search terms 

[secondhand smoke OR environmen al smoke OR smoke 

exposure OR smoke free homes OR obacco smoke exposure 

OR indoor air pollu ion] AND [(communica ion OR risk OR 

media OR heal h) AND campaign] AND [consumer OR public] 

AND [behavior OR a i ude OR knowledge OR awareness] AND 

[evalua ion OR impac OR ou come OR change]. 

13. SAFE FIREARM STORAGE campaign and behavior 

search terms 

[firearm OR firearm safe y OR firearm s orage OR gun s orage 

OR weapon s orage OR gun safe OR firearm safe OR weapon 

safe OR handgun s orage] AND [(communica ion OR risk OR 

media OR heal h) AND campaign] AND [consumer OR public] 

AND [behavior OR a i ude OR knowledge OR awareness] AND 

[evalua ion OR impac OR ou come OR change]. 

A-3 

 

 

Appendix B: 

Coding Manual 

 

 

 

 

 

 

 

 

 

 

 

 

December 2016 

Food Safety Consumer Research Project 

Literature Review: Coding Manual 

Prep red for 

Food Safety Inspection Service 

U.S. Department of Agriculture 

5601 Sunnyside Avenue 

Beltsville MD 20705-5262 

Prep red by 

Jonathan L. Blitstein PhD 

RTI Int rnational 

3040 Cornwallis Road 

R s arch Triangl Park, NC 27709 

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Food S fety Consumer Rese rch: Liter ture Review 

Coding Manual: FSIS Food Saf ty Consum r R s arch Lit ratur R vi w 

Introduction 

This is the coding m nu l for the FSIS Food S fety Consumer Rese rch Liter ture Review. PLEASE EAD 

THIS MANUAL CA EFULLY BEFO E YOU BEGIN CODING. Your prim ry job s coder is to extr ct 

inform tion (v ri bles) s det iled in this m nu l. You do not need re d e ch rticle in full. You do not 

need thorough underst nding of e ch p per. This is very structured exercise in bstr cting nd 

recording inform tion. 

Keep in mind th t uthors do not write for the purpose of system tic bstr ction. Th t me ns th t the 

inform tion we need m y not be presented or, in some c ses, will only be mentioned briefly. Limit 

subjectivity, specul tion, or trying to re d between the lines. Most v ri bles you will code include “not 

specified” or “not mentioned” option. If the inform tion is not presented, use the ‘not specified’ or 

simil r coding c tegories nd move on. 

An in-depth underst nding of the inform tion you re recording is not required. For ex mple, you do 

not need to h ve f mili rity with Soci l Le rning Theory to determine whether or not the uthors 

reported using Soci l Le rning Theory in the development of their ev lu tion. If the uthors did not 

specific lly mention Soci l Le rning Theory, you should ssume th t it w s not used. 

In some pl ces, you will be sked whether the inform tion you re coding is “well described” by the 

 uthors. Use your judgement s re der. For ex mple, if the uthors simply mention Soci l Le rning 

Theory but provide no ddition l inform tion, then the theory is not well described. If, on the other 

h nd, the uthors provide n expl n tion of the ssumed mech nism of ch nge, pointing out Soci l 

Le rning Theory nd cert in key theoretic l constructs, then the use of theory would seem to be well 

described. When confronted with questions bout wh t qu lifies s ‘well described’ sk yourself this 

question – “As re der, did the uthor’s give me enough inform tion to underst nd their position?” 

Stat m nt of Eligibility 

The d t for this system tic review come from ev lu tions of public he lth c mp igns. As in ny 

system tic review, cle r st tement of the eligibility criteri is required both to describe the set of 

included studies nd to lert re ders to the limits of the review. The following re the eligibility criteri 

used to select studies for this review: 

1. The bstr ct is v il ble in the English l ngu ge 

2. The study reports n ev lu tion of public he lth / risk communic tion c mp ign 

3. The study reports on public he lth c mp ign conducted in the US, EU, UK, AU, NZ, C n d , or 

Mexico 

4. The study reports on c mp ign th t ddresses specific he lth beh vior 

5. The study ex mines the effect of the c mp ign on consumers 

6. The study includes qu ntit tive findings 

7. The study is not review or editori l rticle 

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Appendix B — Coding M nu l 

A. Study / R port Charact ristics 

1. (CID) Coder ID number. Enter your coder ID number. 

2. (RID) Report ID number. Enter the report ID number. This is the unique identifier for the d t you 

enter. Indic te by checking the box if you h ve determined th t the report is not ppropri te for 

the liter ture review. 

0 = not ppropri te for the liter ture review 

1 = OPEN TEXT (Record report ID) 

3. (Country) Country of Origin: Where did the c mp ign t ke pl ce? Select all that apply. 

1 = United St tes 

2 = C n d 

3 = United Kingdom 

4 = Europe (not UK) 

5 = Austr li / New Ze l nd 

6 = Mexico 

4. (PUB) Public He lth Dom in: Wh t public he lth dom in w s the focus of the c mp ign? Select 

all that apply. 

1. Food S fety (gener l, s fe food h ndling, prevention of food-borne illness) 

2. Cle n – H ndw shing (rel ted to food prep), cle ning surf ces, not w shing poultry 

3. Sep r te – keeping r w me t/poultry sep r te from re dy-to-e t foods (e.g., using 

sep r te cutting bo rds) 

4. Cook – Thermometer use nd use of proper cooking temper tures 

5. Chill – Refriger tion/cooler use, proper th wing 

6. Poison control 

7. Smoke l rms/home s fety 

8. Or l he lth/hygiene 

9. Exercise 

10. He lthy e ting 

11. Condom use/sexu l beh vior 

12. Secondh nd smoke (prevention) 

13. S fe Fire Arm Stor ge 

14. Other 

B. Campaign Charact ristics 

5. (PER_1) Period of c mp ign dissemin tion (st rt): C lend r ye r when the c mp ign w s first 

dissemin ted. If this inform tion is not provided or c nnot be determined from the report, 

record “NR” for not reported. 

1 = OPEN TEXT (Record ye r) 

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Food S fety Consumer Rese rch: Liter ture Review 

6. (PER_2) Period of c mp ign dissemin tion (end): C lend r ye r when the c mp ign w s ended. If 

this inform tion is not provided or c nnot be determined from the report, record “NR” for not 

reported. NOTE: If the authors indicate that the campaign is ongoing enter the year of article 

publication. 

1 = OPEN TEXT (Record ye r) 

7. (SPON) Source / Sponsor: Enter the reported funding source for this c mp ign ev lu tion. 

0 = Not reported 

1 = St te government (direct sponsor) 

2 = Feder l government (direct sponsor) 

3 = Non-profit / phil nthropic 

4 = Gr nt-funded 

5 = Commerci l / priv te industry 

6 = Public/Priv te p rtnership 

7 = Other (SPECIFY) __________ 

8. (SETTING) Pl ce(s) where the c mp ign w s dissemin ted: Describe where c mp ign w s 

dissemin ted. If the uthors only refer to community-b sed c mp ign, code “Community 

(gener l)”. Use the code “Community (specific)” only if the uthors mention th t the community 

context relev nt to underst nd the imp cts of the c mp ign. For ex mple, if the c mp ign w s 

cultur lly t ilored for Hisp nic group, then dissemin tion in Hisp nic neighborhood would be 

relev nt. If the c mp ign w s for gener l popul tion nd just h ppened to be dissemin ted in 

Hisp nic neighborhood, community would not be relev nt. 

0 = Not reported 

1 = N tion l/St te-wide 

2 = Community (gener l) 

3 = Community (specific) ____________ 

4 = Child C re/School 

5 = University 

6 = Other (SPECIFY) _____________ 

C. Campaign D v lopm nt 

9. (THEORY) Theory guiding the rese rch: Indic te whether the uthors identify p rticul r theory 

or fr mework th t w s used to guide c mp ign development. Select All That Apply 

0 = Not specified 

1 = Soci l Le rning/Soci l Cognitive Theory 

2 = Theory of Pl nned Beh vior/Theory of Re soned Action/Integr tive Theory of Beh vior 

Ch nge 

3 = He lth Belief Model 

4 = Diffusion of innov tions 

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Appendix B — Coding M nu l 

5 = El bor tion Likelihood Model (ELM)/ Heuristic System tic Model (HSM) 

6 = Tr nstheoretic l Model (st ges of ch nge) 

7 = Agend Setting 

8 = Extended P r llel Process Model 

9 = Other (SPECIFY) ______________________ 

10. (SOCMAR) Soci l M rketing: Soci l m rketing ppro ches use the “4 Ps” or m rketing mix 

(product, price, pl cement, nd promotion) in the c mp ign development to encour ge specific 

beh vior. Look specific lly for terms like “soci l m rketing” or “m rketing mix” long with 

descriptions of the steps t ken to promote c mp ign mess ges. 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

11. (BRAND) Br nded: Br nding is process of cre ting n impression in the minds of consumers th t 

promotes f vor ble ttitude tow rd the t rget beh vior. If c mp ign used br nding it will be 

cle rly referred to s “br nded.” Also look for terms like “person lity” or “identity”. 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

D. Formativ R s arch 

12. (FOCUS) Focus groups with priority udience: Do the uthors describe or t le st refer to the f ct 

th t focus group rese rch w s used to develop c mp ign mess ges. Select if focus group w s 

used in the study, nd if the det ils re described well (e.g., number of focus group, number of 

p rticip nts in e ch group, content of discussion). 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

13. (INTV) Interviews with the priority udience. Do the uthors describe or t le st refer to the f ct 

th t interviews were used to develop c mp ign mess ges. Select if interviews were used in the 

study, nd if the det ils re described well (e.g., number of interviews, content of discussion). 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

14. (EXPERT) Use of expert elicit tion. Did the c mp ign developers seek inform tion from experts in 

the field (e.g., c demic, commerci l/industri l) to inform c mp ign development? 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

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Food S fety Consumer Rese rch: Liter ture Review 

15. (STAKE) Input from st keholders. Did the c mp ign developers seek input from st keholders, 

persons who h ve n interest nd re knowledge ble bout the he lth dom in in the popul tion 

of interest? 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

16. (TESTING) Mess ge Testing: The rticle describes process of ssessing the effects or receptivity 

to c mp ign mess ges. Mess ge testing is done fter mess ge development nd before 

implement tion of the c mp ign. Did this c mp ign test its mess ge? 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

E. M ssag Charact ristics 

17. (FRAME) Mess ge Fr me: The two most common fr mes used in public he lth c mp igns re 

g in fr mes nd loss fr mes. A g in-fr med mess ge suggest dded benefits from eng ging in the 

desired beh vior (e.g., incre se your exercise for better he lth; quit smoking nd you’ll live 

longer). Loss fr med mess ges emph size the costs or risks ssoci te with beh viors (e.g., too 

much dded sug r in your diet c n le d to di betes; w shing poultry c n spre d b cteri ). Other 

fr mes m y be described. If the uthor refer to fr me other th n g in or loss, indic te “Other” 

 nd provide brief description. 

0 = Not Specified 

1 = G in Fr me 

2 = Loss Fr me 

3 = Other (Specify) ___________________ 

18. (FOCUS) Mess ge Focus: Does the c mp ign h ve n emotion l or r tion l focus? The uthors 

will use the term “r tion l” or “emotion l” if one of these ppro ches w s used in development 

the mess ges. If neither is specific lly mentioned, record “not specified.” 

0 = Not specified 

1 = R tion l Appe l 

2 = Emotion l Appe l 

19. (ACTION) C ll to Action: A c ll to ction is mess ging devices designed to provoke n udience 

response. C lls to ction usu lly expressed in the form of n imper tive, such s "get out nd 

vote" or "e t your five- -d y". 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

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Appendix B — Coding M nu l 

20. (VISUAL) Visu l Cues nd Icons: Does the rticle describe set of visu l im ges (logo, m scot, use 

of color) used consistently to promote the c mp ign? 

0 = Not mentioned 

1 = Yes, but not well described 

2 = Yes, described very well 

F. Campaign Diss mination Charact ristics 

21. (CHANNEL) Included Ch nnels: Wh t ch nnel did the c mp ign use for its outre ch efforts? 

Select all that apply. 

0 = Not specified 

1 = Public sp ces (buses, billbo rds) 

2 = Print (newsp pers, m g zines) 

3 = R dio / TV 

4 = Internet / soci l medi 

5 = M ss medi (unspecified) 

6 = Other ________________ 

22. (MEDIA_EXP) Me sure of Exposure: Indic tes the nticip ted c mp ign exposure b sed on 

estim tes provided by the medi . This is n ssessment of potenti l exposure mong the 

popul tion, not the study s mple. For r dio nd TV, this will often be reported s GRPs (Gross 

R ting Points), TARPs (Tot l Audience R ting Points), or ‘medi sh re’; For print medi , exposure 

will often be reported s ‘impressions’; for billbo rds nd other medi , exposure m y be reports 

 s the number of ‘views’ or ‘looks.’ 

0 = Not specified 

1 = OPEN TEXT (Record number) 

23. (REACH_EXP) Popul tion re ch: This is nother me sure of potenti l exposure mong the 

popul tion. Unlike medi exposure, which is specific to type of medium, Re ch is more 

commonly reported glob lly for the entire c mp ign. Look specific lly for the term ‘re ch’ or 

‘c mp ign re ch.’ 

0 = Not specified 

1 = OPEN TEXT (Record number) 

Reported w reness of the c mp ign mess ges reported by study participants is c ll RECALL. Aided 

recall consists of providing the respondent with p rts of the c mp ign mess ge (e.g., t g line, logo, or 

phr se) nd sking them if they remember he ring or seeing th t inform tion. Unaided recall consists of 

 sking respondents if they remember ny he ring or seeing mess ges bout the topic of interest. If the 

respondent s ys yes, they re then sked to describe or repe t the mess ge to verify their cl im. Look 

for the terms “ ided rec ll” nd “un ided rec ll.” 

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Food S fety Consumer Rese rch: Liter ture Review 

24. (A_RECALL) Wh t is the mount of Aided rec ll reported in this study? This will typic lly be 

reported s percent ge of the s mple who rec lled the mess ge. If rec ll is reported in some 

other m nner, record “999” for this v ri ble nd enter inform tion on the mount nd form of 

me sure under FINDINGS. 

0 = Not specified 

1 = OPEN TEXT (Report Number) 

25. (UN_RECALL) Un ided rec ll reported. Wh t is the mount of un ided rec ll reported in this 

study? This will typic lly be reported s percent ge of the s mple who rec lled the mess ge. If 

rec ll is reported in some other m nner, record “999” for this v ri ble nd enter inform tion on 

the mount nd form of me sure under FINDINGS. 

0 = Not specified 

1 = OPEN TEXT (Report Number) 

G. Audi nc 

26. (AUD) Did the c mp ign ttempt to re ch everyone in the gener l public, or only specific 

group? 

0 = Gener l udience (SKIP TO Question 29) 

1 = Priority udience 

27. (RISK) At-risk popul tion: Is the priority udience one of the following t risk groups (Select ll 

th t pply)? 

1 = Limited resources (e.g., low income) 

2 = Pregn nt women 

3 = Children below the ge of 5 

4 = P rents 

5 = Elderly (60 ye rs nd bove) 

6 = Immunocompromised 

7 = None of the bove 

28. (SUBPOP) Priority popul tion. Describe the key ch r cteristics of the t rgeted popul tion s 

 ppropri te. Key ch r cteristics m y include ge, r ce/ethnicity, gender, nd loc tion 

1 = OPEN TEXT (Describe) 

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Appendix B — Coding M nu l 

H. Evaluation Charact ristics 

29. (EVAL_DES) Ev lu tion Design: Wh t w s the design of the ev lu tion of the c mp ign? An 

observ tion l design is present in study when l d t re collected from individu ls who were 

exposed to the communic tion c mp ign. Comp r tive designs include two groups of individu ls, 

with one group th t is exposure to the communic tions c mp ign nd nother group is not 

exposure to the communic tion c mp ign. By definition, a comparative design include a control 

or comparison group. 

1 = Observ tion l Study 

2 = Comp r tive Design (experiment l / qu si-experiment l) 

3 = Other ___________________________________ 

30. (TIME) Period of Exposure: How long w s the udience exposed to the c mp ign mess ge? Enter 

the in number of months. If this inform tion is not given explicitly, but PER_1 nd PER_2 c n be 

determined, use these v ri bles to estim te TIME. If only ye r is given for either PER_1 or 

PER_2, ssume the c mp ign l unched/concluded in July. If TIME c nnot be determined, enter 

NR. 

1 = ______ Months (open field) 

 For weeks, divide months by 4 

 For d ys, divide months by 30.5 

 For ye rs, multiple months by 12 

 For mess ge testing or other studies, where p rticip nt re exposed to stimuli 

 nd sked to respond immedi tely, record zero (0) 

31. (SAMPLE) S mple Size: Wh t is the s mple size for the prim ry n lysis? Record inform tion 

 bout the number of p rticip nts contributing to the n lysis. This number m y be different from 

the number of p rticip nts recruited. If pre- nd post-surveys done, t ke the ver ge of the two 

s mple sizes. 

1 = OPEN TEXT (Report number) 

32. (MTYPE) Me sure Type: How w s d t collected to ssess the outcomes nd imp cts of the 

c mp ign? Studies m y report ch nge from pre-test to post-test in one group, difference 

between two groups me sured fter one group w s exposed to the c mp ign, or they m y 

me sure two groups t two occ sions nd me sure the ch nge in one group rel tive to the 

ch nge in the other group. 

1 = Simple cross-section l (one group, one time) 

2 = Ch nge over time, no control or comp rison group 

3 = Difference between two (or more) groups me sured only once 

4 = Ch nge over time within two groups nd comp red those ch nges (i.e., difference-indifference) 

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Food S fety Consumer Rese rch: Liter ture Review 

33. OUTCOME/IMPACT/SCALE. Item 33 is structured s 3x4 d t t ble: 

Wh t were the reported 

c mp ign outcomes? 

Is it st tistic lly 

signific nt? 

Sc le of Me sure 

Beh vior 

Attitude/belief 

Knowledge 

Aw reness 

Dropdowns re provided for e ch of the following v ri bles: 

(OUTCOME) Outcome(s) Reported nd effects: Wh t were the reported outcome of the c mp ign? Did 

knowledge nd/or w reness incre se s result of the c mp ign? Were beh viors nd/or ttitudes 

ch nged? Indicate Yes/No for each. 

1 = Beh viors (Y/N) 

2 = Attitude / belief (Y/N) 

3 = Knowledge (Y/N) 

4 = Aw reness (Y/N) 

(IMPACT) Reports of st tistic lly signific nt ch nge: For e ch outcome, did the uthors report 

st tistic lly signific nt ch nge or difference? Report all that apply. 

1 = Beh viors (Y/N) 

2 = Attitude / belief (Y/N) 

3 = Knowledge (Y/N) 

4 = Aw reness (Y/N) 

(MSCALE) Sc le of Me sure: Report the type me surement used to describe ch nge in the study 

outcomes. 

1 = Me ns (continuous me sures) 

2 = Odds r tio (prob bility of event) 

3 = Frequency (number of people or events) 

4 = St tus (ch nge from one c tegory to nother) 

5 = Other (Specify) 

I. Findings and L ssons L arn d 

34. (FINDINGS) Study’s m in findings: Record in few sentences the m in results of the study. This 

will often be found in the first p r gr ph of the discussion section. Looks for comments th t 

provide gener l summ ry of the n lyses presented or refer to the hypotheses tested. 

1 = OPEN TEXT (Describe) 

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Appendix B — Coding M nu l 

35. (LESSON) Lessons Le rned: Lessons le rned will typic lly be presented in the discussion section. 

Authors will note ch llenges with implementing or ev lu tion the c mp ign nd offer 

suggestions to the re der to minimize or void encountering simil r problems. Record in few 

sentences ny lessons th t were le rned from the c mp ign. 

0 = Not reported 

1 = OPEN TEXT (Describe) 

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