Health Communication and Social Marketing: Campaigns That Include Mass Media and Health-Related Product Distribution

The CPSTF finding is based on evidence from a systematic review of 22 studies (search period 1980 – 2009). The review was conducted on behalf of the CPSTF by a team of specialists in systematic review methods, and in research, practice, and policy related to health communication and social marketing.

Health communication campaigns apply integrated strategies to deliver messages designed, directly or indirectly, to influence health behaviors of target audiences. Messages are communicated through various channels that can be categorized as:

• Mass media (e.g., television, radio, billboards)
• Small media (e.g., brochures, posters)
• Social media (e.g., Facebook , Twitter , web logs)
• Interpersonal communication (e.g., one-on-one or group education)

Drawing on concepts from social marketing, a health communication campaign can be combined with other activities such as distribution of products to further influence health behaviors. The current review was devised to evaluate the effectiveness of the combination of health communication campaigns that meet specific criteria with the distribution of health-related products that also meet specific criteria.

Twenty-two studies with 25 study arms qualified for the review.

• Results from analyses show that effects were favorable for the following outcomes:
  • Health promoting behaviors: absolute median change of 8.4 percentage points (Interquartile Interval [IQI]: 2.7 to 14.5 percentage points; 20 study arms)
    • Use of child safety seats: absolute median change of 8.6 percentage points (IQI: -9.2 to 9.6 percentage points; 3 study arms)
    • Use of condoms: absolute median change of 4.0 percentage points (IQI: -4.0 to 10.8 percentage points; 4 study arms)
    • Use of helmets: absolute median change of 8.4 percentage points (IQI: 2.1 to 18.5 percentage points; 10 study arms)
    • Smoking cessation: absolute median change of 10.0 percentage points (IQI: 3.1 to 16.9 percentage points; 3 study arms)
  • The remaining 5 study arms also evaluated interventions with generally favorable results, but reported results that could not be expressed as percentage point changes in health behaviors: condom use, 2 study arms; physical activity (pedometer use), 2 study arms; and sun protection product use, 1 study.

An overall conclusion about the economic merits of the intervention cannot be reached because available economic information and analyses were incomplete.

The economic review is based on evidence from 15 studies (search period January 1980 December 2009). Included studies provided limited economic information on health communication campaigns to increase use of child booster and car seats (1 study), pedometers (1 study), condoms (4 studies), recreational helmets (5 studies), and nicotine replacement therapy (4 studies). There were no studies of interventions that promoted use of sun protection products.

There were several limitations to the quality of the cost and benefit estimates.

• Intervention costs
  • Most of the studies included either the cost of media or the cost of the product distributed, and not both.
  • Volunteer labor and in-kind contributions were not valued.
  • Target populations were not specified making per capita calculations impossible.
• Economic benefits
  • Monetized benefits from healthcare averted and productivity gains, and quality-adjusted life year (QALY) saved were rarely estimated or modeled.
  • Most studies reported proximal benefits such as quits among smokers or reductions in unprotected sex.
• Cost-benefit and cost-effectiveness
  • Overall assessments could not be made because of incomplete assessments of costs and benefits.

Results suggest that health communication campaigns that include mass media, and product distribution interventions are applicable to:

• A wide variety of broad or narrowly-defined populations provided they are appropriately segmented and targeted.
• Products evaluated in this review and products that were not included but meet the criteria. Interventions were shown to be effective for:
  • Both free and discounted products
  • Single use (e.g., condoms) and reusable (e.g., recreational safety helmets)

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

• The majority of the campaigns researched were short-term; therefore, additional research is needed to assess the sustainability and effectiveness of long-term campaigns.
• There is a common research gap related to the explicit efforts made to gather the most information from all targeted individuals. There is a need to increase and improve the collection on different demographic characteristics. This would help explain the differential effect of the campaigns on age gender, and race/ethnicity.
• There is also a need for researchers to design campaigns comparing the intensity of different study arms. Campaign intensity provides informative evidence on how much promotion is necessary for a targeted audience to receive a message in order to help increase the likelihood of a behavior change.
• Better reporting on intervention details, including descriptions of the methods used to develop campaigns, combined with the use of more consistent terminology within the field, would improve future research and translation activities.
• More complete and high quality economic evaluations of these interventions are necessary.
• More complete and high quality economic evaluations of these interventions are necessary.
• Most studies evaluated proximal outcomes specific to the interventions. Economic outcomes for healthcare use and workplace productivity and expected QALY saved need to be estimated or modeled to operationalize cost-benefit and cost-effectiveness assessments.

• Included studies evaluated campaigns to promote use of child safety seats (3 study arms), condoms (6 study arms), recreational safety helmets (10 study arms), pedometers (2 study arms), over-the-counter nicotine replacement therapy (3 study arms), and sun protection products (1 study).
• Communication campaigns used several different channels, always with mass media (e.g., TV, radio, newspapers) and nearly always including small media (e.g., brochures, posters, fliers) and interpersonal communication (e.g., peer outreach, hotline numbers),over periods of time that ranged from 1 week to 36 months.
• Most often, messages were disseminated via community events (e.g., health fairs, festivals), and occasionally through social media (e.g., Facebook).
• Some campaigns were accompanied by other activities such as providing services (e.g., HIV testing, quitline counseling) or environmental changes (e.g., building walking trails).
• Studies were conducted in a wide range of urban, rural, and suburban settings in the U.S. (20 study arms), Australia (2 study arms), Canada (1 study arm), Belgium (1 study arm), and Israel (1 study arm).
• Many papers did not report details on population demographics, such as race, age, and education. Populations that were addressed, however, included African Americans, people of Hispanic origin, low-income groups, and men who have sex with men.

Robinson MN, Tansil KA, Elder RW, et al. Mass media health communication campaigns combined with health-related product distribution: a Community Guide systematic review. American Journal of Preventive Medicine. 2014;47(3):360-71.

Jacob V, Chattopadhyay SK, Elder RW, et al. Economics of mass media health campaigns with health-related product distribution: a Community Guide systematic review. American Journal of Preventive Medicine. 2014;47(3):348-59.

Community Preventive Services Task Force. Combination of mass media health campaigns and health-related product distribution is recommended to improve healthy behaviors. American Journal of Preventive Medicine. 2014;47(3):372-4.

Effectiveness Review

Analytic Framework

When starting an effectiveness review, the systematic review team develops an analytic framework. The analytic framework illustrates how the intervention approach is thought to affect public health. It guides the search for evidence and may be used to summarize the evidence collected. The analytic framework often includes intermediate outcomes, potential effect modifiers, potential harms, and potential additional benefits.

Effectiveness Review

Summary Evidence Table Effectiveness Review

Economic Review

Summary Evidence Table Economic Review

The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).

Effectiveness Review

Child Safety Seat Campaigns

Ebel BE, Koepsell TD, Bennett EE, Rivara FP. Use of child booster seats in motor vehicles following a community campaign: a controlled trial. JAMA 2003;289(7):879-84.

St Louis RM, Parow JE, Eby DW, Bingham CR, Hockanson HM, and Greenspan AI. Evaluation of community-based programs to increase booster seat use. Accid Anal Prev 2008;40(1):295-302.

Condom Campaigns

Alstead M, Campsmith M, Halley CS, Hartfield K, Goldbaum G, Wood RW. Developing, implementing, and evaluating a condom promotion program targeting sexually active adolescents. AIDS Educ Prev 1999;11(6):497-512.

Kegeles S, Hays R, Pollack L, Coates T. Mobilizing young gay and bisexual men for HIV prevention: a two-community study AID 1999;13:1753 62.

Kennedy MG, Mizuno Y, Seals BF, Myllyluoma J, Weeks-Norton K. Increasing condom use among adolescents with coalition-based social marketing. AIDS 2000;14 (12):1809-18.

O’Leary A, Jemmott LS, Goodhart F, Gebelt J. Effects of an institutional AIDS prevention intervention: moderation by gender AIDS Educ Prev 1996;8(6):516-28.

Ross MW, Chatterjee NS, Leonard L. A community level syphilis prevention programme: outcome data from a controlled trial. Sex Transm Infect 2004;80(2):100-4.

Pedometer Campaigns

De Cocker KA, De Bourdeaudhuij IM, Brown WJ, Cardon GM. Effects of “10,000 steps Ghent”: a whole-community intervention. Am J Prev Med 2007;33(6):455-63.

Brown WJ, Mummery K, Eakin E and Schofield G. 10,000 Steps Rockhampton: evaluation of a whole community approach to improving population levels of physical activity. J of Physic Act and Hlth 2006;3:1-14.

Recreational Safety Helmet Campaigns

DiGuiseppi CG, Rivara FP, Koepsell TD, Polissar L. Bicycle helmet use by children. Evaluation of a community-wide helmet campaign. JAMA 1989;262(16):2256-61.

Levy AS, Hawkes AP, Rossie GV. Helmets for skiers and snowboarders: an injury prevention program. Health Promot Pract 2007;8(3):257-65.

Morris BA, Trimble NE, Fendley SJ. Increasing bicycle helmet use in the community. Measuring response to a wide-scale, 2-year effort. Can Fam Physician 1994;40:1126-31.

Pendergrast RA, Ashworth CS, DuRant RH, Litaker M. Correlates of children’s bicycle helmet use and short-term failure of school-level interventions. Pediatrics 1992;90(3):354-8.

Ressler, WH, Toledo E. Kasdah B’Rosh Tov A Description and Evaluation of the Israeli Bicycle Helmet Campaign, Health Education and Behavior. Health Educ and Behav 1998;25(3):354-70.

Rouzier P, Alto WA. Evolution of a successful community bicycle helmet campaign. J Am Board Fam Pract 1995;8(4):283-7.

Smith PK. Increasing bicycle helmet use in Michigan: a school-based intervention pilot program. Evaluation report. 1991 [Technical report]

Wood T, Milne P. Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia. Accident Analysis and Prevention 1998;20(3):177-85.

Smoking Cessation Campaigns (Quitline)

Bauer J, Carlin-Menter S, Celestino P, Hyland A, Cummings K. Giving away free nicotine medications and a cigarette substitute (Better Quit ) to promote Callsto a Quitline. J Public Health Management Practice 2006;12(1):60 7

Burns E, Levinson A. Reaching Spanish-speaking smokers: state-level evidence of untapped potential for quitline utilization. American Journal of Public Health 2010;100(1):165-70.

Campbell S, Lee L, Haugland C, Helgerson S. Tobacco quitline use enhancing benefit and increasing abstinence. Am J Prev Med 2008;35(4):386-8.

Tinkelman D, Wilson S, Willett J, Sweeney C. Offering free NRT through a tobacco quitline: impact on utilization and quit rates. Tob Control 2007;16:i42-6.

Sun Safety Campaigns

Roberts DC, Black D. Comparison of interventions to reduce sun exposure. Behav Med2009;35(2):67-76.

Campaigns with Condom Promotion Only

DeVroome E, Sandfort T, de Vries K, Paalman M, Tielman R. Evaluation of a safe sex campaign regarding AIDS and other sexually transmitted diseases among young people in the Netherlands. Health Educ Res 1991;6(3):317-25.

Gold J, Goller J, Hellard M, Lim M, Clift P, Fairley C, Hocking J, McNamee K, Guy R. Evaluation of the Victorian ‘You’ll Never Know Who You’ll Meet’ youth awareness campaign. Sexual Health2008; 5:381 404. [Conference Abstract from the Australian Sexual Health Conference 2008 15 September 2008, Perth, Western Australia, Australia]

Romer D, Sznitman S, DiClemente R, Salazar L, Vanable P, Carey M, Hennessey M, Brown L, Valois R, Stanton B, Fortune T, Juzan I. Mass media as an HIV-prevention strategy: using culturally sensitive messages to reduce HIV-associated sexual behavior of at-risk African American youth. American Journal of Public Health 2009;99(12):2150-9.

Rosser S. The effects of using fear in public AIDS education on the behaviour of homosexually active men. Jour Psych and Hum Sex 1991;4(3):123-34.

Traeen B. Learning from the Norwegian experience: attempts to mobilize the youth culture to fight the AIDS epidemic. AIDS Ed and Prev 1992;S43-56.

Economic Review

Alstead M, Campsmith M, Halley CS, Hartfield K, Goldblum G, Wood RW. Developing, implementing, and evaluating a condom promotion program targeting sexually active adolescents. AIDS Educ Prev 1999;11(6):497-512.

Bauer JE, Carlin-Menter SM, Celestino PB, Hyland A, Cummings KM. Giving away free nicotine medications and a cigarette substitute (Better Quit [R]) to promote calls to a Quitline. J Public Health Manag Pract 2006;12(1):60.

Bergman AB, Rivara FP, Richards DD, Rogers LW. The Seattle children’s bicycle helmet campaign. Arch Pediatr Adolesc Med 1990;144(6):727.

Brown WJ, Mummery K, Eakin E, Schofield G. 10,000 Steps Rockhampton: evaluation of a whole community approach to improving population levels of physical activity. J Phys Act Health 2006;3(1):1.

Cummings KM, Fix B, Celestino P, Carlin-Menter S, O’Connor R, Hyland A. Reach, efficacy, and cost-effectiveness of free nicotine medication giveaway programs. J Public Health Manag Pract 2006;12(1):37.

Eakin EG, Mummery K, Reeves MM, et al. Correlates of pedometer use: Results from a community-based physical activity intervention trial (10,000 Steps Rockhampton). Int J Behav Nutr Phys Act 2007;4(1):31.

Fellows JL, Bush T, McAfee T, Dickerson J. Cost effectiveness of the Oregon quitline “free patch initiative”. Tob Control 2007;16(Suppl 1):i47.

Kahn JG, Kegeles SM, Hays R, Beltzer N. Cost-effectiveness of the Mpowerment Project, a community-level intervention for young gay men. J Acquir Immune Defic Syndr 2001;27(5):482.

Kennedy MG, Mizuno Y, Seals BF, Myllyluoma J, Weeks-Norton K. Increasing condom use among adolescents with coalition-based social marketing. AIDS 2000;14(12):1809.

Levy AS, Hawkes AP, Rossie GV. Helmets for skiers and snowboarders: an injury prevention program. Health Promot Pract 2007;8(3):257.

Rebchook GM, Kegeles SM, Huebner D. Translating research into practice: The dissemination and initial implementation of an evidence-based HIV prevention program. AIDS Educ Prev 2006;18(suppl):119-36.

Rouzier P, Alto WA. Evolution of a successful community bicycle helmet campaign. J Am Board Fam Pract 1995;8(4):283.

Smith PK. Increasing bicycle helmet use in Michigan: A school-based intervention pilot program. Evaluation report. Lansing: Michigan Helmet Advisory Committee.

St Louis RM, Parow JE, Eby DW, Bingham CR, Hockanson HM, Greenspan AI. Evaluation of community-based programs to increase booster seat use. Accid Anal Prev 2008;40(1):295-302.

Tinkelman D, Wilson SM, Willett J, Sweeney CT. Offering free NRT through a tobacco quitline: impact on utilisation and quit rates. Tob Control 2007;16(Suppl 1):i42.

Wood T, Milne P. Head injuries to pedal cyclists and the promotion of helmet use in Victoria, Australia. Accid Anal Prev 1988;20(3):177-85.

The following databases were searched from January 1980 to December 2009 to identify studies assessing the effectiveness of health communication campaigns that include product distribution: CINAHL (EbscoHost), Cochrane, Econlit, ERIC (CSA), Health and Safety Science Abstracts (CSA), JSTOR, Medline (Ovid), PILOTS(CSA), PsychInfo (Ovid), Social Service Abstracts (CSA), Sociological Abstracts (CSA), Social Sciences Citation Index (Web of Knowledge). The search yielded 15,491 articles, books, and conference abstracts.

Concept 1) Campaign, Intervention, and Program Keywords
Concept 2) Health communication, Health marketing, and Social marketing Keywords
Concept 3) Product Keywords

MEDLINE + Non-Indexed and In-Process (Ovid)
Concept 1: Programs, campaigns or interventions
(program* or evaluat* or intervention* or study or research*).ti,ab

Concept 2: health communication, health marketing social marketing
(campaign* or consumer research or (health adj2 (communication or information)) or advertising or journalism or marketing).ti,ab

Concept 3a: product search 1 (3352 results)
helmet* or head protect* device* or child safety seat* or booster seat* or car seat* or child restraint system* or carry cot bucket seat* or infant carrier* or convertible seat* or condom* or nicotine gum or pedometer* or step counter* or ((folic acid or folate or folacin or vitamin M or vitamin B9) adj3 (supplement*)) or toothbrush* or dental floss or sunblock* or sun block* or sunscreen* or sun screen* or sun protect* or suntan lotion* or suntan oil* or subsidize* or coupon* or discount* or voucher* or blood pressure monitor* or sphygmomanometer* or blood pressure meter* or insecticide* or repellent* or N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito* or ((nicotine) adj1 (gum* or patch* or lozenge*)) or hat or hats or visor* or antiseptic hand rub or hand hygiene or exp HIV/ or exp Acquired Immunodeficiency Syndrome/ or exp Sexually Transmitted Diseases/ or sexually transmitted disease* or sexually transmitted infection* or STI or STIs or STD or STDs or HIV or AIDS or exp Exercise/ or Physical activit* or Physical inactivit* or Exercis* or obesity or obese or overweight or exp Weight Gain/ or exp Weight Loss/ or (weight adj2 (loss or lost or losses or losing or lose or loses)) or exp Sunburn/ or sunburn*

Concept 3b: product search 2 (28 results)
ear plug* or earplug* or noise reduc* device* or ear protect* device* or ((((protect*) adj2 (gear or device* or mouth or eye)) or wrist pad* or elbow pad* or knee pad* or protective eyewear or goggles or safety glasses or safety lenses or mouthguard or mouth guard) and (sport* or skat* or rollerblad* or athlet*)) or break away base or breakaway base or breakaway-base or personal flotation device* or life jacket* or life-jacket or life vest* or life-vest or ((bear) adj4 (spray* or deterrent*)) or ((reflector* or reflecti* material*) and bicycle*) or grab bars or grab bar or (lip balm and (SPF or sunscreen* or protect*)) or skip* rope or rope skip* or jump* rope or jump-rope or rope jump* or ((exercise or recumbent) adj1 (bike* or bicycle*)) or elliptical trainer* or stair stepper* or stair climber* or rowing machine* or exercise machine* or cross-country ski machine* or exercise equipment or treadmill* or dumbbells or barbells or heart monitor* or heart rate monitor* or interactive videogame* or interactive video game* or Nintendo Wii or Dance Dance Revolution

PSYCINFO (Ovid)
Concept 1: Programs, campaigns or interventions
(program* or evaluat* or intervention* or study or research*).ti,ab

Concept 2: health communication, health marketing social marketing
(campaign* or consumer research or (health adj2 (communication or information)) or advertising or journalism or marketing).ti,ab

Concept 3a: product search 1 (1205 results)
helmet* or head protect* device* or child safety seat* or booster seat* or car seat* or child restraint system* or carry cot bucket seat* or infant carrier* or convertible seat* or condom* or nicotine gum or pedometer* or step counter* or ((folic acid or folate or folacin or vitamin M or vitamin B9) adj3 (supplement*)) or toothbrush* or dental floss or sunblock* or sun block* or sunscreen* or sun screen* or sun protect* or suntan lotion* or suntan oil* or subsidize* or coupon* or discount* or voucher* or blood pressure monitor* or sphygmomanometer* or blood pressure meter* or insecticide* or repellent* or N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito* or ((nicotine) adj1 (gum* or patch* or lozenge*)) or hat or hats or visor* or antiseptic hand rub or hand hygiene or exp HIV/ or exp AIDS/ or exp Sexually Transmitted Diseases/ or sexually transmitted disease* or sexually transmitted infection* or STI or STIs or STD or STDs or HIV or AIDS or exp Exercise/ or Physical activit* or Physical inactivit* or Exercis* or obesity or obese or overweight or exp Weight Gain/ or exp Weight Loss/ or (weight adj2 (loss or lost or losses or losing or lose or loses)) or sunburn*

Concept 3b: product search 2 (11 results)
ear plug* or earplug* or noise reduc* device* or ear protect* device* or ((((protect*) adj2 (gear or device* or mouth or eye)) or wrist pad* or elbow pad* or knee pad* or protective eyewear or goggles or safety glasses or safety lenses or mouthguard or mouth guard) and (sport* or skat* or rollerblad* or athlet*)) or break away base or breakaway base or breakaway-base or personal flotation device* or life jacket* or life-jacket or life vest* or life-vest or ((bear) adj4 (spray* or deterrent*)) or ((reflector* or reflecti* material*) and bicycle*) or grab bars or grab bar or (lip balm and (SPF or sunscreen* or protect*)) or skip* rope or rope skip* or jump* rope or jump-rope or rope jump* or ((exercise or recumbent) adj1 (bike* or bicycle*)) or elliptical trainer* or stair stepper* or stair climber* or rowing machine* or exercise machine* or cross-country ski machine* or exercise equipment or treadmill* or dumbbells or barbells or heart monitor* or heart rate monitor* or interactive videogame* or interactive video game* or Nintendo Wii or Dance Dance Revolution

CSA DATABASES (1606 results total for product search 1; 8 results total for product search 2)
ERIC (761 ; 1)
Social Services Abstracts (244 ; 0)
Health and Safety Science Abstracts (225 ; 5)
PILOTS (0 ; 0)
Sociological Abstracts (369 ; 1)
Concept 1: Programs, campaigns or interventions
TI=(program* or evaluat* or intervention* or study or research*) or AB=(program* or evaluat* or intervention* or study or research*)

Concept 2: health communication, health marketing social marketing
TI=(campaign* or consumer research or (health within 2 (communication or information)) or advertising or journalism or marketing) or AB=(campaign* or consumer research or (health within 2 (communication or information)) or advertising or journalism or marketing)

Concept 3a: product search 1 (results)
helmet* or head protect* device* or child safety seat* or booster seat* or car seat* or child restraint system* or carry cot bucket seat* or infant carrier* or convertible seat* or condom* or nicotine gum or pedometer* or step counter* or ((folic acid or folate or folacin or vitamin M or vitamin B9) within 3 (supplement*)) or toothbrush* or dental floss or sunblock* or sun block* or sunscreen* or sun screen* or sun protect* or suntan lotion* or suntan oil* or subsidize* or coupon* or discount* or voucher* or blood pressure monitor* or sphygmomanometer* or blood pressure meter* or insecticide* or repellent* or N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito* or ((nicotine) within 1 (gum* or patch* or lozenge*)) or hat or hats or visor* or antiseptic hand rub or hand hygiene or sexually transmitted disease* or sexually transmitted infection* or STI or STIs or STD or STDs or HIV or AIDS or Physical activit* or Physical inactivit* or Exercis* or obesity or obese or overweight or (weight within 2 (loss or lost or losses or losing or lose or loses)) or sunburn*

Concept 3b: product search 2 (8 results)
ear plug* or earplug* or noise reduc* device* or ear protect* device* or ((((protect*) within 2 (gear or device* or mouth or eye)) or wrist pad* or elbow pad* or knee pad* or protective eyewear or goggles or safety glasses or safety lenses or mouthguard or mouth guard) and (sport* or skat* or rollerblad* or athlet*)) or break away base or breakaway base or breakaway-base or personal flotation device* or life jacket* or life-jacket or life vest* or life-vest or ((bear) within 4 (spray* or deterrent*)) or ((reflector* or reflecti* material*) and bicycle*) or grab bars or grab bar or (lip balm and (SPF or sunscreen* or protect*)) or skip* rope or rope skip* or jump* rope or jump-rope or rope jump* or ((exercise or recumbent) within 1 (bike* or bicycle*)) or elliptical trainer* or stair stepper* or stair climber* or rowing machine* or exercise machine* or cross-country ski machine* or exercise equipment or treadmill* or dumbbells or barbells or heart monitor* or heart rate monitor* or interactive videogame* or interactive video game* or Nintendo Wii or Dance Dance Revolution

COCHRANE
Concept 1: Programs, campaigns or interventions
(program* or evaluat* or intervention* or study or research*):ti or (program* or evaluat* or intervention* or study or research*):ab

Concept 2: health communication, health marketing social marketing
(campaign* or consumer research or (health near/2 (communication or information)) or advertising or journalism or marketing):ti or (campaign* or consumer research or (health near/2 (communication or information)) or advertising or journalism or marketing):ab

Concept 3a: product search 1 (432 results)
helmet* or head protect* device* or child safety seat* or booster seat* or car seat* or child restraint system* or carry cot bucket seat* or infant carrier* or convertible seat* or condom* or nicotine gum or pedometer* or step counter* or ((folic acid or folate or folacin or vitamin M or vitamin B9) near/3 (supplement*)) or toothbrush* or dental floss or sunblock* or sun block* or sunscreen* or sun screen* or sun protect* or suntan lotion* or suntan oil* or subsidize* or coupon* or discount* or voucher* or blood pressure monitor* or sphygmomanometer* or blood pressure meter* or insecticide* or repellent* or N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito* or ((nicotine) near/1 (gum* or patch* or lozenge*)) or hat or hats or visor* or antiseptic hand rub or hand hygiene or sexually transmitted disease* or sexually transmitted infection* or STI or STIs or STD or STDs or HIV or AIDS or Physical activit* or Physical inactivit* or Exercis* or obesity or obese or overweight or (weight near/2 (loss or lost or losses or losing or lose or loses)) or sunburn*

Concept 3b: product search 2 (25 results)
ear plug* or earplug* or noise reduc* device* or ear protect* device* or ((((protect*) near/2 (gear or device* or mouth or eye)) or wrist pad* or elbow pad* or knee pad* or protective eyewear or goggles or safety glasses or safety lenses or mouthguard or mouth guard) and (sport* or skat* or rollerblad* or athlet*)) or break away base or breakaway base or breakaway-base or personal flotation device* or life jacket* or life-jacket or life vest* or life-vest or ((bear) near/4 (spray* or deterrent*)) or ((reflector* or reflecti* material*) and bicycle*) or grab bars or grab bar or (lip balm and (SPF or sunscreen* or protect*)) or skip* rope or rope skip* or jump* rope or jump-rope or rope jump* or ((exercise or recumbent) near/1 (bike* or bicycle*)) or elliptical trainer* or stair stepper* or stair climber* or rowing machine* or exercise machine* or cross-country ski machine* or exercise equipment or treadmill* or dumbbells or barbells or heart monitor* or heart rate monitor* or interactive videogame* or interactive video game* or Nintendo Wii or Dance Dance Revolution

ECONLIT (EbscoHost)
Concept 1: Programs, campaigns or interventions
TI (program* or evaluat* or intervention* or study or research*)

Concept 2: health communication, health marketing social marketing
TI (campaign* or consumer research or (health N2 (communication or information)) or advertising or journalism or marketing)

Concept 3a: product search 1 (39 results)
helmet* or head protect* device* or child safety seat* or booster seat* or car seat* or child restraint system* or carry cot bucket seat* or infant carrier* or convertible seat* or condom* or nicotine gum or pedometer* or step counter* or (folic acid N3 supplement*) or (folate N3 supplement*) or (folacin N3 supplement*) or (vitamin M N3 supplement*) or (vitamin B9 and supplement*) or toothbrush* or dental floss or sunblock* or sun block* or sunscreen* or sun screen* or sun protect* or suntan lotion* or suntan oil* or subsidize* or coupon* or discount* or voucher* or blood pressure monitor* or sphygmomanometer* or blood pressure meter* or insecticide* or repellent* or N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito* or (nicotine N1 gum*) or (nicotine N1 patch*) or (nicotine N1 lozenge*) or hat or hats or visor* or antiseptic hand rub or hand hygiene or sexually transmitted disease* or sexually transmitted infection* or STI or STIs or STD or STDs or HIV or AIDS or Physical activit* or Physical inactivit* or Exercis* or obesity or obese or overweight or (weight N2 loss) or (weight N2 lost) or (weight N2 losses) or (weight N2 losing) or (weight N2 lose) or (weight N2 loses) or sunburn*

Concept 3b: product search 2 (9 results)
ear plug* or earplug* or noise reduc* device* or ear protect* device* or ((protect* or gear or device* or mouth or eye or wrist pad* or elbow pad* or knee pad* or protective eyewear or goggles or safety glasses or safety lenses or mouthguard or mouth guard) and (sport* or skat* or rollerblad* or athlet*)) or break away base or breakaway base or breakaway-base or personal flotation device* or life jacket* or life-jacket or life vest* or life-vest or ((bear) and (spray* or deterrent*)) or ((reflector* or reflecti* material*) and bicycle*) or grab bars or grab bar or (lip balm and (SPF or sunscreen* or protect*)) or skip* rope or rope skip* or jump* rope or jump-rope or rope jump* or ((exercise or recumbent) and (bike* or bicycle*)) or elliptical trainer* or stair stepper* or stair climber* or rowing machine* or exercise machine* or cross-country ski machine* or exercise equipment or treadmill* or dumbbells or barbells or heart monitor* or heart rate monitor* or interactive videogame* or interactive video game* or Nintendo Wii or Dance Dance Revolution

CINAHL (EbscoHost)
Concept 1: Programs, campaigns or interventions
TI (program* or evaluat* or intervention* or study or research*)

Concept 2: health communication, health marketing social marketing
TI (campaign* or consumer research or (health N2 (communication or information)) or advertising or journalism or marketing)

Concept 3a: product search 1 (143 results)
helmet* or head protect* device* or child safety seat* or booster seat* or car seat* or child restraint system* or carry cot bucket seat* or infant carrier* or convertible seat* or condom* or nicotine gum or pedometer* or step counter* or (folic acid N3 supplement*) or (folate N3 supplement*) or (folacin N3 supplement*) or (vitamin M N3 supplement*) or (vitamin B9 and supplement*) or toothbrush* or dental floss or sunblock* or sun block* or sunscreen* or sun screen* or sun protect* or suntan lotion* or suntan oil* or subsidize* or coupon* or discount* or voucher* or blood pressure monitor* or sphygmomanometer* or blood pressure meter* or insecticide* or repellent* or N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito* or (nicotine N1 gum*) or (nicotine N1 patch*) or (nicotine N1 lozenge*) or hat or hats or visor* or antiseptic hand rub or hand hygiene or sexually transmitted disease* or sexually transmitted infection* or STI or STIs or STD or STDs or HIV or AIDS or Physical activit* or Physical inactivit* or Exercis* or obesity or obese or overweight or (weight N2 loss) or (weight N2 lost) or (weight N2 losses) or (weight N2 losing) or (weight N2 lose) or (weight N2 loses) or sunburn*

Concept 3b: product search 2 (4 results)
ear plug* or earplug* or noise reduc* device* or ear protect* device* or ((protect* or gear or device* or mouth or eye or wrist pad* or elbow pad* or knee pad* or protective eyewear or goggles or safety glasses or safety lenses or mouthguard or mouth guard) and (sport* or skat* or rollerblad* or athlet*)) or break away base or breakaway base or breakaway-base or personal flotation device* or life jacket* or life-jacket or life vest* or life-vest or ((bear) and (spray* or deterrent*)) or ((reflector* or reflecti* material*) and bicycle*) or grab bars or grab bar or (lip balm and (SPF or sunscreen* or protect*)) or skip* rope or rope skip* or jump* rope or jump-rope or rope jump* or ((exercise or recumbent) and (bike* or bicycle*)) or elliptical trainer* or stair stepper* or stair climber* or rowing machine* or exercise machine* or cross-country ski machine* or exercise equipment or treadmill* or dumbbells or barbells or heart monitor* or heart rate monitor* or interactive videogame* or interactive video game* or Nintendo Wii or Dance Dance Revolution

Social Sciences Citation Index (Web of Knowledge)
Concept 1: Programs, campaigns or interventions
TI=(program* or evaluat* or intervention* or study or research*)

Concept 2: health communication, health marketing social marketing
TS=(campaign* or consumer research or (health SAME (communication or information)) or advertising or journalism or marketing)

Concept 3a: product search 1 (609 results)
TS=(helmet* or head protect* or child safety seat* or booster seat* or car seat* or child restraint system* or carry cot bucket seat* or infant carrier* or convertible seat* or condom* or nicotine gum or pedometer* or step counter* or folic acid or folate or folacin or vitamin M or vitamin B9 or toothbrush* or dental floss or sunblock* or sun block* or sunscreen* or sun screen* or sun protect* or suntan lotion* or suntan oil* or subsidize* or coupon* or discount* or voucher* or blood pressure monitor* or sphygmomanometer* or blood pressure meter* or insecticide* or repellent* or N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito* or nicotine gum or nicotine patch* or nicotine lozenge* or hat or hats or visor* or antiseptic hand rub or hand hygiene or sexually transmitted disease* or sexually transmitted infection* or STI or STIs or STD or STDs or HIV or AIDS or Physical activit* or Physical inactivit* or Exercis* or obesity or obese or overweight or weight or sunburn*)

Concept 3b: product search 2 (234 results)
TS=(ear plug* or earplug* or noise reduc* or ear protect* or protect* or gear or device* or mouth or eye or wrist pad* or elbow pad* or knee pad* or protective eyewear or goggles or safety glasses or safety lenses or mouthguard or mouth guard or break away base or breakaway base or breakaway-base or personal flotation device* or life jacket* or life-jacket or life vest* or life-vest or ((bear) and (spray* or deterrent*)) or ((reflector* or reflecti* material*) and bicycle*) or grab bars or grab bar or (lip balm and (SPF or sunscreen* or protect*)) or skip* rope or rope skip* or jump* rope or jump-rope or rope jump* or ((exercise or recumbent) and (bike* or bicycle*)) or elliptical trainer* or stair stepper* or stair climber* or rowing machine* or exercise machine* or cross-country ski machine* or exercise equipment or treadmill* or dumbbells or barbells or heart monitor* or heart rate monitor* or interactive videogame* or interactive video game* or Nintendo Wii or Dance Dance Revolution)

JSTOR
Product 1
TI:(campaign* OR consumer research OR communication OR information OR advertising OR journalism OR marketing OR program OR evaluation OR intervention)
AND
Do each of these in the title, then repeat using the product names in the abstract [results = (x/y)]
(0/6) helmet OR helmets OR head protection OR child safety OR booster seat OR car seat OR child restraint system OR carry cot bucket seat OR infant carrier OR convertible seat OR condom OR nicotine gum
OR
(3/4) pedometer or step counter or folic acid or folate or folacin or vitamin M or vitamin B9 or toothbrush or dental floss or sunblock or sun block or sunscreen or sun screen
OR
(14/63) sun protection or suntan lotion or suntan oil or subsidize or coupon or discount or voucher or blood pressure monitor or sphygmomanometer or blood pressure meter or insecticide or repellent
OR
(3/3) N-diethyl-m-toluamide or DEET or West Nile or citronella oil or mosquito or nicotine gum or nicotine patch or nicotine lozenge or hat or hats or visor or antiseptic hand rub or hand hygiene
OR
(70/159) sexually transmitted or STI or STIs or STD or STDs or HIV or AIDS or Physical activity or Physical inactivity or Exercise or obesity or obese or overweight or weight or sunburn
AND
la:(eng)

Product 2
TITLE: campaign* OR consumer research OR communication OR information OR advertising OR journalism OR marketing OR program OR evaluation OR intervention
AND
Do each of these in the title, then repeat using the product names in the abstract [results = (x/y)]
(43/144)ear plug or earplug or noise reduction or ear or protection or gear or device or mouth or eye or wrist pad or elbow pad or knee pad or protective eyewear or goggles or safety glasses or safety lenses
OR
(0/13) reflecting material or bicycle or mouthguard or mouth guard or break away base or breakaway base or breakaway-base or personal flotation device or life jacket or life-jacket or life vest or life-vest or bear or reflector
OR
(0/0) grab bars or grab bar or lip balm or skipping rope or rope skipping or jump rope or jump-rope or rope jumping or bike or elliptical trainer or stair stepper or stair climber or rowing machine
OR
(7/35) exercise or cross-country or treadmill or dumbbells or barbells or heart monitor or heart rate monitor or interactive videogame or interactive video game or Nintendo Wii or Dance Dance Revolution
AND
la:(eng)

Economic Review

A systematic review of the evidence was conducted to determine the economic effectiveness of health communication campaigns that include mass media and health-related product distribution. The search period of the literature was from January 1980 to December 2009.

In addition to the databases searched in the effectiveness review (i.e., CINAHL; Cochrane; Econlit; ERIC; Health and Safety Science Abstracts; JSTOR; Medline; PILOTS; PsychInfo; Social Service Abstracts; Sociological Abstracts; Social Sciences Citation Index), databases at the Centre for Reviews & Dissemination at the University of York, and Google Scholar also were used.

Search Terms

Economic-specific keywords listed below were combined with effectiveness search terms.

1. Economics
2. Cost
3. Cost-of-Illness
4. Cost-Benefit analysis
5. Cost consequences
6. Cost-Effectiveness analysis
7. Cost minimization analysis
8. Cost-Utility analysis

The following considerations are drawn from studies included in the evidence review, the broader literature, and expert opinion.

• The review team noted that programs have the potential to positively affect populations outside of the initial target group and also encourage community involvement and partnership. For example, retailers might move products to more accessible areas in response to an increased demand).
• One included study reported that targeting condom usage facilitated dialogue between adults and teenagers, and among teenagers themselves, about risky sex behaviors.
• Included studies cited lack of community buy-in and failure of partners to meet their commitments (e.g., retailers charging for products that were intended for free distribution) as barriers to implementation.

Healthy People 2030

Healthy People 2030 includes the following objectives related to this CPSTF recommendation.

• Increase the proportion of adolescent males who used a condom the last time they had sex — FP-06
• Reduce the proportion of deaths of car passengers who weren’t buckled in — IVP-07
• Reduce the proportion of adults who do no physical activity in their free time — PA-01
• Increase the proportion of adults who do enough aerobic physical activity for substantial health benefits — PA-02
• Increase the proportion of adults who do enough aerobic physical activity for extensive health benefits — PA-03
• Increase the proportion of adults who do enough aerobic and muscle-strengthening activity — PA-05
• Increase the proportion of adolescents who do enough aerobic physical activity — PA-06
• Increase the proportion of adolescents who do enough muscle-strengthening activity — PA-07
• Increase the proportion of adolescents who do enough aerobic and muscle-strengthening activity — PA-08
• Increase the proportion of children who do enough aerobic physical activity — PA-09
• Increase the proportion of adults who walk or bike to get places — PA-10
• Increase the proportion of adolescents who walk or bike to get places — PA-11
• Increase successful quit attempts in adults who smoke — TU-14