No abstract

This article demonstrates the usefulness of two theories for the development of effective health communication campaigns. The integrative model of behavioral prediction focuses on changing beliefs about consequences, normative issues, and efficacy with respect to a particular behavior. Media priming theory focuses on strengthening the association between a belief and its outcomes, such as attitude and intention toward performing the behavior. Both the integrative model of behavioral prediction and media priming theory provide guidance with respect to the selection of beliefs to target in an intervention. The article describes the theories, shows how they can be applied to the selection of target beliefs, and, for each theory, defines the criteria for belief selection. The two theories as well as their appropriate analytic strategies are complementary rather than conflicting.Those who design interventions that aim to increase health behavior are faced with a number of decisions when developing the intervention. For example, decisions need to be made concerning the primary goal of the intervention, its target population, and the selection of messages for the intervention. As we will try to demonstrate, two theoretical approaches provide powerful tools for identifying the specific beliefs that need to be addressed if one wishes to change or maintain a given behavior. The two theories exemplify two ways to change a variable, for example, a person's intention to perform a health-protective behavior. First, the integrative model of behavioral prediction represents the more conventional view that changing beliefs underlying the intention to perform a behavior ultimately results in changes in intention. Second, media priming theory represents a more recent account of change. It focuses on the association between beliefs and intention and predicts that a strengthened association between beliefs and intention ultimately results in a change in intention. In this article, we will describe the integrative model of behavioral prediction and media priming theory and demonstrate how these theories make complementary rather than conflicting contributions to the development of effective health communication campaigns.

Behavioural theorists have identified attitudes, perceived norms and self-efficacy as the important determinants of people's intentions to engage in a given behaviour. Because intentions predict behaviour, these same variables also account for a considerable amount of the variation in behaviour. Nevertheless, there is often a substantial proportion of the population who do not act on their intentions. While a recently proposed integrative theory of behaviour suggests that these 'failures' are due either to a lack of skills and/or to the presence of environmental constraints, it has also been argued that the determinants of intention may have a direct, as well as in indirect, effect on behaviour. This paper uses data from a longitudinal study (Project RESPECT) to explore the extent to which attitudes, perceived norms and self-efficacy explain why some people do and others do not act on their intentions to engage in a health protective behaviour. Although the data provide further evidence that these three variables account for a significant proportion of the variance in intentions (and behaviour), they perform poorly when predicting behaviour for persons with pre-existing high intentions. It may be reasonable to ask whether a 'new' theory is needed to explain why some people do, and some people do not, act on their intentions.

In the context of health campaigns, interpersonal communication can serve at least 2 functions: (a) to stimulate change through social interaction and (b) in a secondary diffusion process, to further disseminate message content. In a 3-wave prospective study of 1,079 smokers, the authors demonstrate that mass media messages (antismoking campaigns and news coverage relevant to smoking cessation) have an indirect effect on smoking cessation intention and behavior via interpersonal communication. Exposure to campaigns and news coverage prompts discussion about the campaigns, and, in turn, about smoking cessation. Interpersonal communication regarding smoking cessation then influences intention to quit smoking and attempts to quit smoking. The study finds evidence not only for the social interaction function of interpersonal communication, but also for the secondary diffusion function. A substantial number of smokers who are not directly exposed to the antismoking campaigns are nevertheless indirectly exposed via communication with people who have seen these campaigns. These results imply that encouragement of interpersonal communication can be an important campaign objective.

We discuss how selected theoretical advances address key gaps in our understanding of the intersection of conversation and campaigns. Included are the possibilities that interpersonal interaction might spread inoculation, that social network density might affect the translation of mass media messages into public sentiment, that campaign message form might prompt people to talk, that conversation might be a crucial link between campaign efforts and key political outcomes, and that timing might matter in predicting when talk will have an effect on elections. We also highlight some opportunities for inquiry that these ideas present. Because conversation appears to be a strategic response to increased issue salience and relevance, in part, systematic exploration of the social motives for conversation in campaign contexts promises to be particularly fruitful.In our review of relevant scholarship on the roles of conversation in media campaigns (Southwell & Yzer, 2007), we attempted to describe how conversation and campaigns might be linked. Such effort to incorporate conversation as a variable in campaign effects theory is justifiable on a number of dimensions, not the least of which is the sheer prominence of talk with others as a routine activity in our lives. Conversation comprises an exceptionally large proportion of the communication behavior people typically perform. For example, people are engaged in conversations far more often than they read newspapers or watch television (e.g., Kirchler, 1989). Just noting that such a prominent aspect of daily life is likely to play a role in strategic communication efforts aimed at a large audience, however, is not enough for us to claim much theoretical progress. In fact, communication scholars, such as Katz and Lazarsfeld (1955), have long noted the basic role that talk between people can play, at least in extending the reach of broadcast messages.Having described various other alternatives for ways in which talk and campaigns can intersect beyond the two-step flow notion, we then called for work to theorize the conditions under which such intersection was likely and the constraints likely to affect the realization of these conditions. Indeed, it is remarkable that there appears

Target audience ratings of the likely impact of persuasive messages, known as perceived message effectiveness (PME), are commonly used during message development and selection. PME is also used to examine receptivity of messages after they are fully developed or deployed. Despite this, we know little about the conceptual and methodological characteristics of extant PME measures used in the literature. We conducted a systematic review of tobacco education video, print, and audio campaign studies to examine conceptual and methodological characteristics of PME measures. One hundred twenty-six PME measures from 75 studies conducted in 21 countries with more than 61,000 participants were reviewed. Results indicated considerable variability in measures’ focus on general perceptions of a message (i.e., message perceptions) versus perceptions of expected message effects (i.e., effects perceptions). Considerable variability was also found on underlying persuasive constructs, use of referents, and referencing of behavior in PME items and measures. We conclude with several recommendations for future research on PME measurement and validation.

The inclusion of perceptions of control over behavioral performance has importantly advanced the ability of reasoned action theory to explain behavioral intentions and predict behavior. In consequence, the theory has usefulness as a tool for developing behavior change interventions. Despite the theoretical and practical importance of a perceived behavioral control construct, there remains ambiguity regarding the precise meaning and measurement of items. A central issue is that items used to measure perceived behavioral control often load on two factors, one composed of confidence-framed items and the other of control-framed items. According to reasoned action theory, these two factors represent capacity and autonomy aspects of perceived behavioral control. In this article I review the usefulness of the current dual-aspect conceptualization of perceived behavioral control, present illustrative perceived capacity and autonomy data, and discuss new areas of inquiry that can further advance the conceptualization of perceived behavioral control.

A broader interpretation of self-identity in terms of both current and aspired behavior offers a better understanding of when people might change health-relevant behavior.