Measuring Exposure to Health Messages in Community-Based Intervention Studies: A Systematic Review of Current Practices

Abstract

Accurately measuring exposure is critical to all intervention studies. The present review examines the extent to which best practices in exposure assessment are adhered to in community-based prevention and education studies. A systematic literature review was conducted examining community-based studies testing communication interventions, published in 2003-2007. Of 663 studies identified, 54 met all inclusion criteria and were reviewed for type of exposure assessment conducted (if any), use of exposure data in study analyses, and discussion of biases related to exposure assessment. Although a majority of studies (n = 38; 70%) assessed exposure, most of these used only a simple dichotomous measure (n = 31; 82%), less than half used exposure data to adjust intervention effects (n = 16; 42%), and only six (16%) addressed selective exposure as a possible source of bias. There is substantial room for improvement in measurement and analysis of exposure to communication in community-based disease prevention studies.

Strategies to Facilitate Exposure to Internet-Delivered Health Behavior Change Interventions Aimed at Adolescents or Young Adults: A Systematic Review

“…More uniformity in reporting exposure measures would make it possible to compare or pool the results of various studies. This is in line with recommendations for exposure measures regarding "offline" interventions, for example national campaigns (Southwell, Barmada, Hornik, & Maklan, 2002) and community-based interventions (Morris, 2009).…”

Measures of exposure to theWell LondonPhase-1 intervention and their association with health well-being and social outcomes

“…In the context of effectiveness trials, exposure data can be used to interpret the impact of the intervention on the study outcomes 4. In interventions where participation is voluntary or self-selected, measures of exposure can highlight inequity of access to the intervention among population subgroups of interest in public health 5…”

Impacts of Exemplification and Efficacy as Characteristics of an Online Weight-Loss Message on Selective Exposure and Subsequent Weight-Loss Behavior

“…Existing research on health messages relied on forced exposure in experimental designs, problematic exposure measures in field studies, or neglected the obstacle of selective exposure altogether (Morris, Rooney, Wray, & Kreuter, 2009). Yet framing messages such that they attract targeted individuals is a key goal in health communication.…”