"Objective: To investigate the effect of exposure to 'MTV Shuga:Down South’ (MTVShuga-DS) during the scale-up of combination HIV-prevention interventions on awareness and uptake of sexual reproductive health (SRH) and HIV-prevention services by adolescent girls and young women (AGYW) [...] Conclus
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ions: Among both urban and rural AGYW in South Africa, MTVShuga-DS exposure was associated with increased PrEP awareness and improved demand for some HIV prevention and SRH technologies but not sexual health outcomes. However, exposure to MTVShuga-DS was low. Given these positive indications, supportive programming may be required to raise exposure and allow future evaluation of edu-drama impact in this setting." (Abstract)
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"Adolescent girls and young women (AGYW), aged 15.24 years, are disproportionately affected by HIV and other sexual and reproductive health (SRH) risks due to varying social, cultural, and economic factors that affect their choices and shape their knowledge, understanding, and practices with regard
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to their health. Social Behavioral Change Communication (SBCC) interventions targeted at strengthening the capabilities of individuals and their networks have supported the demand and uptake of prevention services and participation in biomedical research. However, despite growing global recognition of the domain, high-quality evidence on the effectiveness of SBCC remains scattered. This evidence and gap map (EGM) report characterizes the evidence base on SBCC interventions for strengthening HIV Prevention and Research among AGYW in low- and middle-income countries (LMICs), identifying evidence gaps and outlining the scope of future research and program design." (Abstract)
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"Objectives: To examine the association between exposure to breastfeeding television spots and exclusive breastfeeding (EBF). Methods: We performed face-to-face interviews with 11 722 mothers of infants younger than 6 months using 5 cross-sectional surveys 6 or more months apart between 2011 and 201
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4 in Vietnam. Sample sizes were 2065 to 2593, and approximately 50% of participants lived in areas with (Alive & Thrive [A&T]-intensive [I]) and approximately 50% without (A&T-nonintensive [NI]) facilities offering counseling services. We analyzed data at individual and commune levels separately for A&T-I and A&T-NI areas. Results: Exposure to television spots was associated with higher EBF in A&T-I and A&T-NI areas. In A&T-I areas, mothers who could recall at least 1 message were more likely to report EBF. In A&T-NI areas, only recall of at least 3 messages was associated with higher EBF. In communes, 1 message recalled corresponded to 17 percentage points higher EBF prevalence in A&T-I and A&T-NI communes, respectively. Conclusions: Mass media should be part of comprehensive programs to promote EBF." (Abstract)
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"To date, no study has evaluated the effect of a radio-only campaign on infant vaccination coverage, timeliness, and related morbidity in a low-income country. We implemented the "10+10+30" radio campaign involving broadcasting a weekly 10-minute radio drama series on vaccination, followed by a 10-m
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inute discussion by community health workers, and then a 30-minute listener phone-in segment in Jimma Zone, Ethiopia for three months. To assess the impact of 10+10+30, which was aired on a community radio station, we recruited mothers of infants up to 5 weeks old in intervention district clusters that were inside the radio station's reception range (n = 328 dyads) and control district clusters that were outside of the range (n = 332 dyads). Intention-to-treat and per-protocol analyses, adjusted for pre-intervention differences between the districts, were conducted to examine the co-primary outcome of Penta-3 vaccination coverage and timeliness as well as those of other vaccines and outcomes related to infant morbidity. Both intention-to-treat and per-protocol analyses revealed higher vaccine coverage and more timely vaccine administration in the intervention district relative to the control district, with infants in the intervention district being 39% more likely to receive a Penta 3 vaccination. In addition, adjusted regression analyses of maternal retrospective reports over a two-week period revealed 80% less infant diarrhoea, 40% less fever and 58% less cough in the intervention district relative to the control district. This study provides compelling initial evidence that a radio drama integrated with discussion and phone-in components may improve infant vaccination coverage and timeliness and may reduce infant morbidity." (Abstract)
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"This systematic review examines the effectiveness and cost-effectiveness of community engagement interventions on outcomes related to childhood immunisation in low- and middle-income countries (LMICs) and identifies contextual, design and implementation features that may be associated with effectiv
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eness. We identified 61 quantitative and mixed methods impact evaluations and 47 associated qualitative studies related to community engagement interventions for inclusion in the review. For cost-effectiveness analysis 14 of the 61 studies had the needed combination of cost and effectiveness data. The 61 included impact evaluations were concentrated in South Asia and Sub-Saharan Africa and spread across 19 LMICs. The review found that community engagement interventions had a small but significant, positive effect on all primary immunisation outcomes related to coverage and their timeliness. The findings are robust to exclusion of studies assessed as high risk of bias. Qualitative evidence indicates appropriate intervention design, including building in community engagement features; addressing common contextual barriers of immunisation and leveraging facilitators; and accounting for existing implementation constraints and practicalities on the ground are consistently cited as reasons for intervention success." (Abstract)
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"To understand how communication action is conceived and practiced, we conducted a scoping review with a focus on two diseases currently targeted for elimination: lymphatic filariasis (LF) and Chagas disease (CD). We examined 43 studies published between 2012 and 2020 to identify communication pract
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ices, theoretical frameworks informing communication action and levels of intended influence. Community participation was the goal most commonly pursued through communication action, both in LF and CD strategies; important attempts at expanding the scope and reach of this practice were identified. However, our results indicate that while the field of health communication has gained complexity in the understanding of the nature of communication ecologies in public health interventions, neglected tropical diseases (NTD) research has maintained a superficial involvement with health communication theory and science. This article is a call to action to consider the resources offered by the health communication field when researching, designing, or implementing NTD interventions to enhance the possibilities of communication action in implementation settings." (Author summary)
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"This paper tests the effectiveness of an entertainment education television series, MTV Shuga, aimed at providing information and changing attitudes and behaviors related to HIV/AIDS. Using a simple model, the paper shows that “edutainment” can work through an individual or a social channel. Th
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is study is a randomized controlled trial conducted in urban Nigeria, where young viewers were exposed to MTV Shuga or a placebo television series. Among those exposed to MTV Shuga, the trial created additional variation in the social messages they received and the people with whom they watched the show. The study finds significant improvements in knowledge and attitudes toward HIV and risky sexual behavior. Treated subjects are twice as likely to get tested for HIV eight months after the intervention. The study also finds reductions in sexually transmitted diseases among women. These effects are stronger for viewers who reported being more involved with the narrative, consistent with the psychological underpinnings of edutainment." (Abstract)
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"This review presents evidence about the impact of mass media and digital media on young people’s family planning (FP) attitudes and behaviors. It primarily focuses on the Ouagadougou Partnership countries, but also describes lessons learned from other initiatives implemented more widely in Africa
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and elsewhere." (Executive summary)
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"Celebrity endorsements are often sought to influence public opinion. We ask whether celebrity endorsement per se has an effect beyond the fact that their statements are seen by many, and whether on net their statements actually lead people to change their beliefs. To do so, we conducted a nationwid
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e Twitter experiment in Indonesia with 46 high-profile celebrities and organizations, with a total of 7.8 million followers, who agreed to let us randomly tweet or retweet content promoting immunization from their accounts. Our design exploits the structure of what information is passed on along a retweet chain on Twitter to parse reach versus endorsement effects. Endorsements matter: tweets that users can identify as being originated by a celebrity are far more likely to be liked or retweeted by users than similar tweets seen by the same users but without the celebrities' imprimatur. By contrast, explicitly citing sources in the tweets actually reduces diffusion. By randomizing which celebrities tweeted when, we find suggestive evidence that overall exposure to the campaign may influence beliefs about vaccination and knowledge of immunization-seeking behavior by one's network. Taken together, the findings suggest an important role for celebrity endorsement." (Abstract)
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"The article outlines some of the ways in which an understanding of policymaker psychology and factors such as group dynamics and political context are reflected in the grey literature, and the implications of this for understanding the role of storytelling in political advocacy. It highlights pract
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ical advice about storytelling that emerges from the literature, and presents four case studies illustrating aspects of storytelling in action. It concludes by identifying the implications for scientists and other advocates of“evidence informed policymaking”, practitioners and policymakers." (Abstract)
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"Mass distribution campaigns of insecticide-treated nets for malaria prevention are usually accompanied by intensive behaviour change communication (BCC) to encourage hanging and use of nets. However, data on the effectiveness of these communication efforts are scarce. In preparation for the next ro
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und of mass campaigns in Nigeria, a secondary analysis of existing data from post-Campaign surveys was undertaken to investigate the influence of BCC on net hanging and use. Surveys were undertaken between 2009 and 2012 in ten states in Nigeria using standardized questionnaires. Two-stage cluster sampling was used to select households in each study site. Outcomes were defined as the effects of BCC message exposure and recall on knowledge, attitudes, perception as well as intentions and actual use. From the univariable analysis, potential confounders and explanatory variables were identified and key effects explored in multivariable linear or logistic regression models; terms in the models were kept if they had a marginal significance with p<0.2. To quantify the effects from BCC, a treatment effect model was used with an inverse-probability weight regression adjustment. More than half of the respondents (58.4%; 95% CI 56.0, 60.7) had heard a message about net use or hanging during or after the distribution campaign, with media cited as the most common source of information. Attitude towards net use was positively linked to the number of messages recalled and was overall better in the northern study sites. The number of messages recalled was also the strongest predictor of knowledge (p<0.001). All BCC outcomes showed a significant increase in net use, which was strongest for the confidence to take action regarding nets with an overall effect of 17%-point increase of net use comparing poor and excellent confidence levels. Intention to use every night increased net use by 15%-points and discussing net use in the family by 8% points. All these effects were statistically significant (p<0.001). Multichannel BCC campaigns as well as other media were effective in contributing to an increase in net culture, hanging and use, particularly by vulnerable groups." (Abstract)
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"Many people recognise that mass media is important in promoting public health but there have been few attempts to measure how important. An ongoing trial in Burkina Faso (ClinicalTrials.gov, NCT01517230) is an attempt to bring together the very different worlds of mass media and epidemiology: to me
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asure rigorously, using a cluster-randomised design, how many lives mass media can save in a low-income country, and at what cost. Application of the Lives Saved Tool predicts that saturation-based media campaigns could reduce child mortality by 10–20%, at a cost per disability-adjusted life-year that is as low as any existing health intervention. In this Viewpoint we explain the scientific reasoning behind the trial, while stressing the importance of the media methodology used." (Abstract)
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"The purpose of this review is to contribute to the evidence base on health communication evaluation research in order to aid public health professionals and researchers in the development of future evaluation strategies. The review is divided into two sections. In the first section the focus is on
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reviewing evaluations of campaigns undertaken in European Union (EU) and European Economic Area (EEA) countries, however, examples from the wider European region are also included. The second section, addressing challenges posed by campaign evaluation, draws on broader international literature pertaining to the identification of health communication campaign evaluation tools, frameworks and models. It would appear that there has been very few high quality European evaluation studies carried out in the last decade in relation to communicable disease prevention campaigns. Nevertheless, it is evident in reviewing the literature that there are valuable existing frameworks and guidelines that can help guide and inform evaluation research development. The review examined the international English-language literature published between 2000 and 2011 . The reviewers retrieved 160 references of which 35 were examples of evaluations of health communication campaigns carried out in EU/EEA Member States." (Executive summary)
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"This article summarizes evidence for technological advances associated with population-level behavior changes necessary to advance child survival and healthy development in children under 5 years of age in low- and middle-income countries. After a rigorous evidence selection process, the authors as
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sessed science, technology, and innovation papers that used mHealth, social-transmedia, multiplatform media, health literacy, and devices for behavior changes supporting child survival and development. Because of an insufficient number of studies on health literacy and devices that supported causal attribution of interventions to outcomes, the review focused on mHealth, social-transmedia, and multiplatform media. Overall, this review found that some mHealth interventions have sufficient evidence to make topic-specific recommendations for broader implementation, scaling, and next research steps (e.g., adherence to HIV-AIDS antiretroviral therapy, uptake and demand of maternal health service, and compliance with malaria treatment guidelines). While some media evidence demonstrates effectiveness in changing cognitive abilities, knowledge, and attitudes, evidence is minimal on behavioral endpoints linked to child survival." (Abstract)
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"Through a systematic review of the literature, this article summarizes and evaluates evidence for the effectiveness of mass media interventions for child survival. To be included, studies had to describe a mass media intervention; address a child survival health topic; present quantitative data fro
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m a low- or middle-income country; use an evaluation design that compared outcomes using pre- and postintervention data, treatment versus comparison groups, or postintervention data across levels of exposure; and report a behavioral or health outcome. The 111 campaign evaluations that met the inclusion criteria included 15 diarrheal disease, 8 immunization, 2 malaria, 14 nutrition, 1 preventing mother-to-child transmission of HIV, 4 respiratory disease, and 67 reproductive health interventions. These evaluations were then sorted into weak (n=33), moderate (n=32), and stronger evaluations (n=46) on the basis of the sampling method, the evaluation design, and efforts to address threats to inference of mass media effects. The moderate and stronger evaluations provide evidence that mass media-centric campaigns can positively impact a wide range of child survival health behaviors." (Abstract)
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"Promotion of healthy behaviors and prevention of disease are inextricably linked to cultural understandings of health and well-being. Health communication scholarship and practice can substantially and strategically contribute to people living safer, healthier, and happier lives. This book represen
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ts a concrete step in that direction by establishing a strategic framework for guiding global and local health practices. Taking a multi-disciplinary approach, the volume includes state-of-the-art theories that can be applied to health communication interventions and practical guidelines about how to design, implement, and evaluate effective health communication interventions. Few books have synthesized such a broad range of theories and strategies of health communication that are applicable globally, and also provided clear advice about how to apply such strategies. This volume combines academic research and field experience, guided by past and future research agendas and on-the-ground implementation opportunities." (Publisher description)
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"Behaviour change communication is vital for increasing the enactment of particular behaviours known to promote health and growth. The techniques used to change behaviour are important for determining how successful the intervention is. In order to integrate findings from different interventions, we
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need to define and organize the techniques previously used and connect them to effectiveness data. This paper reviews 24 interventions and programs implemented to change four health behaviours related to child health in developing countries: the use of bed nets, hand washing, face washing and complementary feeding. The techniques employed are organized under six categories: information, performance, problem solving, social support, materials, and media. The most successful interventions use three or even four categories of techniques, engaging participants at the behavioural, social, sensory, and cognitive levels. We discuss the link between techniques and theories. We propose that program development would be more systematic if researchers considered a menu of technique categories appropriate for the targeted behaviour and audience when designing their studies." (Abstract)
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