ate expertise. Examples for some people might include having regular mammograms, increasing folic acid intake, improving diabetes self-care behaviors, and encouraging parents to place babies on their backs when sleeping. In contrast, the promotion of health behaviors that are for some people largely mediated by social influences and norms, such as teen pregnancy, tobacco and substance use, and breastfeeding, may be more credibly communicated through peer groups, family or community members, celebrity role models, or religious leaders. Finally, messages that attempt to achieve change in environmental issues or politically mediated public health problems, such as traffic safety or the sale of alcohol and cigarettes to minors, may be communicated most effectively through authority figures and representatives of law enforcement agencies.

Most of the health communication campaigns included in this review used multiple sources of support to most effectively reach the diverse segments of their intended audiences. As an example, the National Safe Kids “Get Into the Game” Campaign relies on relevant celebrities and spokespersons to enhance the impact of messages. Different sources are chosen to reach different age and gender groups. For example, to reach adult audiences, the Surgeon General, injury experts, and Al and Tipper Gore (when he was Vice President) were used as sources of support for campaign messages, while injured children and famous athletes were used to convey messages about safety to children (Cruz and Mickalide, 2000; National Safe Kids, 2000). Similarly, the National Campaign to Prevent Teen Pregnancy reaches a wide range of audiences through credible religious leaders, political leaders, health and research experts, popular and news media, and celebrities selected to be appropriate for populations of different ethnic, gender, and age groups.

The image projected by a health communication campaign is another important element that can be modified for diverse audiences. A health campaign’s image often is referred to as its tone or personality. It can be developed through the type of format, style, music, characters, and so on that are used in the creative execution



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