1. Successful public communication programs have met certain conditions. These include a strong science base for recommended behaviors, a realistic possibility that recommendations can be implemented by the population, coordination with other programs addressing related issues, enough resources available for the development and particularly the transmission of messages so that the intended audience sees them at needed frequency, and often the resources to maintain the campaign over time if the pace of change is slow.

  2. Communication programs may be particularly effective if they are an integral part of a multicomponent intervention. Examples include interventions that complement or facilitate access to services—such as improved local mammography availability— with a variety of communication strategies such as television advertisements, telephone reminders, and personal letters. Similarly, a television series focused on smoking cessation can offer a toll-free telephone number that viewers can call for referral to quit-smoking programs.

  3. Communication campaigns operate at a distance from their audiences. Therefore, they require extensive and virtually continuous gathering of “tracking” data about their target population’s awareness of messages, changes in relevant beliefs, social expectations and self-efficacy with regard to recommended behaviors, as well as measures of those behaviors themselves. This need is magnified in the context of programs that address heterogeneous audiences, when tracking research has to allow estimation of differential trends across important population subgroups.

  4. Communication campaign effects can be magnified if the exposure to messages achieved by the direct buying of media time (e.g., through purchases of broadcast time for TV ads) is complemented by other diffusion of messages. This may involve stimulating coverage of a particular health issue by newspapers or by broadcast news or talk shows, or inclusion of supportive messages in entertainment programming (or discouragement of modeling of problematic behaviors in entertainment programming). From the opposite perspective, some campaigns have been successful in the



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