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PUBLIC SEF:Vs CL ADVERTISING AI'7D HEALTH iNF.OMITICJI3 by Gerhard J. Hannemar,, Ph.D. Directcr, Center for Co.-nmunicat'i~:ons Policy' Research Associate Dean, Annenberg Schocl of Com.-nunications University of Southern-Cali:fornia June 7'„ 1978 s Testiimony'prepared for the Subcommittee on Health and Scientific. Res¢arch of the Conmittee on i3umanResourceE:, United' States Senai.e,, Washir.gton,, D.C. Research reported in this paper was partially supported by the John and Mary R. Marl:le Foundation, the State of California Office of Substance Abuse and the National Institute for Drug Abuse.

PUBLIC SERVICE ADVERTISING AND HEALTH Ii.rORx'IATIC}N Gerhard Ji. Hanneman, Ph.D. Annenberg School of Communication University of Southern California In health news, we are more apt to hear of th,e malprac- tice suit and'trie rise in the cost of health care, than of the successful surgical procedure or the effective enfozcement of sanitation codes ('D. J. Brenner, and' G. 2fi. Quesada in~ The. F'coleofmass M'edia in Health Communications, 1977).1 . Public Service Advertising Government public service announcements~ are generally dissem- inated under a presumption of information as a public good. The k+ene- aduertising in the electronic media is fully iniaccord with the long fits typically assumed of such information re?'ate in the most general senses to the more efficient functioning of society. Public service range Public Health Service strategies3 directed toward providing individuals with information concerning the health risks related to. Despite the positive intentions of most public campaigns, their planners typically assume, somewhat erroneously, as experiences in W the drug abuse prevention field have indicated, that information is contagious, and that if only people were exposed to the "right" infor- i mation,, they would subsequently make rational choices. Further, this line of reasoning goes', that if the public is innoculated with bene- ficiali information, it will spread and prevent unwanted consequences. - Such reasoning has motivated the majority of public prevention/inter- vention campaigns..

Our research~has previously documentedithe gross inefficiency of' routine or laissez-faire distribution of public service advertising by government agencies as a waste of taxpayer dollars.4 Such a statement implies, however, extended discussion of the abilities of'public service advertising to "sell" prosocial behavior, or "unsell" anti-social behavior. Nevertheless, the evidence is almost overwhelming that public service advertising, unless it is highly controlled, is totally ineffective in influencing attitudes and behaviors. On the other hand, evidence is beginning to accumulate that when public advertising is pSanned to compete effectively in the media marketplace,, the consequences are highly bene- ficial. Unwarranted assumptions about random distributiomof public in- formation then, constitute one reasomfor promoting a new approach to public healtli infor.•mation.. time in the FTartford-Boston television markets concerned health needs. At that time I found'that twenty percent of public service announcement than,was apparent in the early 1970s when I began researching its effects' public service advertising about health needs in 1978 appears less credible Yet, due to the strcng demand for commercial TV time, the status of messages; however seventy-five percent of this time was comprised of soli- Society, etc.5 In our recent studies in three California markets we find no basis for revising these statistics,reflecting further on qthe need for citation appeals for various nonprofit agencies such as the American Cancer a new approach by government campaign managers, p ~. The Impact of Public Service Announcements on~the Public ~, I While broadcasters have an outstanding record of response to natural crises, their recordlis less thampositive imtheir response to social

-3- crises such as venereal disease, drug abuse, and so forth. The reason 'for this deals with the factors surrounding the impact of public service announcements on the public. In 1977, the Ohio Association of'Broadcasters, in opposition to RM 2712, a "Petition to Institute a Notice of Inquiry and Proposedi Rule- making on the Airing of Public Service Announcements by Broadcast Licen- sees," stated that additional PSA requirements are unnecessary becausz broadcasting already does "'a meritorious job in furtthering uhe general . heaTth, welfare, and'safety of citizens through a multitude of'PSAs 6 broadcast each week."' ThE NAB further argued in opposition that decisionss on when ard howto deal with centroversial issues cf public importance should be left to the individual broadcaster. while I'am in accord'with the sentiment of the broadcasters, the research evidence indicates that troversi:al messages. By controversy, I mean messages that deal with taboo or sensitive areas, for example, venereal disease. Such messages very infrequently do broadcasters air public service announcements of con- are offensive to certain segments of'the public, and!to others, they prompt "tune-out." Interviews with traffic managers in various markets confirm a tendency of broadcasters to air the least obj'ectionable public service announcements possible. This lack of control over air times is another reason in support of . . .. s a new mandate for public health communications. Other reasons affectir:r, the success or failure of public prevention as fol'lows : . A lack of sophisticated pretesting, typically utilized by commercial advertisers to determine the appropriate- ness of message material, hampers many public prevention campaigns.

Footnotes. 1Brenner, Donald J. and Quesada, Gustavo PK'. The Role of Mass IWied_i aia in Health Communication. Paper presented to the Health Communi,- cation D'ivision,, International Communication Association, Berlin, May 1977. 2The FCC defines a public service announcement as "an announce- ment for which no charg,e is made and which promotes programs, activities, or services of Federal,State, or local governments (;e.g., racruiting, sales of bonds, etc.) or-the programs, activities or services of non- profit organizations (e.g,., UGF, Red Cross Blood Donations, etc.)' and' other announcements regarded as serving community interests, excluding time signals, routine wea'4hFr announcemcnts, and promotional announce-. ments."' 47 C.F.R. 73.112, n. 4 and 73.6',70,, n.4. 3Pub11ic Health Serv.ice. Forward Plan for Health Service, FY-1977- 81. DHEW, (OS) 76-50024, August 1975. 4See Hanneman, G. J. "'Communications, Mass Media and Drug Abuse." In The_ Media and Drug Abuse rlessages. Executive Office of the President, April 1974, pp. 1-12. 5 Hanneman, G. J. et al. "Public Service Advertising on Television.°' Journal of Rroadcastin;, 1T:4 (Pall 1973), pp. 387-404. 6"'Pros and Cons on PSA Proposal." Broadcasting, September 6, 1976, p. 4!0. 7Hanneman, G. J. et -al. The Medicine Man Piessaqe : An Evaluationi. Volume III, Los Angeles: Center for Communications Policy Research,. June 1978'_ s 8 Afforded throughimatching funding provided'by Hoffman LaRcche; Merck, Sharp and Dohme; Abbott Laboratories; and Smith Kline Corporation. 9See for example, Maccoby, N. and Farquhar, J.W. "Communication for Health: Unselling Heart Disease."' Journal of Communication, Summetj 1975, 25:3, 114-126. Q!) ' , 01 tj J -

o Public service campaigns suffer from a lack of evaluationn and particularly a lack of suitable measures of success. Typically, success is measured'with such illusionary measures as percent of people aware, or amount of commercial time or space dollars donated to the cause. The:se may be impressive statistics, but have little to do with the reality of public service advertisings impact. Maximizing the I!mpact of Public HealthlCommunications As described earlier,, evidence is accumulating that health infor- mation campaigns can be successful. Two recent examples beax brief dis- cuss,ion. At the University of Southern California, we recently coinpleted alstudy of a state;,=ide campaign informing adult wol eighteen to forty- nine,, about various da7gers associated with misusing prescribed psycho- active drugs.7The campaign utilized paid televisionltime to enhance its effectiveness.8 Time was bought in a manner consistent with, accepted advertising strategies in terms of gross rating points, reach and fre- quency, as determined for us by a nationall advertisingiagency. We found that in the city tha.t received public service announcements only, there was absolutely no effect of'the campaign on the attitudes and behav~~ors of the women inlregard to our messages. However, in those sites that received various combinations off paid television time, we were able'tol significantly affect certainlattitudes and behaviors concerning drug, misuse. Even when measured five months after the cessation of the cam*- i paign,, the strengtk:. of impact in the paid media sites was still signi- ficantly apparent. The "Three Community Study of the Stanford Heart Disease Preven tion Program,"' described by Dr. Earquhar,9 demonstrated the success of an intensive health intervention campaigniwhich sustained behavioral changes even after the cessation of the media activities. While the

campaign did not, to my knowledge, use paid advertising, the researchers were able to gain the cooperation of broadcasters and devise an inten- sive media schedule comparable to the best paidicampaigns. Certainly such a schedule would not be replicable in larger markets without a considerable expenditure of funds. The two projects demonstrate the factors that maximize the effectiveness of public health communications: reaching the information needy;lo' . PSAs are more attendedto, and credible when produced by e Media time should be purchased and the campaign should endure over time rather than be executed as a br.ief'one- shot activity;. • Public service advertisingican be successful in influen- cing,behaviors when immediately applicable information iss provided'to individuals. Generalized messages to write for pamphlets are highly ineffective; targeting is a prerequisite; .0 Media: campaigns are successful when careful audience 0 State or local control enhances the cooperation of local broadcasters and supporti've i:nstitutions; Since the American public spends forty percent of its leisuree time with television and it is a significant socializing influence in society', TV'is the most cost effective medium in Individuals who are most in need of health information are most dependent upon the eLectronic!s.edi:a;ll professional communication agencies;l~ Ntessage content should be oriented to topics that can be used in social communicatior,s by the audience. PXofessor Kline and his colleagues at the University of'M'ichigan have demonstrated the advantage of structuring,medi!aa campaig,ns so that the interpersonal communication network supports med4_a use.13 In conclusion, I'support legislative activies whi'ch permit better C :. . W . planning; and the use of paid media in the cause of health communications C,J ~j;; prevention activities. ,

. .10 See Comstock, George. Television and Its ViewE-.rs: What Social Science Sees. Santa Monica: R.and, 1976. P-5632. 11Cf. Brenner and Quesada, op cit. Comstock, George. "Television andiSocial Values." Syracuse University, March 1978. laHanneman, G. J. and NrcEwen, William~Ji. "Televised Drug Abuse Appeals: A Content Analysis." Journalism Quarterly, Vol. 50, No. 2 (Summer 1973), pp. 329-333'. 13~torrison, A. J. , Kline, F. G-: , anu Miller, P. V. "Aspects of Adolescent Information Acquisition About Drugs and Alcohol Topics.° In R. E. Ostman (ed.) Communication Research and Drug Education. Beverly Hills: Sage, pp. 133-154. Biographical Sketch Dr. Hanneman received his Ph,D. in Communication from Michigan, State University, where he also received his R.A. in English and Social Sciences, magnalcum laude. He has taught at the University of Connectiwut, and since 1973, at the Annenberg School of Communications. A specialist in mass media and telecommunications poSicy, Dr. Hanneman has published widely, including Communicationiand Behavior, Communication About Drugs; Symbolic Negotiation About Use (in press), and many articles, chapters and papers on various aspects of the mass media. He has directed' numerous research studies investigating the effects of health information campaigns, advertising,and'media regulation on the public. He is a mem- ber of Phi Beta Kappa, Phi Kappa Phi and is listed in Who"s Who in the West.