Use of Mass Communication by Public Health Programs in Nonmetropolitan Regions

ESSAY — Volume 16 — July 25, 2019

Jennifer M. Kreslake, PhD, MPH1; Allison Elkins, MPH1; Christopher N. Thomas, MS, MCHES2; Suzanne Gates, MPH2; Thomas Lehman, MA1 (View author affiliations)

Suggested citation for this article: Kreslake JM, Elkins A, Thomas CN, Gates S, Lehman T. Use of Mass Communication by Public Health Programs in Nonmetropolitan Regions. Prev Chronic Dis 2019;16:190014. DOI: http://dx.doi.org/10.5888/pcd16.190014.

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Background

Mass communication is one component of effective public health program implementation (1). It includes news stories (“earned media”), paid media (advertising), and social and digital media (eg, social networking sites, text messaging, mobile applications, websites, blogs) (1). Earned media can increase the visibility of public health issues and support from community members and leaders (1). Sustained media campaigns are recommended population approaches to modifying diet, physical activity, and tobacco use behaviors (2). Mass communication using various channels has helped increase public awareness, knowledge, attitudes, and behaviors on a multitude of health topics (3,4).

From 2014 to 2017, the Centers for Disease Control and Prevention (CDC) funded 88 communities through Racial and Ethnic Approaches to Community Health (REACH) and Partnerships to Improve Community Health (PICH). REACH funded local health departments, tribes, universities, and community-based organizations to reduce racial and ethnic health disparities in their communities (5). PICH supported similar institutions to improve community health in cities, counties, and American Indian tribes or tribal organizations. Both focused on implementing evidence-based and practice-based strategies for tobacco use and exposure, physical activity, poor nutrition, and access to chronic disease prevention, risk reduction, and disease management opportunities (6). CDC asked funded programs to dedicate 10% of annual funding for mass communication. This was to support program objectives and share program messages, activities, and successes.

Many REACH/PICH programs had limited experience using mass communication to support public health efforts in rural or small towns. In response, CDC provided individualized training, guidance, and technical assistance. This included developing a communication plan, identifying and understanding key audiences, developing and pretesting messages and materials, selecting communication channels (eg, broadcast, print, outdoor, digital) and categories (eg, earned, paid, social or digital media), providing spokesperson training, conducting audience research, and evaluating communication activities.

To understand what contributed to successful communication efforts in nonmetropolitan regions, we conducted individual, 60-minute telephone interviews with personnel overseeing programmatic activities (“program managers”) and mass communication activities (“communication leads”) in 6 REACH/PICH programs. These programs achieved or exceeded annual communication objectives and dedicated at least 10% of annual funding to mass communication. Each interviewed program worked in municipalities with populations of 250,000 or less across multiple US Census regions. Two were tribal programs. By uing a semistructured interview guide, programs were asked open-ended questions about the challenges, opportunities, and promising strategies they encountered when implementing mass communication in small and mid-sized communities. Inductive qualitative analysis identified 4 emergent themes.