Impact Data - Radio Advertising Techniques and Nutrition Education
"An essential component of health and nutrition improvement programs is education of the public about better food choices and health care."
Carried out in the Philippines and Nicaragua, a field experiment led researchers to conclude that health and nutrition education messages patterned after the "reach and frequency" technique of commercial advertising resulted in significant gains in knowledge, increases in positive attitudes, and changes in behaviour. (Reach is the number of different people who are exposed an advertising message at least once. Frequency is the number of times they are exposed to the message.)
Conducted by Manoff International, Inc. with funding from the United States Agency for International Development (USAID), the experiment involved short (1-minute-long) mini-dramas broadcast over local stations for up to 1 year without the support of more conventional education methods, other than those going on before the project began. The themes and messages were developed in consultation with local health and nutrition authorities, recorded using professional talent from local radio stations, tested with representatives of the intended audience before airing them, redrafted, and aired according to the listening habits of the intended audience.
Specifically, in the Philippines, the messages were directed to mothers of children under 12 months. A dialogue between a young mother and her mother presented how to enrich a 6-month-old child's rice porridge with oil, fish, and vegetables for calories, protein, and vitamins. In Nicaragua, the messages were directed to mothers of children 5 years old and under. In 6 separate messages, a doctor and a village wise woman, Doña Carmen, instructed mothers how best to care for their children with diarrhoea. The instructions included: a recipe and dosage for a homemade rehydration fluid, Super Limonada; the proper food for a child with diarrhoea; warnings about giving purges; and the necessity of seeking medical help for serious cases.
The messages were broadcast for approximately 1 year in each country. Evaluation data were gathered through questionnaires administered to mothers in their homes in baseline studies, 6 months after broadcasts began, and then again 23 months after the baseline. One thousand mothers were interviewed in each wave of interviews. In the Philippines, the interviews were divided: 700 in the test group and 300 in the control group. A control group was not possible in Nicaragua. Interviews in both countries were supplemented by self-administered questionnaires to doctors, teachers, and other community workers.
Editor's note: from personal correspondence with the Manoff Group, August 4 2014, here is more on the reach and frequency methodology that informed this experiment: "Richard Manoff's book, Social Marketing: New Imperative for Public Health, ...[has] a discussion of "media weight" (page 170), [defined as] 'the factor that determines the reach and frequency of a mass media campaign...How many times should the message be delivered, where and, if on radio or TV, at what times.' So media weight is a combination of reach (how many of the specific audience you expect to reach at specific times and days using certain stations/channels) and frequency (how often you need to broadcast in order to reach them sufficient times). Media weight seems to be a combination of art and science, and frequent checking in with the audience would seem to be essential."
- In the Philippines, knowledge of why oil was good for the baby increased from 4% to 25% after one year of broadcast, an increase of 21%.
- In Nicaragua, 89% of all respondents knew the purpose of Super Limonada, 55% knew the important ingredients in the correct amounts, and 41% volunteered the correct dosage.
- In the Philippines:
- Twenty-four percent of mothers of infants 6-12 months old reported enriching their child's rice porridge with oil after 1 year of broadcasts, where none did at the baseline (N = 140).
- Twenty-seven percent reported adding chopped fish when 17% did before, an increase of 10% (N = 136).
- Seventeen percent reported adding vegetables where 5% had before, an increase of 12% (N = 136).
- In Nicaragua:
- Twenty-five percent (N = 940) of mothers with children under 5 report using Super Limonada for their child's last case of diarrhoea, where 2% had been giving lemonade before.
- The incidence of feeding during diarrhoea increased by about 10%.
- The practice of giving purges, a common detrimental custom, did not seem to have changed.
In the Philippines, positive attitudes toward putting oil in lugaw (rice porridge) increased from 15% (N = 700) at the baseline to 74% (N = 660) after 1 year; positive attitudes toward adding fish increased from 48% to 81%; and positive attitudes toward adding vegetables increased from 49% to 79%.
- In the Philippines (where most of the changes occurred in the first 6 months of the broadcasts, after which a plateau was maintained. The leveling off is attributed to a marked decrease in exposure to the messages, especially from the most popular stations, and possible message fatigue), 75% of all mothers could recall correctly at least one message element, although radio ownership is only 48%.
- In Nicaragua, after 1 year, 65% of the respondents could correctly recall at least 1 element of the messages.
According to the researchers, the implications of the experiment are that the reach and frequency technique can render broadcasting to unorganised audiences that, combined with the use of radio (an inexpensive medium), can be effective in bringing about behaviour change as well as attitude and knowledge change. It appears that the project development approach may also be useful for planning and implementing other forms of nutrition and health education, including longer radio programmes, posters, pamphlets, etc. Creative talent and management support are available in most countries, although the impetus for developing the programmes and initial technical assistance may have to come from outside.
Radio Advertising Techniques and Nutrition Education: A Summary of a Field Experiment in the Philippines and Nicaragua Final Report [PDF], Manoff International, December 1977, referenced in a posting from Mike Favin to the Health Communication Network within The Communication Initiative Network, July 30 2014; and email from Mike Favin to The Communication Initiative on August 4 2014. Image credit: World Vision Philippines
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