Gynecological cancers—including cervical, ovarian, uterine, vaginal and vulvar cancers—are responsible for nearly 100,000 new diagnoses and more than 30,000 deaths in the United States annually. However, the signs and symptoms are often vague and easy to ignore. In 2009, the Centers for Disease Control and Prevention (CDC) launched a new public service campaign in order to increase awareness of gynecological cancers and encourage women to see their doctors. CDC’s Inside Knowledge public service campaign included television, radio and web advertising directed at women ages 40-60 as well as posters, print materials and training for healthcare providers. The PSAs began to air nationally in fall of 2010. CDC contracted with Battelle to conduct a formal evaluation of the campaign in order to better understand its impact and meet the program evaluation requirements under Johanna’s Law.
Battelle researchers designed and executed the study to evaluate the process, reach and ultimate outcomes of the CDC campaign. Researchers evaluated the materials, delivery channels and overall implementation. A field experiment was used to evaluate the reach, exposure and outcomes for women in four cities (two treatment groups and two matched control groups). Surveys of women in the target population were conducted in all four cities both before and after the treatment period to determine whether the media campaign had a measureable impact on women’s knowledge or intended behaviors in the treatment cities. Key research questions for each phase included:
- Process: Was the campaign delivered according to the media plan? What was the nature of the delivery (what and how) of the interventions? What materials were used to communicate messages to target audiences? In what manner were the target audiences reached?
- Reach/Exposure: What was the reach of the exposure (who, where, when) of campaign efforts? Which target audiences were reached and with what amount of advertising impressions? What percentage of the target audience reports exposure to and understanding of the campaign messages?
- Outcomes: Do women who were exposed to the campaign have higher knowledge of gynecologic cancers and their warning signs/symptoms, higher intentions to seek medical attention, and/or higher intentions to discuss symptoms with their doctor than women not exposed to the campaign? Were there any unintended effects (e.g., increased anxiety or fear) from exposure to the campaign?
The Battelle study showed that CDC’s advertising was effective in raising awareness of the signs and symptoms of gynecological cancer. Key findings included:
- In the post-treatment surveys in the intervention cities, 25% remembered seeing one or more of the Inside Knowledge ads.
- Of the women who remembered the ads, most reported that the campaign was informative, meaningful and convincing; very few women reported that they were irritated or scared by the ads.
- While overall awareness of which cancers are gynecological cancers was high among all groups, women in the treatment cities demonstrated higher knowledge of the warning signs and symptoms of these cancers.
- Intentions to seek care if experiencing symptoms were already high among all groups, and did not show an increase after the intervention.
The results demonstrated that well-designed media campaigns, including radio and television PSAs and web advertising, have the power to make a difference. This is encouraging not only for CDC’s Inside Knowledge campaign, but also for other public health organizations seeking to improve awareness and positive intentions around health risks.