The public health community often relies on Public Service Announcements (PSAs) and other media outreach to educate target populations about critical health risks. But how do you know if a campaign has been effective? Battelle recently completed an evaluation of the Centers for Disease Control and Prevention’s (CDC) Inside Knowledge campaign, which is aimed at increasing awareness of gynecological cancers.
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 CDC launched a new public service campaign in order to increase awareness of gynecological cancers and encourage women to see their doctors. The initiative was in response to Johanna’s Law, named for Johanna Silver Gordon, who died of ovarian cancer in 2000.
CDC contracted with a national advertising agency to develop an integrated campaign that 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 the fall of 2010.
In 2012, CDC contracted with Battelle to conduct a formal evaluation of the program as required by Johanna’s Law. Battelle researchers designed and executed the study to evaluate the process, reach and ultimate outcomes of the CDC campaign. 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?
In order to evaluate the outcomes of the campaign, Battelle set up a field experiment aimed at women in four cities. San Antonio and Milwaukee were used as treatment groups; special paid advertising campaigns were implemented in the cities using CDC’s radio and television PSAs and web ads during the summer of 2015. Las Vegas and Cincinnati were used as comparison cities. Surveys of women in the target population (ages 40-60) 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. Cities were selected based on their demographics, cancer incidence, overall population size and the presence of a large enough population of women in the target group.
The Battelle study demonstrated that CDC’s advertising was effective in raising awareness of the signs and symptoms of gynecological cancer. 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. They also showed higher aided awareness of the ads. Intentions to seek care if experiencing symptoms were already high among all groups, and did not show an increase after the intervention.
The study showed a significant increase in traffic to CDC’s Inside Knowledge website from the treatment cities during the campaign, which dropped off again once the intervention was complete. The CDC also documented several phone calls from the treatment cities during the intervention period.
During the course of the evaluation, Battelle surveyed 2,495 women between the ages of 40 and 60. While 37% had a relative with breast cancer, very few had relatives with gynecological cancers. 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.
The results are encouraging not only for CDC’s Inside Knowledge campaign but for other public health organizations seeking to improve awareness and positive intentions around health risks. The study showed that well-designed media campaigns, including radio and television PSAs and web advertising, have the power to make a difference. Battelle’s evaluation services are helping program planners measure the success of their campaigns and determine when changes are needed to improve campaign efficacy.