Mass media interventions: effects on health services utilisation
26 August 2013
This review aimed to assess whether mass media campaigns increased the use of health services. All the 20 studies included had used interrupted time series designs, with 15 evaluating the impact of formal mass media campaigns, and five media coverage of health-related issues. All but one study concluded that mass media campaigns were effective. The review concludes that planned campaigns and unplanned mass media converge may positively affect the use of health services and should be considered as possible strategies for health promotion by health-care providers and policy-makers. More research on this topic is required, however, given the methodological limitations of existing studies, and the lack of information about the characteristics of successful campaigns.
Citation: Grilli R, Ramsay C, Minozzi S. Mass media interventions: effects on health services utilisation. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD000389. DOI: 10.1002/14651858.C
The mass media frequently cover health related topics, are the leading source of information about important health issues, and are targeted by those who aim to influence the behaviour of health professionals and patients.
To assess the effects of mass media on the utilisation of health services.
We searched the Cochrane Effective Practice and Organisation of Care Group specialised register (1996 to 1999), MEDLINE, EMBASE, Eric, PsycLit (to 1999), and reference lists of articles. We hand searched the journals Communication Research (February 1987 to August 1996), European Journal of Communication (1986 to 1994), Journal of Communication (winter 1986 to summer 1996), Communication Theory (February 1991 to August 1996), Critical Studies in Mass Communication (March 1984 to March 1995) and Journalism Quarterly (1986 to summer 1996).
Randomised trials, controlled clinical trials, controlled before-and-after studies and interrupted time series analyses of mass media interventions. The participants were health care professionals, patients and the general public.
Data collection and analysis
Two reviewers independently extracted data and assessed study quality.
Twenty studies were included. All used interrupted time series designs. Fifteen evaluated the impact of formal mass media campaigns, and five of media coverage of health-related issues. The overall methodological quality was variable. Six studies did not perform any statistical analysis, and nine used inappropriate statistical tests (ie not taking into account the effect of time trend). All of the studies apart from one concluded that mass media was effective. These positive findings were confirmed by our re-analysis in seven studies. The direction of effect was consistent across studies towards the expected change.
Despite the limited information about key aspects of mass media interventions and the poor quality of the available primary research there is evidence that these channels of communication may have an important role in influencing the use of health care interventions. Although the findings of this review may be affected by publication bias, those engaged in promoting better uptake of research information in clinical practice should consider mass media as one of the tools that may encourage the use of effective services and discourage those of unproven effectiveness.