Table 1 Methods of and findings of oral health mass media campaign evaluations
From: Mass media campaigns for the promotion of oral health: a scoping review
Author, campaign year | Scale and location | Target audience | Campaign messages | Media channels | Other campaign elements | Evaluation methods | Sample size, response rate | Campaign exposure | Knowledge, attitude, behaviour change |
|---|---|---|---|---|---|---|---|---|---|
Statewide campaign Minnesota, USA | Adults (18+ years), who did not visit a dentist at least once per year | Periodontal awareness (using health belief model) Message of TV advertisements: “Keep your teeth…before gum disease has you looking for a place to keep them” | Paid advertisements on TV, radio, billboards, bus-side posters | Process evaluation Campaign exposure assessed at 2 month follow-up survey Impact evaluation Cross-sectional interviews 2 months post-campaign. Probabilistic, multi-stage cluster sampling used | N = 1000 adults (response rate not given) | 79% of respondents reported exposure to TV campaign, and 71% correctly recalled campaign message | Knowledge 65% of those recalling the campaign could report causes of tooth loss, vs 56% of those who could not recall (p < 0.05) Behaviours 10% who recalled the campaign vs 6% who did not recall expressed intention to make more preventive dental visits (NS) | ||
Murtomaa and Masalin [21] | National campaign, Finland | 15–50 years | Increase demand for dental services as preventive measure to improve dental health Main message: “Teeth can be kept throughout life” | Paid TV, radio, newspaper and magazine | Information-based mail-campaign aimed at informing dentists about recalling patients preceded the main media campaign Local dental societies arranged free dental visits to coincide with campaign | Impact evaluation Pre- and post-test, with baseline data from national survey on dental service utilisation in 1980 [2 years before campaign], and post-campaign survey in 1983 [12 months after campaign]. Probabilistic, multi-stage cluster sampling used | Pre-campaign N = 648, post-campaign study: N = 694 (response rates not given) | No measures of campaign recall | Behaviour Higher proportion visited the dentist in the past 12 months (65% vs. 54%, p < 0.001) and 24 months (87% vs78%, p < 0.001). Proportion whose last visit was for routine examination was slightly higher (40% vs 36%, NS) |
Schou [22] | National campaign, Scotland | Children 5–7 years and their mothers | Raise awareness about restricting sugar intake to meal times and regular toothbrushing with fluoride toothpaste Campaign slogan: “Go for Good Teeth” | TV (advertisement featuring ‘Bugs Bunny’ shown during children’s viewing time), and pamphlet insert in magazines | Dental health information package distributed via primary schools (poster, letter to parents, ‘brushing scorecard’ to return to school, reward badge, mirror sticker) | Formative evaluation Acceptability and comprehensibility of TV advertisement tested with groups of 5–7 year olds and their parents Process evaluation Campaign exposure and satisfaction, assessed by follow-up interviews with mothers and children post-campaign Impact evaluation. Post-campaign survey with assessment of association between recall and oral health behaviours immediately and after 2 months. Stratified quota sampling was used | Sample: mothers n = 164; Children n = 164 | Prompted recollection of any campaign elements was 77% among mothers and 97% among children; in both groups the scorecard was most often recalled | Behaviour 34% of children recalling the campaign increased their tooth brushing, and 35% reported less sugar intake. 64% of children using the tooth brushing score card |
National campaign, Norway | 15+ year olds | Awareness of causes and symptoms of periodontal disease and knowledge of preventive behaviours Theme was “Perio-Year”, the year against periodontal disease” | Paid radio, TV, newspaper and magazines Some unpaid TV, radio and newspaper | One year of periodontal training and information provided to dentists prior to the campaign, so they would reinforce campaign messages during patient dental visits Booklets distributed to grocery stores, pharmacies and dental offices | Process evaluation Reach via different media channels assessed in first post-campaign survey, and exposure (recall) measured at all follow-up surveys Impact evaluation Pre- and post-test, with follow-up surveys conducted immediately after, and one and three years later. Sampling methods for respondents not described | Survey respondents N = 1100–1200 from baseline (1981), to each follow-up in (1982, 1983, 1985). Sample sizes and response rates not reported | 57.7% of participants had prompted recall of seeing information about oral health in mass media immediately after campaign (1982) compared to 47.7% in the year after (1983) and 46.6% 3 years later (1985) | Knowledge From 1982 to 1983 knowledge of tooth brushing to prevent gingivitis increased from 31.7% to 37.9%, and of interdental aids 47.3% to 55.3% (p < 0.05); no increase observed from 1981 to 1982, or 1983 to 1985 Behaviours Prevalence of daily flossing increased from 20.1% to 24.9% from 1982 to 1983 (p < 0.05); NS in the other years, or in the prevalence of daily use of tooth picks | |
National campaign, China; urban and rural communities | Whole population | “Love Teeth Day” with main message of toothbrushing and using fluoridated toothpaste. Themes added and modified each year | Paid TV, radio, newspaper, to publicise events every year from 1989 to 2010 | Lectures/symposia/knowledge contests, posters, pamphlets, cartoon strips and slides Face-to-face consultations in public spaces. Oral health education and therapeutic work for oral disease with mobile dental equipment in the community and at schools | Process evaluation Delivery and reach assessed by reports from local program organisers in two cities and two counties in each province (1989–1992) Impact evaluation Annual post-campaign questionnaires sent out to public by local program organizers in cities and counties where process evaluation undertaken, 1 month after campaign. Population sampling methods not described | Between 321 and 764 adults each year from 1989 to 1992 (response rates not given) | No measures of campaign recall | Knowledge Proportion of correct answers to oral health knowledge questions rose from 37% in 1989 to 77.7% in 1992 Behaviour Between 1989 and 1992: tooth brushing twice per day rose from 50% to 69.3%; use of fluoridated toothpaste rose from 13.7% to 43.6%; use of qualified toothbrushes increased from 49.1% to 86%; levels of never visiting dentists were 17.4% and 18.3%, respectively | |
National campaign, The Netherlands | Parents of children aged 9–18 months | Awareness of prevention of nursing caries in babies Campaign slogan: "Bottle it up—take a cup! From 9 months onwards" | Paid TV advertisements Unpaid coverage in dental health journals, day-care/playgroup journals, magazines for parents of young children, newspapers, radio and TV | Materials (posters brochures, colouring picture and letter for parents) distributed to child health clinics, municipal public health services, dental services, health shops, children’s hospitals, day-care/ playgroups | Formative evaluation Assessment of salience, clarity, and comprehensibility of campaign brochure and poster by interviews with samples of parents at child health clinics Process evaluation Reach to intermediary child health clinics, satisfaction with materials and contextual influences assessed by follow-up survey; reach to parents by different resources assessed by follow-up survey Impact evaluation Pre-post survey of child health clinics and parents at baseline and 18 months post campaign. Random sample of clinics selected. Sampling methods for parents not described | At baseline N = 128 parent using child health clinics (response rate = 94%), and at follow-up N = 98 (response rate = 98%) | 46% of parents reported seeing the poster, 23% receiving information, and 10% had been given a brochure 50% knew the campaign slogan after the campaign | Knowledge After campaign 78% of parents had heard of nursing caries, vs 60% at baseline (p < 0.05) Behaviour Parents reported using bottle less after the campaign compared (88% vs 64%; p < 0.001). Higher proportion of parents switched from bottle to drinking cup before 12 months of age (88% vs 72% before campaign (NS) | |
Friel et al. [29] | National campaign, Ireland | School children 7–12 years | Oral hygiene; frequency and duration of tooth brushing, amount and type of toothpaste, when to replace toothbrush Advertisements used ‘Smile of the Year’ competition to promote oral hygiene knowledge | Paid TV advertising delivered via a children’s TV program over 6 weeks | Primary school dental nurse-led health education intervention | Process evaluation Campaign exposure assessed at follow-up survey Impact evaluation Quasi- experimental controlled pre- and post test design in 32 schools, with follow-up at 8 weeks after intervention. Schools selected using stratified random sampling. Sampling methods for students not described | At baseline: N = 769 experimental and N = 765 control (response rates not given). At follow-up: N = 743 experimental and N = 659 control | 62.9% of children reported exposure to the TV campaign | Knowledge 75.9% of 11–12 year olds exposed to nurse education plus TVC had knowledge of fluoride toothpaste, vs 65.5% exposed to nurse education only (p < 0.01); no difference in knowledge about sugary foods Behaviours 7–8 year olds exposed to nurse education plus TVC compared with nurse education only had higher levels of brushing twice per day (78% vs 68.4%, p < 0.05), brushing for 3 min (42.5% vs 25%, p < 0.01) and using right amount of toothpaste (49.0% vs 35.1%, p < 0.01) 11–12 year olds those exposed to nurse education plus TVC had higher levels brushing for 3 min (54.1% vs 47.9%, p < 0.01) and using the right amount of toothpaste (64.0% vs 43.6%, p < 0.01) |
National campaign, Sweden | 50–75 years | Knowledge of periodontitis | Paid programme on TV Unpaid newspaper, radio and TV coverage | Brochures for dental clinics | Process evaluation Exposure assessed at follow-up survey Impact evaluation Pre- and post questionnaires of cohort, with follow-up after 6 months. Probabilistic sampling of parents within a panel | N = 630 completed baselined questionnaire (response rate = 70%), with 88.6% of these completing 6 month follow-up | No measures of campaign recall | Knowledge Increased knowledge of mobile teeth as a symptom of poor dental health (65% vs 57%, p < 0.01) and role of careful dental hygiene (73% vs 65%, p = 0.001) | |
Regional campaign, Finland | School children and their carers | Increase daily toothbrushing frequency Campaign slogan: “Once a day is not enough” | Public relations activity to generate unpaid TV coverage | Prior to campaign children received oral health education in school, and in stores, at fairs | Impact evaluation Controlled pre- and post-study comparing both children and parents in Pori with those in the municipality of Rauma after 1 and 3.5 years. All children in the designated school years were selected in each town | Baseline (2001): Pori (intervention group) children N = 1649 (response rate = 97.5%), carers N = 1527 (response rate = 90.3%); Rauma (control group) children N = 734 (response rate = 91.0%), carers N = 693 (response rate = 85.8%) Follow-up (2005): Pori (intervention group) children N = 1598 (response rate = 96.3%), carers N = 1292 (response rate = 77.9%); Rauma (control group) children N = 749 (response rate = 90.6%), carers N = 523 (response rate = 63.2%) | No measures of campaign recall | Knowledge Trend to improved knowledge of oral health behaviours among children and carers in 2005, but NS differences between groups Attitudes Improvements in attitudes towards oral health tended to be greater in children in the control region in 2005, but NS differences NS difference in attitude among carers Behaviours In 2005 all children showed behaviour improvement, but intervention town children had lower consumption of sugary snacks, sports drinks and xylitol products, and smoking prevalence. Improvements in behaviours were not greater among carers in intervention towns | |
Sivaneswaran et al. [34] | Rural town, Australia | Adults 18 years and over | Promoting benefits of water fluoridation ahead of a plebiscite about this policy | Paid newspaper advertisement. Unpaid newspaper, radio and TV | Posters, pamphlets, ‘how to vote’ cards. Lobbying to mobilise the community; children as advocates | Impact evaluation Post-campaign plebiscite of all on electoral roll to measure support for water fluoridation | N = 4,539 (response rate = 86%) | No measures of campaign recall | Attitudes 55.8% of voters agreed with fluoridation of water |
National campaign, Iran | 18–50 years | Knowledge of oral health and periodontal disease | Public service television advertisement delivered via a video animation clip | Process evaluation Campaign exposure measured at time of follow-up survey. At follow-up also measured satisfaction with campaign (appeal, usefulness, relevance, recommended to others) Impact evaluation Survey via interview at baseline and follow-up of cohort immediately following campaign and 3 months later. Probabilistic, multi-stage cluster sampling used | At baseline N = 791 adults (response rate not given); follow-up of 68.6% immediately post-campaign and 37.2% after 3 months | 30% aware of campaign at immediate follow-up | Knowledge Post-campaign knowledge of plaque and gum disease improved more in those recalling the campaign compared with those who did not (52.9% vs 39.1%); mean knowledge score of 0.61 in the exposed vs 0.29 in the unexposed (p < 0.01) At 3 months knowledge scores did not differ between the exposed and unexposed |