Selling Health: Nyc's Development of Hard-Hitting Media Campaigns

Background: This presentation will focus on six years of exploratory and evaluative research on New York City’s successful hard-hitting media campaigns, and how these lessons have subsequently been adapted to inform the development of HIV, nutrition and physical activity campaigns.

Program background: Starting in 2006, New York City began producing and airing hard-hitting anti-tobacco media campaigns to great success, receiving tremendous local, national, and international media attention, and increasing calls to the city’s quitline five-fold.  In order to create and choose ads and messaging, extensive exploratory and evaluative qualitative research (in-depth interviews and focus groups) were conducted throughout the process. 

Evaluation Methods and Results: New York City's methods of media development and testing were initially used for NYC’s development of five hard-hitting anti-smoking campaigns.  These campaigns, ranging from graphic depictions of health effects to testimonials and emotionally-compelling pieces, were all informed by qualitative findings in a variety of ways, which will be discussed in this presentation.  These methods have now been adapted for other New York City campaigns, most recently to educate residents about HIV risks and the effects of sugar sweetened beverage consumption on health.   These ads have helped save lives and shift social norms.  They have received international recognition, and some have been used in many other cities, states and countries.

Conclusions:Messaging around health and behavior change is complicated; in some cases people are being asked to confront addictions and disrupt behavior that is ingrained in their lives and relationships. Therefore, the tenets used to sell other products (pleasure, status and instant gratification) cannot always be employed to sell health. Messaging that impacts the emotions of viewers in other ways must be found.  Hard-hitting media impacts viewers by making them experience negative feelings and fear about unhealthy behaviors while delivering a clear solution or call to action.

Implications for research and/or practice: Focus groups and in-depth interviews are invaluable methods  to understand the public’s responses to and interpretations of messaging.   For example, if a media piece is liked, thought to be palatable or does not create much discussion, it is not likely to  have much impact in the larger media market.  However, those ads that have generated fear, anger, denial, disagreement among focus group participants, and much discussion, have proved to be the most effective campaigns. Qualitative research also allows for discussions of denial.  When speaking to people about their unhealthy behaviors, they are often aware of general consequences, but have developed justifications and explanations for continuing to partake in healthy and sometimes irrational behaviors.  Listening to these methods of denial allows media producers to understand the “believability gap” in their messaging and find ways to minimize this gap, making the messaging all the more relevant, compelling and credible.