Two Key Studies of the Effectiveness of Health Promotion Programmes (DP IB Psychology)

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Key study one: Murphy-Hoefer et al. (2020)

Aim: 

  • To determine the 7-year impact of the Tips From Former Smokers (Tips) campaign on smoking prevalence in the USA:

    • The Tips campaign was a 2012-2018 campaign that interviewed former smokers with health problems to make short fear-arousal videos that were distributed on national media outlets

Procedure: 

  • The Centers for Disease Control and Prevention (CDC) collected data from an ongoing national online survey of adults in the USA between 2012 and 2018 (7 years)

  • Current cigarette smokers were defined as people who smoked at least 100 cigarettes in their lifetime and who smoked every day or some days at the time of survey 

  • At the time of the campaign (2012) there were an estimated 28.3 million smokers in the USA

  • Data on 9,635 current smokers was collected to assess the impact of Tips campaign on attempts to quit smoking and estimates as to how long quitting had been sustained for

Results:

  • Sustained quitting was estimated during 4 of the 7 years of data in the analysis and averaged 7.2% 

  • There was an average of 3.9% increase in quit attempts per quarter

  • There were approximately 16.4 million quit attempts and more than one million estimated sustained quits lasting at least one year

Conclusion:

  • A sustained health promotion programme using fear-arousal videos can be successful when it is based on scientific evidence and is of sufficient intensity and duration

Examiner Tips and Tricks

Studies on health promotion often use a control group that does not receive the health intervention. Do not forget to consider the ethics of this when evaluating the research.

21 Two Key Studies of the Effectiveness of Health Promotion Programmes

Health promotion messages have become more creative over the years - this one is on a crossing in Singapore

Evaluation of Murphy-Hoefer et al. (2020)

Strengths

  • The findings of this large-scale longitudinal survey are supported by three previous studies looking at the results of the Tips campaign for individual years and therefore are likely to be reliable

  • The sample was drawn from a random sampling of US household postal addresses and therefore the results are generalisable to the general US population

Limitations

  • The researchers measured only the results from television exposure and not other media and therefore the figures may be an underestimation of the true picture

  • The analysis used an average campaign effect estimated from 2012 to 2018 and these large figures may hide many small group differences and ignore extraneous variables that could affect the results

Key study two: Nakhimovsky et al. (2016)

Aim: 

  • To conduct a systematic review of the effectiveness of taxation of sweetened soft drinks on obesity in middle-income countries

Procedure: 

  • Nine studies from Brazil, Ecuador, India, Mexico, Peru, and South Africa were reviewed

  • The researchers measured the association between taxes on sweetened soft drinks and their consumption 

  • Outcomes reflecting percentage change in body mass index (BMI), prevalence of obesity, or prevalence of obesity and being overweight were also measured

  • It was not possible to measure outcomes in all of the studies, as in some cases the data had not yet been gathered as the tax was only recently introduced

Results:

  • The reduction in sweetened soft drinks purchased relative to their price was higher (9.1%) among the lowest income group 

  • Milk, fruit juice, bottled water and tea were all identified as partial substitutes 

  • The studies which measured effects on obesity all found a significant reduction of around 3% in obesity levels 

Conclusion:

  • Taxing sweetened soft drinks reduces their consumption and could also also reduce obesity levels, though more research is needed on this

21 Two Key Studies of the Effectiveness of Health Promotion Programmes

Sweetened soft drinks are partly responsible for obesity, tooth decay and type 2 diabetes

Evaluation of Nakhimovsky et al. (2016)

Strengths

  • The researchers selected the studies they analysed carefully, and checked the studies’ funding sources, methodology and statistical analyses in order to increase the reliability of their findings

  • This research fills a gap in the literature as there are very few studies investigating the link between a sweetened soft drinks tax and obesity

Limitations

  • The sample is small, and so generalisation to other middle-income countries is limited

  • There is no way of knowing if obesity levels continued to drop after the study had finished i.e. the findings may have shown a temporary improvement in health

Worked Example

The question is: ’Evaluate the effectiveness of one or more health promotion programmes.’ [22]

The command term “evaluate” requires you to offer an appraisal of the strengths and limitations of the health promotion programme[s] and draw a conclusion as to their effectiveness. This conclusion should be supported by appropriate evidence from one or two studies. Here are two paragraphs for guidance.

The effectiveness of health promotion programmes is often difficult to measure, as it requires self-report from  participants in programmes about their exposure to the media campaign or to the interventions from health professionals. This means the data is subject to memory failure and social desirability bias, which is why measurements that use triangulation of methods or studies that are supported by previous research are the most reliable. Murphy-Hoefer et al. (2020) investigated the effectiveness of the ‘Tips from  former smokers’  health promotion programme that was aimed at encouraging smokers to quit. The programme used short videos, help-to-quit phone lines and media advertisements in order to try and reduce the prevalence rates of smoking in the USA. It has been viewed as successful and is about to be reintroduced in 2024. 

The researchers analysed data from a nationally representative longitudinal survey of US adults who smoke cigarettes, aged 18 years or older in 2012–2018. The 9,635 participants were randomly selected using US household postal addresses and so the results can be generalised beyond the survey sample to the general US population. The results suggested that the Tips health promotion programme resulted in an extra 1 million more US adults giving up smoking between 2012-2018. These findings were supported by findings from previous research while the programme had been  continuing, and so have increased reliability. However, the researchers just measured the results from television exposure and not other media and therefore the figures may be an underestimate. Moreover, this shows correlation only, and there may be other variables that affected the number of people quitting smoking as well as the effects from this programme. 

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