Title: Effectively Communicating the Message
1Effectively Communicating the Message
- January 10, 2005
- Nancy Dubois
- 519.446.3636
- n.dubois_at_utoronto.ca
2Introductions
- Opening Remarks / Welcome
- Introductions Nancy Dubois
- Purpose
- Process
- People
- Place
- Paper
3PURPOSE
- To equip participants with concepts, examples,
and tools to effectively design health
communication messages. - To provide the opportunity to apply these to
actual campaigns.
4PROCESS
- Introductions Overview
- Health Promotion Health Communication
- Effectiveness
- 12 Step Model
- Audience Analysis
- Channels Vehicles
- Effective Message Design Application
- Evaluation of HC Campaigns
- Summary
- Closing Remarks
5PEOPLE
- Name
- Organization / Program Area
- Memorable message?
6PLACE PAPER
- Washrooms
- Cell phones
- Lunch
7The Health Communication Unit
- One of 23 health promotion resource centres in
Ontario funded by MOHLTC - Support for health promoters in the areas of
- program planning
- evaluation
- policy development
- sustainability
- health communication
- In the form of Web resources, electronic /
telephone feedback, on-site consultations and
central/regional training - Service Request Form on Web site
8Ontario Health Promotion Resource System
- www.ohprs.ca
- Leads to all resource centres
- Each has a different mandate
- Plus system-wide efforts in needs assessment,
evaluation, coordination between centres (e.g.
joint events)
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10The Concepts
- Health Promotion
- Health Communication
- Message Development
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12Where Communication Fits
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14Can health communication campaigns work?
- Most researchers agree that campaigns can impact
on awareness, knowledge and attitudes. - However, the research on the major field trials
over the last two decades (Stanford, Minnesota,
COMMIT) has fostered skepticism about the effects
of communications campaigns on actual behaviour,
either initial adoption of new practices, or,
more importantly, long-term behavioural change. - In his recent book, Professor Hornik concludes
that There is good evidence for the effects of
public health communication. - Andreasen, A. 2002. Book review of Public Health
Communication Evidence for Behaviour Change by
Robert Hornik. 2002. In Social Marketing
Quarterly. Vol VIII, No. 3.
15Horniks comments on effectiveness (1)
- Exposure is the key to having a communication
effect the more exposure, the more effect. - However, a minimal level of exposure may be
necessary before any effects can be observed.
This may explain why the well-known, massive
trials have not shown dramatic results the
difference in exposure between intervention and
comparison sites has not been large enough. - As reprinted in Andreasen, A. 2002. Book review
of Public Health Communication Evidence for
Behaviour Change by Robert Hornik. 2002. In
Social Marketing Quarterly. Vol VIII, No. 3.
16Horniks comments on effectiveness (2)
- Communication effects can manifest themselves
along any or all of three pathways - First they can influence individual behaviours
directly. - Second, they can influence the media and opinion
leaders so as to change social norms. - Third, policy-makers can be alerted to the need
for structural changes, which they then bring
about. - As reprinted in Andreasen, A. 2002. Book review
of Public Health Communication Evidence for
Behaviour Change by Robert Hornik. 2002. In
Social Marketing Quarterly. Vol VIII, No. 3.
17Recommendations
- More attention should be paid to setting
realistic, specific and measurable objectives. - Social marketing concepts should become more
central to campaigns, which often mention this
framework but do not integrate it into planning. - Behavioural theories should be more actively
applied to campaign designs.
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19Rationale
- Stages of Change
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
- Awareness
- Information
-
- Cognitive
- Behavioural
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21Recommendations (cont)
- Audience segmentation and research should be more
central to the planning of campaigns. - Communication strategies should be formulated
based on better information about target
audiences communication patterns. - Better understanding of message design decisions
is needed. - A major thrust of campaigns should be altering
the social and physical environment.
22Three Approaches to Health Communication
- Media (Broadcast Narrow-cast)
- Limited involvement
- Appropriate only for certain objectives
- Interpersonal Communication
- May flow from media messages as opinion leaders
and others share, endorse, etc. - More involvement
- Events
- Combination of media and interpersonal
- Designed to be newsworthy
23Five Types of Health Communication
- Persuasive or Behavioural Communications
- (which may employ social marketing strategies)
- Risk Communication
- Media Advocacy
- Entertainment Education
- Interactive Health Communication
- Adapted from Maibach and Holtgrave,
- Advances in Public Health Communication
- from Annual Review of Public Health, 1995
16219-38
24Media Advocacy
- I am now ready to give the answers I have
prepared for your questions. - Charles DeGaulle
- Do you have any questions for my answers?
- Henry Kissinger
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27E-health
- The use of emerging information communication
technology, especially the internet, to improve
health healthcare. - Tom Eng, 2000
- http//www.participaction.com/whistler2001/pdf/Str
echer.pdf - www.shapeup.org
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31The 12 Steps to Health Communication Campaigns
- Project Management
- Revisit Your Health Promotion Strategy
- Analyze and Segment Audiences
- Develop Inventory of Communication Resources
- Set Communication Objectives
- Select Channels and Vehicles
- Combine and Sequence Communication Activities
- Develop the Message Strategy
- Develop Project Identity
- Develop Materials
- Implement Your Campaign
- Complete the Campaign Evaluation
32Step Three
- Audience Analysis and Segmentation
33Audience Analysis
- Involves getting to know your audience.
- Allows you to better predict behaviours and
develop messages that appeal to your audience. - Consists of the gathering, interpretation, and
application of - demographic
- behavioural
- psychographic information.
34Audience analysis helps to
- segment an audience into smaller chunks
- develop priority segments
- select the objectives most appropriate for an
audience - select the best channels and vehicles to reach an
audience - develop messages that are relevant to an audience
- plan and evaluate more easily.
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36Intended audience
- Adults aged 25-45 with 9-13 years of schooling.
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38The 12 Steps to Health Communication Campaigns
- Project Management
- Revisit Your Health Promotion Strategy
- Analyze and Segment Audiences
- Develop Inventory of Communication Resources
- Set Communication Objectives
- Select Channels and Vehicles
- Combine and Sequence Communication Activities
- Develop the Message Strategy
- Develop Project Identity
- Develop Materials
- Implement Your Campaign
- Complete the Campaign Evaluation
39Step Five
- Set Communication Objectives
40Objectives
- OUTCOME Are we doing the right things?
- changes in individuals
- changes in the environment
- changes in organizational or society practices
/ policies - PROCESS Are we doing things right?
41Communication Objectives Worksheet
42Step Six
- Select Communication Channels and Vehicles
43The 12 Steps to Health Communication Campaigns
- Project Management
- Revisit Your Health Promotion Strategy
- Analyze and Segment Audiences
- Develop Inventory of Communication Resources
- Set Communication Objectives
- Select Channels and Vehicles
- Combine and Sequence Communication Activities
- Develop the Message Strategy
- Develop Project Identity
- Develop Materials
- Implement Your Campaign
- Complete the Campaign Evaluation
44Channel
- The fundamental way in which a message is sent
- (via tv, radio, interpersonal communication,
etc.).
45Vehicle
- A specific way to deliver a message through the
channel (e.g. psas, ads, presentations, etc.).
46Choosing the right channels and vehicles
- is essential to achieving maximum impact, and to
reaching the audience on which youve decided to
focus - needs to be tied to Step 4 (Inventory) of what is
available and - will prevent you from committing resources to
something that wont help you reach your
objectives.
47Selecting channels and vehicles is a matter of
48Step Seven
- Combine and Sequence Communication Activities
49Combine and Sequence Worksheet
50Step Eight
51Part of a larger process
52Girls 9-12 CDC
- www.cdc.gov/powerfulbones
53Three Main Message Elements
- The What?
- The So What? (Why now?)
- The Now What?
54Understanding and Using Fear Appeals Based on
work by Kim Witte http//www.thcu.ca/infoandre
sources/Step8MessageDevelopment.htm
556 Cs of Effective Messages
- Courtesy show concern for the intended receiver
- Clarity compose messages that are easy to
understand - Conciseness State what needs to be said in as
few words as possible - Concreteness convey a message in precise terms
- Correctness provide accurate details in an
acceptable format - Completeness include all pertinent information
- Effective Communication for Colleges 9th ed.
Brantley Miller
56Message ClarityBody Mass Index Chart
57Message Clarity
58McGuire - Before taking action, audiences must
- Tune in (exposure)
- Attend to the communication
- Like it, maintain interest
- Comprehend
- Generate related cognitions
- Acquire relevant skills
- Agree with the position (attitude change)
- Store new position in memory
- Retrieve of the new position from memory when
relevant - Decide to act on the basis of retrieved position
- Act on it
- Integration behaviour into lifestyle
- Recruit others to behave likewise
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614 Rules of Persuasion
- Build logical arguments
- The greater the change you advocate, the
stronger your case must be. - Place the strongest parts of your argument
strategically. - Cite authorities
- Present all sides of an argument
- Present sufficient detail
62Health Communication Message Review Tool
- The message will get and maintain audience
attention. - The strongest points are given at the beginning
of the message. - The message is clear (I.e. the audience can
identify the main message points, including
topic, incentives, actions) - The action you are asking the audience to take is
relatively easy. - The message uses incentives effectively (more
than one type, the audience cares about the
incentives presented and the audience thinks the
incentives are serious and likely). - Good evidence for threats and benefits is
provided.
63Health Communication Message Review Tool
- The messenger is seen as credible source of
information. - Messages are believable.
- The message uses an appropriate tone for the
audience (e.g. funny, cheery, serious, dramatic). - The message uses an appeal that is appropriate
for the audience (I.e. rational or emotional).
If fear appeals are used, the audience is
provided with an easy solution. - The message will not harm or be offensive to
people who see it (even people outside the
intended audience). This includes avoiding
blaming the victim. - Identity is displayed throughout.
- Criteria and review tool are available in
WORD/PDF format at http//www.thcu.ca/infoandresou
rces/Step20820Health20Communication20Message2
0Development.htm
641. The message must get and maintain attention
- If you dont capture attention, you cannot be
effective! - It must also maintain audience attention
throughout the message and be memorable. - Different techniques will capture the attention
of different audiences messages must always be
tested to ensure they are engaging.
651. Ways to capture attention
- To make ads
- Attractive
- Interesting
- Entertaining
- Stimulating
- Always apply high quality creative and mechanical
execution (text, graphics, visuals)
- Consider using
- Parody
- Suspense
- Word play
- Sensuality
- Emotionally involving scenes
- Humour
- Vivid visuals
- Striking statements
- Lively language
- Fascinating facts
- Memorable slogans
66- Noted 68
- Associated 52
- Read Most 75
- Gun provides a clear focal point.
- Text on tag tells a clear story that helps
readers make an emotional connection. - Simple, clean design enhances overall readability.
672. Put strongest points at beginning of message
- The information that is most critical for
convincing your audience to adopt the recommended
behaviour should be positioned early in the
message. - That way, audiences who lose interest or become
otherwise distracted will still have the
opportunity to process some key points.
683. The message must be clear
- Can the audience identify the main message
points? - The actions you are asking them to take (Now
What?). - The incentives or reasons for taking those
actions (So What?). - Evidence for the incentives and any background
information or definitions (What?) - Elements that can help or hinder clarity
- language (vocabulary, lingo) and reading level
- pace/speed
- amount of content (avoid trying to cram in too
much) - background (text, graphics, music, etc.) and
- repetition.
693. Use of Statistics
- Statistics should be used with caution in
messages. - Most people overestimate the risk of things like
care and airplane accidents, but underestimate
things like strokes and heart attacks. - People also tend to underestimate the cumulative
probability that an event will occur (e.g. the
odds of wrecking a car by the time you are 18 if
you drive under the influence several times per
year), even if they correctly understand the odds
that the event will occur on any one occasion.
704 The action you are requesting is reasonably
easy.
- Sometimes a behaviour is not acceptable to the
audience because it takes too much effort and
sacrifice. - This can be overcome by presenting easier
behaviours that have fewer barriers and are more
easy and appealing. - From Atkin, C. Theory and Principles of Media
Health Campaigns. In Rice, R. Atkin, C. (Ed.).
Public Communication Campaigns. 3rd Ed. 2001.
714 The action you are requesting is reasonably
easy (2)
- The key is to be aware that target behaviours can
be arranged along a continuum according to - degree of time,
- effort,
- money,
- psychological, and
- social costs.
724 The action you are requesting is reasonably
easy (3)
- For example, abstinence has not been very
effective for alcohol, tobacco and drugs. - Instead, you might promote modestly demanding
behaviours such as sign a pledge card or
abstaining just during a drug-free week. - There are also other responses that might be
targeted, such as awareness, knowledge, beliefs,
values and attitudes that will lead to the focal
behaviour. -
- From Atkin, C. Theory and Principles of Media
Health Campaigns. In Rice, R. Atkin, C. (Ed.).
Public Communication Campaigns. 3rd Ed. 2001.
734 The action you are requesting is reasonably
easy (4)
- Having role models demonstrate the behaviour can
also increase audience confidence that the
behaviour is easy to perform. - Providing solutions to barriers that have been
expressed by the audience can help make the
behaviour easier for the audience. - Not all barriers can be addressed this way
however, in many cases, the actual environment
must be modified.
745. Make effective use of incentives
- Creating a persuasive health communication
message involves more than simply asking the
audience to do what you want. - You must explain to them why they should be
interested in changing their behaviour. - There are different kinds of incentives for
changing behaviour - Physical
- Economic
- Psychological
- Moral-Legal
- Social
- Incentives can be for or against a behaviour
(why or why not).
756. Provide Good Evidence for Threats and
Benefits
- You must provide credible evidence that threats
(associated with not doing the behaviour) and
benefits (of doing the behaviour) are real and
likely. - They must also be convinced that the behaviour
you recommend will actually alleviate the threat
discussed.
766. Provide Good Evidence for Threats and
Benefits (2)
- This can be challenging since different types of
evidence works with different audiences. - For example, audiences that are already
interested in the topic respond to expert quotes,
documentation and statistics, and audiences that
are not involved are more likely to respond to
dramatized case examples and testimonials.
777. The messenger must be a credible source
- The messenger is the model appearing in message
who delivers information, demonstrates behavior,
or provides a testimonial. The source messenger
is helpful in attracting attention, personalizing
abstract concepts by modeling actions and
consequences, bolstering belief formation due to
source credibility, and facilitating retention
due to memorability. -
- Above information presented by Dr. Chuck Atkin
at 2000 Special Topics, THCU workshop).
78Typical Categories of Messengers
- Celebrity (famous athlete or entertainer)
- Public official (government leader or agency
director) - Expert specialist (doctor or researcher)
- Organization leader (hospital administrator or
executive), - Professional performer (standard spokesperson,
attractive model, or character actor) - Ordinary real person (blue-collar man or a
middle-class woman) - Specially experienced person (victim, survivor,
or successful role model) - Unique character (animated, anthropomorphic, or
costumed). - Above information presented by Dr. Chuck Atkin
- at 2000 Special Topics, THCU workshop).
79Selection of Messengers
- In selecting the appropriate messenger, the
crucial factor is which component of influence
model needs a boost. For example, - celebrities help draw attention to a dull topic,
- experts enhance response efficacy,
- ordinary people heighten self-efficacy,
- victims convey the severity of harmful outcomes,
and - victims who share similar characteristics of the
audience should augment susceptibility claims. - Atkin (1994) provides an elaborate discussion of
strengths and weaknesses of various types of
messengers - Above information presented by Dr. Chuck Atkin at
- 2000 Special Topics, THCU workshop).
80Selection of Messengers
- No one messenger is always superior.
- A doctor may communicate trust and expertise in
one campaign, and be perceived as boring in
another. - While celebrities are often seen as trustworthy,
they are much more effective when they have
personal experience with the issue. - Atkin, C. Schiller, L. The Impact of Public
Service Advertising. In Shouting to be heard
Public service advertising in a new media age.
February 2002. Kaiser Family Foundation
81Diffusion of Innovations
Late adopters Macro level ES policy
Early adopters Media individual Change programs
82Credibility
- Messenger credibility is enhanced by
- Power
- Perceived expertise
- Perceived honesty
- Attractiveness
- Being similar to the target audience
838. Messages must be believable
- Messages must be realistic.
- They should not make extreme claims or use
extreme examples. - Avoid highly dramatic episodes.
- Do not provide misleading information
- The audience must believe the information is
accurate. - When in doubt, use a serious tone it is the
safest.
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859. Use an appropriate tone
869. Use an appropriate tone
- Dont preach or dictate
- Serious tone is safest if not too boring or
bland. - Be careful with humour test it first!
87FEAR
- ParticipACTION
- Dont run for the bus you might not make it.
- The average 45 year old Canadian is as fit as
the average 60 year old Swede.
8810. Use an appropriate appeal
- Rational appeals work with audiences that are
already interested in your topic (Atkin 2001). - Emotional appeals work better with audiences that
are not already interested in your topic. - If you frighten the audience, be sure to give
them an easy way to alleviate the threat. - Avoid making your audience anxious, without a way
to reduce the anxiety or they will block out the
message or do the behaviour you dont want them
to do, even more.
89Type of Appeal
- Ethical
- Positive
- Negative
- Rational
- Emotional
- Humour
- Fear
- Compassion
9011. Do not harm the audience
- It can be difficult to control who is exposed to
the message it may unintentionally reach
audiences it wasnt intended for. - Therefore, ethically, developers must consider
the views of anyone who might encounter the
message. - This is mainly a problem for negative messages
that use threats or fear appeals.
9111. This includes avoiding victim blaming
- Complicated behaviours like smoking, eating,
exercising, drinking are not always simple
personal choices. - Be sensitive to the role of an individuals
environment. - Help them to overcome their environment.
- Dont assume it is their fault and all their
responsibility.
9212. Display identity throughout
- A campaign identity includes a name, a
positioning statement or copy platform, a logo, a
slogan, and possibly other images. - Identity distinguishes, defines and synergizes.
93Project Identity
- Defines
- Distinguishes
- Synergizes
94Key Elements of an Identity
- Name
- Positioning Statement or Copy Platform
- Logo
- Images
- Other Considerations
95Identity amplifies the impact of a campaign
- It helps people to remember the key campaign
messages because they can connect discrete
messages with each other. - It stimulates more conversation and comment
(particularly important for behaviour change
campaigns). - In time, the unifying features could come to
represent the messages and the image of the
campaign, leading people to immediately recall
the key campaign messages when the symbol is
presented.
9612. Use a strong slogan
- It should prominently and concisely capture the
main idea. - Examples
- A little more, a little more often.
- Get around the block
- You only have to take it regularly, not
seriously.
97FINAL DECISION q Use q Lose q
Adapt
98Application Task
- Use the Message Review Checklist to critique the
sample products you have brought - Need others to look at?
- Share key insights
99- Noted -34
- Associated -33
- Read Most -22
- Headline over photo (difficult to read).
- Monocromatic pictures least pleasing to people.
- Less attracted to models with parts (ears, etc.)
not showing. - After seeing photo, people look down (missing
headline).
100Principle 7
- When everyone zigs, its time to zag.
- Principles, like rules, are made to be broken.
Just make sure, however, that when you break the
rules, you do so knowingly and with good reason.
101- Noted 3
- Associated 6
- Read Most 11
- Traditional design (eye-catching picture, with
headline below, followed by text) flows readers
through ad. - Text set in serif font and two-columns maximizing
readability. - Response mechanisms correctly placed where
readers look after absorbing centre bottom.
102- Noted 15
- Associated 16
- Read Most 47
- Picture pays off headline, so headline is
positioned at top of ad as initial focal point. - Colour photo is eye catching and contributes to
tragic story. - Copy is legible and compelling with few words.
103Step Twelve
104Why Campaigns Fail (1)
- For the large majority of individuals who are not
receptive to performing the desired health
behaviour, there are a series of resistance
barriers at each stage of response to campaign
messages. - Most elemental problem is the inability of the
campaign to reach the audience and attain
adequate exposure to the messages (due to either
low volume or design elements). - From Atkin, C. 2001. Impact of Public Service
Advertising Research Evidence and Effective
Strategies. Project conducted for Kaiser Family
Foundation.
105Why Campaigns Fail (2)
- Other barriers
- Misperception of susceptibility to negative
outcomes - Deflection of persuasive appeals
- Denial of applicability to self
- Rejection of unpalatable recommendations
- Perception that messages are offensive,
disturbing, boring, stale, preachy, confusing,
irritating, misleading, irrelevant,
uninformative, useless, unbelievable, or
unmotivating. - From Atkin, C. 2001. Impact of Public Service
Advertising Research Evidence and Effective
Strategies. Project conducted for Kaiser Family
Foundation.
106Why Campaigns Fail (3)
- Some messages may produce boomerang effects that
run counter to the campaign objectives or that
undermine other health practices - Alarming statistics or portrayals of
misbehaviours or victims may normalize behaviour - Portraying behaviour as risky may appeal to
risk-takers in the audience - Forbidden fruit might sell the fruit
- Highly threatening appeals may backfire without a
strong efficacy component - Exaggerated claims may undermine credibility
- From Atkin, C. 2001. Impact of Public Service
Advertising Research Evidence and Effective
Strategies. Project conducted for Kaiser Family
Foundation.
107Why Campaigns Fail (4)
- More boomerang effects
- Emphasis on negative outcomes may produce
desensitization - Audiences may shift problems. For example, if
adolescents are successfully scared away from
marijuana, they may drink more heavily. If
teenage drinkers adopt the heavily promoted
designated driver program, non drivers may drink
more heavily. If teenage drivers are convinced
that safety belts will protect them, they may
drive faster and suffer high-speed crashes. - From Atkin, C. 2001. Impact of Public Service
Advertising Research Evidence and Effective
Strategies. Project conducted for Kaiser Family
Foundation.
108Why Campaigns Fail (5)
- Many organizations that sponsor campaigns (and
designers) succumb to various temptations - Regarding focal segment as ignorant or misguided
- Righteous
- Extremist (promoting behaviours that are
unpalatable to audience) - Too politically correct (staying within tight
boundaries of propriety to avoid offending
authorities or interest groups) - Seeking to impress colleagues
- Emphasizing fancy design over solid content
- From Atkin, C. 2001. Impact of Public Service
Advertising Research Evidence and Effective
Strategies. Project conducted for Kaiser Family
Foundation.
109Why Campaigns Fail (6)
- Many campaigns simply do not follow good campaign
planning and design procedures that are known to
be the absolute minimum requirements for a
successful campaign. - Even well-designed campaigns are often
unsuccessful if you dont follow basic best
practices (such as THCUs 12-step process), you
dont have a hope of being effective. - Consider the following study.
110Why Campaigns Fail (7)
- 2000 study of 50 published nutrition and/or
physical activity social marketing campaigns. - Examined
- Goals and reporting on goals
- Planning and background gathering techniques
- Use of behavioural theory
- Identification of target audiences
- Audience analysis and segmentation strategies
- Levels of intervention
- Channel selection
- Formative and summative evaluation
- Alcalay, R. Bell, R. Promoting Nutrition and
Physical Activity Through Social Marketing
Current Practices and Recommendations. June 2000.
For the Cancer Prevention and Nutrition Section
of California Department of Health Services.
Available from Center for Advanced Studies in
Nutrition and Social Marketing.
111Three Types of Evaluation
- Formative evaluation includes audience analysis
and pre-testing. Purpose is to maximize chance
of success before starting. - Process evaluation examines how a program in
progress is operating. - Summative evaluation methods usually consist of a
comparison between audiences awareness,
attitudes and/or behaviour before and after. This
often includes impact (immediate) and outcome
(longer term) results.
112Formative Evaluation Questions
- Audience Analysis
- Who needs or wants our service?
- Who cares about our issue?
- How can we reach them?
- Pre-testing
- Did people understand?
- Is information accurate, attractive, credible?
113Process Evaluation Questions
- Planning
- Was the money spent well?
- Did the timeline work?
- Monitoring/Tracking Implementation
- How many?
- Who did we reach? How did they respond?
- Media coverage?
- Did we act in the right way?
114Summative Evaluation Questions
- Short Term
- Who responded?
- What was the impact?
- What changes in knowledge/attitudes occurred?
- Long Term
- What are the benefits compared to the
costs/other program alternatives?
115Evaluation the 12 Steps
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118Interactive On-line Workbook to build your
Campaign
119Closing Remarks
Evaluation Form
Questions
Comments
- Reflections
- Process
- Outcome
Thank yous