Mass media in health promotion: an analysis using an extended information-processing model.

The information-processing model of the attitude and behavior change process was critically examined and extended from six to 12 levels for a better analysis of change due to mass media campaigns. Findings from social psychology and communications research, and from evaluations of mass media health promotion programs, were reviewed to determine how source, message, channel, receiver, and destination variables affect each of the levels of change of major interest (knowledge, beliefs, attitudes, intentions and behavior). Factors found to most likely induce permanent attitude and behavior change (most important in health promotion) were: presentation and repetition over long time periods, via multiple sources, at different times (including "prime" or high-exposure times), by multiple sources, in novel and involving ways, with appeals to multiple motives, development of social support, and provisions of appropriate behavioral skills, alternatives, and reinforcement (preferably in ways that get the active participation of the audience). Suggestions for evaluation of mass media programs that take account of this complexity were advanced.