MEDIA ADVOCACY

Media advocacy is the process of disseminating policy-related information through the communications media, especially where the aim is to effect action, a change of policy, or to alter the public's view of an issues. While a strict definition of "media" advocacy is limited to the strategic use of mass media in regard to a policy initiative, public health views the term more broadly. Almost identical techniques are often used to encourage people to change health behaviors as those directed towards changing policy; and media advocacy may be a single element of a specific campaign as well as an ongoing process. Media advocacy is practiced at all levels, from national to communitybased campaigns. The ultimate targets of most media advocacy are politicians and other decision makers.

Media advocacy activities may be proactive and initiated by public health workers, or they may be reactive. Reactive media advocacy involves taking action when required, especially when opponents of health policy actively seek to mislead, change the agenda, or divert attention to other issues.

Media advocacy may be used for an ongoing campaign, perhaps to ensure that the need for a new health screening service is kept on the political agenda. Similarly, a health organization may use media advocacy over a short period—to launch a campaign to increase the uptake of a new screening service, for example, or to publicize a new report on health inequalities.

An example of media advocacy with several different interim goals is an ongoing campaign against tobacco. Certain information is directed towards politicians and other opinion leaders whose support is needed for antitobacco measures, while different but related information is aimed at current or potential smokers. While the first is aimed at changing policy, the second seeks a behavior change. Both, however, share the overall goal of reducing tobacco-induced disease. In addition, an ongoing media advocacy program on tobacco will also involve monitoring the media for misleading information put out by those with vested interests in selling tobacco, and offering a prompt rebuttal.

Media advocacy is opportunistic. It exploits opportunities to use the media to convey information to large numbers of people, including special target groups. Those who work in media advocacy have a good understanding of the way the press and broadcasting organizations work; and they maintain good relationships with journalists, so as to be readily accessible to supply information and comment, and work with suitable experts who can give interviews and assist jounalists whenever necessary.

It is important to differentiate between media advocacy, an essential part of what is often termed "public information" work, and paid media campaigns, such as television spots or informational advertisements in newspapers, which are a common feature of "public education" programs. In contrast to the opportunistic and ongoing nature of media advocacy, paid media campaigns involve a more programmed delivery of education-oriented information, based on prior research, to specific target audiences. A public-education program may sometimes be supported by media advocacy, and vice-versa, but more often media advocacy is practiced on its own.

HOW MEDIA ADVOCACY WORKS

Media advocacy for public health assumes that public health advocates and journalists have something to offer each other, that there is a convenient symbiosis between their professions. Those on the health side have potential stories, and they want to get coverage for them as part of a campaign to bring about change, and journalists want new stories to fill time or editorial (i.e., nonadvertising) space in their media. Journalists often rely on specialists to help them gather, analyze, and comment on the material they use, and sometimes to suggest stories in the first place. Public health advocates either are such specialists, or they can provide access to them. They also provide ideas for new stories, new angles on old topics, and substantive information to help the journalist to produce an article or story.

Furthermore, health is a popular topic. Most people have a personal interest in anything affecting what is, as many see it, their most cherished gift—their health. Public health leaders, therefore, by the very nature of their subject, have a head start when competing for the attention of journalists and for space in their media.

Anyone can do media advocacy—from an individual or members of a small, community-based health organization to the largest state or federal government health agency. Few tools are needed other than a telephone and, preferably, personal computing equipment. In larger organizations, a press and public affairs department will usually carry out much of the work, involving others as required. In a smaller organization the functions may be part of an information officer's duties, or, in a very small unit, they may be performed by one person, perhaps the chief executive.

Among the most common activities of media advocacy are the following:

• Monitoring media for coverage of relevant topics; this service is often contracted to specialist agencies, or may be achieved via Internet-based services.
• Identifying and disseminating interesting news stories that support public health policies.
• Responding to journalists' inquiries and information requests.
• Supplying access to experts who can assist journalists.
• Preparing press releases and background papers.
• Arranging press conferences.
• Planning a media diary, including identification of special dates and opportunities.
• Responding to misleading or erroneous items in the media.
• Listing and training individuals to act as experts and spokespersons on particular health issues.
• Searching for new angles on existing stories, and new spokespersons and organizations to back and to speak publicly for the policy—a wide variety of professionals and organizations may be recruited to support public health policy.

To maximize the effectiveness of media advocacy, journalists should be treated with a certain priority; and everyone who can help with a story, such as the chief executive, key experts, and other contacts should observe this policy. It is easier to contact journalists than many other professionals—most are dependent on keeping in touch with their sources and other key contacts, so they tend to be readily accessible.

Where a coalition of health agencies and individuals is working in pursuit of the same goal, it is essential to coordinate activities and information. Disparities in facts and figures provided by different coalition partners may be seized upon by opponents of the policy being proposed, not only damaging the public credibility of those supporting the policy, but discouraging journalists from trusting, or even approaching them again in the future.

For most public health topics, special opportunities will arise for attracting the attention of journalists, and thus getting coverage. In particular, special occasions such as key meetings, publication dates of new statistics or reports, and other important dates (such as anniversaries) should be examined in advance to see whether they can serve as pegs on which news stories can be hung.

Among the pegs and material that can attract media coverage are:

• Publication of a new government policy affecting a health issue.
• New research, such as a study of a disease or of a health care procedure.
• Changes in trends of a disease, or of a factor causing ill health.
• Official action on a health issue.
• Special considerations of women, children, and ethnic groups with regards to a health issue.
• Latest trends in health status or health behaviors among exemplar groups, such as doctors, teachers, or athletes.
• Schools activities about certain health problems.
• Civil-rights issues associated with health.
• Special days or weeks designated as a focus for health issues.

Public health advocates can also make good use of physicians and other health professionals as experts to provide journalists with comments, information, and analysis. In the age of mass communications, with opinions constantly being heard from people described as "experts" on many topical issues, public cynicism may devalue what experts say, as few may be perceived as neutral. However, physicians and other health professionals tend to be perceived as primarily interested in people's health, especially when opposing those with obvious vested interests.

Medical and health publications offer special opportunities for coverage of public health stories. Apart from their potential subject interest, journalists on health publications will tend to have more relevant background knowledge and contacts than those in other media. In addition, some of these journals, especially the leading medical scientific publications, are themselves highly influential with the general media. Most health correspondents on newspapers and in broadcast media scan the leading medical journals, which often serve as the source or inspiration for their own stories.

BENEFITS OF MEDIA ADVOCACY IN PUBLIC HEALTH

There are many benefits of the creative and energetic use of media advocacy in public health. Many public health issues are closely integrated with other aspects of public policy, and therefore part of public debate. It is thus appropriate for public health leaders to inform the debate and ensure that appropriate issues are raised and that accurate information is published.

Among the advantages of media advocacy is that it can reach a wide audience, including key decision makers, and that issues and information presented within news items in the media tend to carry more credibility than those presented in paid media advertisements or in public relations material. It is also inexpensive: apart from the participants' time, there are relatively few costs. In addition, media advocacy on one issue can develop a closer rapport with journalists, which in turn may later benefit coverage of a separate, unrelated health issue. Similarly, it can build the capacity of public health agencies to treat strategic media initiatives as an integral component of health campaigns.

Media advocacy on any area of policy, including public health, can face certain problems, some being a function of success. For example, journalists may feel that coverage of a particular issue has reached saturation. Among other common problems are individual events (and people) are often more attractive as elements in a story than the policy issues underlying the story; health may be seen as a personal responsibility, with public health policy viewed as irrelevant, superfluous, unwanted, or costly to the taxpayer; in libertarian terms, public health policy involving the regulation of certain commercial activities may be seen as politically undesirable; and mass media can trivialize serious issues. As with all aspects of media advocacy, creative thinking and constant reevaluation of strategy are likely to offer the best solutions to these problems.

David Simpson

(see also: Health Promotion and Education; Mass Media; Mass Media and Tobacco Control )