Multimedia Campaign Research Articles

Use of the Persuasive Health Message framework in the development of a community-based mammography promotion campaign.

We describe how the Persuasive Health Message (PHM) framework was used to guide the formative evaluation informing development of messages and materials used in a community-based multi-media campaign intended to motivate low-income African American women to obtain low- or no-cost mammograms through the CDC's National Breast and Cervical Cancer Early Detection Program. Seventy-eight African American women were recruited for eight focus groups that discussed breast cancer screening. The moderator guide was developed in accordance with the PHM framework and solicited information on perceived threat and efficacy, cues, salient beliefs and referents, and barriers to self-efficacy. We created persuasive messages to emphasize that African American women are susceptible to the threat of breast cancer, but that their personal action in obtaining regular mammograms may lead to early detection, subsequent treatment, and reduced cancer mortality. The messages addressed concerns of self-efficacy by emphasizing that uninsured women can also obtain high-quality low- or no-cost mammograms. In an attempt to combat the sentiment that breast cancer is a death sentence, the messages indicated that breast cancer can be successfully treated, especially when detected early. The PHM framework consists of three steps: (1) determine information about threat and efficacy; (2) develop an audience profile; and (3) construct a persuasive message. It offered our team easy-to-follow, flexible steps to create a persuasive and effective campaign promoting awareness and use of mammogram screening among low-income African American women.

Understanding the Role of the OneLove Campaign in Facilitating Drivers of Social and Behavioral Change in Southern Africa: A Qualitative Evaluation

In the wake of the HIV and AIDS pandemic, health communication has played an important role in social and behavior change in HIV prevention and treatment efforts. Despite this significant role, it is not always clear how health communication influences individuals and communities to facilitate social and behavior change. Guided predominantly by Lewin's theory of change in the context of complexity thinking, and supported by qualitative evidence from Soul City Institute's midterm evaluation of the OneLove multimedia campaign in 9 southern African countries, this article illustrates how carefully designed health edutainment communication materials facilitate drivers of social and behavior change. Thus, researched and theory-based health communication aimed at behavior and social change remains an important pillar in HIV prevention and treatment, where personal and social agency remain key.

The ‘Make it Possible’ Multimedia Campaign: Generating a New ‘Everyday’ in Animal Welfare

Although livestock welfare issues were once barely visible to mainstream consumers, animal welfare activists now combine traditional public media advocacy with digital media advocacy to spread their campaign message and mobilise consumers. This article examines one attempt to mainstream animal welfare issues: Animals Australia's ‘Make It Possible’ multimedia campaign. Specifically, we contend that the campaign puts into circulation an ‘affective economy’ (Ahmed, 2004a, 2004b) aimed at proposing and entrenching new modes of everyday behaviour. Core affective positions and their circulation in this economy are considered from three interrelated articulations of this campaign: the release of and public response to the YouTube campaign video; Coles' short-lived offering of campaign shopping bags; and public engagement in the ‘My Make It Possible Story’ website. Analysis also opens up broader questions concerning the relationship between online activism and everyday life, asking how articulations in one domain translate to everyday practices.

Social Media in Advertising Campaigns

Inspired by the increasing popularity of advertising on social media, and especially on social network sites (SNSs), the aim of this study is to give insight into the effectiveness of SNS advertising. The first experimental study compares consumer responses to advertising on SNSs and television (TV) and demonstrates that while TV campaigns are evaluated more positively, SNS campaigns result in more favourable cognitive responses. Moreover, the persuasive intent of SNS campaigns is less recognized than for TV campaigns. Since SNSs are often combined with traditional media in advertising campaigns, the second study examines whether campaigns combining TV and SNSs lead to so-called synergy effects. Results showed that this was not the case: single-medium and multimedia campaigns were equally effective. The third study examines the role of perceived persuasive intent in this relationship and tests whether there is an indirect effect of type of campaign (multimedia or single-medium) on consumer responses via perceived persuasive intent. Results show that SNS–TV campaigns are perceived as less persuasive than SNS-only and TV-only campaigns, resulting in more favourable campaign and brand responses. In sum, the article provides empirical evidence for the value of integrating social media with traditional media in advertising campaigns.

Changes in Obesity Awareness, Obesity Identification, and Self-Assessment of Health: Results from a Statewide Public Education Campaign

Background: Due to the high prevalence of obesity, individuals may be desensitized to weight as a personal health concern. Purpose: To evaluate changes in obesity awareness associated with a statewide public education campaign in Colorado. Methods: Cross-sectional random digit dial telephone surveys (n = 1,107 pre, n = 1101 post) were conducted before and after an intensive 22-week stretch of television advertising, embedded within a multimedia campaign. The main outcomes were awareness of obesity as a personal health issue; correct identification of overweight and obesity; and self-assessment of health status and health behaviors. Results: The pre-advertising survey showed that most individuals believed that their own behaviors were healthier than those of their friends. Respondents frequently were not able to correctly identify an individual as overweight or obese based on height and weight. In the postadvertising survey, individuals were less optimistic about their weight and their health behaviors and were more accurate at identifying overweight and obesity based on height and weight. Discussion: The education campaign increased understanding of obesity as a personal health issue, a necessary precursor to behavior change. Translation to Health Education Practice: Health educators can help individuals to reframe the definition of healthy weight.

Initial recall and understanding of a multimedia communication campaign to promote physical activity among tweens: A process evaluation study

ObjectiveTo examine the degree of awareness and understanding of a multimedia communication campaign (WIXX) aimed at promoting physical activity among tweens (9–13years old) during the early phases of campaign implementation. MethodsThis study adopted a repeated posttest-only design. Two cross-sectional web-based surveys were conducted in Québec, Canada, among tweens three (T1; N=400) and nine (T2; N=403) months after the launch of the campaign in 2012. The activities of the WIXX campaign included website development, community events and paid advertisements. Recall, recognition and understanding of the campaign were the three outcomes. Logistic regression analyses were conducted to examine factors associated with the assessed outcomes. ResultsThe likelihood of having unaided/aided recall (OR=0.7; 95%CI: 0.5, 0.9) rather than no recall decreased between T1 and T2. A significant sex∗survey period interaction effect was observed for recall (p=.04). Tweens were also less likely to recognize the WIXX advertisements at T2 (OR=0.6; 95%CI: 0.5, 0.9) and a significant school grade∗survey period interaction was observed for recognition (p=.002). ConclusionsThe likelihood of recall and recognition decreased across survey periods. Girls were generally more likely to be aware of the WIXX multimedia campaign. Further efforts are required to maintain and increase awareness of WIXX among tweens.

Exploring ethical conflicts in emergency trauma research: The COMBAT (Control of Major Bleeding after Trauma) study experience

Up to 25% of severely injured patients develop trauma-induced coagulopathy. To study interventions for this vulnerable population for whom consent cannot be obtained easily, the Food and Drug Administration issued regulations for emergency research with an exception from informed consent (ER-EIC). We describe the community consultation and public disclosure (CC/PD) process in preparation for an ER-EIC study, namely the Control Of Major Bleeding After Trauma (COMBAT) study. The CC/PD was guided by the four bioethical principles. We used a multimedia approach, including one-way communications (newspaper ads, brochures, television, radio, and web) and two-way communications (interactive in-person presentations at community meetings, printed and online feedback forms) to reach the trials catchment area (Denver County's population: 643,000 and the Denver larger metro area where commuters reside: 2.9 million). Particular attention was given to special-interests groups (eg, Jehovah Witnesses, homeless) and to Spanish-speaking communities (brochures and presentations in Spanish). Opt-out materials were available during on-site presentations or via the COMBAT study website. A total of 227 community organizations were contacted. Brochures were distributed to 11 medical clinics and 3 homeless shelters. The multimedia campaign had the potential to reach an estimated audience of 1.5 million individuals in large metro Denver area, the majority via one-way communication and 1900 in two-way communications. This resource intensive process cost more than $84,000. The CC/PD process is resource-intensive, costly, and complex. Although the multimedia CC/PD reached a large audience, the effectiveness of this process remains elusive. The templates can be helpful to similar ER-EIC studies.

Obese subjects involvement in a population-based survey: the use of information and communication technologies (ICT) to avoid stigmatization.

Epidemiological and health promotion studies in obese subjects are hampered by the difficulty of obtaining a representative sample from the community. The enrollment process can be at high risk of stigmatization. The purpose of this study is to describe an original information and communication technologies (ICT) strategy to get around these ethical and methodological difficulties. A multimedia campaign of communication was organized on the topic of overweight and quality of life (QoL). A specific website was developed to collect via a questionnaire QoL data as well as information related to patient's needs and health perception from participants. To promote the website, multiple information supports were largely diffused. Primary care professionals were solicited to enhance the enrollment. The campaign started with a press conference covered by the main television channels. The ICT-based approach allowed the participation of 4,155 subjects homogeneously distributed with respect to body mass index, age, gender and socioeconomic level. A high percentage of subjects fully completed the web-based questionnaire. The press conference allowed reaching a quarter of the total sample within 5 days. Overweight remains a major public health problem. This survey showed that a holistic approach supported by ICT is a promising way to recruit obese subjects without stigmatizing the disorder.

Influence of area deprivation and perceived neighbourhood safety on active transport to school among urban Quebec preadolescents.

This study examines associations between area deprivation and perceived neighbourhood safety with active transport to school among preadolescents living in urban Quebec. A sample of 809 preadolescents aged 9 to 13 years and one each of their parents living in urban Quebec were recruited by a polling firm for a telephone interview about the Opération WIXX multimedia communication campaign. Opération WIXX was launched in 2012 by Québec en forme to promote physical activity among preadolescents. Logistic regression models predicted active transportation to school (as reported by both the child and his or her parent) from area-level material and social deprivation and from parental and children's perceptions of neighbourhood safety while controlling for socio-demographic variables. Child and parental reports of active commuting to school were highly concordant (Kendall's tau=0.70, p<0.001). Children whose parents felt at ease to let their children actively commute to school (OR=1.75, 95% CI 1.25-2.45; p=0.001) and who lived in areas characterized by the highest material (OR=2.02, 95% CI 1.09-3.76; p=0.026) and social (OR=3.69, 95% CI 2.12-6.42; p<0.001) deprivation were more likely to report actively commuting to school. Parents who felt at ease to let their children actively commute to school (OR=1.60, 95% CI 1.15-2.21; p=0.005) and who lived in neighbourhoods characterized by a higher social deprivation (OR=1.70, 95% CI 1.04-2.79; p=0.036, OR=2.01, 95% CI 1.23-3.29; p=0.006, OR=2.72, 95% CI 1.59-4.63; p<0.001) were more likely to report that their child actively commuted to school. Active commuting to school is associated with parental perceptions of safety and area deprivation.

The Yo me cuido® Program: Addressing Breast Cancer Screening and Prevention Among Hispanic Women.

Breast cancer is less likely to be diagnosed at the earliest stage in Hispanic/Latino (Hispanic) women compared to non-Hispanic White women, even after accounting for differences in age, socioeconomic status, and method of detection. Moffitt Cancer Center created a comprehensive health education program called Yo me cuido (®) (YMC) to address and reduce breast cancer disparities among Spanish- and English-speaking Hispanic women by providing breast cancer and healthy lifestyles awareness and education, and promoting breast cancer screenings, reminders, and referrals for women 40 years and older. The purpose of this paper is to showcase the innovative approaches and methods to cancer prevention and early detection of the YMC program, and to promote it as an effective tool for improving outcomes in community health education, outreach, and engagement activities with Hispanic populations. Key components of the program include educational workshops, mammogram referrals, and a multimedia campaign. The YMC program is unique because of its approaches in reaching the Hispanic population, such as delivering the program with compassionate services to empower participants to live a healthier lifestyle. Additionally, direct follow-up for mammography screenings is provided by program staff. From 2011 to 2013, YMC has educated 2,226 women and 165 men through 93 workshops. About 684 (52 %) women ages 40 and older have had a screening mammogram within their first year of participating in the program. The YMC program is an innovative cancer education and outreach program that has demonstrated a positive impact on the lives of the Hispanic community in the Tampa Bay region.

Commentary: Innovations in programming for HIV among adolescents: towards an AIDS-free generation.

Ultimately achieving an AIDS-free generation might rely more than we thought on developing adolescent leaders as agents of change -- not simply behavior change but societal and legal change. Innovative programming may be expanding adolescents’ social networks and engagement increasing their HIV-specific knowledge and increasing demand for HIV testing and treatment; but what is to meet this demand; and how will the effects of these programs be rigorously measured? Technology companies and mobile host sites are not clinicians or experts in evaluation. Even dizzying advances in technology are useless if adolescents have no access to them or are not able to access health promoting information services or networks. Moving forward technology and social innovators -- young and old -- must task themselves with removing barriers to testing and treatment that will reduce the sheer numbers of HIV infections and AIDS deaths in this population. Innovations must support adolescents’ access to a wider array of confidential testing options available in the community and through the health sector link them to biomedical and other prevention services of proven efficacy such as antiretroviral therapy medical male circumcision and to specific harm reduction interventions. In the years to come it is network disruption -- of entrenched social mores stigma attitudes and discriminatory practices -- that will constitute true innovation. (Excerpts)

Utilizing peer teen advocates and social media to increase human papillomavirus (HPV) vaccination awareness in urban settings

Objectives: HPV vaccination has demonstrated efficacy in reducing HPV prevalence. Lack of knowledge about HPV is consistently noted as a barrier to HPV vaccination. The vaccination rate in Milwaukee is <30%. The Medical College of Wisconsin, The City of Milwaukee Health Department, and The Boys & Girls Clubs of Greater Milwaukee initiated a community-based research pilot aimed at increasing teens’ HPV knowledge with a multimedia campaign designed for their peers. Our goal was to determine the feasibility of incorporating teens into development of HPV-related health messages using social media and conventional media and learn whether their culturally relevant materials would resonate with other teens.

Out-of-Home Innovations in India in the Recent Past

Introduction: The last two decades have witnessed the changing landscape of business policies and consumer behavior caused by rapid technological advances. In particular, consumers in the major cities spend almost half the day outside the home and on-the-go so that the marketer has a complex task in creating a consolidated campaign to reach out to the consumer at an increasing number of touch-points. In addition, with a cluttered television market and growing fragmentation, marketers must seek options in the out-of-home space to improve competitiveness and constantly innovate. However technological improvements have permitted the execution of imaginative ideations like never before and this has allowed marketers to be more innovative in their communication to break through the clutter. However, the out-of-home industry itself has only in the past few years begun to get established and organized and it is yet plagued by a large number or regulatory and fragmentation issues. This research sought to evaluate the extent of evolution of the out-of-home industry through an in-depth understanding of its viability and future potential for marketers which a focus on innovations in the past few years. Methodology: The methodology adopted was intended to create a balance between primary and secondary research without focusing too much on one. Primary research included interviews that were conducted amongst various industry experts, marketing professions and representative consumers. Secondary research on the other side involved a qualitative analysis done with the help of articles from online outdoor advertising forums, newspaper and through reports and case studies to substantiate the primary data. Five campaigns were selected of which there were three outdoor campaigns – Volkswagen’s Vento launch campaign, Tata Docomo’s Do the New campaign and Coca-Cola’s CWG campaign; and two multimedia campaigns – Pepsi Max’s launch campaign and Reebok’s Reezig campaign. These campaigns were selected on the basis of the extensive appreciation and accolades they received in the industry for their innovative work. They were also chosen keeping in mind the potential to draw key universal elements and learnings which can be applied to other campaigns by marketers. Key Findings: Firstly, the research suggests that the out-of-home medium has become a very strong brand-building medium and not just a reminder medium for a variety of brands across product categories. Secondly, it has emerged from the selected case studies that innovative advertising in the outdoor space has led to successful and measurable results which if assessed in more detail would prove high efficacy of advertising through use of innovations. Thirdly, while there is a large potential for the industry in terms of growth and maturity, the retail and merchandising segment is still not being effectively utilized due to a multitude of reasons – most important being the lack of a unified body and experts who can carry it forward. Moreover, with the secrecy surrounding spends by companies on this segment, transparent policies and activities are yet to emerge. Fourthly, the technological progressions in the form of LED, lenticulars and high-impact graphics are now giving marketers the freedom to execute out-of-the box ideas to attract consumers and deliver high recall. However, the cost-effectiveness though very high for campaign specific advertising, still remains debatable when it comes to being used on a large scale. Fifthly, the focus on research-based software and metrics for efficacy though growing slowly but surely is an important trend that will help bring more credibility and stability to the out-of-home medium. Finally, with systemic change still a distant dream and regulatory apathy still a reality, efforts by authorities and industry professionals on self-regulation seem to be boding good news for the viability of the medium.

The effect of a joint communication campaign on multiple sex partners in Mozambique: the role of psychosocial/ideational factors

Mozambique is one of the countries in sub-Saharan Africa most affected by the HIV epidemic. Multiple and concurrent sexual partnerships (MSP/CP) have been recognized as one of the key drivers in the rapid spread of HIV in the region. Though HIV prevention programs have been successful in increasing condom use and HIV testing, reducing the practice of MSP/CP has been more difficult. Grounding their interventions in social and behavior change theory, four organizations in Mozambique joined efforts to implement a year-long, multimedia national campaign for HIV prevention with emphasis on the reduction of MSP/CP. Evaluating its impact and identifying the factors that hinder or contribute to its success are critical to building effective programs in the future. With data from a 2011 population-based survey of 1427 sexually active women and men, multivariate causal attribution (MCA) analysis was used to estimate the impact of the campaign in the four regions of Mozambique with the highest levels of HIV prevalence. The analysis tested the psychosocial pathways through which the campaign was expected to affect MSP. The results indicate that exposure (recall) was high; 81.2% of the respondents could recall one or more of the communication campaign components. The campaign had a significant indirect impact on MSP through its negative effect on attitudes that favor MSP, and its positive effect on knowledge and discussion of MSP risk with sex partner. This study demonstrates the value of identifying appropriate psychosocial factors and using them to design the campaign communication strategy, and evaluate the causal pathways by which it has an impact. The campaign was successful in changing MSP behavior by working through two psychosocial variables.

Analysis of the Benefits and Costs of a National Campaign to Promote Colorectal Cancer Screening

The Centers for Disease Control and Prevention's Screen for Life: National Colorectal Cancer Action Campaign (SFL) is one of the longest running national multimedia campaigns to promote colorectal cancer screening. Since its inception in 1999, no study has quantified the benefits and costs of SFL. We modeled the impact of SFL campaign on screening rates, assuming that the effect size would range from 0.5% to 10% of the unscreened population exposed to the campaign in the last 14 years. Given the estimated benefits of the campaign and costs, we calculated the cost per person screened (2012 dollars). We hypothesize that if 0.5% of the population exposed to campaign messages were screened for colorectal cancer, an additional 251,000 previously unscreened individuals would be screened. The average cost of SFL per person screened would be $2.44. On the other hand, if 10% of the population exposed to campaign messages were screened, an additional 5.01 million individuals would be screened. The average cost per person screened would be $0.12. Results indicate that SFL improves screening rates at a relatively low cost per person screened. The findings in this study provide an important starting point and benchmark for future research efforts to determine the benefits and costs of health communication campaigns to promote cancer prevention.

Multi-Media Campaigns, Interpersonal Contacts and Contraceptive Behaviour in Southwest Nigeria

Recent evidence suggests that mass media may be an effective tool for motivating people to adopt family planning. Little is known, however, about the process by which this takes place. In this exploratory study, we argue that following an exposure to mass media message(s) about family planning, interpersonal discussion of such message(s) is an important intermediate stage in the process of deciding to use or not to use contraception. If this is the case, interpersonal discussion is expected to enhance or attenuate the effects of exposure to media messages on contraceptive behaviour. Our results show that there is a significant positive relationship between exposure to media messages and contraceptive use in Southwest Nigeria. Furthermore, among women who are exposed to media messages, those who discuss the messages with other people are more likely to use contraception compared with those who did not discuss the messages.

Australian Public’s Awareness of Stroke Warning Signs Improves After National Multimedia Campaigns

The aim of this study was to examine the reach and impact of the National Stroke Foundation (NSF) multimedia stroke warning sign campaigns across Australia. A total of 12 439 surveys were performed across 6 states during 6 years on random state-weighted samples of Australians≥40 years old. Awareness of stroke advertising increased 31% to 50% between 2004 and 2010 (P<0.001), as did the unprompted recall of ≥2 most common stroke warning signs 20% to 53% (P<0.001). Awareness of stroke advertising was independently associated with recalling ≥2 common signs (adjusted odds ratio=1.88, 95% confidence interval [1.74-2.04]; P<0.001). Awareness was not greater in respondents with previous stroke or risk factors, except atrial fibrillation. The Australian public's awareness of stroke warning signs has improved since commencement of the NSF campaigns commensurate with greater awareness of stroke advertising. Public education efforts are worthwhile, and future efforts should focus on groups identified with low awareness or those at high risk of stroke.

Participant Profiles According to Recruitment Source in a Large Web-Based Prospective Study: Experience From the Nutrinet-Santé Study

BackgroundInterest in Internet-based epidemiologic research is growing given the logistic and cost advantages. Cohort recruitment to maximally diversify the sociodemographic profiles of participants, however, remains a contentious issue.ObjectiveThe aim of the study was to characterize the sociodemographic profiles according to the recruitment mode of adult volunteers enrolled in a Web-based cohort.MethodsThe French NutriNet-Santé Web-based cohort was launched in 2009. Recruitment is ongoing and largely relies on recurrent multimedia campaigns. One month after enrollment, participants are asked how they learned about the study (eg, general newscast or a health program on television, radio newscast, newspaper articles, Internet, personal advice, leaflet/flyers) The sociodemographic profiles of participants recruited through operative communication channels (radio, print media, Internet, advice) were compared with the profiles of those informed through television by using polytomous logistic regression.ResultsAmong the 88,238 participants enrolled through the end of 2011, 30,401 (34.45%), 16,751 (18.98%), and 14,309 (16.22%) learned about the study from television, Internet, and radio newscasts, respectively. Sociodemographic profiles were various, with 14,541 (16.5%) aged ≥60 years, 20,166 (22.9%) aged <30 years, 27,766 (32.1%) without postsecondary education, 15,397 (19.7%) with household income <€1200/month, and 8258 (10.6%) with household income €3700/month. Compared to employed individuals, unemployed and retired participants were less likely to be informed about the study through other sources than through television (adjusted ORs 0.56-0.83, P<.001). Participants reporting up to secondary education were also less likely to have learned about the study through radio newscasts, newspaper articles, Internet, and advice than through television (adjusted ORs 0.60-0.77, P<.001).ConclusionsTelevision broadcasts appear to permit the recruitment of e-cohort participants with diverse sociodemographic backgrounds, including socioeconomically disadvantaged individuals who are usually difficult to reach and retain in long-term epidemiologic studies. These findings could inform future Web-based studies regarding the development of promising targeted or general population recruitment strategies.

Food Security and Nutritional Status: An Analysis of a Population Benefited by a Food Subsidy Program in Venezuela

This study explored how United States newspaper articles framed the weightloss drugs orlistat, available as Xenical (prescription) and Alli (over-thecounter), from three months prior to each drug's approval by the U.S. Food and Drug Administration (FDA) till 12 months after each medication's introduction to the market. To conduct a content analysis, researchers first developed a codebook containing variables that described the sources of attribution and the features of each drug and tested the codebook in a series of pilot tests to ensure inter-rater reliability (kappa 0.70). A search using LexisNexis Academic yielded 85 Xenical articles and 98 Alli articles. Newspapers with the greatest circulation were frequent publishers of orlistat-related articles. Articles were published most frequently in the month of or after FDA approval and market release. Their newsworthiness was short-lived, however. Physicians and scientists were most frequently quoted in Xenical articles, whereas two thirds of Alli articles included quotes from the drug manufacturer. Laypeople were the second most quoted group for Alli articles. Differences in article incidence and framing were heavily influenced by the manufacturer's multi-media public relations campaign in the months prior to the market-release date and access to the drugs with or without a prescription.

Relationship among Body Mass Index, Adiposity Level and Blood Glucose Levels in a Populations Benefited by a Food Subsidy Program (Red Mercal) in Venezuela

This study explored how United States newspaper articles framed the weightloss drugs orlistat, available as Xenical (prescription) and Alli (over-thecounter), from three months prior to each drug's approval by the U.S. Food and Drug Administration (FDA) till 12 months after each medication's introduction to the market. To conduct a content analysis, researchers first developed a codebook containing variables that described the sources of attribution and the features of each drug and tested the codebook in a series of pilot tests to ensure inter-rater reliability (kappa 0.70). A search using LexisNexis Academic yielded 85 Xenical articles and 98 Alli articles. Newspapers with the greatest circulation were frequent publishers of orlistat-related articles. Articles were published most frequently in the month of or after FDA approval and market release. Their newsworthiness was short-lived, however. Physicians and scientists were most frequently quoted in Xenical articles, whereas two thirds of Alli articles included quotes from the drug manufacturer. Laypeople were the second most quoted group for Alli articles. Differences in article incidence and framing were heavily influenced by the manufacturer's multi-media public relations campaign in the months prior to the market-release date and access to the drugs with or without a prescription.