Health Education and Health Promotion

A Systematic Review of Awareness Campaigns for Disease Prevention: Evaluating their Effectiveness in Promoting Health Behavior Change

Document Type : Systematic Review

Authors

A. Bahmani 1
S. Nili 2
Sh. Doostvandi 1
S.G. Fakhrelkoneini 1

1 Department of Public Health, Faculty of Health, Kurdistan University of Medical Sciences, Sanandaj, Iran

2 Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran

https://doi.org/10.58209/hehp.11.2.223
Abstract
Aim: Considering the importance and effectiveness of disease prevention awareness campaigns in healthcare and their limited use in Iran and worldwide, more widespread implementation of these campaigns could have significant positive impacts on public health outcomes. The aim of this study was to evaluate the effectiveness of disease prevention awareness campaigns.

Methods: For this literature review, we conducted a systematic search of papers published on disease prevention awareness campaigns between 2010 and 2022, in both Persian and English. We limited our search to papers with full text available and searched across multiple credible scientific databases, including ScienceDirect, PubMed, Scopus, Google Scholar, SID and Magiran. We excluded papers that did not align with our research objectives.

Finding: Out of the 44 papers searched on disease prevention awareness campaigns, 18 relevant papers were selected and their results were investigated, of which two cases were in Persian and 16 in English. Most areas used in the awareness campaigns were related to diseases, such as acute coronary syndrome, diabetes, cancers, sexually transmitted diseases, and infectious diseases. The results of this study suggested the effectiveness of organizing awareness campaigns in preventing diseases.

Conclusion: The evidence suggests that awareness campaigns have had a positive impact on reducing the risk of disease and preventing its development. Therefore, it is important to make concerted efforts to develop effective and appropriate awareness campaigns for all individuals at risk.

Keywords

Public Health
Awareness
prevention and control
Diagnosis
Subjects
Introduction
Disease prevention is perceived as specific interventions, both population- and individual-based, for primary and secondary prevention (early diagnosis) to minimize the burden of diseases and their related risk factors [1]. Primary prevention refers to measures that are taken to prevent manifestations of a disease (including measures for health improvement, such as changing the effect of socioeconomic factors on health; presenting information about the risks of behavioral and medical health, and counseling and measures for mitigating them at social and personal levels; nutrition and supplements; educating oral and dental health, as well as clinical preventive services, such as immunization and vaccination of children, adults, the elderly, plus vaccination or prevention post-exposure for those who are subjected to communicable diseases) [2]. Secondary prevention, through early diagnosis, improves the chance of positive health outcomes (these include activities, such as evidence-based screening programs for early diagnosis of diseases or prevention from congenital abnormalities as well as preventive pharmacotherapy with demonstrated effectiveness) [3]. In order to enhance the health literacy of society regarding disease prevention and health promotion, health-promoting behaviors should be done through public awareness campaigns for disease prevention. The campaign to enhance the awareness level of society is used in different areas of public health [4]. Meanwhile, attention to gradual educational approaches to encourage the public to quit risky behaviors with regard to health is increasing. An awareness campaign is considered one of the major components of different types of interventional strategies [5].
An awareness campaign refers to a set of coordinated notification, communication, and educational activities using various notification methods to transmit health promotion messages to a specific population within a specific period along the objectives of the intended program. In some cases, by creating a suitable context, the campaign can help policymakers in their decision-making about health and disease prevention. Awareness campaigns consist of a community of individuals with sufficient information about health promotion programs aimed at establishing sustainable behavioral modification and helping the adoption of proper decisions to improve the health status of individuals [6, 7].
Increasing the health and safety awareness of the audience as well as enhancing the perception and support for health and safety objectives are among the first and most important goals of health awareness campaigns. Disease awareness campaigns are one of the most useful elements in the health care system that guide people to change to eradicate or reduce unhealthy health-related effects [8]. Recently, the mass media campaigns in healthcare have dealt with various issues, such as public health conferences as well as discussions about special diseases, including campaigns for cardiovascular health, tobacco products, alcohol and drug abuse, nutrition, family planning, controlling cancer, vaccination, psychological health, hypertension, AIDS, etc. [9, 10]. Writing an effective message to the audience is the most important tool in a social campaign. For example, the mass media health campaigns (radio and television stations), alongside their typical programs, usually publish different print products, such as posters, booklets, and brochures. Finally, the health campaign activity consists of trying to inform, persuade, or induce motivation to change the behavior of the audience [11].
Health awareness campaigns have found increasing applications in recent years to transmit encouraging messages to conduct a specific behavior in the target group. Considering the importance and effectiveness of this type of intervention in health care as well as their limited use in Iran, it seems that empowering the health and treatment staff to design and implement these types of interventions and also send effective messages to influence groups the goal is necessary. This study was done due to the lack of sufficient conclusive evidence to investigate different types of interventions in disease prevention awareness campaigns worldwide and in Iran. This research investigated studies conducted in this regard as well as their success rate.

Materials and Methods
The present review aimed to investigate disease prevention awareness campaigns from 2010 to 2022 in Persian and English language scientific journals published either in Iran or other countries. In searching studies, databases, including ScienceDirect, PubMed, Scopus, Google Scholar, SID and Magiran were used.
Databases were searched as follows:
A: Applying filters (time and relationship of studies with the desired intended keywords)
B: Using Boolean operators (AND/OR)
The keywords used in this systematic research were classified into two general groups:
Group I: awareness campaign
Group II: disease prevention
The papers containing the mentioned keywords were chosen. Out of 44 searched papers in the scientific databases, 18 interventional, cross-sectional, and qualitative studies that met the inclusion criteria were chosen, and their findings were investigated. The procedure of paper selection is shown in Figure 1. The inclusion criteria were investigating the effectiveness of awareness campaigns in clinical practice, research, and education, Persian and English papers with full text published between 2010 and 2022, and the presence of the keywords or their equivalents in the title or abstract of the papers. The exclusion criteria included papers that did not match the research objectives and studies whose full text was not available or had been published as a letter to the editor; Because all studies searched in this paper were not homogeneous, and their results were not combined quantitatively. Data analysis was performed as a comprehensive review of papers, qualitative collation, and final conclusions. After applying the inclusion criteria, the full text of the papers was read and a summary, including the title of the paper, name of the main author, year of publication, studied population, methodology, and study results was extracted.


Figure 1) Paper selection process based on the inclusion and exclusion criteria

Findings
The purpose of this study was to investigate the effectiveness of awareness campaigns in disease prevention in clinical practice and education. After screening for duplicates and irrelevant papers, 18 papers were selected for review. Of these 18 papers, two were published in Persian and 16 in English. The research settings varied, with five studies conducted in England, three in Iran, two in the US and Australia, and one in Saudi Arabia, Denmark, Ireland, South Korea, Belgium, and Malaysia. Most examined studies were cross-sectional or quasi-experimental in design.
The research subjects included heart attacks and stroke, cancer, headaches induced by indiscriminate use of painkillers, congenital sepsis, healthy citizens, as well as diseases, such as cholera, diabetes, and AIDS. The duration of the awareness campaigns varied across studies, with results presented separately in Table 1. According to the reviewed studies, several information resources were used to implement campaigns, which mostly included social media, websites, and social networks. In most studies reviewed in this research, the goal of campaigns was to increase the level of awareness and try to change positive behavior. The duration of campaigns varied depending on the type of study and the purpose of the study. Overall, the reviewed studies indicated that awareness campaigns can be effective in promoting disease prevention and improving clinical practice and education. However, the effectiveness of these campaigns may vary depending on the specific disease and the characteristics of the target population. The target population in the implementation of campaigns in different studies was different according to the type and purpose of the study.

Table 1) Summarizing the results of examining studies







Discussion
In this review, the type and extent of interventions to evaluate the effectiveness of awareness campaigns for disease prevention as well as their applications were examined in Iran and worldwide. The present research was done to evaluate studies on the importance of awareness campaigns for disease prevention as a step to identify evidence-based interventions. Unfortunately, in spite of extensive evidence, there are still massive gaps in the application of these pieces of evidence for health promotion and disease prevention. There are a few studies on interventions used by awareness campaigns for disease prevention. Accordingly, in this research, the available studies were examined.
Bidin et al. [12], Dombrowski et al. [24], and Flynn et al. [23] studied awareness campaigns about stroke and admitted that the awareness campaign can be significantly effective in the knowledge, attitude, and in many cases, behavior of the target group individuals. They regarded awareness campaigns as something useful, economical, and an investment for health. This is because the implementation of an awareness campaign in most cases has played a key role in rapid as well as emergency admission of patients and prevention of mortality caused by brain stroke. Kennedy et al. [16], Hall et al. [20], and Ball et al.[13]. Studied the effect of awareness campaigns regarding cancers. They found that after holding the awareness campaign, the knowledge and attitude in the target group increased, and the extent of cancer diagnoses in the initial stages of the disease increased compared to pre-intervention. Also, a considerable rise was seen in the referral of patients suspected to have cancer to healthcare and diagnostic centers. In studies by Van Asbroeck et al. [15] and Alaqeel et al. [22] regarding the effect of an awareness campaign on psychoneurological diseases (dementia and epilepsy), the awareness campaign played an effective role in enhancing knowledge and awareness of people. The findings of the reviewed studies emphasize the important role of awareness campaigns in increasing people's awareness, attitude, and behavior. To confirm the results obtained from the reviewed research, Mengel et al., who investigated the effect of awareness campaigns on the risks of alcohol consumption in women, pointed out the positive effects of awareness campaigns on increasing women's awareness [28]. In this regard, Randolph et al. examined 18 awareness campaigns held in different areas. They found that awareness campaigns were effective for awareness in 67% of cases, attitude in 24% of cases, and individual behavior in 89% of cases [29]. Similar findings are frequently observed. These mass media campaigns were successful in delivering the campaign message and increasing awareness on the respective topic [30-33].
Nevertheless, Mellon et al. Reported limited efficiency of an awareness campaign for patients applying for healthcare services with stroke symptoms [9]. Based on the review study by Freimuth about the effect of an awareness campaign on individual behavior, 20 cases of awareness campaigns were successful and nine were unsuccessful [34].
Bonet et al. [18] and Morowatisharifabad et al. [10] assessed infectious diseases (congenital sepsis and cholera) and indicated that awareness campaigns had positive and significant effects on preventing infectious diseases. Also, McFarlane et al. [21] and Bahmani et al. [27] evaluated the effect of implementing an awareness campaign on sexually transmitted diseases and AIDS and revealed that the implementation of awareness campaigns led to enhanced health-promoting behaviors in this regard, especially in young adults and teenagers. In other studies with different subjects, such as the effect of awareness campaigns on preventing drug-induced headaches [17], diabetes [25], chronic kidney disease [14], and cardiac arrest [19], and those assessing healthy people [26], the effectiveness of organizing awareness campaigns has been reported. According to our results, after the implementation of awareness campaigns, the promotion and improvement of the health behavior of the participants were observed. In similar studies on awareness campaigns aimed at increasing physical activity, out of 15 reviewed studies, seven studies showed a significant increase in behavior improvement [35-39].
The duration of awareness campaigns may be either short or long [40]. In the studies examined in this paper, the shortest time was related to the study by Bonet et al. as seven days, while the longest was related to the study by Nehme et al. as ten years [18, 19].
Regarding the method of organizing the awareness campaigns in the examined studies, in some studies, only one method was used, such as the study by Tavousi et al. [26], in which advertisement billboards were used, while in some others, several methods or a combination of methods were employed, such as the study by Morowatisharifabad et al. [10]. In designing and implementing awareness campaigns, essentially the probability of success increases when using multiple methods and interventions [40]. Elder et al. concluded that the effectiveness of an intervention performed by combining several channels in the long run would be greater than other interventions [41].

Conclusion
The findings of this study have important implications for public health policy and clinical practice. According to the results, we can emphasisthe important role of awareness campaigns in increasing awareness and improving people's behavior in various educational and information interventions. It is important that health policymakers pay more attention to awareness campaigns in various fields, which can prevent, control, and reduce the incidence of diseases and improve health behaviors. Therefore, healthcare providers and educators should consider implementing targeted awareness campaigns to promote disease prevention and improve patient outcomes. Future research could further investigate the effectiveness of these campaigns in different populations and settings.

Author's contributions: Data collection and writing the original draft: Sayran Nili, Shokofeh Doostvandi, and Seyedeh Gissia Fakhrelkoneini; Writing, review, and editing: Afshin Bahmani.
Conflict of interest: The authors declared that there is no conflict of interests regarding the publication of this paper.
Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or nonprofit sectors.
Ethical Considerations: This research was approved by the research deputy of Kurdistan University of Medical Sciences with the ethics code IR.MUK.REC.1401.184.
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Health Education and Health Promotion
Volume 11, Issue 2
Spring 2023
Pages 223-230