Media advocacy

Media advocacy is another approach that questions central premises of the traditional paradigm. Media advocacy is the strategic use of mass media to advance social or public policy initiatives (Wallack et al 1993). Its goals are to stimulate debate and promote responsible portrayals and coverage of health issues. Advocacy requires the mobilization of resources and groups in support of certain issues and policies to change public opinion and decisions. It consists of the organization of information for dissemination through various interpersonal and media channels towards gaining political and social acceptance of certain issues.

Like education-entertainment strategies, media advocacy rejects the idea that the media can be a source of only anti-social messages, and instead, proposes to include socially relevant themes in entertainment. Both share the perspective that because the media are the main source of information about health issues, interventions need to focus on the media. Both also believe in the capacity of the media to transmit information that can result in changes. Unlike education-entertainment, which has been mostly concerned with directly influencing audiences, media advocacy centers on shaping the public debate about public health. It is not information-centered but aims to incorporate social themes in entertainment content in order to influence public agendas. It takes a political and social approach that differs from the social-psychological premises and diagnoses found in education-entertainment. And, in contrast to education-entertainment, it is less convinced about the power of the media to be extremely effective in changing attitudes and behavior.

Because it locates problems in political and social conditions, social advocacy promotes social, rather than individual and behavioral, changes to health issues. It approaches health not as a personal issue but as a matter of social justice. It is explicitly set against the individualistic assumptions of mainstream approaches found in the dominant paradigm of development communication that fault individuals for unhealthy and antisocial behaviors and propose individual solutions based on the idea that health is primarily a question of individual responsibility. Instead, it advocates changes in the social environment that legitimize certain behaviors. For example, it sees tobacco and alcohol companies rather than individual smokers and drinkers as responsible for unhealthy behavior. Therefore, those companies should be the targets of advocacy and communication activities. Actions should target, for example, access to unhealthy products by involving communities in implementing policy changes (Holder and Treno 1997)

Here the contrast with behavior-centered health approaches is clear as media advocacy proposes that social conditions should be the target of interventions. Such interventions entail fundamentally a political process of changing conditions and redressing social inequalities rather persuading individuals about the benefits of certain lifestyles and behavior change. Health is a matter of social justice and partnering with interested parties rather than providing information to change individual behavior (Brawley and Martinez-Brawley 1999).

These premises set media advocacy apart from social marketing. Media advocacy criticizes social marketing for having an individualistic, behaviorist approach to health and social problems that narrows interventions to public information campaigns. Media advocacy espouses a community-level model of intervention in health issues. Development, defined to be the well being of communities, can be achieved through promoting structures and policies that support healthy lifestyles. Community organization is the process by which community groups are helped to identify common problems or goals, mobilize resources, and develop and implement strategies for reaching their goals (Glanz and Rimer 1995).

According to media advocacy theory, campaigns are not the panacea not only because their effectiveness is questionable but also because they ignore the social causes of unhealthy behavior. Public service announcements have shown limited success in stimulating change and fail to address the social and economic environment that ultimately determines health risk factors. Social marketing does not face head-on the fundamental structures that sustain unhealthy behavior. Social advocacy does not minimize the importance of individual changes but, instead, it strongly argues that the latter require changes in social conditions. Because external conditions are responsible for health, the strategy should target those conditions instead of centering on lifestyle behaviors. Promoting individual health habits in developing countries without, for example, advocating for clean water supplies underplays the factors responsible for disease.

Media advocacy adopts a participatory approach that emphasizes the need of communities to gain control and power to transform their environments. It assigns the media a pivotal role in raising issues that need to be discussed and putting pressure on decision-makers. However, advocacy is not solely concerned with media actions. Because it concludes that health problems are fundamentally rooted in power inequalities, it promotes a dual strategy to build power that includes the formation of coalitions and grassroots actions coupled with media actions and lobbying.

Media advocacy theory assumes that the media largely shape public debate and, consequently, political and social interventions. To be politically effective, then, influencing news agendas is mandatory. AIDS and tobacco control coalitions and groups in the United States have been successful in their use of the mass media that has resulted in support, funding and the implementation of public policies. Media-savviness is necessary to get widespread coverage of certain health issues and to shape how stories are presented. Here again social advocacy differs from social marketing. Social advocacy is not about putting in action centralized actions to relay information to consumers but, rather, providing skills to communities so they can influence media coverage. It approaches the media not in terms of “health messages” but as agenda-setters of policy initiatives. Placing messages is not only insufficient to correct problems but it is also the wrong strategy: the target of media interventions should be news divisions rather than the advertising departments of media organizations (Wallack 1989).

Moreover, the media might be willing to feature public service announcements for a variety of reasons to further its own goals. Lobbying the media to feature PSAs does not necessarily result in an examination of structural conditions responsible for health problems, however. Media interest in participating in health promotion activities by donating free airtime fall short from moving away from the individualistic view that dominates behavior change models. Such contributions by media organizations do not deal with external factors, unequal access and structures, and the political environment that is ultimately responsible for public health problems. This is why public health needs to incorporate a broader view that conceives actions in terms of community participation and mobilization to transform public opinion and change health policies.

In summary, advocacy consists of a large number of information activities, such as lobbying with decision makers through personal contacts and direct mail; holding seminars, rallies and newsmaking events; ensuring regular newspaper, magazine, television and radio coverage and obtaining endorsements from known people. The goal of advocacy is to make the innovation a political or national priority that cannot be swept aside with a change in government. In the context of development programs, media advocacy may be carried out by key people in international agencies, as well as special ambassadors, but is gradually taken over by people in national and local leadership positions and the print and electronic media.

keywords: change theories

social change