University of Wisconsin-Madison (Gunther), Center for Communication Programs at Johns Hopkins University (Storey)

2003

This 17-page research paper explores the indirect influences of mass communication, examining a theoretical model - the indirect effects model, or influence of presumed influence approach - which proposes that an unintended audience of a campaign or communication may (1) perceive some effect of a message on others, and then (2) react to that perception by changing their own attitudes or behaviours. For example, a politician, believing that news reports about health care fraud will galvanise public opinion, arranges public hearings; this action constitutes a change (whether or not the perception of influence that has motivated the change is accurate). In contrast to the "third-person effect", this model does not depend on a message with perceived negative consequences; furthermore, perceived effect on self is not a necessary component of this model. In short, the hypothesis is that these indirect effects may constitute powerful and important mass media impacts/influences.

To examine one case of indirect effects on an unintended audience, this document draws on evaluation data from a maternal health campaign in Nepal that featured a serial radio drama ("Service Brings Reward") directed at clinic health workers. Designed jointly by the Nepalese Ministry of Health and the Center for Communication Programs of the Johns Hopkins University School of Public Health, this distance education radio serial modeled desirable health worker attitudes and behaviours. Because the radio drama was aired nationally on Radio Nepal, evaluators predicted that, in addition to the intended audience (health care workers), the serial might attract listeners from the everyday Nepalese population (the "client population", or unintended audience). Evaluators hypothesised that, as client population exposure increased, client perceptions of health worker exposure and influence would also increase. Second, they hypothesised that this unintended audience (who perceived health workers to be influenced by the drama) would demonstrate more positive attitudes toward the health workers and report improved interpersonal interactions in their most recent clinic visit.

The data reported in this evaluation were obtained from two sources: clinic-based monitoring of client-health worker interactions (N = 300) and a survey survey of married women of reproductive age who constitute the client population (N = 3817). Results showed that the radio drama programme indeed had an indirect effect on significant numbers of people in the general client population, through the following process:

1. People in the general client population observe and attend to the content of an information campaign, even though they are not part of the intended audience
2. These people anticipate influence of the information campaign on the intended audience (clinic health workers), and a corresponding change in these workers
3. These perceptions of change, whether accurate or not, lead people to develop more positive expectations about the professional qualities of health workers
4. As a result of these expectations, people form more positive attitudes toward health workers
5. More positive attitudes cause the client group to perceive (and perhaps even contribute to) more positive and productive client-health workers interactions and to feel more confident about their own efficacy in dealing with health workers.

The evaluators point out that this above-described process, and its benefits, can occur regardless of any actual positive influence of the campaign on the intended audience (health service providers). Further, these effects of the radio drama can be observed only when mediated by perceived influence on the intended audience. For instance, although many women in the general population listened to the serial, the programme had no direct positive influence on this population. Nevertheless, evaluators found a significant indirect influence on their attitudes and reported behaviours when mediated by their perceptions of impact on the population being addressed (clinic health workers).

The evaluators conclude that, like the Nepal radio drama series examined here, many campaigns may have unanticipated effects that help realise their goals. Unless these unanticipated effects are taken into account and measured, the overall impact of the campaign is underestimated. Also, if understood better and documented properly, programmes can take advantage of these indirect effects purposively to enhance communication-based campaign impact.

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