Academic journal article Canadian Journal of Public Health

A Model of Mechanisms Underlying the Influence of Media on Health Behaviour Norms

Academic journal article Canadian Journal of Public Health

A Model of Mechanisms Underlying the Influence of Media on Health Behaviour Norms

Article excerpt


Media-based interventions are common in health promotion, yet their conceptual underpinnings tend to be based on a simple linear model of direct influence on individuals' health behaviour. Recent studies have suggested that the processes through which media influence health behaviours are actually far more complex. This paper presents a conceptual model of how the medias influence the emergence and maintenance of the social norms that can contribute to shaping health behaviours. Through positive (amplifying) and negative (dampening) loops, a total of six potential influence pathways are proposed, and the role of opinion leaders and specialists is specified. Future directions for empirical tests of the model are identified.

MeSH terms: Social change; mass media; health behaviour; communications media


Les interventions médiatiques sont fréquentes en promotion de la santé. Leurs fondements conceptuels tendent à être basés sur un modèle linéaire d'influence ayant un effet direct sur les comportements sociosanitaires des individus. Or, de récentes recherches suggèrent que les processus médiatiques influençant les comportements sont davantage complexes. Cet article présente un modèle conceptuel au sujet des mécanismes médiatiques façonnant les normes et les comportements. À travers un positionnement positif et négatif, le modèle propose six voies d'action et définit le rôle des spécialistes et des leaders d'opinion. Des pistes de recherche sont proposées.

Socio-environmental models of health and well-being1-5 have considered communications delivered through mass media to be important forces of social influence and socialization for individuals and families. However, little empirical attention has yet been paid to the roles of media in structuring social and physical environments that are supportive of health and well-being. While some research is focussing on settings, legislative environments and macrosocial conditions as determinants of positive health and social outcomes,6,7 we lack a comprehensive understanding of how media contribute to and shape the social norms that influence these determinants, and how they interact with macro-level factors to influence health and well-being at the community level. This lack of attention is surprising, given inconsistent demonstrations of media effects on community-level change in health promotion interventions8,9 despite clear evidence that media influence population levels of unhealthy behaviour such as smoking.10 Recent critical analysis suggests that media-based interventions promoting health and well-being are rarely developed or evaluated using theory-driven, empirical approaches, and that their focus is generally on the direct relationship between media intervention and individual behaviours rather than on using media to reshape the social environment.11,12

This paper presents a conceptual model of how media shape socially constructed understandings of health and interact with other macro-level health determinants (such as institutional agendas and policies) to influence population health. Media are defined very broadly as elements of communication systems that contribute to shared understandings13 of health through the flow of information.14 These communication systems include mass entertainment, information, and instructional/educational systems.

Integrative model

Trying to schematize the place of media in the developing of norms, a preliminary integrative conceptual framework articulates the mechanisms underlying the reciprocal influences of and on media in the production of health-related norms. Figure 1 shows that information relevant to health norms emitted by its initial generators/emitters (for example, specialists such as public health officials or opinion leaders such as politicians or celebrities) is appropriated and transformed through real or virtual interaction with the systems, organizations and individuals that create and implement media products (including broadcasters, producers, writers, regulators, industry associations, etc. …

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