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This document is being maintained for historical purposes, but is now out of date. To view current guidelines please visit:
- HIV/AIDS Guidelines and Recommendations at http://www.cdc.gov/hiv/guidelines/index.html
Guidelines for Health Education and Risk Reduction Activities
April 1995 Centers for Disease Control and Prevention Atlanta, Georgia ***************************************************************************** PUBLIC INFORMATION The Role of Public Information in HIV/AIDS Prevention Public information activities alone do not represent a sufficient HIV prevention strategy. However, planning and implementing effective and efficient public information programs are essential to successful HIV/AIDS prevention efforts. As defined here, the purposes of public information programs are to: - Build general support for safe behavior. - Support personal risk reduction. - Inform persons at risk about infection and how to obtain specific services. - Encourage volunteerism. - Decrease prejudice against persons with HIV disease. Public information programs craft and deliver data-driven and consumer-based messages and strategies to target audiences. The public information program standards and guidelines set forth here are based on CDC's standards for health communication. Definitions CDC defines health communication as a "multidisciplinary, theory-based practice designed to influence the knowledge, attitudes, beliefs, and behaviors of individuals and communities" (Roper, 1993). Sound health communication practice is based on a combination of behavioral and communication sciences, health education, and social marketing. Current practice extends beyond information dissemination to include a variety of proactive strategies addressing both individual and societal change. A communication (public information) program is the delivery of planned messages through one or more channels to target audiences through the use of materials. Successful public information programs share a number of basic characteristics, which include: - A person in charge who manages the program well. - Activities planned to fit what the community and target audience need and want. - A variety of activities, including mass media, that can be directed over a period of time to the target audience. - A measurable program objective or purpose. - A commitment to evaluation -- tracking and measuring progress toward objectives. - A time schedule. - Efficient use of people and other resources. Well-planned and well-executed health communication in public information programs can accomplish the following: - Raise awareness. - Increase knowledge. - Refute myths and misconceptions. - Influence attitudes and social norms. - Reinforce knowledge, attitudes, and behaviors. - Suggest and enable action. - Show the benefits of a behavior. - Increase support and/or demand for services. - Help coalesce organizational relationships. Public information programs should use multiple approaches to motivate and involve people and communities. Using health communication methodologies, however, is not sufficient to guarantee change. Plans for creating sustained behavior change should include information/communications in combination with other prevention strategies. In this way, effective communications can significantly enable and contribute to change. For example, public information programs funded by CDC carry out parts of CDC's overall HIV prevention strategy. Consumer-influenced messages and strategies are best achieved by a systematic approach involving research, planning, implementation, evaluation, and feedback. The purpose of this section is to offer guidelines for conducting public information programs that have been developed as integral parts of an overall HIV-prevention strategy. In addition to planning, pretesting, and evaluating public information strategies, specific components of public information programs -- producing educational materials, working with the print and broadcast media, hotlines, and special events -- are addressed here. Planning for Public Information To be effective, public information programs must be consistent with and supportive of broader programmatic objectives (e.g., to inform target audiences about and motivate them to use existing HIV counseling and testing services). Therefore, public information plans should be developed as one component of the comprehensive HIV prevention plan. During the planning process, a number of key questions should be asked. The answers, which should be derived from targeted needs assessment data, will help to assure that public information efforts will support the HIV/AIDS prevention program objectives. These questions cover the following issues: - What are the media preferences and habits of the target audience? What information sources (such as social networks, churches/religious institutions, coaches) do they consider credible? - What are the media and other organizations that provide information in the targeted area? Which activities are related to public information? What are the specific audiences? - What prevention program goals and objectives can public information support (e.g., increased knowledge, change in attitudes, motivation to act, increased skills, other behaviors)? - What services/program activities should be promoted? - What measurable objectives can be established? How can progress be tracked? - What are the broad message concepts for the target audience? What should they be told? What do they want to know? Who will they believe and trust? - What communication channels are most appropriate for reaching target audiences (e.g., radio, TV, print media, worksite, face-to-face, voluntary organizations, or the health care sector)? - What materials formats will best suit these channels and messages? Are there any existing materials that can be used or adapted? - How can the resources be used most effectively and for what combination of activities? In addition to answering these key questions, an important part of the planning process is determining the short- and long-term objectives of the public information program. Objectives could include the following: - Increase the number of persons (target audience) calling a hotline or requesting information/expressing an interest in other ways. - Increase the number of program participants, volunteers, requests for activities within a community. - Increase beliefs among community leaders that support for HIV/AIDS issues is important. - Increase the numbers of partner, family, or other discussions about HIV/AIDS. A comprehensive program could include all of these objectives. Most communities may find that they can take on one or two objectives at a time, then add to or alter their program focus as the program develops or community needs change. Staff Training in Planning for Public Information Staff working in public information programs should review, discuss, and receive training based upon the CDC health communication framework or a similar planning model such as that found in Making Health Communication Programs Work: A Planner's Guide. (See Resources and References p. 74). Staff should also be familiar with methods for tracking and evaluating public information activities. Table_B1 Standards For Effective Public Information Programs Table_B2 Guidelines For Effective Public Information Programs Channel Selection Communication channels are the routes or methods chosen to reach the target audiences. Types of channels include mass media, interpersonal transactions, and community-based interactions. Understanding the advantages and disadvantages of communication channels can help assure the best use of each, including the coordination of mass media activities with other strategies where beneficial. Each channel has its own characteristics and advantages and disadvantages, as listed here: MASS MEDIA (radio, television, newspapers, magazines) Advantages: can reach many people quickly can provide information can help change and reinforce attitudes can prompt an immediate action (e.g., calling toll-free number) can demonstrate the desired action Disadvantages: are less personal and intimate are less trusted by some people do not permit interaction offer limited time and space offer limited opportunities to communicate complex or controversial information alone, usually cannot change behavior can be costly COMMUNITY CHANNELS (schools, employers, community meetings and organizations, churches/religious institutions, special events) Advantages: may be familiar, trusted, and influential may be more likely than media alone to motivate/support behavior change can reach groups of people at once can sometimes be inexpensive can offer shared experiences Disadvantages: can sometimes be costly can be time consuming may not provide personalized attention INTERPERSONAL CHANNELS (e.g., hotline counselors, parents, health care providers, clergy, educators) Advantages: can be credible can permit two-way discussion can be motivational, influential, supportive Disadvantages: can be expensive can be time consuming can have limited target audience reach Selecting the Appropriate Channel The appropriate channel or channels for a specific project can be selected by assessing whether the channel is: - Likely to reach a significant portion of the target audience. (Local media outlets can provide a demographic profile of their viewers/ readers/listeners.) - Likely to reach them often enough to provide adequate exposure for the message/program. - Credible for the target audience. - Appropriate and accessible for the selected HIV/AIDS message. - Appropriate for the program purpose (e.g., provide new information versus motivate action). - Feasible, given available resources. Choosing multiple channels can help combine the best traits of each and reinforce the message through repetition. For example, a major daily newspaper may reach the most people. Adding stories in a local African American newspaper may provide credibility within that community, and publicizing the hotline in these stories can help the reader get more information tailored to his or her needs. Educational Materials Educational materials are learning or teaching aids. They can be used to reach masses of people, to reinforce or illustrate information given in a one-on-one setting, or serve as references to remind people of information they received earlier. Materials also teach skills by providing hands-on experience or by illustrating a step-by-step approach. Effective materials can also influence attitudes and perceptions. Development or selection of educational materials is directed by several considerations: - What is the public information objective? Is it to inform, demonstrate, persuade, or remind? These considerations determine how educational materials are designed and used. - Who is the target audience? Where (which channels) can they be reached? Are there any target audience preferences for types of materials (e.g., non-print for low-literacy audiences, fotonovelas for Latinas)? - What is the specific message? Is it a skill, an attitude to be considered, medical information, a negotiation approach, or a synopsis of previous instruction? - What materials are already available? Will they fit the audience, channel, and objective? Can they be purchased? Reproduced? Modified? - What financial, staff, and other resources are available for materials development? Should development be handled in-house or by contract? Choose Formats for Education/Information Materials In selecting formats for educational and informational materials, choice should be guided by the amount and type of information to be presented, the channels to be used, and target audience preferences. For most messages, using as many different formats as appropriate will provide more options for message promotion. Commonly used formats include: Channel: Television Formats: Public service announcements, paid advertisements, editorials, news releases, background or question and answer (Q and A) for public affairs programs Channel: Radio Formats: Live announcer copy (PSAs), taped PSAs, topic ideas for call-in shows Channel: Newspaper Formats: News releases, editorials, letters to the editor Channel: Outdoor Formats: Transit ads, various sizes Billboards, various sizes Ads/posters for bus stop enclosures, airports Channel: Community Formats: Posters for beauty and barber shops, pharmacies, grocery stores, worksites Bill inserts: shopping bag inserts or imprints, paycheck inserts Special event giveaways: calendars, fact cards, pencils, balloons, key chains Table top or other displays for health fairs, waiting rooms, libraries, schools Newsletter articles for community, employer, business newsletters Fotonovelas, flyers, pamphlets, coloring books for distribution through community settings Channel: Interpersonal Formats: Posters for physicians' offices and clinic waiting and examination rooms Talking points, note pads for patient counseling, presentations at schools, organizations, religious institutions Videos for classroom use Review Available Materials Before developing new materials, make sure that new production is necessary. If materials are available that will meet identified program needs, expense and effort can be saved. Contact the CDC National AIDS Clearinghouse (1-800-458-5231) to find out what is available. Use the Materials Review Checklist to assess appropriateness of existing materials. (See Appendix E.) Determine whether appropriate materials can be used or modified: - Is the organization willing to share its materials? (Note: Virtually all materials produced by the Federal government are in the public domain. This means that they are not copyrighted and can be freely reproduced.) - Can your program identity be substituted or added to the materials? (Make changes to fit planned public information activities.) - Is the material available in the quantities needed? Is it affordable? - Were the materials tested? With what results? - How are the materials currently being used? By whom? With what effects? - Are the materials suitable for the identified target audience and your community? (Testing may be needed to find out.) - Are the messages consistent with specified public information and prevention program objectives? Pretest Messages and Materials Pretesting is defined as the testing of planned public information strategies, messages, or materials before completion and release to help assure effectiveness. Pretesting is used to help make sure that messages and materials will work. It is important to test messages and draft materials with target audiences. Also, testing with media or other "gatekeepers" is a good idea, e.g., PSA directors or others who can influence whether messages and materials are used. Pretesting can help determine whether messages and materials are: - Understandable. - Relevant. - Attention-getting. - Memorable. - Appealing. - Credible. - Acceptable to the target audience. These factors can make a difference in whether messages or materials contribute to meeting public information objectives. The most frequently used pretest methods include: - Focus groups. - Self-administered questionnaires. - Central location intercept interviews. - Individual interviews. - Theater-style testing. - Readability testing. - Gatekeeper review. Specific pretest methods will vary, depending upon: - Materials format(s). - Complexity of the materials or messages (e.g., for complex messages, more time may be needed to explore audience reactions). - Degree of sensitivity or controversy (e.g., a combination of methods helps make sure that responses are honest). - Previous experience with or knowledge of the target group (i.e., less testing, or less in-depth exploration may be called for if a great deal is already known about audience views). - Resources. - The pretest questions to be explored. Note: Additional information about pretesting can be found in Making Health Communication Programs Work: A Planner's Guide. (See Resources and
References
.) Staff Characteristics for Materials Development and Pretesting Staff who are involved in the development of educational materials should know the attributes and limitations of the educational materials formats to be used. In addition, they should: - Speak, read, and write the language or dialect of the designated audience or have access to someone who does. - Have the ability to identify accurately and incorporate appropriate literacy levels in design of materials. - Communicate effectively in print and audiovisual media, or have access to competent materials producers. - Be familiar with characteristics and life styles of designated audience. - Be non-judgmental. - Know the message and materials objective. - Be able to personalize the material's message to be relevant to the target audience. - Be able to design and conduct message and materials pretests or have access to trained and experienced help. - Be able to design and implement distribution and promotion plans to assure appropriate use of materials to support public information activities. Training for staff materials development and pretesting should: - Emphasize how to design objectives, messages, and educational material. - Instruct how to design and implement dissemination, promotion, and evaluation plans to assure appropriate use of materials. - Inform about sources of additional information and related services. - Teach how to determine appropriate motivator of behavior change. - Instruct how to design and conduct pretests, including how to conduct focus groups. - Provide practice sessions and opportunities for observation before conducting target audience pretests. - Provide other training as needed (e.g., cultural sensitivity, low literacy materials development, sexuality attitudes, interviewing skills). Using the Mass Media Effectively The mass media is a vast and powerful sector of our society that includes television, radio, newspapers, magazines, other mass circulation print vehicles, and outdoor advertising. For HIV/AIDS prevention public information outreach, this category also can include shoppers' weeklies, newsletters published by businesses, periodicals distributed by organizations, newsletters from major employers, school/college newspapers, closed circuit television, and broadcast radio stations. Opportunities for Messages in the Mass Media The media offer more than news and public service announcements: Beyond "hard" news, consider "soft" news that you help create: - an upcoming activity; - an event; - findings from a public opinion poll or survey; - a local angle to a national story; - news appropriate for health or community features; and - community advocacy of an issue that creates news. For entertainment, consider: - features in print or on television; - talk and call-in shows; - health and advice columns; - consumers' own stories; and - interviews with local personalities. In addition to news or public service announcements for television and radio, ask for the following: - businesses to sponsor paid advertisements or add an HIV prevention message to their ads; - stations to include reminders as parts of station breaks; - broadcast associations to help negotiate better rates for paid ads; - the media to help in producing PSAs or video segments; - consideration before a newspaper editorial board; - placement of your spokesperson on news, public affairs, talk shows, call-ins, or editorial segments; - paid advertisements; and - co-sponsorship of events within the community. Editorial time and space includes: - letters to the editor; and - print or broadcast editorials (e.g., on local policies, access to services). Table_B3 The Character of the Media What Makes News Remember that you are competing with all the other news happening on a given day. Be sure that your story has something extra to offer, such as: - Widespread interest or interesting angle. - A local angle. - Timeliness. - Human interest. - Controversy. - Celebrity involvement. - Impact on the community. Note: CDC's two guides, HIV/AIDS Media Relations and HIV/AIDS Managing Issues, provide additional information for working with the mass media. Also, the National Public Health Information Coalition (NPHIC) has prepared a "hands-on" guide for handling media interviews. (See References p. 74.) Working with the Mass Media Involve media professionals in planning. Like many other people, they prefer to be involved from the beginning and to feel their opinions are valued, not just their access to media time and space. Develop a media contact list. The public information office of the state health department probably can get you started. Also, guidance is provided in CDC's Media Relations guide. (See References.) Establish relationships with the media; concentrate on those media outlets your target population is most likely to see, hear, or read. Articulate a role for media that will contribute to objectives and capture the attention of the target population; build capacity to interact effectively with the news media. Media relations can be labor intensive. To make sure that the efforts pay off, consider the following: - Start with a media plan that includes a variety of strategies; coordinate that plan with other program strategies. - Quickly and competently respond to media queries and deadlines. - Plan media activities over time, rather than one event at a time. - Track media results, report successes, and plan for improvement. - Look for opportunities to turn existing events and stories into new angles to support the media strategy. - Recognize the contributions of media, e.g., send letters. - Periodically review what has been accomplished, what needs improvement, and what to do next. To identify media strategies, consider: - What has not been covered and could be covered. - Which media outlets might be interested in doing more. - Which journalists, columnists, or media personalities might be interested. Media strategies should: - Contribute to program objectives. - Be within your means to accomplish. - Consider benefits and limitations of business and other partners. Prioritize media strategies by weighing expected benefits, resources required, and how each could be "sold" to the media. Then, work first on those with the greatest potential. Use information about the public's interest in HIV/AIDS to convince the media to participate. Assess exposure in the media: - Quantity -- how much coverage (seconds, column inches) was received. - Placement -- where the coverage appeared in relation to the target audience's media habits. - Content -- whether it was likely to attract attention (e.g., with a provocative headline or lead in), favorable, accurate, incomplete, misleading, or negative information. - Feedback -- whether the target population and/or decision makers in the community responded in a tangible way. Ways to track media efforts: - Keep a log of media calls -- track what was said, identify who to call back, identify when coverage will occur; use the log to update media contact lists. - Clip and review print coverage; tape to review television and radio coverage (purchase videos of coverage from stations or commercial sources when high-quality videos are needed, e.g., for presentations). - Request from stations a monthly printout that lists when PSAs were shown and the time donated (dollar value). - Include an audience prompt in messages, and monitor who responds. Provide media spokesperson training for staff who work with the media. Staff training should also: - Follow the recommendations in CDC's Media Relations and Managing Issues guides. - Explore options for working with the media beyond PSAs, including establishing media relationships and message placement. Table_B4 Media Idea List Hotlines Because many people are uncomfortable discussing subjects that involve sexual issues and behaviors, accessing a hotline for HIV/AIDS/STD information is a viable, anonymous option. However, hotlines may not be appropriate for satisfying every program need. Information generated through a needs assessment can be used to determine whether a hotline is appropriate; provide indicators for needed hours of operation, number of staff, specialty services (e.g., for Spanish-speaking, the deaf); ascertain appropriate venues for publicizing the hotline number; identify which population(s) should be targeted; and indicate specific information needs. If the establishment of a local hotline is not a viable option, the CDC National AIDS Hotline and the CDC National STD Hotline can be publicized. Why Establish A Hotline? A Hotline can do the following: - Provide easy and immediate access for persons/populations who may not be reached by other methods, e.g., women at risk for HIV infection in rural communities. - Provide an opportunity for a person to frame a question and have anonymous human contact. - Provide information in a confidential manner, maintaining the privacy of the caller. - Provide information in appropriate language level and style and permit discussion of issues caller does not understand. - Afford the caller up-to-date, accurate information. - Provide referrals for counseling and testing, treatment services, and various support systems. - Serve as a monitoring mechanism for impact of public information activities, e.g., PSAs that publicize the hotline number. - Permit pre-screening of "worried well" to decrease unnecessary HIV testing. Quality Assurance A quality assurance plan should be developed as part of the process of establishing a hotline. This plan should address the following minimum requirements: - Description of staff recruitment process and necessary qualifications for specialists. - Information and timeliness for monitoring the specialists for accurate information dissemination, appropriateness of referrals, and proper call management skills. - Performance appraisal based on whether persons are able to achieve standards; remedial activities for elevating performance; volunteers and paid staff judged according to the same expectations; and volunteers should understand that this is a "job" and conform to hours, vacation rules, confidentiality, etc.). - Information on publicizing the hotline (in all languages the hotline offers) and methods for documenting calls. - Explanation of data collection procedures and reporting forms, e.g., collection of information about callers -- who is being reached and what they are asking. - Description of management techniques for referral information, e.g., a regular review of database or written materials. Guidelines for Establishing A Hotline - The hotline should not impose any financial difficulties/barriers on prospective callers (e.g., should be free for the caller). - Days and hours of operation should meet the needs of the target audience (e.g., not just during business hours, when employed callers could not be assured of privacy for calls). - The CDC National STD and the CDC National AIDS Hotline numbers should be provided on a taped message for calls received after normal operating hours in order to provide access to callers having immediate needs. - Physical space should accommodate future staff expansion and additional phone lines. - Telecommunications equipment should be up-to-date and of sufficient capacity. - Venues should be available for publicizing the hotline and should be appropriate for targeted audiences. - Consideration should be given to phone lines that may be needed for special audiences, e.g., non-English speaking people and people who are deaf or hard of hearing. Also consider offering an auto-attendant system to operate during off-hours and weekends. Such a system can offer a menu of pre-recorded messages for callers who do not need to speak with a counselor, but who want quick and anonymous access to information. Staff Characteristics for Hotlines Hotlines are staffed by information specialists who may be paid personnel or volunteers, depending upon available financial resources. If volunteers are used, the organization should commit at least one paid staff person for management purposes. A paid staff member is needed to ensure consistency and continuity of services because of the high turn over of staff commonly experienced among volunteers, the need to ensure quality services, and the need to maintain consistency in the implementation of policies and procedures. The manager should maintain and regularly update a comprehensive list of HIV/AIDS/STD services and organizations. A hard copy and/or computer-based list should be used by information specialists during work hours. Information specialists provide information over the telephone; therefore, they require unique skills and abilities. They should always be prepared for the unexpected and act accordingly. The successful information specialist should possess the following attributes: - Be knowledgeable about HIV/AIDS/STDs. - Understand the importance of anonymity and confidentiality. - Have the ability to speak at various levels that are consistent with the language needs of the callers, e.g., physicians, lay persons who are or are not AIDS-knowledgeable. - Exhibit active listening skills and be courteous, patient, understanding, and compassionate. - Display a sensitive and non-judgmental attitude when callers describe concerns, sexual activities, drug use, and/or symptoms. - Refrain from giving advice during crisis-oriented calls, but appropriately refer to organizations adept in crisis intervention. - Refer callers to appropriate resources in a timely, efficient manner by using proper call management skills. - Demonstrate resourcefulness and ingenuity in providing referrals and finding answers to questions. Once the information specialists have been recruited, they should be comprehensively trained to meet the challenges of their positions. Consider teaming new information specialists with more experienced staff until the new person is comfortable handling calls independently. A training plan should address the following minimum requirements: - Measurable goals and objectives for the training. - Basic medical knowledge about HIV/AIDS/STD, including modes of transmission, disease-causing organisms, signs and symptoms, disease epidemiology, diagnostic methods, disease progression and complications, and treatment. - Knowledge about common myths and misconceptions about HIV/AIDS/STD and correct information to dispel myths and misconceptions. - Skills-building exercises in active listening and effective information dissemination (including crisis intervention). - Interpersonal and multi-cultural communication skills-building. - In-service training and updates on a continual basis to remain current on issues surrounding HIV/AIDS/STD. For additional information, consult the training bulletins that the CDC National AIDS Hotline distributes to state health departments and others. Special Events Special events such as street fairs, job fairs, health fairs, World AIDS Day activities, and local celebrations in communities sometimes can deliver public information to large numbers of people and can gain media exposure. Community Involvement and Support Community groups and organizations can play an important role in implementing special events. Libraries, schools, churches, businesses, or social groups provide leadership in communities and are able to pool resources and inspire citizens to join their efforts. The types of events that can be organized are unlimited and can be as original and varied as the ideas and resources of the people organizing them. Networking can heighten the visibility of events, resulting in greater public awareness when interested persons are identified and contacted. Efforts can begin with one or more of the following types of organizations: - Schools, colleges, and other educational organizations, such as local PTA chapters and nursing schools. - Civic associations, fraternal organizations, social sororities, and clubs. - Community-based organizations including the National Association for the Advancement of Colored People (NAACP), the American Red Cross, the National Urban League, and the Young Men Christian Association/Young Women Christian Association (YMCA/YWCA). - Neighborhood associations. - Churches and other religious institutions. - Businesses such as shopping malls, health and fitness clubs, drug stores, laundromats, bars, bookstores, and groceries where members of the target audience can be found. - Media outlets such as newspapers, television, and radio stations. Creativity is an important aspect of successful special events. A number of innovative ideas have been implemented across the country. For example, The Condom Resource Center whose goal is to reduce the incidence of sexually transmitted disease, including HIV/AIDS infection, sponsors a yearly event entitled "National Condom Week." (See References for contact information.) To distribute pamphlets and condoms, information tables are set up in public areas and in more secluded locations for self-conscious people or people who are shy about sexual matters. Additional public events are staged, such as the following: - A contest for prizes in which people design posters with condom messages. - A contest to guess the number of condoms in the jar with the person with the closest guess winning the contents of the jar. - An annual "media conference" for high school and college newspaper staff to provide accurate information and to encourage coverage of National Condom Week. Planning Special Events - Identify persons and organizations in the community interested in planning an observance or event. - Consider what types of activities will draw the target audience to an event (e.g., different people may be drawn to music, dance, art, sports, celebrity events). - Agree to sponsor an activity or a group of activities making sure that each will contribute to public information objectives with the designated target audience. - Discuss resources needed, such as a guest speaker, financial sponsors, and publicity materials. - Get members of the target audience involved in planning. - Create a planning schedule and set a date for the activity. - Delegate responsibilities for work by assigning persons to be in charge of specific aspects of the planned activity; put people in charge of location, special attractions, hospitality, publicity, and media according to their skills and interests. - Develop a publicity plan to assure attendance; publicity is crucial for the success of any event. - Decide on the most effective way to publicize the events, e.g., announcements in the media and at meetings, flyers, public service announcements, posters, or mass mailings. - Track planning progress: use the planning schedule and publicity plan as a guide to make sure that the event is a success. - Evaluate the success of the event by comparing the number of attendees expected with actual attendance; identify how many of the target audience attended and what they thought of the event; review media coverage and other publicity that supported prevention objectives; identify increased awareness of the program as a result of publicity (e.g., through pre- and post-event surveys); compare effort involved in developing the event with the value of the outcome.
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