Increasingly PSAs are being used to educate the public about a wide variety of health issues, ranging from AIDS to smoking. To discuss the role and future of health-related public service advertising messages, forty-one health communications practitioners from the federal government and private sector met on the campus of the National Institutes of Health. Following is a summary of the one-day meeting at which attendees discussed the current PSA environment, new proposals for paid airtime and a look at future options for health communicators.

Current PSA Environment

Because of increased influx of PSAs and market forces combined with fewer federal regulations ruling broadcasters' programming decisions, PSA time should be declining. Studies differ in their findings on the amount of air time available.

• In the 1970s, the Federal Communications Commission began abolishing the regulations aimed at providing an adequate amount of public interest programming. The Commission now requires only a "general obligation" that broadcasters address issues of concern to their communities.
• The FCC also eliminated the rule which limited broadcasters to 16 minutes of commercials per hour. They are now free to air any number of minutes of commercials.
• Although never strongly enforced, the Fairness Doctrine, until its death in 1987, required broadcasters to devote a reasonable amount of broadcast time to coverage of important controversial public issues, including contrasting points of view. This doctrine was responsible for the anti-smoking advertising campaigns in the late 1960s. In contrast, economic forces now determine if stations will run PSAs.
• Statistics indicate that the volume of PSAs sent to TV stations is increasing. Between 1979 and 1985, the number of PSAs sent to the three major networks increased by 40%. CBS alone received over 5,500 storyboards in 1988.
• The number of commercial TV stations airing PSAs is increasing, particularly with the expanding cable and UHF markets. Even though there are fewer PSAs running on each station, there are a greater number of stations on which to get airtime.
• AIDS, National Cancer Institute, and National Heart, Lung and Blood Institute data from Broadcast Advertisers' Reports indicate a stable, perhaps increasing market in terms of number of spots played. NHBLI reports a steep drop in monthly spots after the initial three month blip for each campaign.

Media Gatekeepers' Interests

Participants shared methods they've used to generate interest in their PSAs.

• A statewide survey of media gatekeepers in Texas showed there was little correlation between what the gatekeeper considered to be an important health problem and the actual magnitude of the health problem on society. We can't assume media people place the same priorities on health messages that we do. Creative education is needed to make an issue appear an important health problem.
• When asked why they do not use broadcasting materials:

-43% of media outlets responded they are inappropriate for station format (wrong tone, wrong kind of presentation for the medium)

-28% have no room for the materials

-18% reported they are uninteresting

-6% replied they are not current.

• A majority of respondents said the quality of the materials in the appropriate format is very important. Surveys indicate that media people do share a commitment to campaigns aimed at improving the public health. The most important factor in determining whether a campaign is aired is the credibility of the source.

How is the Campaign Measured

When the public and private sectors join together to launch a public education campaign, they have the option of buying broadcast air time and quantitatively measuring success through product sales. Since we are precluded from buying airtime, indicators of PSA effectiveness need to be defined and improved.

• Most public health service agencies track BAR data, bounceback cards and response to call-ins or write-ins. These methods, however, are of limited value because BAR data covers only the top 75 markets and is very expensive. Many stations do not take the time to return bounceback cards.
• Most public health agencies supplement these sources with other indicators of PSA usage, such as public requests for information mentioned in PSA materials.
• Few campaigns have been examined to determine effectiveness over time, with most evaluations focusing upon a specific PSA.

Ability to Buy Time

In response to increasing competition and the media's apparent declining usage of PSAs, some health organizations have plans to buy, or have already begun buying air time. The effects these new actions will have on campaigns that continue to rely on donated air time are unclear some issues are:

• Legislation exists stating that the federal government can buy time solely for military recruitment, IRS information, and health professional recruitment. Yet, the Postal Service launched a general promotional campaign in 1988 for which they bought air time.
• Legislation passed in 1988 authorized purchase of air time to support the AIDS public education campaign, but no budget has been allotted. AIDS staff are exploring options for combining use of both free and paid space. A plan for buying time has not been established.
• A number of state campaigns and media grant projects funded by the National Cancer Institute and others are buying media time in state and local markets.
• There are campaigns that pay for some airtime and negotiate free air time as part of the package.

What Factors Contribute to Greater PSA Use?

Participants who had successfully launched PSA campaigns shared their experiences and specific tips on getting the attention of public service directors. Their findings included:

• Stations prefer one health issue per tape and locally tagged spots. Personal delivery has an impact and may increase the chance of play. Visiting stations directly is difficult, but well worth it.
• Photoboards are a must for TV, since station public service directors have little time to view tapes.
• If a spot has a tag the public to write for a free booklet," have an adequate supply of the booklet ready for response. (Write-in booklets are also useful in evaluation, with one airing of a PSA generating 18,000 requests for the free booklet).
• The main criteria for playing a spot is local impact. The more localized the health problem, the better.
• Quality execution is crucial.
• Stations do seek out opportunities for community service (health screenings, health fairs, fund raisers, special call-in shows.)
• Tying a campaign in with another medium is often very effective, (i.e. healthy heart newspaper quiz) in getting the message to the intended audience. A tie-in with a news event also may increase play.
• The use of premiums, hooks, lunch, plaques, awards and other incentives (formal recognition, follow-up letters of appreciation) can be instrumental in building a relationship with the public service director.
• Consider networks as marketing targets and the public service directors as target audiences. Investigate issues/pressures the public service director faces from "upstairs."

Recommendations for Future Action

• Continue to share information among organizations that produce and distribute PSAs.
• Continue to document the PSA environment, i.e. understanding gatekeepers; develop better methods of monitoring; study the impact of buying air time on PSAs.
• Share information and concerns with media through their trade and professional organizations.
• Establish criteria to answer: when is a campaign successful; what are the priority messages, and what should trigger purchase of media time?
• Form and foster public debate at the federal, state and local levels by using opinion polls to bolster positions, or earmarking a proportion of excise taxes on tobacco and alcohol such as the state of Minnesota has done, to support public education campaigns.
• Systematize activities for meetings such as this one - build larger audiences and look for additional sources of money to fund activities. Consider forming a "Public Service Council" to monitor government public service interests.
• Look ahead - seek out new mass media channels for messages such as video cassettes, cable, and the internet.