American Journal of Health Promotion

Current marketing efforts by commercial condom manufacturers are directed at White consumers and therefore neglect inner city Blacks and Latinos as potential users of condoms. This paper reviews “social marketing programs” developed in Third World countries to promote condoms as a contraceptive, often with the financial assistance of the United States or other governments. This technology — which includes product, pricing, distribution, and promotional considerations — should be applied in the United States, especially to reach poor minority populations that are currently at greater risk for teenage pregnancy, AIDS, and other sexually transmitted diseases.

This paper describes a study examining the feasibility of a worksite health promotion program that was repeated twice in one year. Weight control and smoking cessation classes, which included a supporting incentive component, were made available at a worksite of 485 white-collar employees continuously throughout one year. Identical education programs were offered twice at six-month intervals. Results suggest that this model of program implementation is attractive to employees. Total participation over 12 months included an estimated 53% of overweight employees in the weight program and 23 % of smokers in the smoking cessation program. The two series of classes, run back to back, generated similar participation. Thirty-nine percent of weight control participants and six percent of smoking cessation participants who enrolled in the first program also enrolled in the second. Weight losses and smoking cessation rates were comparable for the two cycles, with a mean weight loss of about seven pounds and a smoking cessation rate at six months of about 33%. Surveys of a random sample of employees at baseline and again at 12 months showed a 28% reduction in the prevalence of cigarette smoking, but no change in average weight or the prevalence of overweight. This study suggests that health promotion programs at worksites which offer repeated opportunities for employee participation are promising and deserve further study.

Development communication, particularly within the health sector, is relatively new and still shrouded in mystique. Many health planners and policy-makers in developing countries and elsewhere do not yet fully appreciate the role communication plays in primary health care interventions. Nevertheless, communication theory, embracing diffusion of innovations and social marketing, can make a significant contribution in improving health status. This paper explores, through an examination of the literature and the experience of a worldwide research and development project, the synthesis of development communication, diffusion, social marketing, and primary health care. It attempts to demonstrate the value of integrating these paradigms within the context of a public health communication model. Focusing on the use of radio and interpersonal communication, the paper describes model projects in India and Honduras and reveals through their example the role of communication in changing health behavior in Third World settings.

This article presents six implications for practice that suggest how to optimize the institutionalization of health promotion programs. These six implications were derived from a study of ten health promotion programs funded by the Virginia State Health Department and operated by local schools- and community health agencies.

Institutionalization refers to the long-term survival of health promotion programs, i.e., survival well beyond an initial grant funding period. To generate the implications for practice, a multiple case design for cross-case comparisons was applied to the ten health promotion programs. In brief, the six practice implications are: 1) cultivating a “program champion”; 2) favoring organizations with mature “subsystems”; 3) favoring organizations in which health promotion “fits” with the organization's mission; 4) avoiding brokering relationships; 5) altering lengths of funding periods; and 6) funding existing worthy programs. The significance of these practice implications for both funding and implementing agencies is briefly discussed.