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Media Advocacy: A Strategy for Advancing Policy and Promoting Health

This article was excerpted from a 21 page article originally published in Health Education Quarterly by Lawrence Wallack, professor of public health at the University of California, Berkeley, and co-director of the Berkeley Media Studies Group. Lori Dorfman is also a co-director of the Berkeley Media Studies Group

The mass media, particularly the news media, play an important role in advancing democratic discussion around policy debates. The media effectively set the public agenda for discussion of an issue and establish what the boundaries of that discussion will be. In our mass-mediated democracy , public policy battles are fought not only in City Hall or Congress but on the 10 p.m. news, the front pages, financial section, and even on 24-hour, all talk radio. "Mediated" information can reinforce the status quo or advance policy goals for social change.

Community voices can be conveniently ignored in the din of policy debate. The mass media, especially the news media can amplify voices so that policy makers cannot ignore them.

Media Advocacy

In media advocacy the desired product is the ability of community members to be heard and to exercise influence over the policy environment. By gaining access to the news media and framing problems from a public policy perspective , community groups can apply pressure strategically to key decision makers to change environments. Media advocacy helps create a trained group of media advocates and thus builds the capacity of the community for further change. An important goal is to leave people with a set of critical skills to complement and enhance existing community and advocacy efforts to pursue social change.

Planning Media Advocacy

As with any other approach, media advocacy needs to be based on solid principals of planning. The planning approach used by media advocates is "GOTME": goal, objective, target, message, evaluation.

The second level of objectives involves the identification of specific policies that can be implemented to reach specific objectives. The Mothers Guild decided that if communities adhered to the existing housing code, it would cover many of the problems with which the Guild was concerned. Rather than advancing a new policy , its objective was enforcement of the current policy.

The third level involves specific media objectives. Note that media strategies are not the primary concern but rather are developed to support policy objectives. Achieving the goals and objectives of any program is a long term and complex process that involves a range of strategies; media approaches are only one such strategy, although they represent a particularly powerful tool that can be used to support the overall policy goals.

The Henry Homes Mothers had a clear set of media advocacy objectives: put public housing on the media and public agenda, frame the issue from a tenants rights perspective, and advance a policy initiative (the class action lawsuit) that would increase safety and security in the housing project.

The secondary target is groups or individuals who can be mobilized to apply pressure on those with the power to make the change.

The third target group is the general public.

All media coverage of an issue will provide some degree of public education. So, while media advocacy does not necessarily focus on public education, such initiatives inevitably will serve broader educational interests and contribute to shifts in public opinion.

There are at least three elements to the message. First, there is the clear statement of concern. The second part of the message represents the value dimension, such as the threat to community cohesion and family well-being. The third part elucidates the policy objective. It is as important to describe the policy solution as it is to describe the problem.

The Mothers' Guild had a clear message: that the CHA had broken promises to remedy a terrible situation and should be held to the same standard as any other Chicago landlord. Their appeal was fairness, honesty, and accountability. Also, the very name of the group suggested positive family values and reinforced the emotional value of the appeal. The policy objective was that the CHA adhere to existing standards and regulations.

For any specific policy objective, the message will be more concise and designed to speak to the person with the power to make the necessary change. Tony Schwartz, a renowned political consultant and " guerilla media guru" explains that "shaming" is an extremely powerful motivator in American society. Certainly a subtext of the Henry Horner Homes mothers was to publicly shame the housing authority into responding to their demands.

The basic process evaluation questions in media advocacy revolve around three points:

Basic outcome issues include whether (1) the issue got on the public agenda, (2) it put pressure on and mobilized key decision makers, and (3) the policy was enacted or the change occurred.

The degree to which the issue appeared on the media agenda can be assessed by the amount of coverage generated and the placement of the coverage. The Mothers' Guild received extensive coverage with excellent placement. For example, one of the major Chicago daily newspapers provided front-page coverage, and local television news ran long stories that sometimes were used as teasers for the overall program.

Whether the issue was framed from a public policy perspective can be assessed by a content analysis.

Assessing whether the media coverage advanced the policy can be accomplished by monitoring the progress of legislation and in interviews with key advocates and decision makers. In the example of the Mothers' Guild, the news coverage indicates that the mothers were very effective in framing the message and speaking directly to their target. However, they did not have the organizational capacity to follow up on the attention generated by the initial media coverage.

Therefore, they lost valuable opportunities for advancing the public policy they wanted.

Public opinion polling is one effective way to ascertain whether the issue reached prominence on the public agenda. However, polling can be costly and may not be an option for smaller groups.

Evaluators can examine key documents , such as city council meetings, or conduct interviews with decision makers or journalists to help determine whether media coverage successfully applied pressure that helped mobilize action. The final outcome measure is whether the policy was enacted.

Media advocacy can be a key part of an overall strategy but does not stand alone. Therefore, when we evaluate media advocacy , we tend to look at its contribution to the desired outcome rather than viewing it as a cause of the desired outcome. The complexities of social and political life make isolating media advocacy's contribution difficult; policy battles can take years and involve contributions from various constituencies. However, the demonstrated role of the news media in determining public policy agendas and outcomes means that media advocacy is too important not to do.

Media Advocacy Strategies

Media advocacy uses a wide range of media and advocacy strategies to advance healthy public policy. For example, focus groups and public opinion polling provide intelligence on what people think and the causes and solution of problems. This information can help advocates effectively frame issues for specific audiences.

Also central to media advocacy is community organizing and coalition building. These processes provide the core legitimacy for media advocacy efforts.

The specific news strategies frequently used by media advocates include cultivating professional relationships with journalists, creating news, linking issues with breaking news, and using paid advertising selectively.

Cultivating Relationships

Journalists need information and ideas for stories with importance to the local community. Advocates need to think of themselves as sources for these stories. To be a good source, it is necessary to have expertise, credibility, reliability, and timely information as well as a broad knowledge of an issue. A source should be able to point the journalist to others who can ad to the story and provide sufficient background to cover key points, including the points of opposition.

The first step in cultivating relationships with journalists is to know who is covering your issues. You can do this by watching the news and reading newspapers carefully, noting who writes on the issues and what they say. Second, advocates can send letters about stories that treat the issues fairly and communicate to the journalists what was good about the stories. Remember that journalists' goals differ from advocates' goals in that news emphasizes balance and objectivity. Good feedback to journalists can constructively point out key information that was not included in the stories and provide background materials or suggest alternative or follow-up stories.

The most important factor in developing a relationship with a journalist is having confidence that your issue is important and that you have a thorough understanding of it.

Creating News

Issues that concern large numbers of people, raise broader community issues, involve conflict, controversy or injustice are potential news stories. Every day, news outlets have a "news hole' to fill, and there always is more news than can be covered. The more interesting, important, and easy to cover a story is, the more likely it is to be covered.

There are many opportunities to create news and help set the media and public agendas. For example, the Center for Science in the Public Interest released a study conducted in two public school classrooms showing that fourth-graders were able to name more brands of beer than they could name presidents of the United states. The study received widespread national coverage and helped put issue of the impact of alcohol advertising on children and the need for public health oriented policies on the media, public, and ultimately, policy agendas.

The Henry Horner Homes mothers created news when they filed their class action suit and held a news conference to announce it.

Linking to Breaking News

Every day, there are stories in the news to which advocates can link their issues. The Simpson murder trail provided a remarkable opportunity for domestic violence prevention advocates to "peg" their stories.

Sometimes breaking news can be anticipated. For example, tobacco control advocates around the country knew that the 25th anniversary of the US surgeon general's original report on Smoking and Health would generate substantial news coverage. A group in Vallejo, CA timed the release of its story on a sting operation that revealed sales of cigarettes to minors to coincide with the anniversary. A story about local youths conducting a sting operation may have been newsworthy on any day; however, pegged to a significant anniversary, it became front page news.

A national story with no local "hook" may get 10 to 30 seconds of air time, but with a local angle the story can be expanded to help advance the issue locally and nationally.

Several trauma surgeons in a violence prevention program in California routinely used breaking news about shootings to emphasize the role of handguns in homicide. After media advocacy training they view what used to be routine interviews with journalists as opportunities for advancing specific policies to reduce firearm deaths among youths.

Paid Media

The best way to maximize the chances that your message is presented the way you want it, when you want it, and to the audience you want to reach is by paying for the exposure.

The Health Care Reform Project, which favors employer-paid insurance, sought to purchase time for a television commercial in the Washington, DC area and placed full-page paid advertisements in the New York Times and other major newspapers. The ads pointed out that Pizza hut provided health insurance for their hourly employees in Japan and Germany but not for those in the United States. Pizza Hut was able to block airing of the ads on television but not he full-page newspaper ads. The controversy generated by the ads and their message resulted in a front-page New York Times story and other news coverage. The hoped-for result of the ad was to shame Pizza Hut and other large companies into being more responsive on the health care issue and counter their influence with Congress by exposing this hypocrisy.

Not all paid ads have to be enormously expensive. For example, radio can be a relatively inexpensive way to communicate with an individual organization. A spot during morning drive time urging the city council to support the community by voting for an ordinance limiting alcohol and tobacco billboards can effectively notify the council that the community is watching.

Not every media advocacy initiative will use every media strategy. Varied skill sand resources may predispose one group to paid advertising and another to creating news. However, media advocates must remain opportunistic, that is tuned to the news and ready to take advantage of situation as they unfold in the media, whichever combination of strategies they employ. At the same time, media advocates must maintain a certain vigilance against attracting media for media's sake. They can do this by linking every action to specific goals and objectives.


One of the most powerful tools that we possess to enhance participation, gain power, and expose the limits of our operating assumptions is the mass media. Media advocacy is a tool for shifting power back to the community by cultivating skills that can enhance and amplify the community's voice.

Media advocacy , however, is a tool and not a complete strategy. The use of media as an advocacy tool must be conceived and developed only in the context of other approaches such as community organizing, coalition building, and policy advocacy.

The precise power and effect of media advocacy will have to await more detailed evaluation studies. However, early experience seems to indicate that community groups can use media advocacy techniques effectively to gain access to the news media, frame public discussion around policy issues, and advance healthy public policies over time. Media advocacy can provide community groups with an independent voice to lend visibility, legitimacy and credibility to their concerns.

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