This model likens the effects of the mass media to a hypodermic syringe that has an immediate and direct effect on its audience. It assumes a passive audience which can be swayed by manipulative mass media. This view prompted the development of political broadcasts intended to shift voting intentions.

This view has since been replaced by an aerosol spray analogy:

This model suggests that mass communication influences key opinion leaders who are active members of the mass-media audience. These opinion leaders then spread ideas to other people through interpersonal means of communication (Katz & Lazarsfeld 1955). The process of diffusing innovation or new ideas through a population is based on the finding that the adoption of new behaviours typically follows an S-shaped trajectory (Rogers & Scott 1997). There is usually a slow initial uptake followed by rapid accep­tance, as opinion leaders or early adopters (who are usually from higher socioeconomic groups) communicate the benefits, and then a final slowing as a minority (who tend to be from isolated traditional communities) resist acceptance or change. This suggests that the mass media may be important in raising awareness and communicating basic information, but interpersonal sources, such as friends, peers and known ‘experts’, are most influential in persuading people to make changes.

This model tends to see the audience as more active in selecting and interpreting communications. It suggests that people use the media to meet their own needs, reinforcing existing beliefs or rejecting or reinterpreting communications that do not fit their existing values or beliefs.

This model sees the media as having a key role in creating beliefs and values about health, medicine, disease and illness. The ways in which these are presented, from the kindly doctor in soap operas, to news bulletins on miracle cures and high-tech interventions, all contribute to people’s understanding of health (see, for example, Lupton 1994). Many studies use discourse analysis to reveal the underlying values, concepts and messages implicit in media portrayals of health and ill health. For example, Joffe & Haarhoff (2002) analyse the ways in which diseases such as Ebola are presented as deadly uncontrollable viruses whilst simultaneously giving the message that such diseases pose little threat to the UK. Harrabin et al (2003) argue that public health is neglected in the media. Public health’s long timescale and basis in numerical data make it unattractive to the mass media. Instead, ‘shock horror’ stories of crisis within the National Health Service (NHS) or the appearance of rare diseases tend to dominate the news headlines.

Communication is concerned with the transmission of messages from a sender to a receiver. Messages are coded into signs and symbols which have meaning within specific codes. The message is encoded by the sender, and decoded by the receiver (Figure 12.2). The intention is that messages should be decoded and understood according to the intentions of the sender, but this can be problematic when using the mass media. This is because the mass media targets large audiences simultaneously, and, unlike direct personal communication, there is typically no feedback loop from the receiver back to the sender of the message. This means messages may be interpreted in ways that were not anticipated or intended by the sender. This is one reason why researching the target audience and piloting messages is an important stage in the planned use of the mass media for health promotion.

Figure 12.2 Media messages.

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