We were recently challenged to address a seemingly simple question. However, as with most questions worth asking, the seeming simplicity is deceptive. Here’s the question and how we addressed it.

Is “positive” advertising better than “negative” advertising?

To answer this question, we have to consider a number of variables, including domain, audience, focus and purpose.

Domain: Negative advertising has been shown to be effective in the political domain, but we are interested in the public health/health promotion domain. So our question needs to be modified:

Is “positive” advertising better than “negative” advertising in the public health/health promotion domain?

Audience: We are also interested in a specific audience: late teens to mid-twenties (college age). Negative advertising in the public health domain can be effective with audiences that feel particularly vulnerable to a negative outcome. However, one of the characteristics of the late teens to mid-twenties time of life is a sense of invulnerability, a tendency to the optimistic point of view that – despite what may be generally true – nothing bad will happen to you or your friends. Negative advertising is less effective with audiences that do not feel personal vulnerability for a bad outcome. Our question therefore needs to be modified further:

Is “positive” advertising better than “negative” advertising in the public health/health promotion domain for a college age audience?

Focus: In public health, preventive interventions are often characterized as universal, selective or indicated (corresponding roughly to the older public health division of prevention into primary, secondary and tertiary). Universal, as the name suggests, focuses on a total population (e.g., all college age youth) regardless of risk or vulnerability; selective focuses on individuals or groups at higher risk (e.g., in a college setting, first semester freshmen, members of social fraternities, varsity athletes); indicated prevention is typically one-on-one interventions (e.g., BASICS) with individuals who have already demonstrated illness or sustained negative consequences. Public health advertising is a universal intervention.

So we have yet another modification:

Is “positive” advertising better than “negative” advertising in the public health/health promotion domain for a college age audience, as a universal prevention technique?

Purpose: Finally, we have to consider purpose. We can pose a simple question: Is our purpose to create a memorable ad or is our purpose to change behavior? Too often, public health/health promotion focuses on the short-term goal of memorability rather than the true goal of behavior change. In application to alcohol consumption, the desired behavior change is a change from risky drinking practices to safe drinking practices.

We now have a very specific question:

Is “positive” advertising better than “negative” advertising in the public health/health promotion domain for a college age audience, as a universal prevention technique to promote safe drinking practices?

Although we were unable to find a well-done research study that directly compares the effectiveness of positive versus negative advertising in the full context of interest, the available evidence suggests that positive advertising, partly because it is more similar to alcohol use advertising, is the more effective approach.

The findings and conclusions from a recent content analysis study of “anti-alcohol” advertisements generated by high school and college students are instructive.

Banerjee, S. C., Greene, K., Hecht, M. L., Magsamen-Conrad, K., & Elek, E. (2013). “Drinking Won’t Get You Thinking”: A Content Analysis of Adolescent-Created Print Alcohol Counter-advertisementsHealth communication28(7), 671-682.

Abstract: Involvement in creating antialcohol advertisements generates enthusiasm among adolescents; however, little is known about the messages adolescents develop for these activities. In this article, we present a content analysis of 72 print alcohol counteradvertisements created by high school (age 14–17 years old) and college (18–25 years old) students. The posters were content analyzed for poster message content, persuasion strategies, and production components, and we compared high school and college student posters. All of the posters used a slogan to highlight the main point/message of the ad and counterarguments/consequences to support the slogans. The most frequently depicted consequences were negative consequences of alcohol use, followed by negative–positive consequence comparison. Persuasion strategies were sparingly used in advertisements and included having fun/one of the gang, humor/unexpected, glamour/sex appeal, and endorsement. Finally, posters displayed a number of production techniques including depicting people, clear setting, multiple colors, different font sizes, and object placement. College and high school student-constructed posters were similar on many features (e.g., posters displayed similar frequency of utilization of slogans, negative consequences, and positive–negative consequence comparisons), but were different on the use of positive consequences of not using alcohol and before–after comparisons. Implications for teaching media literacy and involving adolescents and youth in developing alcohol prevention messages are discussed.

The following quotes are from the Discussion and Conclusions (emphasis added):

[There is a need for] …social modeling appeals that emphasize portrayal of desirable behavior to provide positive reinforcement for the viewer (Slater, 1999). Hecht and Miller-Day (2009) also found that positive images of youths refusing drugs are central to prevention messages in the keepin’ it REAL curriculum (Hecht & Miller-Day, 2009). … Research indicates that adolescents want to be listened to, not talked at, and that simple, honest messages work better than complex, misleading messages (e.g., Schiff, 2007). Involving adolescents in counter-ad campaigns to generate messages that resonate well with similar-aged adolescents may work as the foundation for effective strategies for preventing underage alcohol use (see Greene, 2013). Media literacy provides a useful venue for engaging adolescents and young adults in critical examination of persuasive alcohol advertising and in creation of alcohol counteradvertisements. Finally, using similar persuasion and production strategies as used in alcohol advertisements can help increase the appeal of alcohol counteradvertisements (Austin et al., 1999) and should be examined in audiovisual advertisements as well. Prior research on tobacco counteradvertising (American Legacy Foundation’s “Truth” PRINT ALCOHOL COUNTERADVERTISEMENTS 681 campaign) indicates effectiveness for reducing smoking initiation (Apollonio & Malone, 2009). A similar counteradvertising campaign for alcohol reduction is needed and may serve to counter harmful health messages promoted by media.

From our investigations, the answer seems to be “probably yes” for the question as we eventually framed it. However, the purpose of this post is not so much to provide an answer as to provide some insight into how to think about questions of technique in prevention work.