The impact of mass media advertising on a voluntary sterilization program in Brazil.

ABSTRACT

PIP: A simple before-and-after time-series analysis was employed to study the effect of magazine advertising on vasectomy acceptance in Sao Paulo, Brazil. The study design used the single Pro-Pater Sao Paulo clinic and a single intervention, i.e., the mass media promotional campaign. Service statistics for the years 1984-85 provided the baseline; clinic performance was continuously monitored during the intervention and for a 12-month postintervention period. The formal campaign was initiated during September 1985. 4 advertisements ran for 10 weeks in 8 magazines. By the end of the study, the patient file included 3403 records for the baseline period, 1475 records for the campaign, and 5388 records for the post-campaign period. The telephone calls file contained 4393 records and the letters file 386 records. A clear impact of the advertising campaign was demonstrated, both in terms of total number of telephone calls received and in terms of referral source. The advertisements generated 32% of all telephone calls received, 47% of calls received during the campaign itself, and 9-10% of the calls received in the 2nd half of the post-campaign year. As referrals by advertisements dropped off, they were replaced in part by increased referrals from traditional sources, providing the 1st evidence of a "multiplier effect." Magazine referrals were significantly less likely to schedule an intake interview than were callers referred by traditional sources -- 51% versus 78%. Clinic performance was positively and significantly affected by the advertising campaign. The mean daily number of new clients doubled during the campaign as compared to the baseline period and remained 60% higher in the post-campaign period. The mean daily number of vasectomies performed increased 76% from the baseline to the campaign period and stabilized at a level 54% higher than baseline during the post-campaign period. 18% of the new clients arriving during the campaign reporting having seen a magazine advertisement; this figure was 4 of the new clients in the post-campaign period. New clients referred by the campaign were, on the average, 1 year older than those referred by traditional sources. Number of living children did not vary by period. The mean educational level rose slightly during the campaign, after which it returned to baseline levels. The cost of the advertising campaign was offset by the additional revenue gained from the increase in vasectomies performed. In sum, the study findings support the conclusion that mass media that mass media advertising as an effective and cost-effective means to increase the demand for vasectomy services in Sao Paulo, Brazil.