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Health Education Research Advance Access originally published online on May 20, 2004
Health Education Research 2004 19(6):698-706; doi:10.1093/her/cyg090
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Health Education Research Vol.19 no.6, © Oxford University Press 2004; All rights reserved

A cost-effective approach to the development of printed materials: a randomized controlled trial of three strategies

C. L. Paul1,4, S. Redman2 and R. W. Sanson-Fisher3

1 Centre for Health Research & Psych-oncology, Newcastle, NSW 2287, 2 National Breast Cancer Centre, Kings Cross, NSW 2011 and 3 Faculty of Health, University of Newcastle, Callaghan, NSW 2308, Australia

4 Correspondence to: C. Paul; E-mail: chris.paul{at}newcastle.edu.au

Printed materials have been a primary mode of communication in public health education. Three major approaches to the development of these materials—the application of characteristics identified in the literature, behavioral strategies and marketing strategies—have major implications for both the effectiveness and cost of materials. However, little attention has been directed towards the cost-effectiveness of such approaches. In the present study, three pamphlets were developed using successive addition of each approach: first literature characteristics only (‘C’ pamphlet), then behavioral strategies (‘C + B’ pamphlet) and then marketing strategies (‘C + B + M’ pamphlet). Each pamphlet encouraged women to join a Pap Test Reminder Service (PTRS). Each pamphlet was mailed to a randomly selected sample of 2700 women aged 50–69 years. Registrations with the PTRS were monitored and 420 women in each pamphlet group were surveyed by telephone. It was reported that the ‘C + B’ and ‘C + B + M’ pamphlets were significantly more effective than the ‘C’ pamphlet. The ‘C + B’ pamphlet was the most cost-effective of the three pamphlets. There were no significant differences between any of the pamphlet groups on acceptability, knowledge or attitudes. It was suggested that the inclusion of behavioral strategies is likely to be a cost-effective approach to the development of printed health education materials.


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