Grilli R, Freemantle N, Minozzi S, Domenighetti G, Finer D
Agenzia per i Servizi Sanitari Regionali, ASSR, Piazza Gugliemo Marconi 24, Rome, Italy, 00144.
Cochrane Database Syst Rev. 2000(2):CD000389. doi: 10.1002/14651858.CD000389.
The mass media frequently cover health related topics, are the leading source of information about important health issues, and are targeted by those who aim to influence the behaviour of health professionals and patients.
To assess the effects of mass media on the utilisation of health services.
We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE, EMBASE, Eric, PsycLit, and reference lists of articles. We hand searched the journals Communication Research (February 1987 to August 1996), European Journal of Communication (1986 to 1994), Journal of Communication (winter 1986 to summer 1996), Communication Theory (February 1991 to August 1996), Critical Studies in Mass Communication (March 1984 to March 1995) and Journalism Quarterly (1986 to summer 1996).
Randomised trials, controlled clinical trials, controlled before-and-after studies and interrupted time series analyses of mass media interventions. The participants were health care professionals, patients and the general public.
Two reviewers independently extracted data and assessed study quality.
Seventeen studies were included. All used interrupted time series designs. Fourteen evaluated the impact of formal mass media campaigns, and three of media coverage of health related issues. The overall methodological quality was variable. Six studies did not perform any statistical analysis, and seven used inappropriate statistical tests (ie not taking into account the effect of time trend). All of the studies apart from one concluded that mass media was effective. These positive findings were confirmed by our re-analysis in seven studies. The direction of effect was consistent across studies towards the expected change. The pooled effect sizes for studies assessing the impact of mass media on similar aspects of care revealed an effect upon the utilisation of health services that could not be explained by chance alone, ranging from -1.96 (95%CI -1. 19 to -2.73) for campaigns promoting immunisation programmes, to -1. 12 (95%CI -0.49 to -2.36) for those concerning cancer screening.
REVIEWER'S CONCLUSIONS: Despite the limited information about key aspects of mass media interventions and the poor quality of the available primary research, there is evidence that these channels of communication may have an important role in influencing the use of health care interventions. Those engaged in promoting better uptake of research information in clinical practice should consider mass media as one of the tools that may encourage the use of effective services and discourage those of unproven effectiveness.
大众媒体经常报道与健康相关的话题，是重要健康问题信息的主要来源，并且是那些旨在影响卫生专业人员和患者行为的人所针对的目标。
评估大众媒体对卫生服务利用的影响。
我们检索了Cochrane有效实践与护理组织小组的专业注册库、MEDLINE、EMBASE、Eric、PsycLit以及文章的参考文献列表。我们手工检索了《传播研究》（1987年2月至1996年8月）、《欧洲传播杂志》（1986年至1994年）、《传播杂志》（1986年冬季至1996年夏季）、《传播理论》（1991年2月至1996年8月）、《大众传播批判研究》（1984年3月至1995年3月）和《新闻季刊》（1986年至1996年夏季）等期刊。
大众媒体干预的随机试验、对照临床试验、前后对照研究和中断时间序列分析。参与者为卫生保健专业人员、患者和普通公众。
两名评价者独立提取数据并评估研究质量。
纳入了17项研究。所有研究均采用中断时间序列设计。14项研究评估了正式大众媒体宣传活动的影响，3项研究评估了与健康相关问题的媒体报道的影响。总体方法学质量参差不齐。6项研究未进行任何统计分析，7项研究使用了不适当的统计检验（即未考虑时间趋势的影响）。除一项研究外，所有研究均得出大众媒体有效的结论。我们在7项研究中的重新分析证实了这些积极的发现。各项研究的效应方向均与预期变化一致。评估大众媒体对护理类似方面影响的研究的合并效应大小显示，对卫生服务利用有影响，且不能仅用偶然性来解释，促进免疫计划的宣传活动的效应大小为-1.96（95%置信区间-1.19至-2.73），关于癌症筛查宣传活动的效应大小为-1.12（95%置信区间-0.49至-2.36）。
尽管关于大众媒体干预关键方面的信息有限，且现有原始研究质量较差，但有证据表明，这些传播渠道可能在影响卫生保健干预措施的使用方面发挥重要作用。那些致力于在临床实践中促进更好地吸收研究信息的人应将大众媒体视为可能鼓励使用有效服务并劝阻使用未经证实有效的服务的工具之一。
