What is the activity?
Small media are written and printed resources usually intended to be taken away by members of the target audience. They include text-based interventions such as magazines, newsletters, booklets, leaﬂets, posters or cards which come in a variety of shapes and sizes with include variable amounts of text. In printed formats, they are usually made available, or actively distributed to MSM in social or service settings. Alternatively, newsletters or magazines are sometimes mailed (or emailed) directly to users on a mailing list. They can also be delivered as digital media, to smart phones, tablets and similar devices.
There is some overlap between small media and mass media, which becomes apparent when considering how the setting can change the intervention. For example, health promotion information displayed on a sauna locker or in a bar may be called a ‘poster’ and considered small media, but an identical product in the gay press is usally called a mass media ‘advert’. Similarly a magazine may be considered small media until it is delivered electronically to smart phones, tablets and similar devices, when it becomes digital media.
Strengths and limitations
Leaﬂets and other small media help to ensure that a comprehensive source of information on a topic exists. As a part of a HIV prevention programme, different types of small media can draw service users from initial interest (perhaps through a poster), to picking up a leaﬂet (which enables them to gain more detailed information), to making a decision to seek further interventions, and perhaps ultimately to alter their behaviour.
Written interventions cannot be expected to meet complex social needs or address interpersonal problems. Instead, they are best used to convey information, and to raise awareness. In addition, small media can offer information about organisations and their services, thereby promoting access to other interventions.
Where does it happen?
Detailed information on the settings for distributing small media are described in static distribution and interactive distribution. Small media interventions may be encountered in generic or MSM-speciﬁc public or private settings. The choice of setting for the placement or display of written interventions will be inﬂuenced by the appropriateness of the content to the setting.
Challenging or complex content needs careful placement consideration, as some may feel exposed or stereotyped by targeted material placed in a very public environments, for example, if the material is sexually explicit or identifies the recipient as homosexually active. In this way, consideration of the potential settings can inﬂuence small media development, just as the content of small media may inﬂuence the selection of locations for distribution.
Frequently delivered alongside ...
Issues to consider
Less can be more in terms of volume of text. Only the ﬁrst eight words of a headline usually get read. Sentences should never be more than thirteen words long. Posters should only seek to make one point.
The production of high-quality, well evidenced written resources is relatively costly, although the cost per unit delivered to an end user can be relatively low. With this in mind, smaller agencies may choose to distribute writtem interventions produced by others rather than devoting their own resources to development and production. Partnership-working enables the collaborative production of small media resources between agencies. Micro-printing technologies also allow, for some pages of local contact details in a national resource, while still undertaking a large print-run.
‘Support media’ can help to draw service users into conversation with those distributing small media. These items might include pens, stickers, button badges, key-rings, sweets etc. carrying a campaign’s key message and perhaps some contact details. Front-line staff ﬁnd that such items can be vital as icebreakers for verbal interactions, or a useful tool to close a conversation during outreach or detached work.
Complex messages often take time to assimilate, and as a result, may be more suitable to portable (leaﬂet) rather than ﬁxed (poster) formats, so that they can be kept and read more than once.
Small media development must be carefully managed, from the creation of aims, the collection of relevant evidence, to the publication of the ﬁnal product. ‘Mission drift’ is most likely where clear lines of responsibility are lacking, and where external agencies hired to deliver design services are allowed to take control of the health promotion content.
Small media interventions can be designed and delivered to almost any target group. Making the target group clear and obvious - such as on the front cover of a leaflet - is important. As such, all HIV prevention interventions should ensure that they are inoffensive to people with diagnosed HIV, even in materials intended for those who have never tested. Similar attention should be paid to matters of gender, age, ethnic and national identity, sexuality, and educational background. It is important to account for differences in values and personal priorities among those who may come across these written resources.
Peer review and pre-testing campaign ideas and text in the development stage is essential in order to ensure that the aim and the content are uniﬁed, that the essential information is clear, and that the design ideas are acceptable and attractive to readers.
In some instances it might be appropriate to translate small media into other languages for a particular target sub-population. Care should be taken with translations - especially if a translation agency is used - to ensure that sutulties and euphemisms are correctly translated. In some instances, clever 'plays on words' in one language become meaningless or confusing when translated into other languages. Peer review or pre-testing with the target audience should always be included.
Aims and outcomes
The aims and likely outcomes associated with small media interventions are primarily knowledge-based. The list below offers some examples of the aims and outcomes associated with small media interventions, but is not exhaustive.
- Increased understanding that different sexual activities carry differing risks of HIV transmission (see associated choices such as avoiding anal intercourse or using condoms for anal intercourse and aims such as knowing the risks associated with anal intercourse and the benefits of condom use).
- Increased uptake of STI screening and HIV testing (see associated choice and potential aims associated with HIV testing knowledge; STI knowledge; testing opportunities and the skills required).
- Increased understanding of the prevalence of, and problems associated with, undiagnosed HIV infection.
- Increased understanding of the benefits of condom use for anal intercourse (see associated choice regarding condoms for anal intercourse and aims such as knowing the benefits of condom use and having the resources and opportunities to access them and the skills to appropriately use them).
- Increased understanding of the alternatives to risky behaviour (see associated choices such as avoiding anal intercourse or using condoms for anal intercourse and aims such as knowing the risks associated with anal intercourse and the benefits of condom use).
- Increased understanding of means of HIV risk reduction when unprotected anal intercourse does occur (see associated choices such as withdrawal before ejaculation and the knowledge and skills required).
- Increased requests for (and uptake of) PEP following sexual exposure to HIV (see associated choice and the potential aims associated with PEP knowledge, opportunities and skills).
Monitoring and evaluation
A key element of monitoring the production of small media interventions is ensuring that an archive of interventions at various phases of their development is kept for future reference. This allows agencies, partners and researchers to trace the history of small media production.
During various phases of small media development, the ideas, design and language used in the intervention should be pre-tested with people in the target population. This helps agencies to determine if the meaning they intend to convey is clear and unambiguous. Pre-testing can be undertaken as short cognitive interviews with individuals or in focus group settings - comprised of members of the target audience with no professional or personal connection to those developing the intervention. Similarly, focus groups among those in the designated user group can be undertaken after an intervention has run, in order to assess the acceptability of small media interventions, and in order to improve future interventions. Peer review at all phases of design is also likely to be beneﬁcial.
The extent to which small media have reached those in speciﬁc settings or geographical areas can be assessed by coverage surveys, where individuals are asked if they recall seeing a particular item. Coverage questions can be included in broader surveys, which reduces costs, and also facilitates statistical analysis that includes other demographics, leading to a greater understanding about which sub-groups of MSM are most (and least) likely to have seen the intervention.
In terms of outcomes and impact, very little priority is given to evaluation of small media interventions, though there has been end user evaluation of much of the CHAPS small media interventions over the last decade.
Page last updated: 17 June 2013
GMFA's FS magazine provides bi-monthly written information and advice on HIV and sexual health to gay men across England. Originating as a London-only resource, funding from the CHAPS programme expanded FS distribution to five other areas. Six regional editions are tailored to each geographical area. Specific content and local service promotion information is featured in each regional edition, alongside national HIV prevention campaigns. Developing regional editions around a ‘national template’ reduces overall costs and increases equity of access to information, whilst maintaining a regional ‘flavour’ to each edition. FS is also available on GMFA’s website and, in a new development, as a downloadable smartphone app.
Cruising booklet with Police Service
The Eddystone Trust partnered with the local Police Service and the Intercom Trust to produce a booklet to increase men’s awareness of the law and promote safety whilse cruising. The booklet aims to increase reporting of homophobia, including through independent support services, as well as promoting sexual health and giving tips on safer cruising. The booklet is widely distributed through cruising areas, gay venues, the police service and LGBT groups and associations. This development process fostered dialogue between the police and LGBT groups and lead to revisions of local guidance on policing public sex environments. It also improved trust between local communities and the police.
Outreach support materials
Outreach support materials (‘knick knacks’) have been central to CHAPS national campaigns for the last decade. They facilitate face-to-face interventions between workers and men and are highly valued by outreach staff as an aid to their work. Knick knacks typically cost around 50p - £1 per unit, and carry the core campaign message (and website address). Evaluation shows they work best when they are high quality, with a practical use and relate to the campaign topic. They also aid in targeting sub-populations: button badges and lip balm were chosen to increase younger men’s engagement with a recent condom campaign as previous experience showed these had particular appeal with this group.