Formative Evaluation

Formative evaluation (also known as formative evaluation research or formative research), serves an important role in health campaigns and interventions designed to encourage, reinforce, and change behaviors. Formative evaluation occurs well in advance of a campaign. In fact, this type of research occurs prior to designing and disseminating health messages to the intended audience. Conducting formative research is imperative for health practitioners as it enables them to better understand their audience. Typically, formative evaluation is divided into two stages—preproduction research and pilot testing.

The objective behind preproduction research is to learn as much as possible about the intended audience. For most health campaigns the researchers and practitioners behind the campaign are not part of the intended audience. In many cases, the beliefs and attitudes toward the advocated behavior vary considerably between health practitioners and the target audience. Theory plays a pivotal role during preproduction research. Theories are road maps that show how certain variables are interconnected in explaining which variables are effective at predicting attitudes, behavioral intentions, and behaviors. In essence, theory is instructive in that it informs researchers about what questions to ask of the target audience.

Theories such as the activation model of information exposure, diffusion theory, the extended parallel process model, the health belief model, psychological reactance theory, the theory of normative social behavior, the theory of planned behavior, and the transtheoretical model outline key variables for campaigners to ask of their intended audience. For instance, the health belief model identifies six key constructs (barriers, benefits, cues to action, self-efficacy, severity, and susceptibility) for health practitioners to ask of their intended audience to gain a greater understanding of the audience's understanding of the health behaviors to be promoted. In short, theories play a pivotal role in instructing health campaigners with respect to what questions they should ask the intended audience before designing their campaign materials.

In addition to identifying key questions to ask of the intended audience, theories often articulate how these variables influence behavior. For instance, the extended parallel process model informs health practitioners about how to design a fear-appeal message. According to the model, a fear-appeal message should communicate the health threat (severity and susceptibility) and the recommended response (self-efficacy and response-efficacy) in order to produce favorable beliefs, attitudes, and intentions toward the advocacy. The model warns against campaigns communicating the seriousness and vulnerability of the health threat without also addressing the recommended response, as this approach can result in a number of maladaptive outcomes including, but not limited to, defensive avoidance, denial, message and source derogation, and psychological reactance, which in turn can result in unfavorable attitudes and intentions toward the advocacy. In the end, preproduction research enables health campaigners to better understand the various beliefs and influences held by the intended audience. This understanding is necessary prior to designing effective campaign messages that are relevant and sensitive to the target audience.

Identifying key message features is important for health campaigners during preproduction research but it is equally important to identify the best outlets to disseminate health messages. Choosing among various print outlets (brochures, billboards, magazines, newspapers, and posters), radio stations, television networks, and social media sites, among others, are important decisions for health practitioners. After all, messages can be consistent with the needs and wants of the target audience, but if they never reach the target audience then they will not be effective. The only way to ensure that health campaigners can select the correct outlets in which to place their messages is to recruit a representative sample from the target audience to learn where audience members go for information and entertainment. With this knowledge, practitioners know where to disseminate their campaign messages.

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