Summary: There has been a proliferation of digital sexual health interventions targeting adolescents; however, limited evaluative reviews have compared the effectiveness of multiple digital tools for sexual health literacy and behaviour change. This study conducted a systematic literature review, screened 9881 records and analysed 61 studies. Findings suggest that websites and mobile phones dominate digital sexual health interventions, with a majority effectively delivering cognitive (e.g. awareness and attitudes about sexual and reproductive health) and behavioural outcomes (e.g. abstinence and use of contraception). The most popular sexual health promotion mechanisms were interactive websites, text messaging and phone calls, and online education programmes, followed by mobile applications—fewer studies in this review utilized social media, games and multimedia. Previous reviews focused on single outcome measures (e.g. sexually transmitted infection testing) to assess interventions’ effectiveness. The current review moves beyond single outcome measures to cover a wider range of behavioural and non-behavioural sexual health issues and contexts covered in the literature. Four main categories were analysed as outcomes: cognitive perceptions, promoting sexual health-related behaviours, promoting sexual health-related products and services, and impact (viral load). Seventy-nine per cent of interventions focused on preventive sexual health behaviours and products (e.g. condoms) and services (e.g. HIV testing). Overall, 75% of studies effectively changed sexual health behaviour and cognitive perceptions. However, the digital-only tools did not vary from the blended formats, in influence outcomes, even after categorizing them into behavioural or non-behavioural outcomes. Compared to previous systematic reviews, more studies from the last decade used rigorous research design in the form of randomized controlled trials, non-randomized control trials, and quasi-experiments and lasted longer.

Background: Social media offers a cost-effective and wide-reaching advertising platform for marketers. Objectively testing the effectiveness of social media advertising remains difficult due to a lack of guiding frameworks and applicable behavioral measures. This study examines advertising appeals’ effectiveness in driving engagement and actions on and beyond social media platforms. Method: In an experiment, positive, negative and coactive ads were shared on social media and promoted for a week. The three ads were controlled in an A/B testing experiment to ensure applicable comparison. Measures used included impressions, likes, shares and clicks following the multi-actor social media engagement framework. Data were extracted using Facebook ads manager and website data. Significance was tested through a series of chi-square tests. Results: The promoted ads reached over 21,000 users. Significant effect was found for appeal type on engagement and behavioral actions. The findings support the use of negative advertising appeals over positive and coactive appeals. Conclusion: Practically, in the charity and environment context, advertisers aiming to drive engagement on social media as well as behavioral actions beyond social media should consider negative advertising appeals. Theoretically, this study demonstrates the value of using the multi-actor social media engagement framework to test advertising appeal effectiveness. Further, this study proposes an extension to evaluate behavioral outcomes.

Summary: Positive, negative and coactive appeals are used in advertising. The evidence base indicates mixed results making practitioner guidance on optimal advertising appeals difficult. This study aims to identify the most effective advertising appeals and it seeks to synthesize relevant literature up to August 2019. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses framework a total of 31 studies were identified and analyzed. Emotional appeals, theory utilization, materials, results and quality were examined. Across multiple contexts, results from this review found that positive appeals were more often effective than coactive and negative appeals. Most studies examined fear and humour appeals, reflecting a literature skew towards the two emotional appeals. The Effective Public Health Practice Project framework was applied to assess the quality of the studies and identified that there remains opportunity for improvement in research design of advertising studies. Only one-third of studies utilized theory, signalling the need for more theory testing and application in future research. Scholars should look at increasing methodological strength by drawing more representative samples, establishing strong study designs and valid data collection methods. In the meantime, advertisers are encouraged to employ and test more positive and coactive advertising appeals.

Background: The use of advertising to influence social behavior is one element of social marketing campaigns. While it is known that informational appeals are less effective in changing social perceptions and behaviors, the literature presents mixed and inconsistent results of which appeal (i.e. positive negative or both) is more effective in changing social behavior. The purpose of this study is to investigate the effectiveness of positive, negative and a combination of both appeals on young adults’ drink driving perceptions. Focus: This article is related to research and evaluation of the social marketing field. Research Question: Which, if any, of positive, negative or combination of both emotional appeals, is most effective in changing young adults’ drink driving attitudes, norms and intentions and how well do intentions explain behavior? Importance to the Field: The study builds on, and extends previous research exploring the effectiveness of emotional appeals, contributing to the literature by exploring both emotional appeals along the testing of each appeal separately. The research also validates the TRA’s utility beyond previously explored contexts. At a practical level, the research informs the work of advertising message design. It is recommended that, social marketers consider combined emotional appeals approach when designing messages. Methods: Respondents were randomly exposed to one of three emotional appeals (positive, negative or both) and asked to complete a questionnaire about their attitudes, norms and intentions to drink drive before and after exposure. Two analyses were used, Partial Least Squares Structural Equation Modeling to validate the Theory of Reasoned Action (TRA), and paired sample t-tests to assess change of perceptions over time between the three groups. Results: First the study found the TRA to have a strong predictive utility in explaining drink driving intentions. Second, the combination of both positive and negative emotional appeals was found more effective in changing drink driving attitudes, norms and intentions of young adults. Recommendations for Research or Practice: The study recommends that, social marketers consider combined emotional appeals approach when designing messages. However, further investigation is required to confirm this recommendation and as in any campaign, pre-testing the advertisements with the target audience is a must. Limitations: The key limitations of the study include the use of non-probability sampling, self-reported data, and varied exposure times. Future research should utilize autonomic measures to accurately assess perceptions and emotions as well as unifying the time of exposure for all emotional appeals.

Advertising appeals effectiveness has long been a point of debate in the literature. This study empirically tests hope and shame online advertisements aimed at enhancing donation quality to charities. Following a sequential research design the current research carries two studies to tests the effect of hope and shame appeal messages on social media on behavioral engagement measures, guided by the multi‐actor engagement framework. Findings indicate shame appeals framed as losses are more effective in driving engagement than hope gain framed messages. The overall findings provide supporting evidence for the interplay between negative emotions and message framing. To achieve higher engagement and trigger behavior change while utilizing budgets effectively, charities would benefit from utilizing loss framed and shame inducing advertising messages.

Background: The lack of trust in vaccines is a major contributor to vaccine hesitancy. To overcome vaccine hesitancy for the COVID-19 vaccine, the Australian government launched multiple public health campaigns to encourage vaccine uptake. This sentiment analysis examines the effect of public health campaigns and COVID-19–related events on sentiment and vaccine uptake. Objective: This study aims to examine the relationship between sentiment and COVID-19 vaccine uptake and government actions that impacted public sentiment about the vaccine. Methods: Using machine learning methods, we collected 137,523 publicly available English language tweets published in Australia between February and October 2021 that contained COVID-19 vaccine–related keywords. Machine learning methods were used to extract topics and sentiments relating to COVID-19 vaccination. The relationship between public vaccination sentiment on Twitter and vaccine uptake was examined. Results: The majority of collected tweets expressed negative (n=91,052, 66%) rather than positive (n=21,686, 16%) or neutral (n=24,785, 18%) sentiments. Topics discussed within the study time frame included the role of the government in the vaccination rollout, availability and accessibility of the vaccine, and vaccine efficacy. There was a significant positive correlation between negative sentiment and the number of vaccine doses administered daily (r267=.15, P<.05), with positive sentiment showing the inverse effect. Public health campaigns, lockdowns, and antivaccination protests were associated with increased negative sentiment, while vaccination mandates had no significant effect on sentiment. Conclusions: The study findings demonstrate that negative sentiment was more prevalent on Twitter during the Australian vaccination rollout but vaccine uptake remained high. Australians expressed anger at the slow rollout and limited availability of the vaccine during the study period. Public health campaigns, lockdowns, and antivaccination rallies increased negative sentiment. In contrast, news of increased vaccine availability for the public and government acquisition of more doses were key government actions that reduced negative sentiment. These findings can be used to inform government communication planning.