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Introduction: A systematic literature review examined the published evidence on the effectiveness of European promotional communications for national immunisation schedule (NIS) vaccinations. The review was commissioned by the European Centre for Disease Prevention and Control (ECDC) and conducted by the Institute for Social Marketing at the University of Stirling.The purpose of the review: ‘Immunisation hesitancy' has negatively impacted population uptake of routine immunisation. A substantial body of evaluated communication activity promoting nationally indicated routine immunisation has been published. This systematic review of the evidence aims to: collate and map the types of promotional communication that have been used; assess the quality of the evaluative research reporting on these promotional communications; and assess the applicability of this evidence to immunisation policy, strategy and practice priorities. The analysis and findings are intended to provide a current status report on the evidence, and evidence gaps for good practice in national immunisation promotional communications, thus supporting countries in their communication activities for the prevention and control of communicable diseases.Objectives of the review: The review aimed to answer the following research questions: Which audiences have been targeted by NIS promotional communications? Which communication methods and approaches have been used to promote or reinforce NIS vaccination uptake? What theoretical underpinnings are used to inform communication methods and approaches? Which settings and communication channels have been used to promote or reinforce NIS vaccination uptake? What is the evidence for effectiveness of communication initiatives in changing or reinforcing knowledge, attitudes or behaviour towards NIS? What is the evidence for impact of NIS communication initiatives to control communicable disease? What impact have campaign communications promoting NIS had on public acceptance and vaccine uptake rates?

Executive Summary: A literature review of trust and reputation management by and for public health organisations involved in communicable disease control was conducted by the Institute for Social Marketing. The Institute is a joint research initiative of the University of Stirling and the Open University in the UK. The review examined the international English-language literature published during the period 2005-2010, drawn from a range of communication sub-disciplines. A glossary of the sub-disciplines is provided in the appendix. The evidence base was found to be in an emergent phase and is therefore somewhat limited, although largely consistent. Elements of good practice identified included the need for long-term and proactive planning of trust and reputation management; strong media relations skills; proactive relationship building with key stakeholders; integration with technical disease prevention and control functions; and enhanced commitment to transparency and two-way dialogues. A focus on crisis communication, mass (undifferentiated) communication and communication to support technical functions was apparent in the literature. A limited understanding of the role and nature of risk communication; the benefits of adopting a strategic, rather than reactive approach to trust and reputation management and the potential benefits of full integration with immediate and long-term public health goals was also apparent. Recommendations for future research and development of good practice are evaluations specifically focused on the impact of public health activities on trust and reputation; adopting a strategic approach to trust and reputation planning which coordinates the full range of communication functions and objectives; plus organisational capacity building in communication functions such as risk communication, environmental scanning and mass media relations.

Background: This review examined evidence for school and family linked alcohol education programmes to reduce or prevent the misuse of alcohol by young people. The review aimed to identify critical programme or contextual elements positively associated with evidence of effectiveness. The review paid particular attention to, but was not confined to programmes that included social norms education and/or life skills training and/or the Good Behaviour Game and/or peer-to-peer delivery components. The review was conducted by the Institute for Social Marketing, a joint initiative of the University of Stirling and the Open University. It was commissioned by the Alcohol Education and Research Council (AERC) on behalf of the Drinkaware Trust (DAT) who provided the funding. The original stated purpose of the study was 'to collate evidence that would help to inform how best DAT could approach and be involved in school-based alcohol education across the UK'. Methods: Systematic literature search methods were used, along with a combined quality appraisal and evidence weighting assessment to identify 'promising' interventions. Promising interventions were defined as any intervention where study design was assessed as sound. Weight of evidence for aggregated evaluation results for each intervention was classified as equivocal or convincing. Any intervention reporting adverse effects on substance misuse was excluded. After all relevance and quality screening was completed, the review identified 39 studies collectively reporting on 25 interventions. The results were analysed thematically and with reference to pre-specified research questions. Findings: - The most effective social norms interventions targeted peer alcohol use. Social norm change objectives in both school-based and family components were common and associated with effectiveness. Most of the evidence of effectiveness was derived from mass marketed (not personalised) social norms and did not appear to be informed by dedicated formative research. - Life Skills Training (LST) was also a popular approach, often combined with approaches intended to strengthen protective family factors. Most of the evidence derived from the USA, so cultural transferability remains unclear and requires further piloting. - There was evidence that peer-to-peer delivery is more effective when combined with peer driven planning and other techniques aimed at deeper engagement with target audiences and genuine participatory change. - Reducing environmental availability of alcohol to young people as well as community tolerance of young people's consumption of alcohol appears to enhance the effectiveness of school and family linked alcohol education programmes. - The evidence indicates that a range of education approaches and delivery methods can make a small positive contribution to harm reduction, but there are many examples of interventions which are ineffective or harmful. - Neither knowledge and attitude change, nor acceptability of an intervention is predictive of positive behaviour change. - Involving external specialists can enhance acceptability and effectiveness, but is not critical to effectiveness. - Interventions perceived by target audiences as personally relevant achieve higher retention rates and are more effective than interventions that do not resonate with day to day concerns and circumstances of target audiences. - There is evidence that programme effects, can be sustained up to six years after intervention completion. However, for most interventions positive effects decline fairly rapidly over time and therefore some type(s) of reinforcement intervention are required to maintain positive effects. - Short duration, low-involvement interventions can achieve similar short-term effects to more intensive and longer term interventions. - Most combined family and school‐based interventions appear to lack a holistic perspective or any explanation for how the two components integrated and/or complemented one another within the overall programme design and its aims. Strategic Implications and Recommendations: Combined school and family based alcohol education interventions will be most effective when integrated with broader based environmental interventions. Integration with community interventions can also help to build community ownership and improve intervention acceptability. Explicit linkage of educational interventions with environmental intervention is therefore recommended. Clear conceptual rationale for both the individual content and the integration of school and family components may strengthen efficacy and cost effectiveness. Research in the future on which elements are best delivered via school and which via family programme components would be helpful to future programme design and planning. An overarching strategy grounded in a theoretical model with clear goals and rationale will help guide consistency of messages, priorities and credibility of intervention agents and harm reduction/prevention objectives. This may be especially critical if multiple programmes and target audiences are supported by an intervention organisation. Bottom up/participatory planning and delivery of current practice could be strengthened significantly and the use of specialists in participatory research, development and evaluation are recommended. Consistent, systematic and pre-planned evaluation of future interventions would make a valuable contribution to the scientific evidence base and development of better practice and is therefore recommended. Restricting funding of all future intervention proposals to those which provide a detailed (including dedicated budget) evaluation plan would help to generate reliable and credible practice based evidence. Research into the cost-effectiveness and efficacy of a planned series of short duration, age appropriate interventions would be a useful contribution to the evidence base and development of better practice. Behaviour change must be the definitive measure of effectiveness. It is recommended that scaling up investment should be restricted to approaches and methods that have previously demonstrated measurable (albeit probably small) reductions in alcohol use/misuse, and report comprehensive implementation details.

This document reviews evidence to December 2008 on the global extent and nature of food promotion to children, and its effects on their food knowledge, preferences, behaviour and diet related health outcomes. The review was commissioned by the World Health Organization (WHO) and updates a systematic review of the evidence conducted on behalf of WHO in 2006. Studies examining the extent and nature of food promotion to children consistently conclude that food promotion is the most prevalent marketing category targeting children and young people. Content analysis research finds that the majority of foods and food products promoted are energy dense, high fat, sugar and/or high salt, and in sharp contrast to national and international dietary guidelines. Sugar-sweetened breakfast cereals, soft-drinks, confectionary and savoury snacks are the most frequently advertised categories, with fast-food promotion continuing to gain marketing share. Promotion of unprocessed foods, such as fruit and vegetables, wholegrain and milk is found to be almost zero.