Harnessing insights to effectively change behaviour: The collective impact of our cancer screening and prevention behaviour change campaigns

Overview

Behaviour change campaigns are a known cost-effective long-term strategy in the overall control of cancer¹. As the state’s dedicated cancer control organisation, the Cancer Institute NSW (the Institute) collaborates with, and educates the community on how forming healthier habits and participating in cancer screening today can reduce the risk of developing cancer in the future.

In addition to evidence reviews and analysis, we conduct extensive research and community engagement to inform, develop and implement a range of behaviour change campaigns across key areas of cancer prevention and screening. We use evidence to identify the focus audiences with the greatest need, understand their behaviour, develop the most effective behaviour change messages and discover how to reach them.

Over the 22-23 and 23-24 financial years, the Institute launched or repeated 10 behaviour change campaigns:

• Anti-vaping - 'Every Vape is a Hit to Your Health’ (23-24) and ‘Do You Know What You’re Vaping?’ (22-23)  
• Anti-tobacco – ‘New Year, New You’ (‘24), ‘Beat the Cravings’ (22-23 and 23-24), ‘Quitting Smoking in Pregnancy’ (22-23) and ‘16 Cancers’ (repeated in 23-24)
• Breast cancer screening - ‘Breast Cancer Doesn’t Wait’ (2023-24),  
• Bowel cancer screening – ‘Do the Test’ [bowel cancer] (22-23)
• Skin cancer prevention – ‘If You Could See UV’ (23-24) and ‘Change Your Routine’ (22-23)

Health professionals can access the resources as they need them, enabling them to tailor their learning to their professional needs.
 

Evaluation methodology

In planning a behaviour change campaign, developmental research, media analysis and pre-testing is essential to ensure the campaign is best placed to meet objectives. During this time, we work with focus audiences to understand the barriers and motivators of their behaviour, as well as the best ways to reach them. We ensure that these insights are captured from NSW’s diverse and multifaceted communities, including Aboriginal people and culturally and linguistically diverse groups.
 

Between 2022 and 2024, our behaviour change campaigns were translated into up to six languages, with supporting assets (e.g. website and brochures) translated in up to 27 different languages. A number of our campaigns were designed to specifically address the needs of Aboriginal communities.

A tailored evaluation methodology is used for each campaign to ensure the key objectives are achieved, including influencing positive behaviour change. Our evaluations mostly utilise online tracking surveys to evaluate effectiveness, with additional qualitative research undertaken, particularly with focus populations. Additional evaluation methods include media tracking and analysis and behaviour change measures such as website visits and bookings.

Key findings

Cost benefit analysis

Modelling of behaviour change campaigns led by the Institute from 2022-24 estimates a total saving for NSW of over 200 million dollars.

This value is calculated by looking at expected participation increases across screening programs, as well as estimated positive behaviour changes (such as increasing sun protection or reducing use or uptake of smoking or e-cigarettes). This in turn contributes to reductions in incidence of cancer, reduced mortality associated with earlier diagnosis of cancers and lower medical costs due to cancers being detected and treated at an earlier stage.

As a result of our 23-24 tobacco control campaign, it was estimated that 19,039 people aged 16 years and over tried to quit smoking and 3,280 life years could be saved, with a cost saving of $98.5 million for NSW.

The 23-24 ‘If You Could See UV’ campaign was estimated to prevent 2,345 skin cancers in NSW, which equates to a cost-saving of $20.2 million for NSW.

Campaign recognition

Measuring recognition helps us ensure we are reaching our target audiences. All campaigns evaluated met or exceeded expectations for recognition.

The ‘Every vape is a hit to your health’ campaign achieved 64% prompted recognition for the full campaign, far surpassing the target of 45%. This demonstrates wide reach and cut through with this often ‘hard to reach’ young target audience. 83% of Aboriginal and Torres Strait Islander respondents aged 14-24 recognised at least one asset of the campaign.

More 18–24-year-olds in NSW (target audience) recognised the ‘If You Could see UV’ campaign than expected (55% against a target of 45%), peaking at 69% during the campaign period. Overall, the campaign reached a higher number of the target audience than expected, with nearly all media targets met and exceeded.

“First, a letter in the mail from the NSW Government encouraging me to book in for a mammogram, now this ad in my newsfeed. My Grandmother passed away from breast cancer, having battled it for many years. Maybe the universe is trying to tell me something.”

Vanessa – Facebook, ‘Breast Cancer Doesn’t Wait’ campaign, September 2022

 

Recall of campaign messages

It’s imperative that our focus audiences not only see our campaigns, but that the messages are memorable to them.

61% of ‘Breast cancer doesn’t wait’ campaign recognisers could state the recommended age for breast screening and 70% knew that the recommended screening interval is two years. Campaign recognisers’ main message takeaways aligned with the overall campaign goals to increase screening participation.

Almost half (47%) of campaign recognisers correctly identified the ‘If you could see UV’ call to action describing the main message as ‘protect yourself from the sun’. 75% agreed that it made them feel concerned about their UV exposure.

61% of ‘Every vape is a hit to your health’ campaign recognisers correctly identified the main message of the ad being ‘vaping harms / is dangerous’. Among Aboriginal young people there was also a high degree of alignment between the campaign’s key messages and responders’ takeaways from the campaign.

Impact

Campaigns have had significant impact on influencing positive behaviour changes in their target audiences.

Evaluations over 2022-23 and 2023-24 revealed that the ‘If You Could See UV’ campaign has been effective in warning the audience about the serious threat of skin cancer and motivating them to protect their skin. More than three quarters (77%) of ‘If You Could See UV’ campaign recognisers aged 18-24 years stated they intended to use sun protection when outdoors over summer.

60% of Aboriginal adults surveyed who smoke who recognised the ‘Beat the Cravings’ campaign indicated they had made a quit attempt as a result of seeing the ads; and 60% had talked to someone about quitting.

Two-thirds (68%) of young people surveyed who vape recognised the ‘Every Vape is a Hit to Your Health’ campaign, and 46% of these said they were seriously considering quitting in the next six months (well above the target of 38%), Furthermore, 80% of Aboriginal respondents aged 14-24 years who vape said the campaign made them feel motivated to try to quit vaping.

74% of ‘Breast Cancer Doesn’t Wait’ recognisers who had not participated in breast screening in the last 12 months stated they intended to screen after seeing the campaign.

 

“I quit nearly 2 years ago and saved $10,000. I wish I’d done it sooner. Never too late to start.”

Tammy – Facebook, [tobacco control] November 2024

"I’ve just turned 49, and now this is in my feed? Ok then, where do I sign up?"

Sean – Facebook, Do the Test’ [bowel cancer screening], January 2023

Personal relevancy

Respondents to the evaluation surveys indicated that they found the campaigns to be personally relevant.

The majority of those who recognised the ‘If you could see UV’ video agreed it was easy to understand (93%), believable (89%), informative (88%), made them feel concerned about their sun/UV exposure (81%), and was for ‘people like me’ (72%).

92% of current smokers reported that the messaging of ‘Beat the cravings’ was believable (40%) or somewhat believable (52%).

The majority of 14–24-year-olds who recognised the ‘Every vape is a hit to your health’ health harms video or outdoor ads agreed it was easy to understand (90%), believable (86%) and informative (80%). Most Aboriginal young people surveyed also found the campaign video relevant and believable.

“It really made me think about my health in the long term especially cause I’m only still young”

Aboriginal qualitative evaluation participant, ‘Beat the Cravings’ campaign

 

Opportunities

The Institute remains committed to its vision of lessening the impact of cancer in NSW. We will continue to collaborate with communities and use evidence to lead effective behaviour change campaigns to support the people of NSW to reduce their cancer risk or increase the likelihood of finding cancer early.

There are also growing opportunities to explore sharing campaigns with other jurisdictions, helping to avoid duplication of effort and increase cost benefit.
 

The Institute is a national leader in developing effective behaviour change campaigns. We receive regular requests from across Australia and internationally to licence our campaigns, further recognition of their relevance and reach across a wide audience. Licencing also encourages further cost saving and reduces duplication of effort.

From 2022 the following campaigns have been licenced by other states:

‘If You Could See UV/Arrows’  

• Melanoma Australia, for educational purposes (2023-25)
• Cancer Council WA for online testing against other campaigns delivered (July–October 2024)
• Cancer Council Victoria, for educational purposes and use of CGI footage (2023-26)

‘Beat the Cravings’

• Cancer Council Tasmania (QUIT Tasmania), use of three TV commercials (December 2024)
• Cancer Council Victoria, repeat use as part of their 2023-24 campaign (May–June 2024)  

‘Every Vape is a Hit to Your Health’

• Preventive Health South Australia (SA Gov), across catch up TV, online video, social media, radio, digital display, posters and out of home (May–June and September–October 2024)
• Cancer Council WA, across catch-up TV, online video, social media, online advertising, eDM, digital display, posters and out of home (for use in 2025)

‘New Year, New You’

• Cancer Council Victoria (QUIT), repeat use for 2023-24 campaign

‘You Quit, You Win’

• Preventive Health South Australia (SA Gov), repeat use for 2023-24 campaign across television, cinema and digital (May–June 2024)

 

Link to NSW Cancer Plan

Our behaviour change campaigns contribute significantly to the delivery of the NSW Cancer Plan, specifically priorities 1 and 2, the prevention of cancers and screening and early detection of cancers. Additionally, all our behaviour change campaigns align to NSW Cancer Plan overarching principles seeking to improve awareness and provide education for focus populations (equity of outcomes) and by ensuring our campaigns are informed by people’s experiences, and are responsive to their needs and preferences (person-centredness).