Changes in Social Representations Resulting from a Media Campaign

1. Changes in Social Representations Resulting from a Media Campaign Mary Anne LAURIDepartment of Psychology University of Malta, MALTA. mary-anne.lauri@um.edu.mt and Josef LAURIDepartment of Mathematics University of Malta MALTA.

2. Introduction This paper addresses the problem of organ shortage in organ transplantation and discusses how his problem can be mitigated through public communication campaigns. Specifically it will discuss how the social representations which the public have of organ donors can be changed through a national campaign promoting organ donation.

3. Formative Research Before Campaign The findings presented in this paper are part of a wider research project on an organ donation campaign carried out in Malta (Lauri, 2001). The research carried out before the campaign involved the use of surveys, interviews, focus groups and analysis of the media. The research reported here analyses part of the data collected through focus groups.

4. Formative Research Before Campaign The two main aims of the campaign were to increase the level of knowledge on organ donation and to encourage people to carry the donor card thereby pledging their organs after their death. Great emphasis was directed at the perceptions which people had of organ donors because research had shown that positive perceptions of organ donors and organ donation were the best precursors of people becoming organ donors.

5. The Campaign The campaign made use of all important media channels available at the time in Malta. In particular, the campaign team made use of: • Print Media • Radio • Television • Direct advertising as well as Public Relations were used.

6. The Print Media The initial phase of the campaign targeted the print media. Public service announcements promoting the campaign appeared on all newspapers. These included a form which the public could use to request information, a picture of a donor card, and a form to register one’s name in the National Organ Donor Register. Newspapers featured press releases, interviews with people who had donated organs and also with those who had received organs.

7. Radio During the third week of the campaign, radio was included. Radio is the ideal medium for instant feedback. People could phone during programmes on organ donation aired on different radio stations to ask questions and get immediate answers. The radio campaign was strengthened by three 40-second public service announcements made by well-known Maltese public personalities.

8. Television Use of television started in the fourth week of the campaign. Advertising during prime time was used to give the widest possible coverage to the campaign’s messages. The television advert depicted a typical Maltese family discussing organ donation during dinner. The family environment was used to emphasise that organ donation should be a family decision. The leading role was performed by a television personality who anchored a popular weekly television programme.

9. Public Relations Besides the adverts, many presenters of popular discussion programmes, both on radio and television, accepted to discuss the topic of organ donation in their programmes. This put the topic on the public agenda. This phenomenon was further reinforced with the coverage of all media events related to organ donation on the major news bulletins seen by a big number of Maltese viewers.

10. Indicators of the Success of the Campaign There were many indicators of the success of the organ donation campaign. The number of people who carried a donor card went up from 9% of the population before the campaign to 17% after the campaign. The number of kidney transplantations performed in the year following the campaign went up from 4 in the year before the campaign to 14 in the year after the campaign

11. Other Indicators There were other indicators of the success of the campaign. In this paper we will only discuss the changes in social representations which took place amongst the focus group participants. Since this study was not experimental, it is difficult to say that the changes registered in the social representations towards organ donors were the result of the campaign. We can only claim that the campaign was probably one of the main instigators of the changes in social representations of organ donors.

12. Studying Social Representations Breakwell and Canter (1993) have argued that virtually every method known to social science has been used at some point in order to study social representations. • Ethnographic studies (e.g. Jodolet, 1991) • Experiments (eg. Abric, 1984) • Questionnaires (eg. Agostinos, 1990) • Interviews (eg. Molinari and Emiliani, 1990) • Focus groups (eg. Jovchelovitch and Gervais, 1999) • Free associations (e.g., Di Giacomo, 1980)

13. Studying Social Representations Moreover, different researchers have used different tools to analyse the data. For example, • Multidimensional scaling (eg. Uzzell and Blud, 1993) • Correspondence analysis (eg. Hammond, 1993) • Cluster analysis (eg. Fife-Shaw, 1993) • Discriminant analysis (eg. Zani, 1993)

14. Methodology:Focus Groups In the part of the study being reported on in this presentation, focus groups were used to find out the participants’ views of organ donation, organ donors and non-donors. Focus groups are an ideal tool to collect data when the purpose of the research is to elicit people’s own understandings, opinions, views and how these are elaborated and negotiated in a social context.

15. Sampling Procedure Participants were recruited from different towns and villages from all over the island to avoid possible biases of particular communities. This was done by approaching people in supermarkets, asking them whether they were willing to take part in a discussion on organ donation as part of a research project. Those who accepted were invited to give the names of friends who they thought would be willing to accompany them for the discussion.

16. Participants A letter was sent to 57 prospective participants giving them more information about the project and also the time and place of the focus group. The people were again reminded of the discussion, by telephone, one day before the focus group. Sixteen persons dropped out. Each of the five groups was made up of eight people on average. They were evenly distributed between women and men, and between young and middle-aged people with different levels of education.

17. Procedure Participants were asked to discuss their views on organ donation, that is, whether they agreed or disagreed with the issue and the reasons why they agreed or disagreed. In the last part of the discussion they were also asked to talk about the type of persons who, in their opinion, were willing to donate organs after their death and the type of persons who were not. This was done through the use of photos with the aim of eliciting the perceptions which participants had of donors and non-donors.

18. Photolanguage Using photographs at the end of a group discussion instead of keywords, like in other studies (e.g., Di Giacomo, 1980), had two added advantages. • It made it easier for participants to assign freely, personality traits to donors and non-donors. • The reasons given for choosing particular photographs would have been influenced by both ‘personal’ and ‘group’ beliefs aired in the focus groups. This interplay between personal beliefs and the beliefs of the group, mirrors the process that happens in everyday life in a community.

19. Materials The photos depicted people of all ages, coming from different socio-economic backgrounds and depicting different lifestyles. For example, photos showed an older person working in the fields, an airline pilot, a young person playing the guitar, a woman with a child and a family around a dinner table. A few of the photos were of Maltese media personalities and public persons.

20. Aims of Using Photos Participants were asked to choose a photograph of persons who, they thought, would typically donate their organs and of those who would not. The aims of the exercise were two. The first aim was to find out what traits people attributed to organ donors and non-donors. These trait descriptions revealed the characteristics which were associated with organ donors and non-donors. The second aim was to find out whether these traits changed as a result of a campaign.

21. Perceptions Before and After the Campaign The views of the participants were examined at two points, once before the launching of the campaign and once again, two months after the end of the campaign. The aim of this exercise was to see if there were any changes in the perceptions of the participants as a result of the campaign. Of course a change in perceptions is often the result of a number of factors and the observed changes could not be solely attributed to the effect of the campaign.

22. Results For each photo chosen, the participants were asked to give reasons for their choice. The reasons given described traits which, participants perceived, donor would have. The basic units of analysis which were recorded from this exercise were the traits which participants projected onto the person in the photo they had chosen. Each unit will be referred to as an utterance. A single participant could have produced more than one utterance.

23. Results (cont.) This “textual” data was elaborated as follows. Each utterance was classified on two variables. The first variable DONOR classified (i) whether the utterance was intended to describe a likely donor or non-donor and (ii) whether it was used in a focus group before or after the campaign. This variable DONOR therefore had four levels: Yes before, Yes after, No before, No after.

24. Results (cont.) The second variable DESCRIPTION classified the reason expressed by the participant for choosing the photograph. In the first phase of the analysis, all the different traits attributed to donors or non-donors referred to by these utterances were analysed and synonyms were grouped together under one label. As a result, 35 different traits were identified. These traits, for example “old”, “kind” and “happy” were the levels of the variable DESCRIPTION.

25. Coding Reliability To test for coding reliability, a second coder was given the transcript from which the utterances were extracted and asked to classify them according to the 35 traits which had been identified in the first phase. The classifications carried out by the second coder matched with the first coding for 91% of the utterances.

26. Analysis of Data Traits which were mentioned only once were discarded. This was done to eliminate one-off descriptions which did not represent shared ideas. This left 215 different utterances classified into 27 traits, which therefore became the levels of the variable DESCRIPTION. A contingency table showing the distribution of these utterances amongst the 27 traits and the four donor/non-donor levels is shown in Table 1.

27. Contingency Table for Variables Donor by Description

28. Correspondence Analysis A correspondence analysis was then performed on the data. The aim of correspondence analysis is to help show visually the relationships between the levels in a contingency table. Correspondence analysis is a very appropriate tool within the context of this investigation of social representations because it is designed as “an aid to interpretation … [and] … the researcher is never far from her own data.” (Hammond, 1993)

29. Correspondence Analysis (cont.) In correspondence analysis, the different levels of the two categorical variables are given scores on one or more dimensions. This is done in such a way that levels that are more alike will get similar scores. Therefore if the scores are then plotted as graphs, levels that are alike appear close to each other whereas levels that are dissimilar appear far apart.

30. Correspondence Analysis (cont.) The ANACOR procedure in SPSS was used to carry out the correspondence analysis on the above contingency table. Four normalisation methods are provided by ANACOR. Canonical normalisation was chosen since the aim here was to analyse the similarities between the levels of DONOR and also between the levels of DESCRIPTION.

31. Row and Column Scores (Canonical normalization) 1.84 Pro environment 1.31 Caring .78 YES BEFORE Public figure Loves life Sportive D .25 i (1)NO BEFORE m Young * (2) e Family person (3)NO AFTER n s -.29 i Happy Kind o Modern n Well informed Manual worker 2 -.82 Analytic YES AFTER Generous -1.35 -1.89 -2.42 Religious -2.22 -1.83 -1.45 -1.06 -.67 -.29 .10 .48 .87 1.25 1.64 2.02 Dimension 1 Summary of multiple points in the plot Point Actual label (1) Cold (1) Afraid (1) Does not care about others (1) Uninformed (1) Unhelpful (2) Conservative (2) Old (2) Does not understand (2) Vain (3) Middle aged (3) Uneducated (3) Egocentric Correspondence Analysis – Dimension 1 by Dimension 2

32. A one-dimensional representation To focus attention on representations of organ donors, a second analysis of the data was performed using only the utterances describing donors. Therefore the levels of the variable DONOR became two: “Yes before” and “Yes after”. There were now 107 utterances, corresponding to 21 different levels of the variable DESCRIPTION. A contingency table showing the distribution of these utterances amongst the 21 traits and the two donor levels is shown in Table 2.

33. DONOR YES YES Total BEFORE AFTER DESCRIPTION Public figure 13 5 18 Well informed 3 4 7 Young 5 4 9 Family person 1 6 5 1 Caring 1 11 2 3 Sportive 4 2 6 Loves life 4 2 6 Pro environment 3 0 3 Kind 3 3 6 Happy 2 2 4 Religious 0 4 4 Analytic 2 4 6 Generous 2 5 7 Manual work 0 3 3 Modern 2 2 4 Total 60 47 107 Contingency Table for Variables Donors by Description for utterances describing donors

34. A One-dimensional Representation

35. Analysis of Results Analysing the results of Figure 1 and Figure 2, it is clear that before the campaign, donors were generally perceived to be young persons, people who care about others, who practise a sport, who love and appreciate life, and who are pro-environment. Public figures were very often chosen and perceived to be donors.

36. Analysis of Results In the post-campaign focus groups, donors were perceived to be ordinary people: manual workers and persons who have a family. They were also seen to be educated, analytic, happy, kind, modern and well-informed, who are generous and who are religious.

37. Conclusion Before the campaign, donors were associated with particular categories of people: public figures, young and sportive persons, professionals and people with good jobs. After the campaign it seems that donors were more readily perceived to be the ordinary person, a member of a family, and therefore possibly oneself.