In an organisation such as a department of health, the central task is to identify health problems for people and develop ways to prevent and treat them. The two-way asymmetric model aids this by committing practitioners to understand the message to be disseminated and then to disseminate it effectively through a strong knowledge and understanding of the target public to persuade that public to respond to the message in the desired manner. An institutionalised commitment to informing planning of communications efforts through knowledge of audiences through market or social research, part of the two-way asymmetric model, is not seen in the case.

The application of factors for successful campaigns

The factors of successful communications campaigns, as outlined by Windahl et al (1997), drawing on Rice and Aitkin (1989) and Rogers and Story (1987), can be applied directly to the case. Examination of the case through the application of these factors breaks down the elements of the case, providing insight into the challenges of the planners, the areas where the planners planned well and where the planning fell short.

1. The role of mass media. Initial awareness and knowledge can be created by mass media.

The only mention of media in the relevant sections of the "Standards" document is under recruitment, where means of recruitment are listed, such as letters of invitation, family physicians, community and women's groups and community organisations, group presentations, "the media, etc." (1994).

The media to be used was not defined. It was not accompanied by a centrally organised media campaign such as developed television or radio campaign. This was essentially due to budget. The only promotional tool committed to by the central department, the DHCS, was the standard brochure. The entire budget for promotion for DHCS was about £170,000 each year (G. Weseen, 1995).

Region 6 did advertise, as a public announcement, on community television. In New Brunswick there are free access public television channels broadcasting to the local community, which have low viewership when compared to commercial channels. On this, Region 6 made an announcement that included a number to call to make a breast cancer screening appointment (Bosca, 1997).