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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
BACHELOR THESIS IN MARKETING AND MANAGEMENT COMMUNICATION
REDUCING THE RISK OF CANCER:
A MULTIMODAL ANALYSIS OF PERSUASIVE
STRATEGIES IN CANCER PREVENTION
POSTERS
GRETE SAVINCIUTE
EXAM NUMBER: 401951
AARHUS SCHOOL OF BUSINESS AND SOCIAL SCIENCES
SUPERVISOR: CARMEN DANIELA MAIER
6th May 2013
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
Abstract
One of the biggest threats in nowadays society is cancer, a disease which causes about 13% of all
the deaths worldwide and this number, unfortunately, is increasing. Due to extensive research
cancer treatment is improving, but in order to save people’s lives, medical resources and money,
more attention should be drawn on cancer prevention, since 30% of cancers could be prevented just
by changing behaviour and lifestyles. In order to increase awareness about the importance of cancer
prevention, as well as to influence behaviour change many campaigns are released by various
organizations.
This paper presents a multimodal analysis of persuasive strategies of ten posters from five
organizations which aim to reduce the risk of cancer. These posters are analyzed based on
interdisciplinary theoretical background of social semiotics, persuasion and social marketing.
Halliday and Kress and van Leeuwen’s notions of three metafunctions are applied to analyze visual
and textual resources. Furthermore, Gass and Seiter’s theory of motivational appeals are employed
when identifying persuasive tools of influencing behaviour change and evoking certain emotions.
Finally, social marketing context and Kotler’s exchange theory are taken into account to analyze the
buy-sell process in terms of trading cancer prevention actions and benefits gained.
As the analysis shows, the most prominent strategy is using fear appeal by the means of images and
texts. The danger of death, as the fatal consequence of cancer is highlighted in the analyzed
materials and it is used as a trigger to influence cancer screening or lifestyle changes in order to
reduce the risk of cancer. Besides, other appeals like humour, guilt, pride are identified to evoke
certain emotions according to the target audience addressed. Analysis shows, that the persuasive
strategies highly depend on the target audience, as adjusting the motivational appeals and offered
benefits helps in influencing people to take action against cancer, and also in the meaning-making
process. Finally, it is evident that the more relevant the issue is to a person, the more likely he/she is
to adopt promoted behaviour. Not only the problem is supposed to be relevant, but also the gained
benefits should be worth the efforts. Therefore, the posters promote the idea of long and healthy life
without cancer and more importantly, personalized gains like improved lifestyle or parenthood,
increased self-esteem or advantages of living to be old.
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
This thesis provides an in-depth multimodal analysis which is a starting point of making
connections between textual and visual resources to be used in combination with motivational
appeals in order to influence behaviour towards reducing the risk of cancer.
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
Contents
Abstract ............................................................................................................................................. 2
1.
Introduction ........................................................................................................................ 6
1.1
Motivation ..................................................................................................................................... 6
1.2
Problem Statement ......................................................................................................................... 7
1.3
Choice of method and theory......................................................................................................... 8
1.4
Deliminations................................................................................................................................. 8
1.5
Structue .......................................................................................................................................... 8
2.
Background ......................................................................................................................... 9
3.
Theory............................................................................................................................... 11
3.1 Social Semiotics .......................................................................................................................... 11
3.2
Multimodality ....................................................................................................................... 12
3.3
Persuasion ............................................................................................................................ 14
3.4
Social Marketing ................................................................................................................... 15
4. Method ................................................................................................................................ 18
5. Analysis ................................................................................................................................ 22
Utah Cancer Action Network ............................................................................................................ 22
German Cancer Aid........................................................................................................................... 24
The League Against Cancer ............................................................................................................ 25
Cancer Patients Aid Association ........................................................................................................ 27
Canadian Breast Cancer Foundation .................................................................................................. 29
Social Marketing Strategies .............................................................................................................. 30
6. Conclusions .......................................................................................................................... 31
References ............................................................................................................................... 34
Appendix 1 ............................................................................................................................... 36
Appendix 2 ............................................................................................................................... 37
Appendix 3 ............................................................................................................................... 38
Appendix 4 ............................................................................................................................... 39
Appendix 5 ............................................................................................................................... 40
Appendix 6 ............................................................................................................................... 41
Appendix 7 ............................................................................................................................... 42
Appendix 8 ............................................................................................................................... 43
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
Appendix 9 ............................................................................................................................... 44
Appendix 10 ............................................................................................................................. 45
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
1. Introduction
Cancer, due to its high mortality rate, estimated as being the cause of 13% from all the deaths
worldwide in 20081 is one of the major fears in everybody’s life. However, not all of us fdo
everything what is possible to prevent it. Threatening is the spread of cancer, which is predicted to
increase from 7.6 million deaths in 2008 to 13.1 million deaths in 20302. It is highly important to
educate people about cancer: its symptoms, forms, treatment and mostly – prevention, as 30% of the
worldwide cancers could be prevented3. According to the World Health Organization, the main
causes of cancer are based on humans’ behavior such as inappropriate diet, lack of physical
activities, consumption of alcohol, smoking, abuse of natural or artificial sun, etc. Just by taking
care of our habits and actions we can minimize the risk of getting cancer. Moreover, regular visits
to the doctor for health check-ups and early detection of cancer are significant means of cancer
prevention.
As people lack knowledge, will or motivation to take care of their health, various organizations like
American Cancer Society, which focuses on cancer prevention and treatment, or Australian Chronic
Disease Prevention Alliance, which deals with a wider variety of diseases make campaigns in order
to increase society’s awareness about health issues. This kind of campaigns, which do no aim for
profit, but for the society’s well-being belong to social marketing, which Kotler et al. (2006) define
as "a process that applies marketing principles and techniques to create, communicate, and deliver
value in order to influence target audience behaviors that benefit society (public health, safety, the
environment and communities) as well as the target audience" (Kotler et al. 2006 in Kotler et al.
2011: 2). Social marketing is widely used when delivering healthcare messages and cancer
prevention is not an exception, as many campaigns have been created in order to educate people
about this disease.
1.1 Motivation
1
http://www.who.int/mediacentre/factsheets/fs297/en/
http://www.who.int/mediacentre/factsheets/fs297/en/
3
http://www.who.int/cancer/en/
2
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
Based on the previous information, this paper aims to conduct an in-depth analysis of ten posters
regarding cancer prevention from five non-governmental organizations: Utah Cancer Action
Network, (Utah, US), German Cancer Aid (Germany), League Against Cancer/Liga Contra el
Cancer (Florida, US), Cancer Patients Aid Association (India), and Canadian Breast Cancer
Foundation (Canada). Two posters from each organization will be analyzed in terms of their visual
and textual persuasive strategies used with the aim to increase their audience’s knowledge about
cancer prevention and influence cancer preventive behaviour.
The motivation to analyze cancer prevention posters arise from the relevance of this issue in
nowadays society. Even people seem to be aware of the danger of cancer, they still do not put much
effort into preventing it. Nevertheless, Canadian Breast Cancer Foundation states that our health
depends on our lifestyles and therefore, changes in everyday behaviour are essential for avoiding
cancer.4 As the mortality of cancer is steadily increasing, it is vital to educate people about the
preventive methods in a persuasive and appealing manner.
1.2 Problem Statement
Considering the above background information, it is interesting to look into how organizations use
visual and textual resources in order to convince their audience to take preventive actions against
cancer. Therefore, the problem statement of this thesis is two-folded and is defined by the following
questions:
What visual and textual persuasive strategies do non-governmental cancer organizations use in
order to increase society’s awareness of the importance of cancer prevention?
How do these organizations differentiate each other for communicating multimodally with their
audience?
Due to complex texts I have decided to make discourse analysis which enables to evaluate how
interaction of different modes carries a persuasive message.
4
http://onenewthing.ca/learn-more
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
1.3 Choice of method and theory
Since the paper has a complex goal, theories from several scientific fields will be applied. First of
all, as the analysis will be based on interpretations of textual and visual resources of the posters,
theories of social semiotics will be used as the foundation. Garzone et al (2007) argue that text and
visuals are two different modes in a printed advertisements and “their interaction is crucial for the
effective delivery of the message” (Garzone et al. 2007: 33). Based on this, multimodal analysis
seems essential when analyzing the persuasive strategies of the posters. This analysis will be based
on three metafunctions’ theories by Halliday and Kress and van Leeuwen. Furthermore, Gass and
Seiter’s persuasion theory of motivational appeals will be employed in order to identify the most
prominent appeals and their variations based on the target audience addressed. Finally, to examine
the overall context of the posters, regarding their goal of influencing behavior change, Kotler’s
theory of exchange will be used to analyze the buy-sell process in terms of social marketing.
1.4 Deliminations
This thesis will analyze posters from five different organizations which represent culturally diverse
backgrounds. However, this paper will be more focused not on the organizations, but their strategies
used when increasing awareness of cancer prevention. Even though, this analysis will research how
these organizations differentiate each other when reaching their social marketing goal.
The types of cancer the posters deal with are breast, skin, lungs, prostate and the final one is general
cancer prevention. Therefore, this paper will not look into campaigns of other types of cancer.
Moreover, the audience these posters address is diverse in terms of age, gender or nationality, even
though, they aim to approach English speakers and adults.
1.5 Structue
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
This paper will consist of six parts, the first one being introduction, followed by background
information, where cancer organizations will be briefly introduced. Then the paper will provide
theoretical background to be used for the visual and textual analysis. The fourth part introduces to
the methodology of this thesis within the framework of chosen theories. Following this, the analysis
of ten cancer prevention posters will be presented, where the theories will be applied to analyze
how visuals and texts were used as persuasive tools. Finally, the thesis will be summed up in the
conclusion.
2. Background
From numerous organizations working towards reducing the numbers of cancer victims, five have
been chosen for the analysis of this paper. These organizations originate from different parts of the
world, but they have the same goal of educating people about cancer prevention and its treatment.
Posters chosen for analysis focus on diverse types of cancer and target particular audiences. These
organizations will be briefly presented in the following paragraphs.
Utah Cancer Action Network
Utah Cancer Action Network (UCAN) is a network of people and organizations working on cancer
prevention in Utah, USA. UCAN serves as a platform of collaboration and networking between
community organizations and does it with the main goal of providing services and programs
towards cancer prevention and control. This organization focuses on colorectal, prostate, skin and
women’s cancers. Two posters which have been chosen for analysis are targeted at men and
encourage them to participate in cancer screening.5
German Cancer Aid
German Cancer Aid/ The Deutsche Krebshilfe was founded in 1974 by Dr. Mildred Scheel, and it
was the leading organization fighting cancer in Europe. The purpose of this organization is to fight
any kind of cancer by supporting “research projects to improve prevention, diagnosis, therapy,
5
http://health.utah.gov/ucan/About_UCAN/About/About%20UCAN.php
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
after-care and self-help”. The analyzed posters of German Cancer Aid are aimed at preventing skin
cancer and are targeted at parents to educate them about the harm sun may cause to their children. 6
The League Against Cancer
The League Against Cancer / Liga Contra el Cancer is a community based organization which was
established in 1975 in Miami, USA. Volunteering specialists of this organization provide free
medical care for people with low-income. Besides treatment, the organization also offer free cancer
screenings as well as educate people about the ways to avoid this disease. The print ads to be
analyzed are targeted to broad audience, as it does not specify any type of cancer or any particular
group of people, basically promoting regular cancer screening in order to prevent it and live till old
age. 7
Cancer Patients Aid Association
Cancer Patients Aid Association (CPAA) was established in 1969 by Mr. Y. K. Sapru and it
operates all over India as well as some neighbour countries. This charitable organization works in
the fields of “patient care, aid and assistance, awareness and advocacy”. It looks at cancer from a
very wide perspective realizing the importance of increasing general awareness about cancer,
preventing it, treating patients, as well as psychological and social side effects of cancer. Even
CPAA include various types of cancer in their prevention/treatment programs, the materials chosen
for analysis focus on smoking, as a fatal factor causing cancer. 8
Canadian Breast Cancer Foundation
Unlike the previously mentioned organizations, Canadian Breast Cancer Foundation focuses only
on one type of cancer. It started its charitable movement towards breast cancer prevention and
treatment in 1986 and since then it works to “fund, support, and advocate for education and
awareness programs”. Today this organization is the leading one in Canada and helps women to
6
http://www.krebshilfe.de/english.html
http://ligacontraelcancer.org/la-liga-history/
8
http://www.cpaaindia.org/aboutus/index.htm
7
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
fight cancer. An example of its efforts will be analyzed in this paper: two posters encouraging
women to be strong and take good care of their health. 9
3. Theory
3.1 Social Semiotics
Semiotics is a science of signs, founded by the Swiss linguist Ferdinand de Saussure. In the field of
semiotics signs may be language, images, sounds, basically “everything that can be taken as a sign”
(Eco 1976 in Chandler 1995: 8) and semiotics helps in the process of meaning-making when it
comes to the sign and its connotation.
The main concept in the science of semiotics is sign which according to Saussure is composed of “a
signifier” (the form taken by the sign) and “the signified” (the concept represented) (Chandler
1995). Saussure’s notion of a sign was expanded by Roland Barthes, the French semiotician who
looked into how signs work in culture and divided signification in two orders: denotation and
connotation.10 Denotation refers to the first layer of a meaning of sign, which is not coded and
basically explains “who or what is being depicted” (van Leeuwen and Jewitt 2001: 94). Connotation
is a more complex definition, which describes the deeper layers of meaning, taking into account the
culture, values and interpretations of what the sign stands for. Combination of both representational
(‘denotative’) and symbolic (‘connotative’) meaning is useful for visual analysis of pictures.
The social aspect of semiotic studies adds another dimension and explains that the signs cannot be
interpreted in isolation, but on the contrary, has to be analyzed in social circumstances. Social
semiotics is useful as a “tool for use in critical research” (van Leeuwen and Jewitt 2001: 136)
serving for meaning-making and therefore applicable for textual and visual analysis of cancer
prevention posters. British linguist M.A.K. Halliday states that language has three metafunctions:
ideational, interpersonal and textual (Stillar 1998). Based on Halliday’s work, Gunther Kress and
9
http://www.cbcf.org/central/AboutUsMain/OurPurpose/Pages/default.aspx
http://faculty.washington.edu/cbehler/glossary/signific.html
10
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
Theo van Leeuwen have adapted these metafunctions for any semiotic system. As the analysis of
cancer prevention posters will be based on these concepts, the three metafunctions will be explained
in more details in the following paragraphs.
3.2
Multimodality
Multimodality is a term which refers to a combination of “various sign systems (modes)” in any
type of communication (Stockl 2004: 9). Modes are not considered as a stable concept, but rather
constantly “shaped by the daily social interaction of people” (Jewitt 2009: 21). Therefore, the aim
of multimodal analysis is to investigate how modal resources are used in a particular context and are
“shaped and construed by social, cultural and historical factors” (Jewitt 2009: 22).
In multimodal texts both textual and visual resources take part in coding a message, hence their
interaction is very important for understanding the overall meaning. Van Leeuwen (2005) argues
that when analyzing visual communication, it is essential to consider “two verbal and visual modes
of communication in print advertising with complex interaction between them" (van Leeuwen 2005:
8). In order to categorize possible text-image linkages Van Leeuwen uses Barthes and Halliday’s
research. For a deeper understanding of the twofold iconic message, Barthes (1977) has
distinguished two-types of text-image relation: anchorage and relay. Anchorage is most common in
press and advertisements and directs “the reader through the signifieds of the image, causing him to
avoid some and receive others” (Barthes 1977: 40). The reader is guided in the perception process
when the words help to find one of various meaning. Relay is not such a common function and in
this case the text and image are in a complementary relationship and hence “the words, in the same
way as the images, are fragments of a more general syntagm” (Barthes 1977: 41). Besides Barthes,
Halliday has also investigated how text and image are related and presented concepts of elaboration
and extension. Van Leeuwen combines Halliday’s ideas with Barthes’ linguistic functions of
anchorage and relay and sums up text-image relation in the following table (Kress and Van
Leeuwen 1998):
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
The table shows two types of text-image relations: elaboration and extension. Elaboration could be
two-folded as well: it is split into specification and explanation. In the case of specification the
image could illustrate the text by making it more specific or the text could be an anchorage in
making the image more specific. Extension relations could be three types: similarity, contract or
complement. In the case of similarity both the text and image provide similar content, while in
contrast the contents are different. Lastly, if the image gives additional information besides the text
(or vice versa) it’s called complement relation or relay.
When the text-image connection is clarified, it is important to look into how it could be interpreted
in different social contexts. To do so, a multimodal discourse analysis (MDA) can be applied. The
term derives from Halliday’s notion of social systemic functional grammar which was the basis of
O’Halloran’s multimodal discourse analysis (Jewitt 2009). Kress and van Leeuwen (2001) argue
that discourses are “socially constructed knowledges of (some aspect of) reality” (Kress and van
Leeuwen 2001: 4). Discourse represents a constructed reality using different modes and their
combinations. For analyzing discursive practices in a multimodal text, social and cultural contexts
should be taken into account, as the main focus of MDA is rather the social system of the text, than
the sign-maker.
Advertisements belong to a type of multimodal texts where the written language and images “and
their interaction is crucial for the effective delivery of the message” (Garzone et al. 2007: 33). The
aim of an advertisement in social marketing context is to persuade the audience for a behavioural
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
change, therefore it is important to look into the persuasive strategies used in multimodal texts.
These theories will be presented in the following part of the paper.
3.3
Persuasion
Persuasion is a tool highly used in advertising, both commercial (in order to sell products and
services) and non-commercial (in order to sell ideas and values). Virtanen and Halmari (2005)
define persuasion as “all linguistic behaviour that attempts to either change the thinking or
behaviour of an audience, or to strengthen its beliefs, should the audience already agree” (Virtanen
and Halmari 2005: 3). As mentioned before, behaviour change is one of the main objectives in
social marketing, therefore persuasion is an essential mean which is used in order to reach that goal.
Virtanen and Halmari (2005) distinguish two types of persuasion: explicit and implicit. While
explicit persuasion is easy to notice, implicit is less obvious. The less audience is aware of
persuasion in a message, the more they will be affected by it, and therefore, the authors argue for
implicit persuasion often being the best choice (Virtanen & Halmari, 2004). On the other hand,
Gass and Seiter (2011) state that both types of persuasive strategies could be successful if applied
according to the context. They argue that it is essential to take the audience into account, choosing
the strategy based on the receivers’ previous knowledge about the issue as well as its relevance for
the person. Therefore, for an effective persuasive communication it is crucial to know your target
audience.
In order to successfully target specific groups of people, campaigns may use different appeals. Gass
and Seiter (2011) define motivational appeals as a drive which encourages people to do something.
The authors distinguish several types of motivational appeals: fear, pity, guilt, humour, sex etc. Any
motivational appeal or a combination of them is used to persuade the audience to change behaviour
or attitudes. Some appeals are proved to be highly effective in persuasion efforts, while the others
are less effective How they are applied in particular cases of social marketing campaigns will be
seen in the analysis part of this paper.
Besides motivational appeals, the message creators can apply seven functions of persuasion
presented by Stockl (1997): Attention, Comprehend, Yield, Memorise, Imagine, Distract and
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BA MMC
Bachelor Thesis
2013
Please. Attention is the first persuasion function, which explains how the receiver’s interest is
attracted. It is followed by the function of Comprehension, which makes the material
understandable from emotional and cognitive perspectives. Yield is highly important when creating
credibility and trustworthiness. Furthermore, Memorise stimulates the receiver’s memory while
Imagine refers to the ability of projecting the receiver into the world represented by text and
images. Distract function is used with the aim to decrease receiver’s resistance. Finally, Please
function refers to the entertaining purpose so that the receiver would enjoy the process of
understanding the text. As well as motivational appeals, these functions are not compulsory and are
rather used in combinations. Moreover, they can be expressed through both textual and visual
resources.
3.4
Social Marketing
The term of social marketing was first defined by Kotler and Zaltman in 1971, but as the definition
was problematic and not explicit enough, it was redefined and now explains social marketing as
“the use of marketing principles and techniques to influence a target audience to voluntarily accept,
reject, modify, or abandon a behaviour for the benefit of individuals, groups, or society as a whole”
(Kotler et al. 2002: 5). The main difference from commercial marketing is that social marketing
does not aim for financial benefits and instead of products and services sells ideas and values.
Social marketing is used in the fields of healthcare, environment protection, community wellbeing,
safety, and education. Lee and Kotler (2008) distinguish two types of social marketing: downstream
and upstream. The first one focuses on marketing individual behaviours, whereas the second one is
directed to policy makers, media and other types of social influencers. Social marketing campaigns
are usually initiated by governmental organizations, non-profit organizations and in some cases forprofit organizations, with the aim to benefit their customers as well as organizational goals. On the
other hand, Rangun and Karim (1991) argue that “the social change is the primary (rather than
secondary) purpose of the campaign” (Rangun and Karim 1991: 3) and therefore, for-profit
organizations’ campaigns could not fall into the category of social marketing, due to their primary
goal of gaining profit instead of societal benefit.
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Grete Savinciute 401951
BA MMC
Bachelor Thesis
2013
The challenging task of social marketing is to engage the audience and influence it for the
behavioural change, therefore the key element for a successful social marketing campaign is to offer
significant benefits. As initiating change is not an easy task, Andreasen (1994) proposes to take it
step by step and groups these steps into five categories: “basic education, value change, attitude
change, motivation to act, and training and reinforcement” (Andreasen 1994: 111). In order to
follow these steps, the sender of a message has to know well the audience, and therefore requires
conducting a market research and finding out into what category the target audience fits.
Thorough planning is essential for a successful campaign and therefore Maibach et al (1993)
present six steps planning process of a social marketing campaign: 1) planning, 2) theory, 3)
communication analysis, 4) implementation and 5) evaluation and reorientation (Maibach et al.
1993 in Perloff 2010). Firstly, in the planning stage campaigners have to set goals which are the
basis of the whole campaign, defining whether it will aim to change the attitudes or behaviour of the
target audience. Secondly, the success of a campaign is based on the theoretical background chosen.
Theories and models from marketing and semiotics are usually applied for a development of a
social marketing campaign (Perloff 2010: 332). Thirdly, communication analysis is required, when
the planner has to find out what are target audience’s perceptions regarding the topic. A successful
communication message is created according to these perceptions. During the implementation phase
the campaign is “designed, finalized and launched” (Perloff 2010: 333). This phase is merely based
on marketing principles and the marketing mix of 4 P’s. Finally, the campaign has to be evaluated
and reoriented, investigating the effects on individual, community or state level. It is essential to
evaluate a campaign, as it “indicates whether campaign objectives have been met” (Perloff 2010:
334). Evaluation gives knowledge for future improvements of the ongoing or upcoming campaigns.
When applying these planning steps in real life, it is important to take cultural aspect into
consideration, because it has a great influence on how the campaign should be shaped.
There are numerous theories, models and strategies to be applied when creating a social marketing
campaign, for example, the mix of 4 P’s, Theory of Planned Behaviour and Reasoned Action,
Stages of Change Model, Exchange Theory, the Health Belief model and others. They will be
briefly presented in the following paragraphs.
Theory of planned behaviour and reasoned action was formulated by Ajzen and Fishbein in 1980s.
They argue that “person's behaviour is determined by his/her intention to perform the behaviour and
that this intention is, in turn, a function of his/her attitude toward the behaviour and his/her
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BA MMC
Bachelor Thesis
2013
subjective norm”. This theory explains that the likelihood for a person to actually perform certain
behaviour is dependent on his/her readiness and intention. At the same time the intention is
dependent on their attitude toward the specific behaviour, their subjective norms and their perceived
behavioural control. The intention is stronger if the person is in favour of the attitude and subjective
norm, and has a high perceived control. 11
The stages of change model were introduced in the end of 1970s by James Prochaska and Carlo
DiClemente. The model shows that behavioural change does not happen at once, but is done in
several steps, which are precontemplation, contemplation, preparation, action and maintenance. It is
argued that a long-term change cannot be imposed from the outside, but conversely, comes from the
inside, therefore, in this case a campaign could be seen just as a stimulus for a change, but not the
main reason. 12
Exchange theory explains that “individuals, groups, or organizations have resources that they want
to exchange, or might conceivably exchange, for perceived benefits” (Lefebvre and Flora 1988:
302). Various transactions between the promoters and the audience could be considered as
exchange, nonetheless the transactions should have a “buy-and-sell intention” (Lefebvre and Flora
1988: 302). In the case of public health campaigns people buy intangible goods such as values and
beliefs. Moreover, the theory looks into how to initiate exchange through different approaches
(from threat to volunteerism).
Health Belief Model is a psychological behavioural model developed in the 1950s by US Public
Health service workers. The model proposes a list of factors which influence how people change
behaviour due to health threat: perception of the severity of the threat, perception of possible
benefits of proposed behaviour, perceived costs and obstacles, internal and external incentives that
stimulate people to act. A person’s likelihood to take action proposed in any healthcare related
campaign depends on threat and cost-benefit appraisals, which are influenced my demographics and
psychological aspects. Besides, internal (a person’s physical condition) and external (mass media or
11
http://www.utwente.nl/cw/theorieenoverzicht/Theory%20Clusters/Health%20Communication/theory_planned_beha
vior.doc/
12
(http://www.addictioninfo.org/articles/11/1/Stages-of-Change-Model/Page1.html
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Bachelor Thesis
2013
other people’s opinion) factors have a significant power in the decision making of whether to take
the suggested action or not (Kotler and Lee 2008).
Most of the presented social marketing theories draw attention on the social and cultural contexts
which influence behavioural change. Moreover, a person’s individual values and intentions towards
proposed change are taken into account. Most importantly, for a successful perception of a
campaign, a person has to find it relevant and with beneficial exchange.
4. Method
As indicated before, this paper is based on three theoretical frameworks of social semiotics,
persuasion and social marketing, and analyzes how the concepts of these theories are applied in
social marketing campaigns and expressed visually and textually.
Based on the interdisciplinary background of this research, hermeneutics is chosen as the most
relevant methodology. Hermeneutics, as the science of interpreting signs, is argued to be the most
applicable method for multimodal analysis, which will be conducted based on three metafunctions
of Halliday and Kress and van Leeuwen. In the following paragraphs I will present the main
conceptions of each metafunction.
To begin with, the ideational metafunction aims to “represent objects and their relations in a world
outside the representational system” (Kress and van Leeuwen 2006: 42). There are two types of
processes within this metafunction: narrative and conceptual. The narrative processes serve to
represent actions, events and processes of change and therefore could be divided into action and
reaction processes. One of the main concepts is vector, which shows the process of interaction.
Within action processes, there are transactional and non-transactional processes, which explain if
the vector formed by an element in a picture points at any other participant of the picture, or not. If
the vector connects two participants, the one which initiates the act is called actor; the participant at
which the vector is pointed at is called the goal.
Moving on to conceptual processes, they aim to represent participants “in terms of their more
generalized and more or less stable and timeless essence, in terms of class, or structure or meaning”
(Kress and van Leeuwen 2006: 78). Conceptual processes are divided into classificational, symbolic
and analytical. Classificational processes have two kinds of participants: superordinates and
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subordinates. Classificational processes may relate participants into a covert taxonomy, or overt
taxonomy: single-level or multi-level. The analytical processes relate participants into the partwhole structure (carrier being the whole and possessive attributes - the parts). The last symbolic
processes show what the participants are or mean and are divided into attributive or suggestive. In
attributive process, the carrier is a participant “whose meaning or identity is established in the
relation” (Kress and van Leeuwen 2006: 105), while the symbolic attribute “represents the meaning
or identity itself” (Kress and van Leeuwen 2006: 105). Symbolic attributes are characterized as
being salient in the picture, being pointed at, looking out of place or conventionally related to
symbolic values. In the suggestive process there is only a carrier and its meaning and identity are
“coming from within…deriving from qualities of the Carrier” (Kress and van Leeuwen 2006: 106).
The interpersonal metafunction deals with the projection of “relations between the producer of the
(complex) sign, and the receiver/reproducer of that sign” (Kress and van Leeuwen 2006: 42). This
relation is initiated through the gaze, size of frame and perspective. Gaze could be two-types: when
the participant of the image has a direct eye contact with the viewer (demand picture) and the one
where eye-contact is missing (offer picture). The size of the picture’s frame could institute three
types of social distance: 1) intimate (close shot when only the head and shoulders of the participant
are visible), 2) social (medium shot when the participant is seen till the waist), 3) impersonal (long
shot (the whole body of participant is visible). Finally, relations could be established by attitude
(perspective) which could be subjective (imposed) or objective and is expressed through different
types of angles. First, if the angle is frontal, the viewer feels that what is depicted in the picture is
part of his/her world. The use of frontal angle is called involvement. Opposite to that is detachment,
when oblique angle is used and the viewer doesn’t relate to the world shown in the picture. If the
picture is shown from a high angle and makes the objects in it seem small and insignificant, the
viewer is given the power. Eye-level view gives equality between the participant and viewer, and
lastly, if low angle is used, the objects look imposed and it is called representation power. In the
case of objectivity, the world in the picture is shown naturalistic and may be orientated to action by
using frontal angle, or focused on knowledge by using top-down angle.
Modality, which is included in the interpersonal function of visual analysis helps in producing
“shared truths aligning readers or listeners with some statements and distancing them from others”
(Kress and van Leeuwen 2006: 155). Reliability of the visual message is based on modality, which
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could be expressed by modality markers: colour saturation, colour differentiation, colour
modulation, contextualization, representation, depth, illumination and brightness.
The third textual metafunction focuses on text itself and how signs “cohere both internally with
each other and externally with the context” (Kress and van Leeuwen 2006: 43). Moreover, it
analyses the composition which “relates the representational and interactive meanings of the image
to each other through interrelated systems” (Kress and van Leeuwen 2006: 177): 1) information
value (placement of objects on the left and right, top and bottom, centre and margins; 2) salience
(degree to which an object attracts attention by its placement, size, colour etc.); 3) framing (by
elements which connect or disconnect objects creating dividing lines or actual framing lines).
Talking about the placement of the elements of the picture, they could be centred of polarized.
In the linguistic perspective, ideational function is reveals the content construction and explains
how language “represents things, concepts, relations, and events and their circumstances” (Stillar
1998: 20). Ideational metafunction distinguishes three classes of processes: action, mental and
relational. Besides, each of them have subclasses and are usually accompanied by different
participants. Processes show “what is “going on” in the text” and are expressed by verbs. Moreover,
ideational function looks into the circumstances, such as time, place or manner.
Interpersonal function is about relation between the reader and text participant and language is a
tool to construct these interactions. Halliday argues for two types of linguistic resources regarding
interpersonal function: positional and relational. They can be analyzed in the categories of speech
function, modality, attitudinal lexis and sentence adjuncts.
Textual function deals with the cohesion and coherence of the text and how it “exhibits structure
and organization” (Stillar 1998: 21). Language’s function of being able to “link different parts of
the text with one another, and link the text with its context” (Stillar 1998: 46) is expressed through
the resources of thematic structure and cohesive devices
Besides multimodal analysis of three metafunctions, this paper will look into motivational appeals
present in the social marketing campaigns. As presented in the theory section, there are various
appeals used as a tool to persuade certain behaviour, however, in the analyzed materials just some
of them are significant.
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First of all, the most prominent one is fear appeal, which is widely used in the context of social
marketing, notwithstanding frequently debated (Kotler and Lee 2008). Perloff (2010) describes fear
appeal as “a persuasive communication that tries to scare people into changing their attitudes by
conjuring up negative consequences that will occur if they do not comply with the message
recommendations” (Perloff 2010: 196). Researchers claim that the greater is the threat, the greater is
perceived persuasion (Gass and Seiter 2011: 272). On the other hand, Perloff (2010) argues that
threatening messages “must work on a cognitive, as well as affective, level” (Perloff 2010: 198).
Consequently, a successful message should not only arouse fear, but also suggest an easily
applicable solution.
Another appeals detected in social marketing campaigns are guilt and pity, which are usually used
in combination. Even these appeals are highly effective when used for donation purposes (Gass and
Seiter 2011: 274), they could be also applied in public health context as in the case of cancer
prevention. The authors state that it is crucial to design guilt and pity appealing message
emphasising “the positive self-feelings that come from doing the right thing” (Gass and Seiter 2011:
276). Basically, behaviour change itself instead of the wrong behaviour should be highlighted for
effective persuasion.
Humour appeal does not seem to be used often in health messages, especially the ones regarding
cancer. However, persuading the audience to take cancer preventative actions may be successfully
done by the use of humour. This appeal could serve in several ways: 1) capturing attention, 2)
distracting the viewer’s mind and therefore facilitating comprehension of the message, 3) giving
credibility to the sender as well as reducing psychological reactance (Gass and Seiter 2011: 278).
From social marketing perspective, behaviour change initiation could be seen as a buy-sell action,
and might be triggered through different approaches. Similarly to motivational appeals, social
marketers use the concepts of threats and benefits which are explained in the exchange theory. This
theory states that “consumer must perceive benefits that are equal or exceed the perceived costs”
(Kotler et al. 2002: 11). In terms of commercial marketing, products or services are exchanged to
money. However, in the case of social marketing, this exchange process is more complicated, as
people exchange their attitudes or behaviour to the perceived benefits. Benefits are defined as
“”gains” that the target audience could see through adopting the targeted behaviour” (Kotler et al.
2011: 21). In most of the analyzed cancer prevention posters the benefits are related to better health
in exchange to preventive actions or lifestyle changes. Lefebvre and Flora (1988) list the resources
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that could be used in the exchange process: “money, time, physical and cognitive effort (such as is
needed to maintain an exercise program or quit smoking), lifestyle, psychological factors (e.g.,
coping skills/abilities, self-efficacy/esteem) and social contacts” (Lefebvre and Flora 1988: 303).
First step for a successful behavior change initiation is to target a person who would feel relevance
to the promoted issue. Furthermore, if the perceived benefits are worth giving away own resources,
he/she would get engaged and take action. Lefebvre and Flora (1998) argue that people could be
persuaded for an exchange differently: they can be threatened, coerced, command or suggested a
voluntarily exchange (Lefebvre and Flora 1988: 303). Persuasive strategies may vary due to the
target audience, topic, relevance, desired outcomes and other factors. These different approaches
can be expressed textually or visually and in the following analysis I will look what strategies were
chosen by organizations when influencing cancer prevention actions and how they were
differentiated based on the target audience.
5. Analysis
The multimodal analysis is conducted at the level of each metafunction and the persuasive strategies
are also discussed metafunctionally. Aspects of social marketing strategies are summarized at the
end of multimodal analysis. The structure of my analysis chapter is motivated by the different levels
of abstraction implied by each theoretical perspective. As there are ten posters, two of each
organization, they will be analyzed in pairs and later on they will be compared in terms of the
audience addressed and persuasive strategies applied.
Utah Cancer Action Network
The posters promote regular prostate cancer screening and are targeted at men aged forty and older.
Men are encouraged to be manly and do not be afraid of the screening, which could be very helpful
in cancer detection and prevention.
Ideational metafunction
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Both of the analyzed pictures belong to conceptual symbolic process, where the men are the
carriers, who represent strong and manly men by their possessive attributes such as leather clothes,
boots, trainers, weights and masculine bodies with tattoos. Despite the fact that both of the
participants are represented as physically strong men, their posture signals them being terrified
(eyes wide open, open mouths, bodies hiding under the blankets in the corner or under the bed).
Surprisingly ridiculous behaviour of men whose looks show them being invincible is depicted to
encourage the viewers to act opposite and do not be afraid. This encouragement is also expressed
through text, in which the participants become generalized by using plural “men”, addressing the
message to all the men. Besides, encouragement to take action is expressed through action
processes like “get checked”, “talk”, “call”. The use of present tense makes the situation important
and relevant.
Interpersonal metafunction
Considering the gaze of the participants, a personal relation is established through a direct gaze to
the viewer, what makes these pictures demanding. That means the viewer is invited to engage with
the participants and relate themselves to what is shown. Besides, frontal angle of the pictures
contributes when convincing the viewer to relate to the presented world. As the target audience is
men, they are demanded to relate themselves to physically strong men shown in the pictures and ask
themselves, if they (as well as the participants) are afraid of prostate cancer screening. Textually,
the readers are not addressed at first, as the text begins with declarative sentences which basically
state the general truth about how real men are. Later, if the reader is interested and reads further, the
sender addresses him directly by using personal pronoun “you” and imperative mood, which
describes the actions a real man should take to prevent cancer.
Textual metafunction
Regarding the text in both of the posters, it is placed at the bottom of the page, which is considered
to represent the real situation, which in this case is the encouragement to the audience to be manly
and do cancer screening regularly. The pictures show reversed idea on masculine men, who are
scared and hiding like small kids, on the other hand, the text explains, that the reality is opposite,
and real men are not afraid. Referring to van Leeuwen’s image-text linkages, it can be summed up
that the image is in contrast to the text, but at the same time the text serves as a clarification.
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These posters are designed in the contrast method to catch viewers’ attention, as they might be not
so intrigued by health promotion message. In the posters we can recognize fear, masculinity and
humour appeals. The combination of these three appeals is used in order to target men, who are
invited to relate to the participants, in terms of recognizing themselves as strong and manly, but
conversely to the participants, not afraid of cancer screening, as this fear is presented ridiculous and
not matching with the qualities of a real man.
German Cancer Aid
Both of the posters are created regarding the danger of sun as the main cause of skin cancer. The
posters are targeted at parents, who are urged to protect their children from the sunlight and in this
way to take care of their children’s health or even save their lives.
Ideational metafunction
In the first picture narrative processes could be identified: unitransactional process is established
when the boy (actor) is touching the reaper (goal), while two girls looking outside the picture frame
form non-transactional processes. In the second picture we can see the same pattern of narrative
processes with the playing girls (interactors) who form a bitransactional process. These actions of
playing emphasize the fact that children are not aware of the danger, and therefore parents are
encouraged to take care of their children. In the pictures circumstantial attributes as green forest,
lake, inflatable boat, and playground create a delightful summer atmosphere which is in opposition
to the danger of sun which can cause skin cancer. The reaper could be also seen as a carrier in a
conceptual symbolic process with the black cloak as a symbolic attribute of danger to strengthen the
threat and educate about the fatal effect of sun. From the textual perspective, the most important is
the stressed threat, expressed by a pronoun “someone”, which does not specify the danger, but let
the readers conclude themselves by connecting the text with the picture. The urge to save children is
stressed by the present tense verb “take”, explaining the consequences in the future tense (“someone
else will”).
Interpersonal metafunction
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Due to the children’s direct gaze to the viewer, the first poster is a demand picture, where the
viewer is directly addressed. In the second picture the position is more neutral because of the
absence of direct gaze and therefore the viewer is left to form his/her own opinion. Both pictures are
designed to create social distance because of the long shot, letting the viewer to observe the
depicted situation. Furthermore, the pictures have different perspectives, as the first picture is
shown from a frontal angle, engaging the viewer to the situation, while the second picture is shown
from a low angle what makes the reaper to seem superior and powerful. Modality markers are
highly important in these two pictures, as the bright colours and blurriness highlight the effect of
bright sun, which is emphasized because of its danger to skin. Regarding the text, imperative mood
is used to urge the parents to get engaged and save their children from sun. Moreover, modality
marker “will” yet again stress the danger of sun as the cause of cancer which may lead to death.
Textual metafunction
There is a centred composition in both of the pictures with the most important element (the reaper)
placed in the centre of the pictures. Besides, the reaper’s meaning is highlighted by the contrast of
colours (bright colours vs. black) and the opposition between young and playful children and the
reaper carrying along the threat of death. To make the reader afraid of the harm the sun does to the
children, sentences are connected by a causal cohesive device “or”, which is used to again
emphasise the threat.
As evident from textual and visual resources, fear appeal is used in both of the posters. Fear of
losing a child is used as a trigger to make parents aware of the harm of sunlight, as well as to urge
them to protect their children. Humans tend to have a great fear of death, therefore not cancer itself,
but death, as the worst consequence of this disease, was chosen in this case. Besides, guilt appeal is
also significant in these posters, as they address parents and appeal to parental responsibility of
protecting their children. By using a combination of fear and guilt appeals, the sender has a great
power of persuading the target audience to take action.
The League Against Cancer
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Posters of this organization do not specify their audience, but target general public. Otherwise, it
could be argued that the posters aim at young or middle-aged people, but not the elderly. Contrary
to the previous posters, these ones send a broader and more positive meaning, giving emphasis to
the advantages of avoiding cancer and living until old age.
Ideational metafunction
In both of the pictures several narrative processes can be recognized (action processes where
participants are connected by vectors or reaction where they are connected by eyelines). In the first
picture these narrative processes set a storyline of a summer day on the beach where people are
enjoying each other’s company. Participants are shown in a manner of contrast, putting emphasis on
the elderly couple in the middle, who are depicted as happy and self-confident due to their facial
expressions and postures. Their happiness is highlighted in order to illustrate the advantages of
being old. In the second picture the story is based on the myth of Titanic based on the circumstantial
details of an ocean, sinking ship and a lifesaving boat. The main participants are a group of elderly
people on the lifesaving boat who are shown joyful and excited, similarly to the first picture
accentuating the benefit of being old. Furthermore, visual message is supported by the texts, which
define the actual advantages (“Nobody wants to steal your partner anymore”, “They save you
first”). The present tense is used in order to project the readers into the future, where they are
already old, so that they would see the perspective of taking care of their health now in order to live
until old age.
Interpersonal metafunction
Both of the pictures are considered as offer pictures due to the absence of direct gaze to the viewer,
so the viewers are presented with general situations. By showing these situations from a frontal
angle, viewers are invited to relate themselves to the participants and contemplate the fact of living
until being old as an advantage. Considering the colours, the first picture is designed in vintage type
colour saturation highlighting the theme of elderly. On the other hand, dark colours are dominating
in the second picture which together with the sinking ship symbolizing the threat of death in the
opposition of bright waves and moon carrying the elderly towards survival. Looking from the
textual side, declarative sentences are used to show the common truth why being old is an
advantage. Additionally, the readers are invited to relate with the depicted situations by the use of
personal pronouns (“yours”, “you”).
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Textual metafunction
Regarding the composition, we can identify central elements in both pictures: elderly couple in the
first and lifesaving boat with the elderly in the second. These participants are made salient by
contrasting them with young people (in the first case) and emphasizing their happiness in a tragic
situation (in the second case). All of this salience can be argued to be used in order to emphasize the
advantage of being old due to detecting cancer early. Overall, the texts of both posters serve as
elaborations, specifying the messages depicted by images and therefore communicating clear
meaning: preventing cancer gives you an advantage to live until old age.
In order to persuade the audience, The League Against Cancer uses humour appeal to convince
people that preventing cancer leads to a joyful old age. In the first picture, elderly couple are shown
happy together and opposite from the youth, they do not have to worry about any competition
attracting men/women. In the second picture, dramatic situation of a ship wreck is illustrated
through humoristic viewpoint, focusing on the benefit of being old. Even humour appeal is the most
prominent, fear could be also identified. The target audience is indirectly threatened that if people
do not prevent cancer, they may die before getting old. In these posters humour appeal helps to
catch viewers’ attention and facilitate the meaning-making process of an implicit threatening
message.
Cancer Patients Aid Association
The posters of CPAA are created with the purpose to prevent lung cancer, and therefore, are
targeted at smokers. Smoking is known as one of the main reasons of lung cancer, hence it is
important to educate society about the harm this habit cause to people’s health.
Ideational metafunction
In both of the pictures the participants are arms holding cigarettes and burning themselves. Through
this metaphorical visualisation suggestive conceptual processes are formed depicting the arms as
carriers of the meaning clarified in the text: “Cigarettes smoke people”. In the first picture we can
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see bedroom setting with minimalistic details and therefore focusing the viewer’s attention to the
main participant. In the second picture action takes place in a restaurant again without too many
background details positioning the participants into the centre of attention. The short metaphoric
text draws attention by reversed participant roles (instead of people smoking cigarettes, cigarettes
are said to be smoking people) therefore highlighting the negative and killing effect of smoking.
Present tense is used to stress the significance of the issue.
Interpersonal metafunction
As there is no gaze in the pictures, both of them are offer pictures giving the opportunity for the
audience to observe. Due to frontal angle both pictures are seeking to involve the viewer to the
depicted situation threatening smokers about the damage of this habit. Regarding modality markers,
colour saturation, differentiation and modulation are low, keeping the style plain and simple and
emphasizing the image of hand-cigarette and its burning process as a way of self-destruction.
Moreover, the dominance of greyish/brownish colours could be associated with the ashes of
cigarettes showing that smokers’ lives are boring and without any exciting details. Textually, the
message does not address the readers directly, but by a declarative sentence states the general
knowledge. In this way the sender does not impose any attitude, but rather leaves the audience to
contemplate if this habit is worth the consequences.
Textual metafunction
The composition of both pictures is based on the centred information value as the main elements are
placed in the centre of the composition and there are no other salient details around. The text is used
as an elaboration of the picture, repeating the same idea as illustrated visually.
These simplistic posters persuade by using fear appeal, showing the fatal effect of smoking.
Smokers, as the main target audience are influenced to see this habit as a process of self-destruction,
which leads not only to lung cancer, but consequently, may be the cause of death. Pity/guilt appeal
may be recognized, as the target audience is convinced to regret smoking due to its negative effect.
The message is simple, but catchy due to reversed roles of people and cigarettes, which in this case
are more powerful than human beings.
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Canadian Breast Cancer Foundation
These breast cancer prevention posters are targeted at women and they aim to improve the overall
women self perception, as well as encourage taking care of themselves and reducing the risk of
breast cancer. Posters illustrate women who are depicted as role models: self-confident, strong,
knowing their dreams and life goals and most importantly, leading a healthy lifestyle.
Ideational metafunction
Both posters show woman who are carriers in symbolic conceptual processes. In the first picture the
carrier has a leather jacket, helmet, boots and a motorcycle as symbolic attributes which help in
creating the meaning of a strong, confident woman. It is not a typical woman presentation, therefore
the poster (with the additional information in the text) sends a message to the target audience to not
be afraid to follow their dreams and lead a healthy lifestyle in order to stay well. The second picture
reveals the same idea by showing a woman tennis player whose symbolic attributes are tennis
clothing, racket and balls. Textually, the sender projects the reader into the situation by stressing
“you” as the participant, elaborating on the looks, attitudes and behaviour of successful women. The
headline (“You don’t have to be good to be healthy”) encourages women to be themselves: do
whatever their dreams are, while the ending of texts puts focus on the importance of healthy
lifestyle – well-known factor for reducing the risk of cancer.
Interpersonal metafunction
While the first picture is a demand picture as the participant is looking directly into the viewer and
engaging into the situation, the second one is an offer picture and leaves the viewer to decide own
opinion. Furthermore, it could be argued that the audience is to be involved through the frontal
angle, which suggests that the world depicted in the pictures is also the world of the viewers’.
Considering the modality markers, the significant one is contextualization of the background in both
pictures, as they are both blurry and that highlights the importance of the participants – strong and
confident women. Like visually, textually the depicted world is imposed as the viewers’ world, by
the repetitive use of personal pronoun “you”. Women are invited to engage to lifestyle changes
which lead to happier and healthier life. By the use of adverbs (“better”, “stronger”) and adjectives
(“good”, “healthy”, “wonderful”) the texts reveal that lifestyle changes are good if they are
combined with healthy habits and persuade women to take action towards self-development.
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Textual metafunction
Regarding the composition, the first picture could be identified as polarized, when the main element
(the woman participant in this case) is placed on the right side. Therefore, she represents the new
viewpoint – woman can be strong, do the things they always dreamed of and besides, reduce the
risk of breast cancer. The second picture has the main participant in the centre of the composition
and hence draws attention on itself as an element of contemplation. Texts in these posters serve as
an elaboration, because the pictures themselves cannot reveal the whole idea. They provide
encouraging description which explains how any woman could become similar to the depicted role
models.
Differently from most of the analyzed posters, these ones do not try to persuade by threatening, but
on the contrary, by motivating the target audience. Feminine appeal could be identified as
constructing the image of a strong and self-confident woman, whose goal is to treat herself well by
doing what she wants and leading a healthy lifestyle. Additionally, as an opposition of guilt appeal,
pride is used. Women are encouraged to be proud of themselves and their healthy choices in life.
Social Marketing Strategies
Based on the exchange theory presented before, the following paragraphs will look into how the
analyzed posters communicate threats/benefits to their audiences.
To begin with, the main persuasive tool recognized in almost all of the posters is threat of cancer or
death as a consequence of this disease. Threatening is represented visually (for example, images of
burning hand-cigarette, symbol of death, postures of scared men) or textually (“Cigarettes smoke
people”, “Someone else will”). Implicitly or explicitly the target audience is threatened to change
behaviour in order to avoid cancer and its consequences. To avoid the dangers people are suggested
to take certain actions like cancer screening, protecting children from the sun, quitting smoking or
leading healthy lifestyle. In some of the posters senders clearly communicate what should be done
to prevent cancer (“take”, “call”, “reduce” etc.), while the others do not mention anything. This
could be seen as a drawback for a successful persuasion, as like indicated previously, messages
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should include both cognitive and affective elements, therefore if the audience is not suggested a
precise action plan it may not get engaged in behaviour change. On the other hand, it could be
argued that some of the posters do not aim to change people’s behaviour, but to inform them about
the importance of prevention and the harm of cancer.
Furthermore, the posters not only threaten or inform, but also communicate the benefits people may
gain by adopting promoted behaviour. The main explicitly illustrated benefit is living a long, happy
and healthy life. Besides, there are more benefits, which are not so obvious, for example: increased
masculinity of femininity, improved lifestyle or parenthood, enhanced self-esteem and selfrealization. These benefits are used according to the target audience, for each of them highlighting
specific benefits that are considered as important. In comparison, when targeting men, the sender
tries to encourage masculinity by using humorously showing weak men, while when targeting
women, strong and confident role models are depicted encouraging the audience to improve their
lifestyles. Another contrasting examples are posters from Cancer Patients Aid Association and The
League Against Cancer. While the first one emphasizes the harm of smoking, the second one
focuses on the advantages of staying healthy. In connection to the target audience, smokers are
addressed by pointing out the consequences of this habit, whereas general public is informed that
preventing cancer is a long-term benefit.
All considered, the perception of suggested behaviour change highly depends on the target audience
and its characteristics. If people find it relevant and the gained benefits would be worth changing
behaviour, they would be more willing to get engaged. Summing up, a successful communication
message should not only have an affective impact, stimulating certain emotions, but also to be
followed by precise suggestions how the desired benefits can be gained.
6. Conclusions
The purpose of this paper was to analyze ten cancer prevention posters in terms of their visual and
textual persuasive strategies. In order to identify visual and textual resources, multimodal discourse
analysis was used based on the theories of Halliday and Kress and van Leeuwen. Furthermore, Gass
and Seiter’s theory of motivational appeals was employed to assess the most prominent appeals
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used to persuade behavioural change. What is more, these campaigns were analyzed taking into
account that they originate from the field of social marketing. Therefore, the analysis looked into
how the campaigns differentiate themselves according to the target audience and threats/benefits
they promote with regard to the exchange theory of Kotler.
Interdisciplinary research has helped to find out that social marketing campaigns try to initiate
cancer prevention by sending creative and catchy messages which combine visual and textual
resources. Visually, most of the pictures are designed according to contrast principle, for example,
showing physically strong men who are scared like little children, an elderly couple surrounded by
youth or small happy children playing with the reaper. Textually, the viewers are either intimidated
to change their behaviour by emphasizing the danger of cancer, or contrarily, are encouraged to
adopt cancer preventive behaviour stressing the advantages of being healthy or detecting cancer in
time. In some of the posters more direct and explicit manner could be identified (directly addressing
the viewer by gaze and personal pronoun “you”), while the other ones depict more general and
implicit situations which let the audience to contemplate by themselves and evaluate the
threats/benefits of suggested behaviour. Multimodally, the viewer has to find the situation relevant
to be willing to pay the price of changing behaviour in exchange to the benefits. In order to trigger
behavioural change, the senders try to evoke particular emotions, which could influence the
adoption of promoted solutions.
The audiences’ emotions are induced by the use of motivational appeals. Fear appeal is highly used
in social marketing campaigns, and cancer prevention seems to be no exception. Fear appeal was
indicated as the most prominent appeal in the analyzed posters as the audience is threatened about
the harm of cancer, emphasizing the fact that regular screening can reduce the risk. The use of fear
appeal could be concluded as not particularly successful due to the lack of clear suggestions of
avoiding cancer. For instance, CPAA simply illustrates the harm of smoking without providing the
audience with further information about how to get rid of this habit or who to contact for help.
Besides fear, humorous appeal can be also identified, even if the usage of humour could be
considered as inappropriate when communicating about cancer. Nevertheless, humour is applied to
catch viewer’s attention, as well as increase sender’s credibility.
The analyzed posters are targeted at a specific audience, for instance, men/women, parents, smokers
etc. and the tactics of persuasion are adopted according to what is relevant for each group. Based on
the findings, differences in gender discourse could be identified regarding the persuasive appeals
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when targeting men/women. While men were depicted through humorous lenses as ridiculously
scared, women were targeted by showing encouraging and self-confident female participants and
appealing to their pride.
In order to successfully target particular audience, senders focus on what is relevant for specific
group of people, and hence, promote important benefits or use certain threats to influence behaviour
change. Findings of the analysis show that the main benefit of adopting cancer preventive behaviour
is long and healthy life, yet it is not the only one. Most of the other benefits are focused on personal
gain, like increased self-esteem, improved lifestyle or parenthood. In exchange to these gains people
are asked to use their resources for cancer screening, changing lifestyles or taking better care of
themselves and their families.
Overall, the thesis has analyzed just several campaigns and identified the main persuasive patterns
used when influencing behaviour change. For a further and more extensive research, more
campaigns with other target audiences could be chosen. Furthermore, as multimodal discourse
analysis does not evaluate the success of such campaigns, reception analysis could be added to
examine audience response to visual and textual messages.
Nevertheless, such a detailed multimodal analysis of posters’ is an important first step to be taken in
order to highlight various aspects related to the use of motivational appeals in regards to the target
audience. The analysis shows the relevance of adopting such theoretical frameworks of social
semiotics, persuasion and social marketing especially in terms of the meaning-making potential of
the interplay of two semiotic modes.
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References
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Lefebvre, R. C., and Flora J. A. (1988). Social Marketing and Public Health Intervention. Health
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Perloff, R. M. (2010). The Dynamics of Persuasion. Communication and Attitudes in the 21st
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Van Leeuwen, T. (2005). Information Linking. In Introducing Social Semiotics. London:
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Appendix 1
1 Utah Cancer Action Network
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Appendix 2
2 Utah Cancer Action Network
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Appendix 3
3German Cancer Aid
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Appendix 4
4German Cancer Aid
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Appendix 5
5The League Against Cancer
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Appendix 6
6 The League Against Cancer
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Appendix 7
7Cancer Patients Aid Association
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Appendix 8
8 Cancer Patients Aid Association
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Appendix 9
9 Canadian Breast Cancer Foundation
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Appendix 10
10 Canadian Breast Cancer Foundation
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