Degree Name

Doctor of Philosophy


School of Psychology


As the population ages and people have longer life expectancies, it is imperative to direct more preventative health promotion messages to older adults. Asthma is a chronic condition that has a serious impact on older adults that could be addressed by preventative health promotion activity. This doctoral thesis examines the promotion of asthma to older adults through two literature reviews and three empirical papers.

The first review paper describes the impact asthma has on older adults and the effectiveness of asthma awareness interventions, and argues for the social marketing framework as an appropriate foundation for future interventions. The review concludes that older adults are an important target group for asthma-focused health promotion due to the severe impact of the disease on this population, and their general lack of asthma knowledge and commonly held misperceptions about asthma. The paper proposes the development of a pilot asthma awareness intervention, and recommends that the impact of the pilot intervention be evaluated by examining changes in asthma knowledge and perceptions and, in the longer term, improvements in the respiratory health and quality of life of older people in the target community.

The second review identifies social marketing campaigns that have promoted disease awareness and health behaviour change to adults aged 55 years and over. A systematic literature search identified 19 evaluated interventions published between January 2001 and March 2013 that predominantly utilised social marketing techniques and that targeted older adults. The key lessons learned from the studies centre on segmentation, message development and content, and behavioural outcomes. The conclusions provide guidance to health promoters and social marketers who may develop interventions for this population. The synthesis of intervention evaluations highlights two broad categories of important factors for health promoters to consider in the development of successful health promotion programs for older adults; they should (1) empower audience segments with specific, positive, and relevant health messages, and (2) promote health messages through individuals and groups that are well-known and trusted.

The first empirical paper examines the asthma perceptions of older adults, identifies gaps in their asthma knowledge, and relates their perceptions and knowledge to concepts from the Health Belief Model and social marketing. A large-scale survey assessed the asthma perceptions and knowledge of a random sample of 4,066 Australian adults aged 55 years and over. The findings suggest that the majority of older adults with an asthma diagnosis do not properly manage their symptoms. In addition, the lack of asthma knowledge demonstrated by older adults illustrate that they need to be made aware of key symptoms, the prevalence of asthma in the older adult population, and be empowered to take control of their respiratory health. The paper demonstrates that the target population can be meaningfully segmented on the basis of recent experience of breathlessness and asthma diagnosis. The four segments had significantly different asthma perceptions, perceived self-efficacy, asthma knowledge, general health and mood. The synthesis of the findings from the study was used to guide the development of a social marketing intervention.

The second empirical paper describes the development and pre-testing of asthma awareness campaign materials for older adults. The study sought to ascertain aspects of the campaign materials that engaged older adults, to determine which types of taglines and images were effective in conveying particular messages, and to obtain suggestions for improvements on the materials. Four focus groups with 34 participants were held in community centres and libraries across the target region. Participants were shown each set of campaign materials separately, and discussed the messages within each of the three campaigns and the effectiveness of the taglines and the images. Participants also discussed the relevance of the posters to other individuals from their own demographic, and offered suggestions for improvement. The primary finding from the focus groups was that older people want a “human element” to be depicted in campaign materials; this includes having people in the images that they can relate to, and portraying important relationships and everyday activities that they can readily identify with. The inclusion of this human element may increase the likelihood that older adults engage with campaigns and take note of important health messages. The paper concludes that health promoters need to consider the discussed elements and incorporate them into campaigns directed at older adults to ensure maximum audience engagement and, subsequently, improvements in the targeted health behaviours.

The third and final empirical paper describes the multifaceted evaluation of the ‘Get Your Life Back’ social marketing campaign to increase asthma awareness among older adults in a regional Australian community. The primary objective of this paper is to describe the process and impact evaluations of the ‘Get Your Life Back’ campaign, which aimed to increase awareness of asthma and encourage action in older adults with respiratory symptoms. Surveys were mailed to 1104 older adults in an intervention region and a control region immediately prior to and following the social marketing campaign. Campaign awareness, message recall, materials recognition, and actions taken as a result of the campaign were assessed in both regions. A final sample of 710 older adults completed the survey at both baseline and follow-up. The intervention increased the asthma information seeking behaviours of older adults in the intervention community compared to the control community. This paper concludes with six key recommendations made on the basis of the ‘Get Your Life Back’ evaluation. Health promoters interested in the development of asthma awareness campaigns targeting older adults should carefully consider: the segmentation of their target audience, the planned duration of campaign activities, the resources necessary to adequately audit campaign implementation, strategies to raise awareness among health professionals in addition to the target audience, the use of community partnerships to strengthen the impacts of campaigns, and the utilisation of mass media to ensure maximum exposure of older adults to campaign messages.

This doctoral research provides original findings on designing asthma promotion materials for older adult audiences; a novel method of effectively segmenting older adult audiences to reach those who would benefit most from managing their respiratory symptoms; and a set of recommendations resulting from the evaluation of the pilot ‘Get Your Life Back’ campaign.

FoR codes (2008)

111712 Health Promotion, 150502 Marketing Communications, 170106 Health, Clinical and Counselling Psychology



Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.