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Grete Savinciute 401951 Bachelor ThesisBA MMC 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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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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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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ContentsAbstract................................................................................................................................................2

1. Introduction..........................................................................................................................61.1 Motivation....................................................................................................................................61.2 Problem Statement........................................................................................................................71.3 Choice of method and theory........................................................................................................81.4 Deliminations................................................................................................................................81.5 Structue.........................................................................................................................................8

2. Background...........................................................................................................................9

3. Theory................................................................................................................................113.1 Social Semiotics.............................................................................................................................113.2 Multimodality..........................................................................................................................123.3 Persuasion...............................................................................................................................143.4 Social Marketing......................................................................................................................15

4. Method..................................................................................................................................18

5. Analysis..................................................................................................................................22Utah Cancer Action Network...............................................................................................................22German Cancer Aid.............................................................................................................................24The League Against Cancer...............................................................................................................25Cancer Patients Aid Association..........................................................................................................27Canadian Breast Cancer Foundation....................................................................................................29Social 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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Appendix 9.................................................................................................................................44

Appendix 10...............................................................................................................................45

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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/2 http://www.who.int/mediacentre/factsheets/fs297/en/3 http://www.who.int/cancer/en/

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http://www.who.int/cancer/en/


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-morePage 7 of 45


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

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

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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,

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

5 http://health.utah.gov/ucan/About_UCAN/About/About%20UCAN.php6 http://www.krebshilfe.de/english.html

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http://en.wikipedia.org/wiki/Mildred_Scheel


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

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

7 http://ligacontraelcancer.org/la-liga-history/8 http://www.cpaaindia.org/aboutus/index.htm9 http://www.cbcf.org/central/AboutUsMain/OurPurpose/Pages/default.aspx

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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

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 10 http://faculty.washington.edu/cbehler/glossary/signific.html

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http://faculty.washington.edu/cbehler/glossary/signific.html


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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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

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.

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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

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.

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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 for-

profit 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.

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.

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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

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

11 http://www.utwente.nl/cw/theorieenoverzicht/Theory%20Clusters/Health%20Communication/theory_planned_behavior.doc/

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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

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.

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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

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 part-

whole 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

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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

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

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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.

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: Page 20 of 45


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

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.

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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

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 Page 22 of 45


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.

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.


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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”).


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.


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

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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

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.


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

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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.


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”).


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

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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.


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

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.


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 Page 27 of 45


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.


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.

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.


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

Page 28 of 45


“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.


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.


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

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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

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 self-

realization. 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

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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

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

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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

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

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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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Appendix 1

Page 36 of 451 Utah Cancer Action Network


Appendix 2

Page 37 of 452 Utah Cancer Action Network


Appendix 3

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3German Cancer Aid


Appendix 4

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4German Cancer Aid


Appendix 5

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5The League Against Cancer


Appendix 6

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6 The League Against Cancer


Appendix 7

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7Cancer Patients Aid Association


Appendix 8

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8 Cancer Patients Aid Association


Appendix 9

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9 Canadian Breast Cancer Foundation


Appendix 10

10 Canadian Breast Cancer Foundation

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Documents

Bla bla bla: a multimodal analysis of persuasive …pure.au.dk/portal/files/54003494/BA_Thesis.docx · Web viewReferring to van Leeuwen’s image-text linkages, it can be summed up