The Relationship between Media Advertising and Attitudinal Changes during COVID-19


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Introduction
Novel Corona Virus emerged as a signi cant healthcare challenge at the end of December 2019 in Wuhan, China. Currently, it is spreading in almost every part of the world, including Europe, North America, Asia and Africa with 13.6 million con rmed cases and 585,000 deaths worldwide (Petrosillo et al. 2020). However, Covid-19, as a healthcare concern, is not a new phenomenon. The world already confronted endemics such as Severe Acute Respiratory Response (SARS) and Middle Eastern Respiratory Syndrome (MERS), Zika, EBOLA and others. Although SARS and MERS disseminated through nosocomial speed, a current pandemic is widely transmitting to the community (Munster et al. 2020). New Corona Virus emerged as pandemic, raised extraordinary concerns for the healthcare system worldwide (WHO 2020). Additionally, there is yet no vaccine developed to counteract against the Corona Virus. Although healthcare professionals are making efforts to nd a cure, still the vaccine development is in process (Fda and Cber 2020). Due to these reasons, practicing preventive measures to diminish the spread of disease is of extreme signi cance. Preventive measures include hand washing (Humran and Alahmary 2018), use of sanitizers, wearing face masks, keep social distancing, take steam gargles, avoid crowded places, cleaning and disinfecting surfaces and taking healthy diet to keep the immune system healthy all are highly recommended. For these preventive proposals to be helpful, the role of social institutions guarantees the appropriate health education of people (Road 2020).
In this context, the role of mass media is of greater magnitude. Media platforms are playing a pivotal role in communication between researchers, scientists, public health experts and funding agencies, for an effective and rapid global response. (Roy et al. 2020). They also aim to facilitate information dissemination and improving knowledge, awareness, and healthcare practices among the public (Gralinski and Menachery 2020). The role of the media during previous outbreaks, e.g. reporting and framing HIV/AIDS issues within the context of a growing epidemic is well recognized as the media reporting play an essential role in developing public understanding of crucial elements of the disease. They also promote understanding among the professionals working in the eld.
For instance, healthcare workers and volunteers often consider the newspapers as their primary source of regular information on HIV/AIDS research. Besides, the press also plays an essential role in mediating the response to HIV/AIDS policy issues, and provides a forum for discourse (Shepperson 2000). Similarly, the potential of media advertisement to alter public behavior is highly recognized. Media advertisements are well capable of accessing a more signi cant number of masses to spread healthcare awareness. Several studies witnessed that healthcare advertisements positively in uence more than 70% of individuals (Balamurugan 2018). As media platforms play a mediating role between the public and healthcare professionals, today, advertisements are an essential ally of spreading healthcare awareness. These advertisements contain essential information which is highly accessible for everyone. Healthcare ministries and professionals design the unique public service healthcare advertisements and choose different traditional and new media platforms to display them (Naveena 2015). Such as, several medical centers resort to media advertising for healthcare awareness in the United States. They not only promote their services, but also keep the patients updated about the importance of healthcare measures and playing their signi cant part to facilitate the patients from healthcare innovations (Larson et al. 2005). Such advertisements evolved by keeping the social health and wellbeing under consideration. Nevertheless, besides traditional media, the role of social media is also of more considerable signi cance because keeping pace with technology is an essential strategy for public persuasion and awareness (Radu et al. 2018).
Thus, this study aims to scrutinize the potential relationship between mass media advertisements designed to spread Covid-19 awareness and attitudinal changes in Sahiwal, Pakistan. As, mitigating the pandemic high relies upon preventive measures and ) media advertisements serve as a powerful means of communication between the marketers and audiences (Alhawamdeh, Alghizzawi, and Habes 2020). This study also analyzed the perception regarding overall Public Service Advertisements, designated for social wellbeing and change as well as, the researchers assessed the public opinion towards healthcare advertising in general.

Covid-19 in the Pakistani Scenario:
Pakistan is located in South Asia and borders to China to the Northeast, Iran to the Northwest, Afghanistan to North & West and the southern boundary marks with the Arabian sea (US Dept 2007). The total population of Pakistan is 220 892 340, which constitutes almost 2.8% of the world's population. Moreover, Pakistan has a diverse healthcare system that includes the public sector, private, donor agencies, civil societies and philanthropic contributors. However, the healthcare system in Pakistan lacks primary infrastructure and facilities, especially in the majority of the rural areas (Kumar and Bano 2017). Especially during Covid-19, when Pakistan is bordered with the epicenter of the Corona Virus, China and Iran with the third-highest number of Covid-19 cases, Pakistan needs a high level of preparedness and action before the situation becomes worse (Saqlain et al. 2020). As of July 17th, 2020, the total 259,999 of active cases recorded with 5,475 deaths. A more detailed record of these details is given in Chart 1.
During the early days, despite the briskly growing number of cases, Pakistan lacked primary diagnostic facilities. Suspected samples were being sent to international laboratories until the country received test kits from China and Japan (Saqlain et al. 2020). An increasing number of Corona positive cases raised serious healthcare concerns in Pakistan (Rahman Qureshi et al. 2020) and counteract against it, Pakistan National Institute of Health (NIH) is playing a preeminent role by issuing protocols concerning prevention and detection of Covid-19 cases. Also, the National Institute of Health (NIH) started several awareness-based campaigns by using both traditional and new media platforms. During the early days, despite the briskly growing number of cases, Pakistan lacked primary diagnostic facilities. The suspected samples were being sent to international laboratories until the country received test kits from China and Japan (Saqlain et al. 2020). An increasing number of Corona positive cases raised serious healthcare concerns in Pakistan (Rahman Qureshi et al. 2020). To counteract against it, Pakistan National Institute of Health (NIH) is playing a pre-eminent role by issuing protocols concerning prevention and detection of Covid-19 cases. Also, the National Institute of Health (NIH) started several awareness-based campaigns by using both traditional and new media platforms.
2. Literature Review And The Conceptual Framework 2.1 Public Service Advertisements: Public service Advertisements are paid or unpaid, highly in uential, aimed to cause attitudinal change. For social well-being aspirations, these advertisements tend to spread awareness concerning ongoing social and health issues (Singh 2017). To highlight this phenomenon, (Park, Turner, and Pastore 2008) examined the recruitment of volunteers to help the players during Special Olympics by using either of the two routes described in Elaboration Likelihood Theory (ELM). The researchers selected n= 221 participants and selected empathy as a mediator of persuasion. Findings revealed that individuals highly used central route of persuasion along-with empathy for making a suitable decision. However, the people with both low and high empathy mainly depend on the central cue and decided on the rational argumentation. As per noted by (Govoni 2012), for the government and non-pro t organizations, Public Service Advertisements are the primary constituencies. They are designed to educate the public, to raise awareness, to raise money, to modify behaviors. These Public Service Advertisements address several issues, i.e. substance abuse, rights of children, healthcare awareness and others. (Jones 2012) further examined this correlation between Public Service Advertisement and the reaction of Generation-Y concerning alcohol consumption. The researcher selected a sample of 'n= 177' college-level students and recorded their responses regarding organ donation and drug abuse by using survey questionnaires. The results indicated that although the majority of students convinced with the message content, the advertisements prescribing organ donation persuaded comparatively more participants than drug abuse. However, the researcher concluded that prior knowledge and awareness about the issue are two robust mechanisms that can work along-with advertisements for the attitudinal change. Media advertising is a symmetrical process where both consumers and marketers are equally bene ted. (Yuan 2013) examined the potential behavioral changes caused by Public Service Advertisements among the youth for book reading in the United States, Mexico and China. The researcher used the Case Study approach and gathered data from secondary resources, i.e. government published statistical record, previous studies and the other relevant evidence. The results indicated that Public Service Healthcare Advertisements largely in uenced people to adopt book reading. However, instead of buying books, people mostly preferred a donated book. Thus, the researchers concluded media advertisement as a powerful tool to reinforce behavioral changes among the public.
For instance, the role of Public Service Advertisements is prominent mainly, aimed for behavioral changes among children and teenagers in China and Hong Kong. As (Chan and Huang 2015) scrutinized the role of Social Marketing advertisements and used the Case study approach. Results revealed that participants showed a positive response towards food water reduction and green living campaigns. According to the researchers, the relevant advertisements contained highly persuasive messages and the respondents accepted by using cognitive reasoning, which further led to persuasion.
Similarly, (Paul and Singh 2016) assessed the role of Public Service Advertisements for social well-being in general. The researchers used review approach and selected a sample of 'n=24' peer-reviewed research studies. The results revealed that Public Service Advertisements always contain hard-hitting educational messages to persuade audiences. They promote constructive ideas to promote social wellbeing through an attitudinal change. Therefore, issues identi ed and raised through Public Service Advertisements gain an increased awareness and a positive response from society. Since television, radio, newspapers, Social Media, magazines and others are reliable strategic means of communication. Public Service Advertisements are specially designed to bring behavioral changes by using words, demonstrations, symbols and others (Ahmad Tajuddin 2017). To further assess the different aspects of Public Service Advertisements (Ti et al. 2017) examined the content and impacts of Public Service Advertisements by Korean Centers for Disease Control and Prevention (KCDC) regarding growing cardiovascular diseases. The researchers used n= 13 survey questionnaires by using Computer Assisted Personal Interview (CAPI) system. 75% of participants revealed that the message content was easily understandable for them; however, 70% of respondents agreed that they are willing to act accordingly.
Similarly, (Raza 2018) conducted a comparative analysis of Public Service Advertisements published after the earthquake in Pakistan (2005). The researcher selected n= 3 English newspapers in Pakistan and utilized content analysis technique. The results revealed that newspapers published several Public Service Advertisements during the selected period. Moreover, Daily Dawn published a comparatively higher number of relevant ads than The Daily Nation and the News. Overall, the total number of published ads showed that newspapers are expressing more profound concern for print media towards public wellbeing and rehabilitation. According to the ndings of (Bertrand et al. 2010), the role of Public Service advertisements is distinguished due to increased e ciency for healthcare awareness. They target vulnerable individuals and easily persuade them for their wellbeing. (Henley, Ranganathan, and Gurtu 2018) also scrutinized the role of public service advertisements to spread awareness regarding mobile phone usage during driving among American youth. The researchers used the quantitative method, and ndings revealed that Public Service Advertisements are strongly associated with the behavioral change among individuals. The respondents also expressed the importance of relevant media advertisements for social wellbeing in general.
H1: There is a positive relationship between mass media and public service healthcare advertisements 2.2 Role of Media Advertisements in Healthcare Awareness: According to (Masoni, Guel , and Gensini 2011), for healthcare awareness, organizations resort to all the media platforms. Mainly, when it is about digital media advertisements, they are more accessible for users. Companies also use pop-up advertisements with catchy graphics and phrases that instantly grab users' attention. For instance, online platforms widely advertise smoking, HIV and Cancer awareness which in uenced many individuals worldwide. Increased health concerns also demand other mass media platforms work as an ally for spreading healthcare awareness. Both international and national level media platforms connect healthcare professionals and the public. For this purpose, several human resources and communication channels are strategically preferred, including advertising, campaigns, talk shows and others (Naveena 2015). In this regard, (Larson et al. 2005) investigated the use of media advertising by media centers in the United States. The researchers selected a sample of n= 17 medical centers awarded as "America's Best Hospitals" and used semi-structured questionnaires. N= 16 medical centers revealed that they resort to media advertising for promotional advertising and also to spread healthcare awareness. For advertising purposes, they consult institutional review board which further sets the advertising strategies and handle budgetary matters. The advertising content mainly contains public service, healthcare information, the introduction of newly improved drugs, therapeutic techniques and others. (Lapointe, Ramaprasad, and Vedel 2014) also scrutinized how healthcare professionals and organizations collectively use Social Media platforms to raise healthcare awareness among the masses. The researchers used a multiple case study method and found that healthcare communities and organizations use different social networking platforms to spread healthcare awareness. Particularly for cancer awareness, the organization mostly prefers several Social Networking Sites that fully support the principle objectivities of these organizations and communities.
According to (Krishen and Bui 2015), healthcare advertisements sometimes contain fear-based framing that ensures positive outcomes. As the fear-based framing is an essential strategy in market-based communication, the researcher further analyzed the role and effectiveness of healthcare advertisements regarding obesity in America. Data gathered from a sample of n= 122 respondents in the Western part of the US revealed that participants showed a great willingness to eat a healthy diet and exercise to avoid obesity. By providing "a consequence image" in the advertisements, the message directly convinced the participants to change their attitudes. As per noted by (Gollust, Fowler, and Niederdeppe 2019), the role of media for supporting healthcare practices and motivating the public to take healthcare measures is of a more signi cant concern today. To spread public awareness regarding healthcare, previously identi ed three functions are highly relevant: surveillance, interpretation and socialization Furthermore, (El-Jardali et al. 2015) investigated the use of newspapers regarding healthcare awareness in Lebanon. The researchers used media content analysis and also employed semi-structured surveys from n= 27 local journalists, advertisers, healthcare professionals and policymakers. Researchers found that out of 1,279, 39.8% of reports highlighting the opinion of health professionals, 5.9% of articles were based on evidence from peer-reviewed research studies. According to the researchers, the use of content-speci c strategies for spreading healthcare awareness are not only for people having ongoing health issues but also, teaches them ways to adopt a healthy lifestyle. The use of media for healthcare advertising and awareness has improved substantially. Healthcare marketers are more concerned about designing advertising strategies that can cause attitudinal changes among patients.
Today, the role of mass media is equally important as a mediator of communication between healthcare professionals and the public (Radu et al. 2018). To validate this, (Paul and Singh 2016) investigated the extent to which different healthcare awareness articles published in local newspapers of Manipur, India. The researchers selected healthcare articles published during 2011 and 2012 from n= 4 English and n= 6 Manipuri language. Results indicated that during the one-year total n= 10 874 were published on different healthcare topics. 72.9% of articles related to general public health, and 95.9% of articles were injuryrelated. However, 45.8% of articles were primarily published in the healthcare section of the newspaper. The researchers concluded higher sensitivity and concern towards healthcare issues in the local news media, predicting positive outcomes in the future. (Alshammari et al. 2017) also a rmed the role of media-based healthcare advertisements in Rajasthan, India. The researchers selected a sample of n= 130 individuals (n= 83 males, n= 37 females) and used structured survey questionnaires for data gathering purposes. The results showed that media advertisements played a robust, decisive role to alter audience behavior to achieve better healthcare services. Moreover, the role of the media was highly instrumental in persuading people for better health and healthy behaviors. According to (Ekiyor and Fatih Altan 2019), healthcare institutions mostly focus on communicating directly with the masses. For this purpose, they resort to mass media, especially advertising, to spread their message. Organizations using media advertisements use different strategic designs for their messages and successfully reinforce the attitudinal change. Although they do not offer any nancial bene ts to advertisers, still they are an integral part of media messages.
H2: There is a positive relationship between mass media advertisements and coronavirus awareness in Pakistan 2.3 Impacts of Public Service Healthcare Awareness Advertising: Healthcare advertisers aim to persuade the public for the necessary healthcare measures. Several studies a rmed the impacts of these advertisements as passive, highly persuasive and in uential for audiences. "Media advertisement campaigns", i.e. drugs, alcohol usage, HIV, Cancer awareness, Tuberculosis and others are the leading examples of mass media causing positive behavioral change (Wake eld, Loken, and Hornik 2010). To a rm this, (Judie-lynn 2009) scrutinized the impacts of televised healthcare advertisements for HIV awareness from 2005 to 2007 in Kenya. The researcher utilized semi-structured interviews and selected n= 200 individuals. Findings revealed that both male and female respondents indicated a great attitudinal change due to televised HIV awareness advertisements. For them, advertisements were highly appealing as they largely contained sexualization, but they also persuaded them for safer sex against HIV. (Anthony 2011) further highlighted the impacts of televised healthcare advertising regarding AIDS/HIV awareness in Nigeria. The researcher selected n= 160 local respondents from different age groups and professions, having a moderate amount of knowledge regarding increasing HIV in the country. The results indicated that, by setting the agenda for public awareness, the role of television advertising was highly signi cant to raise awareness.
According to the respondents, these advertisements are effectively informing them about the menace of HIV and also educating them regarding all the precautionary measures. Similarly, (Gordon et al. 2012) also witnessed the impacts of media advertising. The researchers preferred different communication resources to spread lung cancer awareness, including pamphlets, newspapers' advertisements, website' promotions, television and radio advertisements Mainly named as "the systematic application of marketing approaches", the advertisements technique was applied to the heavy smoking community in Don caster, England. Although, the researchers found some primary barriers, yet the results revealed strong positive impacts of marketing and communication strategies on triggering the behavioral change among individuals. According to (Kennedy-tucker and Kennedy-tucker 2014), media advertisements aim to support social causes, are strategically supervised and endorsed by medical centers and healthcare professionals. They not only educate the public but also, inform them about the unhealthy practices that can damage their physical and mental health. Healthcare advertisements by different medical centers and units can also validate this phenomenon as (Househ 2013) reviewed the impacts of Social Media based healthcare advertisements on medical professionals and their patients in general. According to the estimated results, 65% of medical professionals use Social Media for professional purposes, and 74% of online users prefer social media platforms to stay updated about healthcare programs, technologies and medications through online advertising. Thus the researcher concluded that use of major Social Media platforms, i.e. Twitter, Instagram, YouTube, Facebook and others for healthcare advertising and awareness purposes had revolutionized the patterns of attitudinal changes. Especially when the healthcare sector aims to reach out to the general population, the role of Social Media platforms is highly prominent. For this purpose, (Naveena 2015) analyzed the impacts of national-level healthcare advertisements broadcasted/published on Radio, Newspapers, Social Media and Television in India. The researcher used n= 46 structured questionnaires to determine the impacts of these advertisements. Results showed that more than 65% of these platforms are easily accessible for the audience all over India, which means that they conveniently experience exposure to healthcare advertisements. 85% of participants revealed that these advertisements strongly in uence public attitudes and behavior. Therefore, the researchers concluded that media platforms greatly help healthcare sector to access the public for healthcare awareness and digital media is comparatively more effective, fast, in nite, e cient, convenient, and of greater in uence than the face to face communication. Likewise, (JANG et al. 2016) investigated the impacts of Public Service Advertisements regarding cardiovascular diseases in South Korea. The researchers used descriptive quantitative method and selected a sample of n= 1000 individuals from 15 provinces. Findings showed that a majority (70%) of participants expressed persuasion towards adopting healthcare measures to avoid these diseases, and 24% revealed a slight persuasion that they would try hard to follow the healthcare measures. Thus, the researchers found a strong signi cant relationship between Public Service Advertisements and attitudinal change among study respondents. According to (Lapierre et al. 2017), the in uence of healthcare advertisements is a highly prominent special on the children and the young generation. Moreover, as youngsters comparatively more prefer digital media, they frequently experience watching healthcare advertisements, which is highly bene cial for them. To empirically validate this proposition, (Yom-Tov et al. 2018) scrutinized the integration and impacts of online healthcare advertisements on weight loss, exercise and healthy food adoption among internet users. The researchers used a longitudinal study design and gathered the response before and after exposure to the advertisements. The results indicated that the majority (48%) of respondents expressed their willingness regarding weight loss, exercise and healthy diet consumption. However, 32% of participants showed a slight willingness and only 20% of them refused to take any action towards healthcare. As per noted by (Kim and Diwas 2020), the role of media advertisements is highly in uential in bringing positive attitudinal changes. Besides, using rational argumentation as logical reasoning is another major strategic move to bring the desired outcomes.
H3: There is a positive relationship between Coivd-19 based media' advertisements and attitudinal change

Theoretical Framework & Conceptual Model
Social Learning theory proposed by Albert Bandura (1971) supports the primary conceptual framework of the current study. According to (Nabavi 2016), Social Learning theory is widely preferred for promoting desirable behavior and attitudinal change among the masses. We derive these attitudinal changes both through environmental elements and observational learning. We also developed "anticipated consequences" to bring certain attitudinal change, and our cognition allows us of insight and foresight (Brady 2017). The subsequent imitation and observation help humans to learn certain behavior. Besides, they also rely on manipulating rewards and consequences of imitating any particular behavior (Lyons and Berge 2012). Here the role of selected exposure and repetition (Ali 2020), especially in media advertisements, largely facilitates learning and behavioral change (Tri Harinie 2017). (Figure 2 contains the conceptual framework supported primarily by Social Learning theory in Health Communication).
Especially when organizations want to promote healthcare through communication resources, Social Learning theory provides a basic framework. As people adopt behaviors that are promoted by major platforms, "Social Learning" theories change perceptions and reinforces attitudinal changes (Health Communication Capacity Collaborative 2016)-also a rmed by (Stalburg 2016), as she argued that medical education and healthcare promotion; widely resort to Social Learning theory. As individuals learn through models, they consider observational learning as an important of attitudinal change. Also, today when along-with traditional media, digital media is also promoting healthcare through different platforms, observational factors reinforcing behavioral changes, leading individuals to adopt a healthy lifestyle in general (Catford 2011). As (I et al. 2015) argued that the use of health communication ensures immediate learning and behavior changes among the masses. Although many external and internal factors may hinder the learning process, the modeled behavior becomes a part of one's daily life practices (Verouden 2016).

Study Design:
This study is exploratory and inspired by several previously conducted investigations Alshammari et al. 2017;Muhaisen 2020). For the data gathering purpose, the researchers used well-develop, structured survey questionnaires as the survey method is capable of information gathering directly from the study participants and is relatively convenient to generalize (Glasow 2005). For data' manipulation and analysis process, the researchers used the Statistical Package for Social Sciences (SPSS Version 64 bit).

Population & Sampling:
The study population involved respondents from Sahiwal, Pakistan. The researchers randomly selected a sample of n= 179 respondents and used convenient sampling method as it was an only suitable technique to select the participants meeting the inclusion criteria (Sedgwick 2013) during Covid-19 lockdown situation. All the respondents appropriately lled the questionnaires, so the response rate was 100%. The survey packet was sent during the peak of Covid-19 pandemic (May 10th, 2020to May, 19th 2020. The questionnaires contained three basic demographical queries and sixteen questions on a 3 points Likert scale, relevant to study variables investigating the respondents' opinion regarding healthcare advertisements, their role in Covid-19 pandemic and their behavioral impacts. Further, the researchers used web-based surveys for data gathering purposes due to previously mentioned lockdown limitations.

Demographical Data:
Table 1 below shows the results of the demographical data. The ndings indicated that 69.7% of respondents were females, and 30.3% were males. Further, 47.2% of participants were between 16 to 25 years, 30.3% of respondents ranged between 26 and 35, 11.2% of respondents were between 36 to 45 years, 7.9% percent were 46 and above. Similarly, 5.1% of respondents had a secondary school degree, 10.7% were high school graduated or less, 24.2% had a bachelor's degree, 39.9% were university graduates, 17.4% possessed Masters level degree and 2.8% respondents had Doctorate. The respondents from diverse age groups and quali cation lled the questionnaires. The researchers measured demographical data by using IBM Statistical Package for Social Sciences Version 22. The research questionnaire is designed under the supervision of the subject experts. All the study variables also ensured the validity of the research instrument. Moreover, the researchers also tested the reliability of the research instrument as it determines the extent to which the research tool can provide valid and generalizable results (Taherdoost 2018). For reliability analysis, the researchers used Cronbach Alpha test. The Cronbach Alpha value of a= 0.812 a rmed that the research instrument is highly reliable. The values gathered by using Cronbach Alpha test are mentioned in Table 2 below:

Statistical Analysis And Results
The researchers employed descriptive statistics to calculate the frequency and percentage of the responses using the Statistical Package for Social Sciences (Arkkelin, 2014). The analysis procedure took two phases (i). First, the researchers calculated the frequencies and percentages of obtained responses and (ii) Second, the researchers conducted Multiple Regression Analysis to examine the proposed relationship between study variables. According to (Uyanık & Güler, 2013), multiple regression analysis is a helpful technique to test the potential connection between the variables. Therefore, the results indicated a positive relationship between media advertisements, healthcare awareness, and attitudinal changes among the audience statistically. In support of H1, the majority of participants (n= 132 or 74.2%) revealed that media in Pakistan frequently broadcast pubic service advertisements that quickly grab their attention (n= 128, 71.9%).
According to n= 122 or 69.7% of respondents, these advertisements give positive, constructive messages, and they (n= 147, 82.6%) appreciate the media efforts regarding Public Service Advertisements. Moreover, n= 151 or 84.8% of respondents also believed that these messages are well capable of bringing positive changes.
Notably, regarding Covid-19 awareness, n= 140 or 78.7% of participants agreed that media sources are regularly showing awareness advertisements which are keeping them (n= 145 or 81.5%) updated about the current Scenario of Corona Virus in Pakistan and worldwide. Thus, according to n= 127 or 71.3% of respondents, these advertisements contain useful information regarding public awareness of Covid-19. As this study contains three dependent variables, Mulitple Regression Analysis was the most suitable test to validate the postulations (Grégoire 2015). To highlight the assessment results, the researchers obtained RSquare, t-value and p-value and mentioned them in Table 3 below. Based on data analysis, H1, H2 and H3 were fully supported by empirical data. Thus, "Public Service Advertising" (PSA) and "Healthcare Advertisements" are positively correlated with the attitudinal change (β= .518, P= .000), (β= 7.439, P= .000), (β= 6.422, P= .000) respectively. Thus mass media marketing is positively associated with attitudinal changes among the audience. These results are consistent with the study conducted by ) as they also found a positive correlation between media marketing and attitudinal change among the study respondents. Thus mass media marketing is positively associated with attitudinal changes among the audience.  (Ingenhoff and Koelling 2012). Especially during the current pandemic, media platforms are playing an important role to spread awareness (Mejia et al. 2020). In this regard, the role of Public Service Healthcare Advertising is remarkable for persuading the audience (Alhawamdeh, Alghizzawi, and Habes 2020). Medical practitioners also consider controlling the infection through preventive measures as one of the most effective strategy (Collinson, Khan, and Heffernan 2015). Therefore, in support of H1, H2 and H3, we conclude that media advertising is playing a substantial role in knowledge, awareness and shaping attitudes of people (Karasneh et al. 2020) in Sahiwal, Pakistan.
According to (Alhawamdeh, Alghizzawi, and Habes 2020), mass media platforms are currently playing a signi cant part in bringing positive behavioral changes. They are capable of persuading the audience with rational argumentation and providing models to imitate and learn. Behaviorists widely suggest Social Learning theory as a basic mechanism to reinforce attitudinal changes in healthcare. For instance, to avoid obesity, some people show increased motivation for weight loss. They are psychologically motivated to control their urges for food and overeating as they determine the consequences related to over-eating (Braungart, Braungart, and Pamela R. Gramet 2011). In healthcare communication, observational learning is a prominent technique to avail attitudinal change (O'Regan et al. 2016). A study conducted by (Abramowitz et al. 2017) also validated the in uential role of health communication, especially through media platforms during the Ebola outbreak. According to researchers, people heavily relied on television, radio, newspapers, and digital media platforms to adopt preventive measures. Media platforms worked as social learning institutions and basic mechanisms to reinforce attitudinal change and adopt preventive measures during the endemic. Similarly, (Alhawamdeh, Alghizzawi, and Habes 2020) cited the importance of media marketing to encourage early breast cancer screening among Jordanian women. According to the researchers, increased dependence on mass media platforms is of greater signi cance to motivate people for personal healthcare through persuasive advertisements. Particularly, during the current pandemic (Wang et al. 2020), Public Service Healthcare advertising is largely promoting public healthcare awareness (Hong Cheng, Kotler, and Lee 2013).
Similarly, ) also consider media advertising as an important source to spread Covid-19 awareness. Their study results are fully consistent with the current study, validating the potential and impacts of media marketing as a primary mechanism of awareness and behavioral change. We can see that this role is based on the "transactional model" of communication asymmetrical and motivates rational thinking. For this purpose, social marketers pay special consideration to persuasion, exposure, and behavioral theories where behavior modeling and observation are specially used (Evans 2006). In this regard, (WHO 2017) proposed designing a strategic framework for healthcare' communication and emphasized all the traditional and digital media platforms to play their part. The World Health Organization also suggested the universal applicability of the relevant strategic healthcare communication. Although healthcare communication can confront to certain limitations, the proposed strategic models can help to avail desired behavioral changes. When technology is evolving, and media platforms are accessible for everyone (Cordos, Bolboaca, and Drugan 2017), health communication is of greater magnitude (Abdul, Ansari, and Khan 2020).

Discussion & Conclusion
The COVID-19 pandemic happens in a much more programmed and linked environment, relative to the 2002-2003 outbreak. The sum of data generated from the dawn of humankind through 2003 is produced and disseminated in a moment today. In addition, advanced computational models, such as those focused on the machine learning, have shown tremendous prospective to trace the source or forecast the future spread of infectious diseases. Therefore, leveraging massive data and smart dissection, putting them for effective use to ensure public health and creating awareness among the general public through media platforms, is imperative. Relying on digital data sources, such as data from mobile phones and other digital devices and spreading it among people through media advertisements, is of particular value in outbreaks caused by newly discovered pathogens, for which o cial data and reliable forecasts are still scarce (Ienca and Vayena 2020). COVID-19 pandemic has triggered a global health emergency that has a profound effect on how we interpret our society and our daily lives. Not only the spread rate of pandemic and transmission methods jeopardized our sense of safety, but the precautionary measures implemented to control the rise of transmission of the virus also require social distancing by refraining from doing what is inherently human, which is to nd comfort in the company of others. Within this context of physical threat, social and physical distancing, the role of the different mass media channels and social media in lives on individual, social and societal levels cannot be underestimated.
After the declaration of the COVID-19 pandemic, the government of Pakistan took several measures to cope with it (NIH 2020). To overcome the disease outbreak, Pakistan National Institute of Health played a pivotal role in devising and circulating protocols regarding COVID-19 prevention, transmission and defection, as well as launching public awareness campaigns on media platforms. These relate to the use of personal protective equipment and facemasks, the handling of suspected cases, sample' collection and transport through a virus transport medium, and adequate hand and general body hygiene (NIH 2020).
As validated by the study results, media advertisements are playing an in uential role in keeping the general population aware of the protective measures. The proposed model also anticipated the potential impacts of Coivd-19 awareness campaigns and results further authenticated the propositions as the need for communication with the public during the health crisis is of more considerable signi cance (Naveena 2015). This study also witnessed that the media platforms are following every step of this journey -with multiple stories, incessant headlines and continuous updates across the past few weeks. Mass media have long been recognized as powerful forces shaping how we experience the world and ourselves focusing on generating awareness without causing panic or speculating too much.
Healthcare experts are giving great emphasis on advertising health communication strategies that are collaboratively designed, implemented, and evaluated.
Besides news updates and short informative videos and info graphics, Media outlets also initiated a competition inviting children and parents to share activities they are doing at home during self-isolation. Moreover, besides traditional media channels, Social media platforms are also playing a crucial role in disseminating news about the spread of COVID-19. Additionally, with such a broad scope of responsibility and overall power over the distribution of information, many platforms are rushing to do what they can to help, including donating to support relief efforts, taking steps to prevent fake news, and offering advice to the general public (Brindha 2020).
Therefore, mass media enabled healthcare professionals to directly access the public to expand their research regarding healthcare awareness. The media platforms not only facilitate the spread of information, but also in uence public opinion and behavior. Mainly, media advertisements that are capable of accessing almost all the parts of Pakistan are highly in uential in spreading Covid-19 awareness messages. Advertisements on traditional media platforms are an effective way to convince the target audience, and Social Media is also playing their part. However, the growing number of Corona positive cases is a signi cant challenge for all social institutions as Pakistan is a developing country with limited healthcare and nancial resources (Waris et al. 2020). Besides government, major social institutions like the media are further required to play their role more effectively as the global health emergency is briskly growing (Saqlain et al. 2020) and overburdening the healthcare sector in Pakistan.

Study Contributions:
This study examined the role of mass media advertisements regarding Covid-19 awareness. The researchers employed a self-constructed model as the conceptual framework of study. The ndings are consistent with the previous studies highlighting the role and effectiveness of healthcare advertisements on audience behavior. As per noted by (Banerjee and Dash 2013) media advertising aimed to spread disease awareness from a campaign effectiveness point of view, is highly persuasive and fruitful. However, more media-based campaigns should be designed to optimize relevant advertisement features. Thus the model proposed in this study can be applied to the other investigation, and constructive outcomes can be obtained.

Limitations & Recommendations:
Previous studies witnessed the power of media advertisements to spread healthcare' awareness, and the current analysis validated this proposition. However, this study contains some limitations. First, due to the lockdown situation in Pakistan, we used convenience sampling method and gathered the data by webbased surveys, we did not have any particular sampling frame. Second, Corona Virus cases are briskly growing; the statistics we used might change in the upcoming days. Therefore, we suggest more studies to scrutinize the effectiveness of media' advertisements and other relevant content to spread disease awareness. For this reason, the proposed model can be used to improve the contributions of Covid-19 awareness campaigns. Regression Analysis of the Conceptual Framework