Background: Evaluations of physical activity and health media campaigns have been limited and ignore the complex process of communication and the socially constructed nature of news messages.

Methods: A systematic search strategy was conducted of the literature which was then assessed from two perspectives. First, studies since 1998 were reviewed for their success in impacting message recall and behavior change. Second, employing a critical media studies perspective the papers were assessed for the presence of a more sophisticated understanding of the media processes of inception, transmission and reception.

Results: Overall, recent studies support mass media interventions in influencing short-term physical activity message recall and to a lesser extent associated changes in physical activity knowledge. However, the majority of the papers were found to follow a social marketing or media advocacy theory of media promotion with little in-depth consideration of the comprehensive media processes involved in creating media messages and meaning.

Conclusions: Simplistic understandings of media transmission dominate in assessing physical activity and health media campaigns. Fuller understandings of the success of media campaigns, the recall of media messages or associated behaviour change can only truly be understood through the application of a more sophisticated form of media analysis.