It's better together! European perspective on benefits and challenges associated with cross-border health communication campaigns.

Recent years have witnessed greater involvement of European Union (EU) organisations in health communication campaigns that address chronic diseases and that are designed for implementation in multiple countries. This development raises challenges inherent in adapting the design of public health communication campaigns to multi-national settings. This article provides a first exploratory investigation of these challenges and how to address them based on data gathered from four expert focus groups, each concentrated on a common risk factor for chronic disease: smoking, alcohol consumption, unhealthy diet and sedentary lifestyle. Despite the exploratory nature of the data, it was possible to identify several common key challenges: variation in behaviours, social and cultural norms, and issues related to language and communication channels, the divide between EU stakeholders and local actors, and differences in national legislation and available resources. Two risk factor-specific challenges were also identified: effective messaging for complex issues (unhealthy diet) and the involvement of industry representatives (smoking, sedentary lifestyle). We propose conceiving of cross-national communication campaigns as providing a common blueprint and structure that can inform and support the development of differentiated yet harmonised local campaigns.