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    Social Marketing:
    An Introduction
    Sara Ackerman, MPH, PhD
+
    What is Social Marketing?


       The use of concepts and strategies
     from commercial marketing to influence
         individual and social practices,
        with a goal of improved human or
              environmental health
+
    How does social marketing differ
    from commercial marketing?
      similar strategies:
      both sell products, ideas, practices




      different goals:
      profit vs. health or well being
+
    Social marketing is not the same as
          social media marketing!
+
“Social marketing
critically examines
commercial
marketing so as to
learn from its
successes and
curb its excesses.”
+




    www.adbusters.org
+
    Dominant behavior change
    communications campaigns aim to:

        PROTECT             WARN
+


    PROTECT   WARN
+
    Beyond warn and protect…
+
            …integrating interests of the
            audience with those of the
            sponsor…




photo credit: www.adpunch.org
+
        Social marketing can be used to
        influence:

individual                         behaviors
social   processes
    and norms
policies

institutional                            practices

image credit: http://culturegenderhealth.blogspot.com/
+
    Social marketing draws on methods
    and theories from:
      Anthropology

      Behavioral   economics
      Design

      Persuasive   technology research
      Public   health
      Social   psychology
+
    Social marketing strategies are
    used to:
      Develop   communication campaigns

      AND…
      Design   educational materials
      Improve   services
      Re-design   structural/environmental
      conditions
+
    Some health topics that have been
    addressed by social marketing:
+

    Why might social marketing be

    more difficult than commercial

             marketing?
You’re trying to influence
people to do things they are
 uncomfortable with, don’t
  want to do, or can’t do
+



    social marketing
     principles and
        methods
+
          focus on audience

• Do you really know what’s
  best for your audience?


• Start by engaging and
  understanding your
  audience



photo credit: Ian Webster
+
       audience insight

    • formative research

    • process and outcome evaluation using
      “participant observation” and other
      qualitative methods
+
audience segmentation
    • one size fits all solution rarely works for
      complex behaviors
    • “psychographics”:
         values
         interests
         activities
         opinions
         geographic location
+
            your audience/
            target may be:
    • people whom you want to do
      something different
    • enablers
    • barriers
+
         how are audience
         segments chosen?
    • persuadable?
    • size and potential impact
    • need
    • influence on primary audience
    • accessibility
    • resources needed to reach audience
    • equity/social justice considerations
+
        exchange

       what I need for target audience
                      vs.
    what they desire, care about, aspire to
+
    exchange




               image credit: http://bit.ly/nvfY0Z
+
     questioning the “rational man”
    theory of exchange




                      Image credit: Fairfax County, Virginia: http://www.fairfaxcounty.gov/hd/flu/
+
“Marketing Mix”/4Ps
1.   PRODUCT and its presumed
     benefit

2.   PRICE, or what audience has to do
     to obtain product

3.   PLACE, or how product reaches
     audience

4.   PROMOTION, or strategy to
     create and sustain demand for
     product
+
      4Ps +
5.   PUBLICS

6.   PARTNERSHIP

7.   POLICY

8.   PURSE STRINGS

9.   POLITICS
+
     Critique of 4Ps
1.   Checklist?

2.   The 4Ps are not behavior change tools

3.   What about barriers/benefits?
+
    Alternatives to 4Ps
Community-Based Social Marketing:

-   behavior change via addressing
    barriers

-   less focus on attitudes & beliefs




                                        http://www.cbsm.com/public/world.lasso
+
Total Process Planning
Model




                 image and content credit: UK Alcohol Learning Centre
+
    SCOPE                               DEVELOP
       Identify and consult with          Look at current services
        stakeholders
                                           Involve stakeholders
       Conduct preliminary research
                                           Look at similar or competing
       Learn about your audience           programs – how will they
                                            reinforce or undermine your
        using qualitative methods           project?
       Segment your audience              Use theory appropriate to
                                            problem and audience
       Decide on research methods
                                           Develop barrier and exchange
       Develop evaluation procedures       model

                                           Test your project
+
    IMPLEMENT                        EVALUATE

       Use a range of strategies       PROCESS and OUTCOME
        and tailor campaign to           equally important.
        audience segments                 Process evaluation:
                                           insight into deviations from
       Conduct process evaluation         plan; understand what
        to determine if program is         produced observed
        being implemented as               outcomes
        planned and how people are
                                          Outcome evaluation: did
        responding
                                           you reach target audience;
       Continue working with              did desired outcome
        stakeholders                       occur?
+
    FOLLOW-UP

       Share/disseminate best
        practices

       Continue to track outcomes
        and assess sustainability of
        target behavior
+
    theories/explanatory models used in
    social marketing

    individual                         social/relational
       Social Cognitive Theory       social theory:
                                       citizenship, subjectivity, embodi
       Health Belief Model            ment, social/symbolic
                                       capital, power, historical context
       Stages of Change
                                      social network analysis
       Diffusion of Innovations
                                      coalition/collaboration (PAR)

                                      social justice, environmental
                                       justice
+
    critiques of social marketing



                 individual


            social, economic, en
            vironmental, instituti
            onal context
+
    Historical changes in
    smoking practices in
    U.S.
+
       SM relies too heavily on
       psychological behavior
          change theories

    “One principle that distinguishes the best
    social marketers is an unrelenting
    understanding, empathy and advocacy of the
    perspective of our priority population or
    community that is not slanted by what the
    theory or research evidence does or does not
    tell us.”
              - Craig Lefebvre
+
              Health behaviors are
               “wicked problems”!
    Effective change programs do not ONLY communicate
                   persuasive messages.

             They also try to modify the context
               using multi-faceted strategies.




                                                   photo credit:
                                                   NY Times, Dec.13, 2009
+ Another example of redesigning the
   environment to promote behavior
   change
+
    Unintended consequences
    of social marketing:
       Australia’s Slip Slop Slap
       campaign
       to prevent skin cancer
+
    Case Study:
           Cleanyourhands campaign
            UK National Social
            Marketing Center (NSMC)

     Social    marketing strategies

       Scale
+
    NSMC hand hygiene project in a
    Scottish hospital
 hand    hygiene compliance high, but hospital acquired infections
    increasing

 running    out of new ways to “sell” hand hygiene

 carrot  not stick – need to persuade
    people that it’s in their interests to comply

Project:

 tailored   interventions

 “clean   leaders”
+
    NSMC hand hygiene project in a
    Scottish hospital
    WHO 5 moments depiction: great in principle
    but not in practice
+
    alternative representation of 5 moments:
+




 gel:
     myths and
 dispensers

 canpatients
 remind staff to
 clean hands?

 clean   zones



                   image and content credit: UK National Social Marketing Centre
+
    Case Study #2:
       Copenhagen cycling
       campaign
Goal:

        increase commuting by bicycle to:
        - reduce pollution and congestion
        - improve public health

Strategy:

       - foster and spread “bicycle culture”
       - change infrastructure to reduce
barriers to     cycling
                          photo and content credit: City of Copenhagen Technical and Environmental Administration
+
    infrastructure
+
    bicycle culture




                      http://www.copenhagencyclechic.com/
+
        outcomes

       2010: 37% of people in greater Copenhagen
        commuted by bike

       planners’ goal: 50% by 2015

       public satisfaction with cycling
               1995: 17%
               2004: 83%
               2010: 94%

       survey: why do you cycle?
           55% it’s faster
           33% it’s more convenient
           32% it’s healthy
           29% it’s cheap
+
    Thank you!




                 photo credit: William Couch

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Social Marketing Strategies in Health Care: An Introduction

  • 1. + Social Marketing: An Introduction Sara Ackerman, MPH, PhD
  • 2. + What is Social Marketing? The use of concepts and strategies from commercial marketing to influence individual and social practices, with a goal of improved human or environmental health
  • 3. + How does social marketing differ from commercial marketing? similar strategies: both sell products, ideas, practices different goals: profit vs. health or well being
  • 4. + Social marketing is not the same as social media marketing!
  • 5. + “Social marketing critically examines commercial marketing so as to learn from its successes and curb its excesses.”
  • 6. + www.adbusters.org
  • 7. + Dominant behavior change communications campaigns aim to: PROTECT WARN
  • 8. + PROTECT WARN
  • 9. + Beyond warn and protect…
  • 10. + …integrating interests of the audience with those of the sponsor… photo credit: www.adpunch.org
  • 11. + Social marketing can be used to influence: individual behaviors social processes and norms policies institutional practices image credit: http://culturegenderhealth.blogspot.com/
  • 12. + Social marketing draws on methods and theories from:  Anthropology  Behavioral economics  Design  Persuasive technology research  Public health  Social psychology
  • 13. + Social marketing strategies are used to:  Develop communication campaigns AND…  Design educational materials  Improve services  Re-design structural/environmental conditions
  • 14. + Some health topics that have been addressed by social marketing:
  • 15. + Why might social marketing be more difficult than commercial marketing?
  • 16. You’re trying to influence people to do things they are uncomfortable with, don’t want to do, or can’t do
  • 17. + social marketing principles and methods
  • 18. + focus on audience • Do you really know what’s best for your audience? • Start by engaging and understanding your audience photo credit: Ian Webster
  • 19. + audience insight • formative research • process and outcome evaluation using “participant observation” and other qualitative methods
  • 20. + audience segmentation • one size fits all solution rarely works for complex behaviors • “psychographics”: values interests activities opinions geographic location
  • 21. + your audience/ target may be: • people whom you want to do something different • enablers • barriers
  • 22. + how are audience segments chosen? • persuadable? • size and potential impact • need • influence on primary audience • accessibility • resources needed to reach audience • equity/social justice considerations
  • 23. + exchange what I need for target audience vs. what they desire, care about, aspire to
  • 24. + exchange image credit: http://bit.ly/nvfY0Z
  • 25. + questioning the “rational man” theory of exchange Image credit: Fairfax County, Virginia: http://www.fairfaxcounty.gov/hd/flu/
  • 26. + “Marketing Mix”/4Ps 1. PRODUCT and its presumed benefit 2. PRICE, or what audience has to do to obtain product 3. PLACE, or how product reaches audience 4. PROMOTION, or strategy to create and sustain demand for product
  • 27. + 4Ps + 5. PUBLICS 6. PARTNERSHIP 7. POLICY 8. PURSE STRINGS 9. POLITICS
  • 28. + Critique of 4Ps 1. Checklist? 2. The 4Ps are not behavior change tools 3. What about barriers/benefits?
  • 29. + Alternatives to 4Ps Community-Based Social Marketing: - behavior change via addressing barriers - less focus on attitudes & beliefs http://www.cbsm.com/public/world.lasso
  • 30. + Total Process Planning Model image and content credit: UK Alcohol Learning Centre
  • 31. + SCOPE DEVELOP  Identify and consult with  Look at current services stakeholders  Involve stakeholders  Conduct preliminary research  Look at similar or competing  Learn about your audience programs – how will they reinforce or undermine your using qualitative methods project?  Segment your audience  Use theory appropriate to problem and audience  Decide on research methods  Develop barrier and exchange  Develop evaluation procedures model  Test your project
  • 32. + IMPLEMENT EVALUATE  Use a range of strategies  PROCESS and OUTCOME and tailor campaign to equally important. audience segments  Process evaluation: insight into deviations from  Conduct process evaluation plan; understand what to determine if program is produced observed being implemented as outcomes planned and how people are  Outcome evaluation: did responding you reach target audience;  Continue working with did desired outcome stakeholders occur?
  • 33. + FOLLOW-UP  Share/disseminate best practices  Continue to track outcomes and assess sustainability of target behavior
  • 34. + theories/explanatory models used in social marketing individual social/relational  Social Cognitive Theory  social theory: citizenship, subjectivity, embodi  Health Belief Model ment, social/symbolic capital, power, historical context  Stages of Change  social network analysis  Diffusion of Innovations  coalition/collaboration (PAR)  social justice, environmental justice
  • 35. + critiques of social marketing individual social, economic, en vironmental, instituti onal context
  • 36. + Historical changes in smoking practices in U.S.
  • 37. + SM relies too heavily on psychological behavior change theories “One principle that distinguishes the best social marketers is an unrelenting understanding, empathy and advocacy of the perspective of our priority population or community that is not slanted by what the theory or research evidence does or does not tell us.” - Craig Lefebvre
  • 38. + Health behaviors are “wicked problems”! Effective change programs do not ONLY communicate persuasive messages. They also try to modify the context using multi-faceted strategies. photo credit: NY Times, Dec.13, 2009
  • 39. + Another example of redesigning the environment to promote behavior change
  • 40. + Unintended consequences of social marketing: Australia’s Slip Slop Slap campaign to prevent skin cancer
  • 41. + Case Study: Cleanyourhands campaign UK National Social Marketing Center (NSMC)  Social marketing strategies  Scale
  • 42. + NSMC hand hygiene project in a Scottish hospital  hand hygiene compliance high, but hospital acquired infections increasing  running out of new ways to “sell” hand hygiene  carrot not stick – need to persuade people that it’s in their interests to comply Project:  tailored interventions  “clean leaders”
  • 43. + NSMC hand hygiene project in a Scottish hospital WHO 5 moments depiction: great in principle but not in practice
  • 44. + alternative representation of 5 moments:
  • 45. +  gel: myths and dispensers  canpatients remind staff to clean hands?  clean zones image and content credit: UK National Social Marketing Centre
  • 46. + Case Study #2: Copenhagen cycling campaign Goal: increase commuting by bicycle to: - reduce pollution and congestion - improve public health Strategy: - foster and spread “bicycle culture” - change infrastructure to reduce barriers to cycling photo and content credit: City of Copenhagen Technical and Environmental Administration
  • 47. + infrastructure
  • 48. + bicycle culture http://www.copenhagencyclechic.com/
  • 49. + outcomes  2010: 37% of people in greater Copenhagen commuted by bike  planners’ goal: 50% by 2015  public satisfaction with cycling 1995: 17% 2004: 83% 2010: 94%  survey: why do you cycle?  55% it’s faster  33% it’s more convenient  32% it’s healthy  29% it’s cheap
  • 50. + Thank you! photo credit: William Couch

Notas do Editor

  1. coke ad: what is being sold here? lifestyle by way of drinking cokedesired outcome: selling more coke
  2. - In the mid-2000s, social media and its commentators co-opted the term social marketing, which has been used since the early 1970s. Social media marketing is commercial marketing via online tools and platforms that people use to share info. with each other. The purpose is to recruit consumers in marketing efforts. - social media are an influential feature of the social landscape – how might they influence social marketing campaigns?
  3. Critical social marketing considers commercial marketing as both a resource and part of the problem. Social and commercial marketing are uneasy bedfellows and often work at cross purposes.
  4. example of critical social marketing: working directly against goals of commercial marketing
  5. Gov’t/public health message traditionally exemplified by public service announcement/now adopted by social marketers1) protect you from disease, from yourself or other people2) warn you about the consequences of particular behaviors
  6. Warn, protect, plus exchange… (what kind of influence is mobilized here?)
  7. What is the message of this campaign? That you won’t be able to wear your couture if you smoke and then die of lung cancer, or that lung cancer makes you less attractive? Target audience (segmentation): young women/readers of fashion magazines. Do you think this campaign would be effective?
  8. persuasive technology: study of human-computer interaction and the social influence of computers and other electronic devices; e.g. digital health coaching
  9. communication: most commonly used SM method (examples I’ve used so far)However, multi-level approaches are increasingly popular, and we’ll look at some examples laterwhy change environ? make it easier for people to adopt specific behavior
  10. these are all patient-focused topics or conditionsprovider behavior is also targeted
  11. e.g. give up addictive behavior; resist peer pressure, be uncomfortable, establish new habits, hear bad news, give up looking good (sunscreen), remember somethingWhat is going on in this message about HIV testing? A happy couple “knows” their HIV status. But what exactly do they know? What does the campaign promise?
  12. Bottom-up, not top down. Not expert driven. You may think you know what your audience’s needs are, but your program is unlikely to succeed if these presumed needs don’t match the priorities and concerns of your audience- protect/warn not enough- engage and understand in order to create program focused on their values, priorities and circumstances
  13. deeper understanding of the values, priorities, and practices of the intended audience
  14. all behaviors have complex determinants, i.e. different social, economic, structural factors can influence the same behaviormove away from conventional epidemiological categories (race, age, sex)
  15. i.e. target may not necessarily be the people whose behavior you want to influence, but those around them who have influence on their behaviorspeople/institutions/environments/policies that can make it easier for them to changepeople/institutions/environments/policies that can make it harder for them to change
  16. i.e. which segment should you focus on?stages of change; social norms
  17. based on idea that people act when they anticipate getting something they value or desire, or when benefits of practice are outweighed by its costs (physical, social, financial)i.e. how can you integrate interests of audience with those of sponsor (they are already intertwined)
  18. - what do people want/value: money, comfort, security, fun, health, beauty/sex appeal, happiness, romance, sex, excitement, rest, recognition, popularity, sympathy, pleasure, entertainment, peace of mind, convenienceupcoming examples shift away from protect and warn strategy and use value exchange instead
  19. many social marketers assume that exchange is voluntary and based on individual needs/wants However, individual wants may also be traded for the greater good, as in the case of vaccinesSo we need a more social framing of exchange
  20. conceptual framework used to design and plan SM programs. a. product: condom; -service: medical exam; -practice: breastfeeding, eating healthy diet; -feeling: hope, fun, social acceptanceb. importance of learning audiences’ perception of the issue and the product, including how important they feel it is to take action2. price/cost may be monetary or may involve time, effort, or risk of embarrassment or disapproval. Requires knowledge of audience’s perception of costs and benefits3. Place: requires knowledge about activities and habits of target audience, including where/when they might think about issue. Ex: mobile phone/age4. promotion can include advertising, public relations, promotions, media advocacy, environmental/structural change, institutional change, policy
  21. audiences your program has to address in order to be successful, inc. policymakers, gatekeepers, groups involved in approval or implementation of programcollaborating with organizations with similar goals can strengthen a program, since social and health issues are complex. e.g. patient advocacy groupspolicy change may be needed to support sustainability of programfunding sources and their prioritieslocal, nationalALL: individual behavior change is difficult to sustain if the social, economic, institutional environment doesn’t support the change over the long run
  22. The model suggests that a program will be successful if it can check off each of the PsMay act as impediment to thinking strategically about barriers and benefits and the tools needed to address them
  23. based on an understanding that programs that rely primarily on media advertising can be effective in creating public awareness and understanding of an issue, but are limited in their ability to foster behavior change. CBSM: beh change via direct engagement with communities and emphasis on reducing barriers to desired behaviorattitudes, belief, knowledge are difficult to change and often poor predictors of behavior2. used most often to promote environmentally sustainable behaviors, e.g. reducing energy consumption and waste, recycling, driving less
  24. 1. This is a planning model that some social marketers use instead of the 4Ps
  25. stakeholders: community advisory committeeaudience: where do they live, how do they think about their health, what are their social networks and values, what are the social, environ, econ determinants of behavior?- current services: can they be incorporated into your program?
  26. range of strategies to avoid one size fits all: , e.g. education, support, re-design environment, regulation/control
  27. Indiv theories often do not account for complex, relational, contingent nature of behavior, and may be particularly inapplicable to communities that are not white, educated, middle class.
  28. - Too focused on individual, not enough on context that shapes individuals: e.g. social processes, physical infrastructure, institutional culture, regulatory system, economic conditionsBehaviors can be very difficult to change if the environment that supports that behavior isn’t altered.Many SM campaigns use a large-scale, one-size-fits-all communications approach, which is not very effective on its ownMulti-disciplinary teams can help balance this out
  29. 2000 U.S. National Cancer Institute study reported that media campaigns produce reductions in smoking only when other social and structural factors actively change the environment of the smokerBogart, etc.: Hollywood representations reflect change in social value of smoking. From sophisticated and symbol of masculine strength to socially undesirableregulation has made places where smoking is permissible increasingly scarce
  30. many campaigns are theory-driven, rather than using theory in conjunction with an in-depth exploration of audience priorities and values. behavior change theories tend to reduce complex social behaviors to simple models focused on individual cognition, which can hide other important influences on behavior - not to mention the embodied, habitual nature of most behaviors
  31. Wicked: Shaped by complex, interdependent, changing factors – institutional, economic, social, technological. If these factor are not addressed by a behavior change intervention, it is less likely to succeed. Kaiser redesigned patient room not only to appeal to patients as consumers, but based on evidence that privacy, lighting, noise, and views of nature all affect patient outcomes.
  32. There is a small literature examining the unintended consequences of social marketing campaigns, e.g. negative effects of eliciting fear in an audience.Hand out 4Ps from Slip Slop Slap campaign w/Sid the Seagull
  33. Was it focused on communications, or were other approaches used as well? How was audience segmentation employed?Could a similar campaign be designed on a smaller scale and with a lower budget?
  34. more recent, smaller scale project than case study, based on some of its insightspractical interventions developed by staff after extensive investigation, and adapted for different wards and staff groupsimportance of champions – “clean leaders”
  35. in the right place and consistently full; address myths (dry skin)clean zones throughout hospital
  36. - reduce barriers goal: increase appeal of cycling by equalizing diff modes of transport
  37. train cars dedicated to bike, wheelchair and stroller transport; stairways with bike ramps, bike lanes physically separated from traffic (average width 7 ft, enabling conversation and overtaking), green bicycle routes (fast, safe, pleasant), abundant and convenient bike parking, re-designed intersections to reduce potential for bike-car collisions, readily available public bicycles
  38. public events promoting cycling, media campaign, “cycle chic”, (no helmets!)
  39. 30-40% of Danes are physically inactiveplanners: coalition of gov’t & industrycycling campaigns have increased cycling across the country, which has had a positive impact on public health. however, when people are asked why they cycle, health is not the top reason. nor is reducing carbon footprint. therefore, the campaign has very successfully blended the goals of the planners (reduced pollution and improved public health) with directly addressing the priorities of target population (commuters) – convenient, fast, safe, low-cost means of commuting