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coke ad: what is being sold here? lifestyle by way of drinking cokedesired outcome: selling more coke
- 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?
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.
example of critical social marketing: working directly against goals of commercial marketing
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
Warn, protect, plus exchange… (what kind of influence is mobilized here?)
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?
persuasive technology: study of human-computer interaction and the social influence of computers and other electronic devices; e.g. digital health coaching
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
these are all patient-focused topics or conditionsprovider behavior is also targeted
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?
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
deeper understanding of the values, priorities, and practices of the intended audience
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)
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
i.e. which segment should you focus on?stages of change; social norms
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)
- 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
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
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
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
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
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
1. This is a planning model that some social marketers use instead of the 4Ps
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?
range of strategies to avoid one size fits all: , e.g. education, support, re-design environment, regulation/control
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.
- 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
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
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
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.
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
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?
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”
in the right place and consistently full; address myths (dry skin)clean zones throughout hospital
- reduce barriers goal: increase appeal of cycling by equalizing diff modes of transport
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
public events promoting cycling, media campaign, “cycle chic”, (no helmets!)
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
Social Marketing Strategies in Health Care: An Introduction
+ 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 marketingcritically examinescommercialmarketing so as tolearn from itssuccesses andcurb its excesses.”
+ questioning the “rational man” theory of exchange Image credit: Fairfax County, Virginia: http://www.fairfaxcounty.gov/hd/flu/
+“Marketing Mix”/4Ps1. PRODUCT and its presumed benefit2. PRICE, or what audience has to do to obtain product3. PLACE, or how product reaches audience4. PROMOTION, or strategy to create and sustain demand for product
+ Critique of 4Ps1. Checklist?2. The 4Ps are not behavior change tools3. What about barriers/benefits?
+ Alternatives to 4PsCommunity-Based Social Marketing:- behavior change via addressing barriers- less focus on attitudes & beliefs http://www.cbsm.com/public/world.lasso
+Total Process PlanningModel 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 complyProject: tailored interventions “clean leaders”
+ NSMC hand hygiene project in a Scottish hospital WHO 5 moments depiction: great in principle but not in practice
+ 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 campaignGoal: increase commuting by bicycle to: - reduce pollution and congestion - improve public healthStrategy: - foster and spread “bicycle culture” - change infrastructure to reducebarriers to cycling photo and content credit: City of Copenhagen Technical and Environmental Administration
+ 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