Transcript Role of Health Communications and Social Marketing in

Health Communications and
Social Marketing for IPP
Sureyya E. Hornston, PhD, MPH
Centers for Disease Control and Prevention (CDC),
Division of STD Prevention,
Behavioral Interventions and Research Branch
Atlanta, GA
May 17, 2007
Session Outline
How does mind work? Facts and
Realities
 Effective Health Communication Efforts
 Incorporating Social Marketing Principles
 Resources
 What’s next? Putting it all together

My Objectives:

Introduce effective health
communications and social marketing
principles

Assist audience in starting to think like a
“marketer” for future IPP initiatives
Newsweek and Discovery
Channel Poll (2000)
 83%
of the respondents knew
about the harmful effects of sugar
and fatty foods
 Only
42% were seriously trying to
improve their diets.
Things to ponder about…
More information in the last 30 yrs. than
in the previous 5000 yrs.
 More than 4000 books published
around the world every day.
 As volume increases, is any of the
information getting into people’s
minds???

“Positioning” AND “Re-positioning”

MIND: The ultimate marketing battleground

The better understanding of how mind works
= the better “positioning”

Positioning and re-positioning determine how
people will think about your “Product/process/
idea” – Appeal via the benefits
Understanding the MIND

Minds are limited.

Minds hate confusion and can lose
focus easily.

Minds are insecure.

Minds don’t change easily.
Minds are limited

First, get through the “volume control”

Second, the message is in short-term
memory (Rule of Seven)

Third, it must be transferred to long-term
memory (80% never gets transferred!)
WHY?? Because, minds have to be selective.

Message = Not interesting, not emotional.
Minds hate confusion and can
lose focus easily.
Information and data
 More information = More confusion
 Solution:
 Bite size information that is easily
understood and KISS
 Focus on a few powerful information
and drive it into the mind.

Minds are insecure
Most people tend to do what others do
 “Principle of social proof”
Behavior is correct = others perform it
This can be a conduit to influencing
behaviors by:
 Testimonials
 Creating a “bandwagon” effect

Minds don’t change easily
“Belief systems are important from the
perspective of information, because beliefs
are thought to provide the cognitive
foundation of an attitude. In order to change
an attitude, it is necessary to modify the
information on which the attitude rests. It is
therefore, necessary to change a person’s
beliefs, eliminate old beliefs, or introduce
new beliefs.”
Attitudes & Perceptions by Drs. Petty and
Cacioppo
What can we do?

Effective Communication
AND

Social Marketing can help…
Effective health
communication efforts
Segment the general population
and
 Target specific audiences with specific health
messages (Audience segmentation)

ONE SIZE DOES NOT FIT ALL!
Benefits of audience segmentation

Effective use of resources

Culturally competent, customized strategies

Appropriate channels of communication

Providing pportunity to establish partnerships
with audience focus

Identification of the “easier to change”
audiences (Diffusion of Innovations Theory)
Segmenting the general
population

Demographics

Physical/Medical history
Behavioral characteristics
(“Do’ers” versus “Non-Do’ers”)

Effective health communication
efforts (Cont’d.)
 Develop
audience-centered
messages with a “consumer
perspective”
 Capture
and secure the attention of
the “right audience”
Effective health communication
efforts (Cont’d.)
Make messages crystal clear, and include
easy action steps – appropriate for the
audience’s stage of readiness
Example:
 Target audience at Pre-contemplation: No
perceived risk/relevance - Increase
awareness
 Target audience at Contemplation: Promote
benefits, minimize perceived costs

Effective health communication
efforts (Cont’d.)
For message delivery
 Involve a multi-pronged “systems
approach” (Different modes and
channels)

Plenty of repeat messaging (One-time
messaging does not work!)
Effective health communication
efforts (Cont’d.)
 Base
communication interventions
on a behavioral theory or model
 Consider
using social marketing
principles and techniques
What is Social Marketing?
Social marketing is...“The application of
commercial marketing techniques to the
analysis, planning, execution,and
evaluation of programs designed to
influence the voluntary behavior of
target audiences in order to improve
their personal welfare and that of their
society.”
Alan Andreason
Social Marketing is…
“the design, implementation and control
of programs aimed at increasing the
acceptability of a social idea or practice
in one group of target adopters.”
Philip Kotler and Gerald Zaltman
Social Marketing is not…

Advertising

Public relations

Slick packaging of communication materials

Condom distribution

Health education
Difference between Health
Education/Promotion and Social
Marketing?
Health education/Promo: Relays
information, and educates individuals
about a certain health issue
END PRODUCT: Individuals who are
educated
 SM’ing: Focuses on “exchange of
value,” “competition,” and careful
audience segmentation
END PRODUCT: Behavior change

Marketing
“Marketing is co-existent with life. I offer
something and you give me something
back. Even in relationships, you are
marketing yourself, because you want
the other person to accept you.”
Dr. Sydney Levy - University of Arizona
Social Marketing:
A Model for Interventions that
Facilitate Change
WHY THEY WANT
TO DO IT
Pricing
Increasing knowledge
Increasing benefits
Decreasing barriers
Improving self-efficacy
Increasing social pressure
or norms
What is the health
problem?
What actions could
reduce the problem
WHO MUST ACT TO
RESOLVE PROBLEM
Target audience
Stakeholder,group,or
individual market
research
WHERE (HOW) THEY CAN
DO BEHAVIOR
Place
HOW YOU TELL THEM ABOUT
THE WHAT, WHY, WHERE,
AND HOW
Promotion or Communication
classroom teaching
mass media messages
media advocacy
small group discussion
patient/doctor interaction
point of purchase displays
community meetings
worksite education
ETC, ETC
community resources
partnerships
specific clinics
product offering sites
**may be where they learn how
to do behavior (training)
WHAT ACTION MUST BE
TAKEN
Product or Behavior
describing the action in a way
that is relevant to the target
audience and helps fulfill some
unmet need, but not contrary
to science
Social Marketing as a Model for Interventions that Facilitate Change
Dr. Susan D. Kirby, 1995
POLICY/RULES THAT
INFLUENCE THE ACTION
Policy, rules, legislation
Methods we can use to increase
social pressure, provide
protection for public,
create action by third parties, and
create incentives for health
enhancing policies
Social Marketing Elements


WHO needs to change

WHAT must they DO

WHY and WHY they might
NOT do this behavior


WHERE or WHEN they will get
access, learn how, or see new
behavior


HOW you will tell them about
the WHO, WHAT, WHY,
WHERE and WHEN


Intended Audience
Specific behavioral
objective
Key factors influencing
behavior in audience
Interventions that
address the behavioral
influencing factors
Communication
component of
intervention plans
Four P’s of Social Marketing
 Product
 Price
 Place
 Promotion
• Pull & Push
• Policy
Four P’s of Social Marketing
(Cont’d.)
Product:
 Tangible
(e.g. Condoms,
medication)
 Intangible
(Behavior change among
certain target audiences to do the
intended behavior)
Four P’s of Social Marketing
(Cont’d.)
Price:

Direct cost of the product in $$’s
 Indirect
cost of the product
(psychological, social, situational)
Four P’s of Social Marketing
(Cont’d.)
Place:
 Message
dissemination (via
electronic or print media, billboards,
etc.)
 Product distribution

Going where the “customer” is
Four P’s of Social Marketing
(Cont’d.)
Promotion:
Communicate to the target
audience(s) that the product is
worth the price.
Other P’s of Social Marketing
Pull & Push:
 Two
strategies that work together
“Push” is aimed at the “distributor”
 “Pull” is aimed at the “consumer”
 Reinforcing, synergistic effect

Other P’s of Social Marketing
Policy:
What can be done at organizational level
or at government level to support the
changes we are striving for?
Exercise One
What is the “Price?”
Everyone is tuned into…
….WIIIFM
Everyone is tuned into…
What
Is
In
It
For
Me??
WIIIFM
Everyone is tuned into…
What
Is
In
It
For
Me??
WIIIFM
WIIIFM in Social Marketing

If you do X you will get Y
X is a behavior
Y is something valued by
audience
 tangible
 intangible
Incorporating WIIIFM
Think from audience perspective
 Address influencing factors from their
perspective
 Communicate from their perspective
 Finding a MATCH between the desired
program behavior and WHY the
audience might WANT to do it

Whose Payoff?


Marketing Dept. of
XYZ Company
GOAL = $$
Does not tell audience
to buy products, so the
company will make $$
 Understands
audience
 Fills an audience
need
 Tells audience how
product fills their
need
Us: Health Education or
Communication
program


GOAL = Decrease
incidence/(-)behavior
Tells audience that
numbers are bad and
they need to be
better
 Tells audiences
what to do without
any audience view
 Not framed acc. to
audience’s needs
Health is not an end in itself…
It is a means to a valued end
 Our
job is to translate the value of a
behavior into the audiences’
language
 Values
vary greatly across people
a major reason to segment
populations
Exercise Two
Whose Benefit?
WIIIFM?
Resources

STD Communications Database
Research - Syphilis Elimination
Effort (SEE) Toolkit

What is STD Communications
Database?
 A web-based
tool that enhances
formative research
http://www.cdc.gov/std/commdata/
Information on characteristics,
knowledge, attitudes, behaviors, and
practices (KABPs) of various target
audiences and at-risk populations on
matters relating to STDs

What is “SEE Community
Mobilization Toolkit?”


A toolkit containing
audience-specific
products
Purpose: Give state
and local health
departments the
tools to reach out
and build necessary
coalitions for syphilis
elimination work
WHO? - Selected target
audiences
 Policy
Makers/Opinion Leaders
 Health
Care Providers
 Community
Representatives
Methodology – How?

Literature review and “environmental scanning”

Formative research

Recruitment via “snowball” sampling technique

Open-ended key informant interviews (238
interviews at nine sites)

Data analysis
WHAT? - Research Questions
 Perceived
severity of syphilis
 Barriers and overcoming these
barriers
 Suggested messages, tones,
spokespersons
 Preferred methods and channels of
receiving information
 Relationship between HIV and syphilis
Findings
A)Barriers to recognition of syphilis as
an important PH issue and to
garnering support:
 Lack of awareness and knowledge
about syphilis
 Characterization of syphilis as a
“second class disease” – Stigma
 Lack of advocacy and spokespersons
Barriers to recognition of syphilis as
an important PH issue and to
garnering support (Cont’d)
 Difficulty of talking about matters
relating to sex and STDs
 Lack of funds and resources
 Distrust of gov’t institutions
 Separate approaches for each STD and
HIV
 Competition from other issues
 Issues relating to reimbursement
Findings
B) Overcoming these barriers

Increase knowledge and awareness
about syphilis among TA
 Increase
knowledge and awareness
about syphilis in general public
 Increase
funding
Findings
C) Suggested messages, tones,
spokespersons
General theme: Fact-filled, serious tone
emphasizing syphilis rates and
consequences of syphilis
“Get the facts out;educate people. You
have to be blunt with them and correct
the idea that syphilis is gone.”
“There is nothing funny about syphilis”
Suggested messages, tones,
spokespersons (Cont’d.)
Elected Officials preferred local
community leaders
 Opinion Leaders: Local and nat’l
celebrities, political leaders as
spokespersons
 CBOs emphasized the importance of
clergy’s role, and culturally sensitive
messages

Suggested messages, tones,
spokespersons (Cont’d.)
HCP: Medical authority (Surgeon General, CDC,
professional organizations)
 Need for clarification of what syphilis
elimination means
 Simple treatment protocols and guidelines
 Info. on prevalence, signs, symptoms
 Relevance of syphilis to one’s practice
 Guidance on sexual history taking
Findings
D) Preferred method/channels of
receiving information
 CBOs and community leaders: Internet
and mass media, newsletters
 HC providers: Professional literature
and meetings, newsletters, other HCPs
 Elected Officials: Internet, mass media,
newsletters from authoritative sources
Summary of Findings
Main Gaps in Knowledge and Awareness

Signs and symptoms of syphilis

“Syphilis is a disease of yesterday”

National Syphilis Elimination Plan
What to do with these
findings?
Increase knowledge and awareness
about syphilis among selected target
audiences and in general public
BY:
Developing fact-filled, culturally
sensitive communication materials with
a serious tone for all target audiences
AND
facilitate community mobilization
A Sampling of SEE Toolkit
Materials
 Community
Mobilization Guide
 Various brochures
 Camera-ready print ads
 Syphilis
pocket guide and sexual
history taking pamphlet for health
care providers (HCPs)
A Sampling of SEE Toolkit
Materials (cont.)
 Tip
sheets
 Contact
lists (Local CBOs and Policy
Makers)
 MSM-specific
materials
Availability of SEE Toolkit
Materials (Cont’d.)

On the web:
http://www.cdc.gov/std/see/

CDC Warehouse (Order by phone or via
the order form online)
In summary…
For each target audience segment

Identify benefits that matter to the target audience

Consider ALL costs and barriers to the suggested behaviors

Also consider the WIIIFM

Make the suggested behavior easy to do or break it down to
easy action steps based on the stage of readiness

Deliver messages in a clear, uncluttered and uniform manner

For message delivery, involve a multi-pronged “systems
approach” with plenty of repeat messaging
CDC’s Commitment to You
 Training
 Technical
assistance
THANK
YOU!
Wrap up & Questions
Exercise Three
What’s next?