Social Marketing Theory

by Hendrika Meischke Social marketing theory is a combination of theoretical perspectives and a set of marketing techniques. Social marketing has been defined as: "the design, implementation, and control of programs seeking to increase the acceptability of a social idea or practice in a target group.1 It utilizes concepts of market segmentation, consumer research, idea configuration, communication, facilitation, incentives, and exchange theory to maximize target group response.1 In social marketing the intervention is developed from a solid base of communication and social-psychological theories: marketing techniques are used to supplement message development and program implementation.2 Social Marketing theory is based on the "marketing philosophy" that people will adopt new behaviors, or ideas if they feel that something of value is exchanged between him/her and the "social marketer".3 Thus, one of the goals of a social marketer should be to meet consumer needs and wants The "something" can be a tangible product (i.e., oral contraceptive) or an idea (i.e., notion of family planning) or both. Another assumption is that well-honed and demonstrably effective techniques from the commercial business sector can successfully and efficiently be applied to advance social causes.4 These techniques include the five "P's"- product, price, place, promotion and positioning. In brief, the product refers to the behavior (i.e., eating low fat foods) or idea (i.e., eat five fruits and vegetables a day for better health) that the audience needs to accept. A product line refers to the variety in which the product can be promoted (i.e. drink fruit juice instead of eating a banana) to attain the goal of adoption of the product. The price of the product refers to the monetary as well as the non-monetary cost of a product. These non-monetary costs include psychological, social, or convenience costs. For instance, promotion of a low fat diet may not only require buying higher priced low fat products but also increase difficulty in obtaining such products, preparing them and making them part of a new lifestyle. Reducing these costs greatly increase the chances that a new idea/product will be adopted. The place refers to the distribution sites of the product. The greater the number of distribution sites and the more convenient and appropriate the places where the product can be found the better chance that awareness and use of the product is facilitated. Promotion of a product refers to the ways in which the audience is made aware of the product, such as use of advertisements, direct marketing and other avenues. In the promotion of a product social marketing campaigns rely on the interaction between mass media and interpersonal channels for increasing awareness and facilitating change. Positioning refers to the psychological "image" of the product. For instance, the promotion of a low fat diet can be "positioned" as a healthy way to a "slimmer" body, or, a way to reduce the chances of getting health disease or certain types of cancer. Social-psychological theories, complemented with empirical evidence, are important in establishing the variables of importance for adoption of the "product". Careful definition of the problem and clear objective setting are important to any campaign. However, the most significant contribution of social marketing has been the strong focus on consumer needs.2 To maximize the five P's in a social marketing campaign, identification of needs and wants of "consumer" is key to successful marketing of ideas and behaviors. To find out more about the needs and wants of the audience is to conduct intensive audience analysis, including preproduction and production research5, and to design campaign elements for different subgroups (audience segmentation). Audience segmentation refers to the process of breaking down the mass audience into smaller subgroups that are internally as homogeneous as possible while being as different as possible from other groups. However, the "audience" in a social

marketing campaign consists of many different stakeholders. The success of social marketing campaigns is largely dependent on the "buy-in" of all the stakeholders (i.e., the community at large).3 Most social marketing campaigns rely to some extent on the use of existing agencies in the communities for distribution and promotion of the product. In the past four decades, Social marketing theory has become one of the most popular frameworks for the design, implementation and evaluation of health behavior interventions, both in the United States and abroad. The early campaigns, in the 1950's, were conducted in developing countries and focused on family planning, oral rehydration and immunization campaigns. In the past two decades social marketing campaigns have been conducted in developed countries as well , to bring about other kinds of behavior change: smoking cessation, diet, condom use, helmet use and other preventive health behaviors. There is a great deal of literature on some very successful programs in developing countries. 6-10 In the United States, successful social marketing campaigns include campaigns on: cardiovascular health,11-12 , increasing fruits and vegetables (5-A-Day campaign)13,increasing low-fat eating for Americans,14 decreasing drug use15 increasing condom use16-18 and HIV counseling.19 Evaluation of Social Marketing campaigns include many different formative, process and outcome measures from audience analysis (i.e. focus group research) to assessment of community involvement, tracking of promotional activities; counting of actual sales of Social Marketing products, as well as evaluation of changes in awareness, attitudes and behaviors. The measures for these evaluations are generally based on program goals and other theoretical frameworks. Critique Because social marketing theory is more like a "set of principles" rather than a formal theory, there are few campaigns that include all Social Marketing constructs simultaneously. Most interventions are "losely" based on social marketing principles, most often including only one or two aspects of this comprehensive theoretical and technical framework,20-24 most notably audience analysis (most often through focus group or survey research), audience segmentation and involvement of community agencies. In general the empirical evidence seems to support the importance of thorough audience analysis and involvement of community agencies for successful design and implementation of health behavior campaigns. This suggests that knowledge of the audience's beliefs, attitudes and behaviors is critical in the design of an effective intervention. Indeed, one of the criticisms of Social Marketing has been that the main emphasis is on the individual rather than the individuals' larger environment.2 It appears that the endorsement, support and resources of individuals' social and physical environment facilitates or hampers campaign activities. It is not clear how the individuals' beliefs/attitudes/behaviors is affected directly by the person's environment. Emerging and related concepts in Social Marketing Meeting individuals needs and desires is a corner stone of Social Marketing. Newer, interactive technologies are able to tailor messages to meet those needs in a quick and efficient manner. Use of computers in generating such messages and use of the World Wide Web/Internet to facilitate the dissemination of this process will greatly enhance health care professionals' ability to target subgroups with relevant information. Related to Social Marketing is the notion of "edu-entertainment". Edu-entertainment refers to the use of traditional entertainment media (i.e. soap operas, rock songs, theater) for educational purposes. There are many examples of use of entertainment programming for the adopting of social ideas and health habits.25-27 In some programs, health issues are portrayed within the entertainment programming. In other programs, 90-second health segments follow popular

shows such as ER or Chicago Hope with the intention to instruct viewers on how to prevent the type of injury or disease portrayed in the weekly television drama. Although it's difficult to implement and evaluate such program, they hold great promise for reaching audiences with important life-style information at a time when they are likely not resisting the message. Another approach to behavior change which has gained visibility in the past decades is Media Advocacy. Media advocacy is the "strategic use of mass media for advancing a social or public policy initiative"".2 Media advocacy promotes a range of strategies to stimulate broad-based media coverage in order to reframe public debate to increase public support for more effective policy level approaches to public health problems.28 Strategies used to accomplish these goals include: "creative epidemiology", "issue framing: and "gaining access to media outlets". References 1. Kotler, P. (1975). Marketing for nonprofit organizations. Englewood Cliffs, NJ:Prentice Hall. 2. Wallack L. 1990.Improving Health Promotion: media advocacy and social marketing approaches. In C. Atkin & L. Wallack (eds). Mass Communication and Public Health. Complexities and Conflicts. Sage, Newbury Park 1990. 3. Solomon, D.S. A Social Marketing Perspective on Communication Campaigns. In R.Rice and C. Atkin (eds). Public Communication Campaigns. 2nd edition. Sage, Newbury Park. 1989. 4. Chapman Walsh, D., Rudd, R.E., Moeykens B.A. & Moloney, T.W. (1993). Social Marketing for Public Health. Health Affairs,Summer;104-119. 5. Atkin, C., & Freimuth, V. Formative Evaluation Research in Campaign Design. . In R.Rice and C. Atkin (eds). Public Communication Campaigns. 2nd edition. Sage, Newbury Park. 1989. 6. DeJong, W. Condom promotion: The need for a social marketing program in America's inner cities. Am J Health Promotion, 1989;3(4):5-10. 7. Altman L, Piotrow PT. 1989. Social Marketing: does it work? Population Reports 13;393-05. 8. Sherris, J.D., Ravenholt, B.B., Blackburn, R. 1985. Contraceptive Social Marketing: Lessons from experience. Population Reports, 30-J774-811. 9. Clift E. 1989. Social Marketing and Communication: changing health behavior in the Third World. Am J Health Promotion3:17-24. 10. Population Services International (PSI). 1991. Social Marketing and Communications for Health. Washington D.C. 11. Maccoby N, Farquhar JW, Wood P, Alexander J. 1977. Reducing the risk of cardiopulmonary disese: effects of a communication based campaign on knowledge and behavior. J. Community Health 3:100-14. 12. Farquhar J.W., Fortmann, S.P., Flora, J.A., Taylor, C.B., Haskell, W.L., Williams, P.T., Maccoby, N., Wood, P.D. Effects of communitywide education on cardiovascular disease risk factors. The Stanford Five-City Projects. JAMA. 1990.264(3):359-65.

13. Foerster S.B., Kizer, K.W., Disogra, L.K., Bal, D.G., Krieg, B.F., Bunch K.L. California's "5a-day-for better health" campaign: An innovative population-based effort to effect large-scale dietary change. Am J Prev Med. 1995 11(2):124-31. 14. Samuels, S.E. Project LEAN - Lessons learned from a National Social Marketing Campaign. Public Health Reports, 1993;108(1):45-53. 15. Backer T. E., & Marston, G. Partnership for a drug-free America: An experiment in Social Marketing. In T.E. Backer and E.M. Rogers (eds). Organizational Aspects of Health Communication Campaigns: What works? Sage. Newbury Park. 1993