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 ³marketer´ for future IPP initiatives 

 Only .Newsweek and Discovery Channel Poll (2000)  83% of the respondents knew about the harmful effects of sugar and fatty foods 42% were seriously trying to improve their diets.


 As volume increases. than in the previous 5000 yrs.  More than 4000 books published around the world every day.Things to ponder about« More information in the last 30 yrs. is any of the information getting into people¶s minds???  .

³Positioning´ AND ³Re-positioning´  MIND: The ultimate marketing battleground The better understanding of how mind works = the better ³positioning´ Positioning and re-positioning determine how repeople will think about your ³Product/process/ idea´ ± Appeal via the benefits   .

Minds hate confusion and can lose focus easily. Minds are insecure. Minds don¶t change easily.   .Understanding the MIND   Minds are limited.

  . it must be transferred to long-term longmemory (80% never gets transferred!) WHY?? Because. the message is in short-term shortmemory (Rule of Seven) Third.Minds are limited   First. Message = Not interesting. not emotional. minds have to be selective. get through the ³volume control´ Second.

 . Information and data  More information = More confusion  Solution: Solution:  Bite size information that is easily understood and KISS  Focus on a few powerful information and drive it into the mind.Minds hate confusion and can lose focus easily.

Minds are insecure Most people tend to do what others do  ³Principle of social proof´ Behavior is correct = others perform it This can be a conduit to influencing behaviors by:  Testimonials  Creating a ³bandwagon´ effect  .

necessary to change a person¶s beliefs. because beliefs are thought to provide the cognitive foundation of an attitude. In order to change an attitude.Minds don¶t change easily ³Belief systems are important from the perspective of information. eliminate old beliefs. or introduce new beliefs. Petty and Cacioppo .´ Attitudes & Perceptions by Drs. It is therefore. it is necessary to modify the information on which the attitude rests.

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 ³easier to change´ audiences (Diffusion of Innovations Theory)  .

Segmenting the general population  Demographics Physical/Medical history   Behavioral characteristics (³Do¶ers´ versus ³Non-Do¶ers´) ³Non- .

)  Develop audienceaudience-centered messages with a ³consumer perspective´ and secure the attention of the ³right audience´  Capture .Effective health communication efforts (Cont¶d.

and include easy action steps ± appropriate for the audience¶s stage of readiness Example: Example:  Target audience at Pre-contemplation: No Preperceived risk/relevance .) Make messages crystal clear.Increase awareness  Target audience at Contemplation: Promote benefits.Effective health communication efforts (Cont¶d. minimize perceived costs  .

) For message delivery  Involve a multi-pronged ³systems multiapproach´ (Different modes and channels)  Plenty of repeat messaging (One-time (Onemessaging does not work!) .Effective health communication efforts (Cont¶d.

Effective health communication efforts (Cont¶d.)  Base communication interventions on a behavioral theory or model using social marketing principles and techniques  Consider .

.´ Alan Andreason . execution.³The commercial marketing techniques to the analysis... planning.³The application of is..What is Social Marketing? Social marketing is.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.

implementation and control of programs aimed at increasing the acceptability of a social idea or practice in one group of target adopters.Social Marketing is« ³the design.´ 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 education/Promo: information, and educates individuals about a certain health issue END PRODUCT: Individuals who are educated  SM¶ing: Focuses on ³exchange of SM¶ing: value,´ ³competition,´ and careful audience segmentation END PRODUCT: Behavior change

³Marketing is co-existent with life. I offer cosomething 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







Susan D. provide protection for public. WHY. legislation Methods we can use to increase social pressure. and create incentives for health enhancing policies Social Marketing as a Model for Interventions that Facilitate Change Dr. rules. ETC What is the health problem? What actions could reduce the problem WHO MUST ACT TO RESOLVE PROBLEM Target audience Stakeholder. create action by third parties. 1995 .or individual market research WHERE (HOW) THEY CAN DO BEHAVIOR Place 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 POLICY/RULES THAT INFLUENCE THE ACTION Policy.Social Marketing: A Model for Interventions that Facilitate Change Increasing knowledge Increasing benefits Decreasing barriers Improving self-efficacy Increasing social pressure or norms WHY THEY WANT TO DO IT Pricing HOW YOU TELL THEM ABOUT THE WHAT. 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.

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. WHY. learn how. WHAT. or see new behavior HOW you will tell them about the WHO. 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 .

g. Condoms.Four P¶s of Social Marketing (Cont¶d. medication) (Behavior change among certain target audiences to do the intended behavior)  Intangible .) Product:  Tangible (e.

social.) Price:  Direct cost of the product in $$¶s cost of the product (psychological. situational)  Indirect .Four P¶s of Social Marketing (Cont¶d.

billboards.) Place:  Message dissemination (via electronic or print media.Four P¶s of Social Marketing (Cont¶d.) Going where the ³customer´ is  Product distribution  . etc.

) Promotion: Communicate to the target audience(s) that the product is worth the price. .Four P¶s of Social Marketing (Cont¶d.

Other P¶s of Social Marketing Pull & Push:  Two  strategies that work together ³Push´ is aimed at the ³distributor´  ³Pull´ is aimed at the ³consumer´  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 ³Price?´ .

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  .




to audience¶s needs . so the company will make $$  Understands audience  Fills an audience need  Tells audience how product fills their need Us: Health Education or Communication program   GOAL = Decrease incidence/(incidence/(-)behavior Tells audience that numbers are bad and they need to be better  Tells audiences what to do without any audience view  Not framed acc. of XYZ Company GOAL = $$ Does not tell audience to buy products.Whose Payoff?   Marketing Dept.

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 vary greatly across people a major reason to segment populations  Values .

Exercise Two Whose Benefit? WIIIFM? .

Syphilis Elimination Effort (SEE) Toolkit .Resources  STD Communications Database  Research .

behaviors. attitudes. knowledge.cdc.What is STD Communications Database?  A web-based tool that enhances webformative research http://www. and practices (KABPs) of various target audiences and at-risk populations on atmatters relating to STDs  .gov/std/commdata/ Information on characteristics.

What is ³SEE Community Mobilization Toolkit?´   A toolkit containing audienceaudience-specific products Purpose: Purpose: Give state and local health departments the tools to reach out and build necessary coalitions for syphilis elimination work .

Selected target audiences  Policy  Health Makers/Opinion Leaders Care Providers Representatives  Community .WHO? .

Methodology ± How? Literature review and ³environmental scanning´ Formative research  Recruitment via ³snowball´ sampling technique OpenOpen-ended key informant interviews (238 interviews at nine sites) Data analysis   .

tones.Research Questions  Perceived severity of syphilis  Barriers and overcoming these barriers  Suggested messages. spokespersons  Preferred methods and channels of receiving information  Relationship between HIV and syphilis .WHAT? .

Findings A)Barriers 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 ³second 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 knowledge and awareness about syphilis in general public funding  Increase  Increase .

serious tone Factemphasizing syphilis rates and consequences of syphilis ³Get the facts out.Findings C) Suggested messages.´ ³There is nothing funny about syphilis´ . tones. You have to be blunt with them and correct the idea that syphilis is gone. spokespersons General theme: Fact-filled.educate people.

tones. political leaders as spokespersons  CBOs emphasized the importance of clergy¶s role.) Elected Officials preferred local community leaders  Opinion Leaders: Local and nat¶l celebrities. spokespersons (Cont¶d. and culturally sensitive messages  .Suggested messages.

tones.) HCP: Medical authority (Surgeon General. symptoms Relevance of syphilis to one¶s practice Guidance on sexual history taking .Suggested messages. on prevalence. spokespersons (Cont¶d. professional organizations) Need for clarification of what syphilis elimination means Simple treatment protocols and guidelines Info. CDC. signs.

newsletters. newsletters  HC providers: Professional literature providers: and meetings. other HCPs  Elected Officials: Internet. Officials: newsletters from authoritative sources . mass media.Findings D) Preferred method/channels of receiving information  CBOs and community leaders: Internet leaders: and mass media.

Summary of Findings Main Gaps in Knowledge and Awareness  Signs and symptoms of syphilis ³Syphilis is a disease of yesterday´ National Syphilis Elimination Plan   .

culturally factsensitive communication materials with a serious tone for all target audiences AND facilitate community mobilization .What to do with these findings? Increase knowledge and awareness about syphilis among selected target audiences and in general public BY: Developing fact-filled.

A Sampling of SEE Toolkit Materials  Community Mobilization Guide  Various brochures  Camera-ready print ads Camera Syphilis pocket guide and sexual history taking pamphlet for health care providers (HCPs) .

)  Tip sheets lists (Local CBOs and Policy  Contact Makers)  MSM-specific MSM- materials .A Sampling of SEE Toolkit Materials (cont.

cdc.Availability of SEE Toolkit Materials (Cont¶d.)  On the web: CDC Warehouse (Order by phone or via the order form online)  .

uncluttered and uniform manner For message delivery. involve a multi-pronged ³systems multiapproach´ with plenty of repeat messaging    .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.

CDC¶s Commitment to You  Training  Technical assistance .

THANK YOU! Wrap up & Questions .

Exercise Three What¶s next? .

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