Picking through the social marketer's toolkit

In my previous entry, I highlighted some of the most successful healthy diet campaigns delivered so far by social marketers. The question now becomes, what lessons can be learned from these case studies? What are the key components of a successful dietary health message?

Several commonalities quickly emerge from a casual examination of the campaigns. First and foremost, every campaign conveyed a very simple message. The taglines ‘1% or Less’ and ‘Go for 2&5’ are succinct, catchy and highly memorable - increased awareness is virtually guaranteed with this approach. Secondly and more importantly, the messages were specific and actionable - they instructed the audience to change a particular dietary habit, rather than vaguely saying, ‘eat better.’ This is consistent with previous studies that continually demonstrate that a persuasive social marketing message with an explicit conclusion or recommendation is more successful than one which does not [1].

Another identifiable theme is that of message exposure; specifically, disseminating a message for a substantial period of time. Each of the successful Australian fruit and veg campaigns ran for three whole years, and evaluation of the Victorian 2 Fruit and 5 Veg Every Day campaign even revealed that audience awareness levels closely paralleled the budget being spent on advertising at any one time [2]. And, although the relatively brief 1% or Less campaign was clearly effective at instigating short-term behavioural change, evaluations of a replication of the campaign done in Hawaii recommended booster sessions in order for the effect to last [3].

Case studies aside, according to studies done on the topic there are several other message tactics that social marketers should employ, including:

• · Segmenting the population and tailoring messages to each segment, rather than using a mass, ‘one size fits all’ approach [4], [5], [6]



• · Employing a positive, rather than a negative appeal [4]
  


• · Using a credible, and preferably also a likeable and attractive message source [1]



• · Communicating the campaign message on multiple levels/channels [7], [8]
  

Now let’s delve a little deeper. Marketing theory is central to all social marketing campaigns, and while its application in social marketing campaigns may not be obvious initially, you can rest assured that social marketers base every one of their decisions upon it.

Take the example of behavioural change theory. Being that the core objective of social marketing is to change a population’s behaviour, it stands to reason that social marketers will be familiar with the relevant theory in order to recognise and predict the potential influences upon them. Social Cognitive Theory, the Social Ecological Model, the Theory of Reasoned Action, the Theory of Planned Behaviour and the Health Belief Model are all examples of behavioural change theories that have shaped the implementation of past health campaigns [7]. The 1% or Less campaign, for example, was founded upon the Theory of Reasoned Action. This theory, developed by Ajzen (1985) focuses on the influence of intention on any potential change in behaviour, which is in turn influenced by personal attitude and social norms [9].

Even the most simple and unsophisticated elements of a social marketing campaign are in fact rooted in marketing theory. Take, for example, the basic commonalities I pointed out earlier, such as having a concise message with a call to action. These tactics are actually grounded in message effects theory, which focuses on how formats, structure, and features of messages influence audience perceptions about health and health behaviours [7].

To wrap up, we have a sound understanding of the elements that a social marketing campaign designed to improve Australians’ dietary health should have. However, the challenges faced by social marketers in this field are enormous in both size and complexity, and any benchmarks of success need to be realistic. Obesity is a multi-pronged issue requiring a multi-pronged solution, but social marketing will certainly have an important role to play as authorities strive for a fitter and healthier Australia.

References:

1. Barbara, J.W., Designing Media Messages About Health and Nutrition: What Strategies Are Most Effective? Journal of Nutrition Education and Behavior, 2007. 39(2S): p. S13.

2. Robert, H. and K. Bridget, Communication and Diet: An Overview of Experience and Principles. Journal of Nutrition Education and Behavior, 2007. 39(2S): p. S5.

3. Maddock, J.P., et al., Statewide Implementation of the 1% or Less Campaign. Health Education and Behavior, 2007. 34(6): p. 953.

4. Snyder, L.B., Health communication campaigns and their impact on behavior. J Nutr Educ Behav, 2007. 39(2 Suppl): p. S32-40.

5. Steven, E.S. and M. Michelle Neyman, Evaluation of the Energize Your Life! Social Marketing Campaign Pilot Study to Increase Fruit Intake Among Community College Students. Journal of American College Health, 2006. 55(1): p. 33.

6. Hawly, L., D. Harker, and M. Harker, A social cognitive approach to tackle inactivity and obesity in young Australians. Journal of Business Research, 2010. 63(2): p. 116-120.

7. Fitzgibbon, M., et al., Communicating Healthy Eating: Lessons Learned and Future Directions. Journal of Nutrition Education and Behavior, 2007. 39(2, Supplement): p. S63-S71.

8. Evans, W.D., et al., The 5-4-3-2-1 Go! Intervention: Social Marketing Strategies for Nutrition. Journal of Nutrition Education and Behavior, 2007. 39(2S): p. S55.

9. Madden, T.J., P.S. Ellen, and I. Ajzen, A Comparison of the Theory of Planned Behavior and the Theory of Reasoned Action. Personality and Social Psychology Bulletin, 1992. 18(1): p. 3-9.

Social marketing... could it really make you choose the apple over the Mars Bar?

Marketing is about people. It’s about influencing them to like and adopt what you have to offer them. But successfully altering an audience’s behaviour to achieve this goal (and then to make that behavioural change actually last) is every marketer’s ultimate challenge.

For social marketers, ‘challenge’ could be considered as a bit of an understatement. In essence, a social marketing campaign will ask an individual to stop doing an activity that is easy or pleasurable to instead begin doing something more exerting or even painful. Whether it is as straightforward as giving up three seconds of your life to put on a seatbelt, or as demanding as resisting Nicotine cravings to quit smoking, social marketing campaigns ask people to give up what is easy, in order to do what is right.

Diet improvement is certainly not exempt from the hurdles faced in other social marketing fields. In fact, a unique combination of factors means social marketers in this line of work are confronted with one of the most daunting challenges of all. Just consider some of these issues:

• 
  
  They face a David and Goliath-like battle with the junk food industry, which is believed to spend at least $200 million a year on TV advertising and sport sponsorships in Australia [1].
  


• 
  
  A recent study has suggested that the sugar, fat and sodium in junk food have the same addictive response in the brain as heroin and cocaine [2].
  

• 
  
  Unlike causes where one simple proposal can be made (e.g. “belt up” or “don’t smoke”), dietary recommendations can be much more complex, varying from one individual to the next, depending on body mass index, age, genetics, activity level, specific medical conditions, and so on [3].
  

• 
  
  There is no genuine agreement about which dietary strategies are actually most effective [3]. As evidence of this fact, you need only to consider the seemingly endless spate of diet books and weight loss programs that capitalise on consumers’ uncertainty.

• 
  
  Following from the point above, recommendations can be contradictory. For example, one study shows fibre reduces colon cancer risk and another shows no association between the two [3].
  

• 
  
  If individuals adopt one specific behaviour, there’s a chance they will only replace it with an alternative that has no greater benefit [3]. For example, swapping full-fat yoghurt for another that has lower fat, but far more sugar.
  
  

In spite of these challenges, there have been some examples of success at positively influencing dietary habits with social marketing.

The best local case is the Go for 2and5 campaign. It used its catchy tagline to increase Western Australian adults’ awareness of the need to eat more fruit and vegetables and to encourage them to increase their intake to the respective 2 serves and 5 serves every day. Running from 2002 to 2005, it employed a comprehensive multi-strategy approach that included mass media advertising, public relations, publications and an interactive website. The campaign was successful at increasing awareness in WA adults, and it resulted in a net average increase of 0.2 servings of fruit and 0.8 servings of vegetables across the population [3].

Go for 2and5 drew from the earlier 2 Fruit and 5 Veg Every Day TV advertising campaign which ran in Victoria from 1992 to 1995. After its first year of running, reported consumption of fruit and veg had significantly increased, and this higher level of consumption seemed to be maintained throughout the campaign. [3].

Looking overseas, the 1% or Less campaign which ran in the USA is a held as a model of campaign success. In the small community of Wheeling, West Virginia, health promoters ran paid advertising for 6 weeks preaching one simple recommendation: switching from full-fat milk to 1% or fat-free milk. In the month after the campaign ran, low-fat milk increased from 29% of all milk sales to 46%, and the increase had been sustained 6-months later [3]. The campaign was so successful it was replicated in other communities and, later, on a state wide scale in Hawaii, where a 10% positive change was reported immediately following the campaign [4].

On face value, you might be thinking the results of these campaigns actually aren’t all that impressive. In a sense, you’d be right, but recall again the challenges social marketers face - especially those in the nutrition game. A behavioural change effect of only 5 to 10% is actually considered a substantial success in social marketing [5], and these campaigns have met and exceeded these benchmarks.

Stay tuned for my next and final entry, where these campaigns will be examined further to glean insights into the critical components of a successful social marketing nutrition campaign.

References:

1. Caldwell, A. Health groups unite to fight junk food ads. 2009.

2. Balaji, R., Junk food may be addictive. Student BMJ, 2003. 11: p. 50.

3. Robert, H. and K. Bridget, Communication and Diet: An Overview of Experience and Principles. Journal of Nutrition Education and Behavior, 2007. 39(2S): p. S5.

4. Maddock, J.P., et al., Statewide Implementation of the 1% or Less Campaign. Health Education and Behavior, 2007. 34(6): p. 953.

5. Fishbein, M., Editorial: Great expectations, or do we ask too much from community-level interventions? American Journal of Public Health, 1996. 86(8): p. 1075.

Social marketing? You meant social media right? .....Right?

Sooner than the word ‘marketing’ can be uttered from my mouth when I tell others about my chosen career path, it is all too commonly met with contemptuous reactions along the lines of, “Oh yeah, so selling people stuff they don’t want, right?”

Indeed, thanks to the nature of capitalism and the unethical manner in which some of the world’s most lucrative brands make their money (think about what McDonald’s and Coca-Cola are actually selling), such stigmas are unavoidable - and perhaps warranted.

Perhaps this is why the sub-industry of social marketing (no, not social media) is so refreshing. Rather than persuading people to forsake their own best interests in the pursuit of profit, social marketing, as the term implies, does the precise opposite. It borrows and re-applies the principles of commercial marketing for the noble purpose of improving the voluntary health behaviours of society [1]. In the case of obesity, the desired behavioural change outcome would be to improve a population’s diet and/or increase their level of physical activity.

To expound further, take the cornerstone of commercial marketing theory, the 4 P’s. Yes, it does apply to social marketing... but with a twist:

• Product refers to the end benefit of adopting the desired behavioural change. In the case of getting fitter and losing weight, the product would comprise ‘features’ such as more energy, decreased risk of disease and higher self-esteem [1].

• Price still refers to the cost paid by the consumer in order to achieve the promised benefit. Only the cost is far more intangible than money. It could comprise such aspects as diminished pleasure, psychological stress or loss of time [1].

• Promotion still refers to the communication strategies used to convey the product’s attributes and prompt adoption of the product. In social marketing, promotion strategies can go beyond the traditional avenues such as advertising and also include such things as policy changes, skill building and community-based activities [1].

• Place (a.k.a. distribution) still refers to where and when the consumer will perform the desired behaviour and receive the associated services. In this case, the ‘place’ could be a fitness class or healthy cooking session. [1]

If I’ve done my job correctly, by now you should have a sound understanding of (and respect for) social marketing and how it works. In my next entry, we begin to look at some of the specific challenges social marketers face when dealing with dietary behaviour.

References:

1. Sonya, G. and A.B. Carol, SOCIAL MARKETING IN PUBLIC HEALTH. Annual Review of Public Health, 2005. 26: p. 319.

Obesity: a weighty issue.

Obesity is on the rise. The average weight of Australian adults has been increasing by around 0.5kg-1kg for each of the past 20 years, culminating in an astounding 61% of Australian adults - and a quarter of Australian children - being overweight or obese in 2007-08 [1, 2]. Moreover, 3.71 million Aussies (17.5%) have been categorised as obese. On a pure baseline projection (in other words, the best case scenario) this means that by 2025, 4.6 million Australians - or 18.3% of the population - will be obese. But, on current trends, the figure is likely to be closer to 7 million [3].

Among our own age group (18-24 years old), 39.9% of males and 34.9% of females have been estimated to be overweight or obese [1]. This is an increase upon previous generations [1], but to gain a true understanding of the implications, you need to think of the bigger picture. Lifelong health behaviours tend to be established in early adulthood [4], and there is evidence to suggest that unhealthy habits are often picked up in the years directly following high school [5]. So you can premise that Australian adults are developing poor health habits in their younger years; habits which then last into their mature years, and then begin to cause weight gain as their metabolism slows. This notion can be supported by the fact that with each subsequent age category, the incidence of overweight and obesity almost always climbs higher [1]. In other words, as Australians get older, they get fatter.

So, why should we care? As long as you don’t mind carrying a bit of extra padding around, what’s the problem? Unfortunately, as the statistics prove, the consequences of overweight and obesity are more serious than that...

• · High body mass is responsible for 7.5% of Australia’s total burden of disease and injury, ranked slightly behind only tobacco (7.8%) and high blood pressure (7.6%). But with smoking rates declining, high body mass is likely to soon overtake tobacco as the leading modifiable cause of disease and injury burden [1].
  


• · According to recent estimates, almost a quarter of all type 2 diabetes and osteoarthritis cases are caused by obesity [1].
  


• · Obesity also accounts for one fifth of all cardiovascular disease, as well as several major cancers, including breast, kidney, uterine and colorectal cancer [1]
  
  

o Disturbingly, the fact that obesity causes cancer is not that widely known. According to a recent study, over 40% of Australians didn’t believe it did [6].

The economic cost of all of this is enormous. In 2008, Access Economics estimated the overall cost of obesity to Australian society and governments to be a whopping $58.2 billion. The net cost of ‘lost wellbeing’ was valued at just under $50 billion, with the direct financial cost to the Australian community an estimated $8.3 billion. Two billion of this was borne by the Australian healthcare system - that’s a Fiona Stanley Hospital. Not to mention the impact on your own hip pocket... almost a third of the direct cost is paid for by individuals.

Clearly, obesity is a problem - one of the biggest facing Australian society. The question is, how can we prevent it getting any worse? How can we best encourage people to develop healthy lifestyle behaviours before it is too late? Through the application of social marketing and associated theory, the rest of this blog will investigate these matters.

References:

1. Obesity Working Group, Australia: the healthiest country by 2020. Technical Report No 1., in Obesity in Australia: a need for urgent action2009, National Preventative Health Taskforce Canberra.

2. Australian Bureau of Statistics, Overweight and Obesity in Australia: a Snapshot, 2008, ABS: Canberra.

3. Access Economics, The growing cost of obesity in 2008: three years on, 2008, Diabetes Australia: Canberra.

4. Kicklighter, J., et al., College Freshmen Perceptions of Effective and Ineffective Aspects of Nutrition Education. Journal of American College Health, 2010. 59(2): p. 98.

5. Allman-farinelli, M., et al., Age, period and birth cohort effects on prevalence of overweight and obesity in Australian adults from 1990 to 2000. European Journal of Clinical Nutrition, 2008. 62(7): p. 898.

6. Lorie, A. Report: 'Shocking' number don't know obesity causes cancer. CNN, 2009.