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 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 WHY THEY WANT TO DO IT

Pricing

Increasing knowledge Increasing benefits Decreasing barriers Improving self-efficacy Increasing social pressure or norms 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) 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 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, 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 as a Model for Interventions that Facilitate Change Dr. Susan D. Kirby, 1995

Social Marketing Elements

 WHO needs to change  WHAT must they DO  WHY NOT and WHY they might 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?