Elaboration Likelihood Model (ELM)

1. Elaboration Likelihood Model (ELM) • Goal = to change attitudes toward a specific behavior in order to ultimately change the behavior • Attitude formation occurs through one of 2 cognitive pathways: • Central Route • Peripheral Route

2. Elaboration Likelihood Model (ELM)

3. Routes of Processing Central Route Processing: • -conscious thought pertaining to the behavior (similar to value-expectancy theories) • -Health communications should provide detailed information so an evaluation can be made • -Evaluation leads to attitude formation • -Info in campaign message should be tailored to the target audience • -Interventions should provide the audience with information to make a pro’s vs. con’s analysis (value) • leads to an enduring attitude with high probability of behavior change.

4. Routes of Processing Peripheral Route Processing: • Attitudes are formed based on emotion or feeling (rather than the behavior itself) • Downside: resulting attitude is not as resistant to counter-persuasion (less enduring) • Useful as a method of initial persuasion to get target to perform behavior • then promote continued repetition of behavior aimed at central processing route to get attitude change • Benefit = quickly instills favorable attitudes (even if temporary)

6. Social Marketing • Should take upstream approach • Focus on effects of environmental factors on individual behavior (“new” public health) • Techniques borrowed from commercial marketing • Selling a product (ideas, behaviors, health programs) • Used to benefit greater good of population instead of bringing profit to marketer. • Consumer-oriented

7. Social Marketing Strengths: • Cost-effective • Audience-driven • Wide range of communication channels • Ability to change social norms and promote environment of change • Ability to change a wide range of behaviors • Empowerment of communities

8. 4 “P”s of Social Marketing

9. Product • Tangible: • Product, program, or service • Intangible: • Behavioral practices, change in attitudes, beliefs or ideas. • Important to know perceptions of target audience about the health issue • Will product be a good solution for this population? • Research using focus groups, interviews, surveys, etc. = critical to understand perceptions • Applying the different theories to this research gives framework for analyzing perceptions and attitudes

12. Product • Diffusion Theory: When designing product, marketer should consider… • Trialability • Compatibility • Relative advantage • Stages of Change Theory: matching product characteristics to different stages of target audience • Theory of Reasoned Action: use to understand underlying beliefs about + and – behavior outcomes of behavior • Elaborative Likelihood Model: use to craft the best message to persuade audience to adopt product.

13. Price • Monetary Cost • Ex. Cost of mammogram or buying condoms • Psychological/Social Cost • Ex. Embarrassment, fear, time • Idea is to minimize costs and maximize benefits of product (benefits outweigh the costs)

14. Price • Social Cognitive Theory: if a product reinforces its use, will result in better cost-benefit ratio. • Breaking ultimate behavior goal into smaller ones for target audience • Small goals have less associated cost and are easier to attain • Shaping & Successive Approximation • Self-efficacy • Expectancies

15. Place • Point of contact with target audience • Physical location (clinic, school, store) • Media (t.v., radio, internet) • Environmental factors • Accessibility • Research should focus on activities/habits of target audience • Also consider their experience & satisfaction with current delivery system

16. “5-A-Day” Campaign

17. Promotion • Communication strategies that inform, persuade, and influence beliefs and behaviors relevant to the product • Uses different channels or delivery systems to promote product • Focus = creating demand for product • Communication: public service announcements, media events, swag, ads, PR, editorials, etc

18. Promotion • Many value-expectancy theories inform message development • Create heightened sense of perceived threat/vulnerability • Portray use of product resulting in more benefits vs. costs and that benefits are of value to target audience • Provide a reason for listening to the message • Determine most effective & efficient way to deliver message toward increasing demand

19. SM: Misconceptions • Misconception that social marketing relies primarily on advertising • Social marketers should use an integrated marketing mix • Social marketing “blames the victim” • Target the environment and policy makers • Social marketing is manipulative • Develop affordable and accessible products so people can take control; create a supportive environment for change • Enable the audience to become partners (Grier & Bryant, 2005)

20. Conclusions • Social Marketing is most effective when it considers how all elements are interconnected • Bottom-up approach • involving community members in process to ensure sustainability • Upstream approach • Target policy makers of environmental structures that influence behavior • Should help people understand their own needs and those of their community

21. Activity • Break into 6 groups • Develop the four “P”’s for a health communication intervention/campaign related to one of the following topics: • Eating more fruits and vegetables • Brushing your teeth 3 times a day • Practicing safer sex • Increasing activity level • Reducing substance use among teens • Increasing hours of sleep among working adults • Product • Place • Price • Promotion

22. Tailored Communications • Audience Segmentation & Message Targeting • Target population is segmented into parts that receive different kinds of messages • Message Tailoring (newer practice) • Operates at individual level • “Any combination of strategies and information intended to reach an individual based on characteristics that are unique to that person, related to outcome of interest and derived from an individual assessment.”

24. Message Tailoring • Diminishes mismatch between group-targeted messages and some members in the group. • Is the extra burden of assessing individuals worth the pay off in terms of impact (attitude/behavior change)? • Especially when targeting practices are considered more cost-effective and feasible? • Signs point to yes! • 57 studies of tailored print interventions revealed they have been useful in changing behaviors and more effective than targeted interventions when compared

25. Message Tailoring • Steps: • Assessment (surveys) to obtain demographic information • Feedback: computer alogrithms to drive and select most appropriate message for individual based on assessment • Message mailed or emailed to individual