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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

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health communications and social marketing for ipp

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
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
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
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
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
“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
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
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
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
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
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
What can we do?
  • Effective Communication

AND

  • Social Marketing can help…
effective health communication efforts
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
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
Segmenting the general population
  • Demographics
  • Physical/Medical history
  • Behavioral characteristics

(“Do’ers” versus “Non-Do’ers”)

effective health communication efforts cont d
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 d18
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 d19
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 d20
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

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
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
Social Marketing is not…
  • Advertising
  • Public relations
  • Slick packaging of communication materials
  • Condom distribution
  • Health education
difference between health education promotion and social marketing
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

“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

slide32

Social Marketing:

A Model for Interventions that

Facilitate Change

HOW YOU TELL THEM ABOUT

WHY THEY WANT TO DO IT

THE WHAT, WHY, WHERE,

AND HOW

Pricing

Promotion or Communication

Increasing knowledge

classroom teaching

Increasing benefits

mass media messages

Decreasing barriers

media advocacy

Improving self-efficacy

small group discussion

Increasing social pressure

patient/doctor interaction

or norms

point of purchase displays

community meetings

What is the health

WHO MUST ACT TO

WHERE (HOW) THEY CAN

worksite education

problem?

RESOLVE PROBLEM

DO BEHAVIOR

ETC, ETC

What actions could

Target audience

Place

Stakeholder,group,or

reduce the problem

individual market

community resources

research

partnerships

specific clinics

product offering sites

**may be where they learn how

to do behavior (training)

POLICY/RULES THAT

INFLUENCE THE ACTION

WHAT ACTION MUST BE

Policy, rules, legislation

TAKEN

Methods we can use to increase

Product or Behavior

social pressure, provide

describing the action in a way

protection for public,

that is relevant to the target

create action by third parties, and

audience and helps fulfill some

create incentives for health

unmet need, but not contrary

enhancing policies

to science

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 andWHYthey might NOT 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

Social Marketing Elements
four p s of social marketing
Four P’s of Social Marketing
  • Product
  • Price
  • Place
  • Promotion
  • Pull & Push
  • Policy
four p s of social marketing cont d
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 d36
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 d37
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 d38
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
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 marketing40
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
Exercise One

What is the “Price?”

everyone is tuned into43
Everyone is tuned into…

What

Is

In

It

For

Me??

WIIIFM

everyone is tuned into44
Everyone is tuned into…

What

Is

In

It

For

Me??

WIIIFM

wiiifm in social marketing
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
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

Whose Payoff?
health is not an end in itself it is a means to a valued end
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
Exercise Two

Whose Benefit?

WIIIFM?

resources
Resources
  • STD Communications Database
  • Research - Syphilis Elimination Effort (SEE) Toolkit
what is std communications database
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
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
WHO? - Selected target audiences
  • Policy Makers/Opinion Leaders
  • Health Care Providers
  • Community Representatives
methodology how
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
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
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
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
findings62
Findings

B) Overcoming these barriers

  • Increase knowledge and awareness about syphilis among TA
  • Increase knowledge and awareness about syphilis in general public
  • Increase funding
findings63
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
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 d65
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
findings66
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
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
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
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
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
Availability of SEE Toolkit Materials (Cont’d.)
  • On the web:
  • CDC Warehouse (Order by phone or via the order form online)

http://www.cdc.gov/std/see/

in summary
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
CDC’s Commitment to You
  • Training
  • Technical assistance
exercise three
Exercise Three

What’s next?