Mediaboss Marketing

theory to identify connections between behavioural

determinants of poor nutrition, such as eating habits

within the family, availability of food with high calorie

and low nutrient density (junk food) in the community,

and the glamorisation of fast food in advertising. Social

marketers use such factors to construct conceptual

frameworks that model complex pathways from

messages to changes in behaviour (fig 3).

In applying theory based conceptual models, social

marketers again use commercial marketing strategies

based on the marketing mix.

2

For example, they

develop brands on the basis of health behaviour and

lifestyles, as commercial marketers would with prod-

ucts. Targeted and tailored message strategies have

been used in antismoking campaigns to build brand

equity

a set of attributes that a consumer has for a

product, service, or (in the case health campaigns) set

of behaviours.

13

Brands underlying the VERB cam-

paign (which encourages young people to be

physically active) and Truth campaigns were based on

alternative healthy behaviours, marketed using socially

appealing images that portrayed healthy lifestyles as

preferable to junk food or fast food and cigarettes.

14 15

Can social marketing change health

behaviour?

The best evidence that social marketing is effective

comes from studies of mass communication cam-

paigns. The lessons learned from these campaigns can

be applied to other modes of communication, such as

communication mediated by healthcare providers and

interpersonal communication (for example, mass

nutrition messages can be used in interactions between

doctors and patients).

Social marketing campaigns can change health

behaviour and behavioural mediators, but the effects

are often small.

5

For example, antismoking campaigns,

such as the American Legacy Foundations Truth cam-

paign, can reduce the number of people who start

smoking and progress to established smoking.

16

From

1999 to 2002, the prevalence of smoking in young

people in the US decreased from 25.3% to 18%, and

the Truth campaign was responsible for about 22% of

that decrease.

16

This is a small effect by clinical standards, but it

shows that social marketing can have a big impact at

the population level. For example, if the number of

young people in the US was 40 million, 10.1 million

would have smoked in 1999, and this would be reduced

to 7.2 million by 2002. In this example, the Truth cam-

paign would be responsible for nearly 640 000 young

people not star ting to smoke; this would result in

millions of added life years and reductions in

healthcare costs and other social costs.

In a study of 48 social marketing campaigns in the

US based on the mass media, the average campaign

accounted for about 9% of the favourable changes in

health risk behaviour, but the results were variable.

17

Non-coercive campaigns (those that simply delivered

health information) accounted for about 5% of the

observed variation.

17

A study of 17 recent European health campaigns

on a range of topics including promotion of testing for

HIV, admissions for myocardial infarction, immunisa-

tions, and cancer screening also found small but posi-

tive effects.

18

This study showed that behaviours that

need to be changed once or only a few times are easier

to promote than those that must be repeated and

maintained over time.

19

Some examples (such as breast

feeding, taking vitamin A supplements, and switching

to skimmed milk) have shown greater effect sizes, and

they seem to have higher rates of success.

19 20

Implications for healthcare practitioners

This brief overview indicates that social marketing prac-

tices can be useful in healthcare practice. Firstly, during

social marketing campaigns, such as antismoking

campaigns, practitioners should reinforce media mes-

sages through brief counselling. Secondly, practitioners

can make a valuable contribution by providing another

communication channel to reach the target audience.

Finally, because practitioners are a trusted source of

health information, their reinforcement of social

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(PDF) How social marketing works in health care