Community-based Prevention Marketing Research Articles

Tackling the social marketing formative research bottleneck: comparative analysis of the complementary nature of community-generated personas and focus groups

Purpose This study aims to understand the utility of personas and illustrate, through a case study, how a persona-building exercise in a Community Based Prevention Marketing (CBPM) training of community leaders elicited important insights that complemented findings from ongoing formative research on vaccine hesitancy in the Hispanic/Latino population in the USA during COVID-19 pandemic. Design/methodology/approach An exploratory concurrent parallel qualitative study design compared three personas created by community-based organization members (n = 37) to transcripts from five formative research focus groups (n = 30) from the same project. All participants in this study were recruited by the National COVID-19 Resiliency Network as part of their capacity-building and formative research activities. Grounded theory guided the content analysis. Findings This study found personas and focus groups to be complementary. A high degree of co-occurrence was observed when investigating the uptake of the COVID-19 vaccine under the categories of barriers, culture and communication. Between the two methods, the authors found strong associations between fear, disruption to the value system, work-related barriers, inaccessibility to health care and information sources and misinformation. Areas of divergence were negligible. Research limitations/implications While personas provided background information about the population and sharing “how” to reach the priority population, focus groups provided the “why” behind the behavior, followed by “how”. Practical implications A community-driven persona-building process built on cultural community knowledge and existing data can build community capacity, provide rich information to assist in the creation of tailored messages, strategies and overall interventions during a public health crisis and provide user-centered, evidence-based information about a priority population while researchers and practitioners wait on the results from formative research. Originality/value This case study provided a unique opportunity to analyze the complementary effectiveness of two methods acting in tandem to understand the priority population: stakeholder-informed persona-building and participant-informed focus group interviews. Understanding their complementary nature addresses a time gap that often exists between researchers and practitioners during times of crises and builds on recommendations associated with bringing rigor into practice, promoting academic contribution to real-world issues and building collaborative partnerships. Finally, it supports the utility of a nimble tool that improves social marketers’ ability to know more about their audience for intervention design when time is of the essence and formative research is ongoing.

Using Community-Based Prevention Marketing to Generate Demand for Healthy Diets in Jordan.

Jordan has been experiencing a nutrition transition with high rates of micronutrient deficiencies and rising overweight and obesity rates. This highlights the need to generate demand for healthy diets. This study used a community-based prevention marketing approach and worked with local communities as partners to develop a set of behavior change interventions to improve healthy eating within vulnerable communities. Individual, family, and paired-friendship interviews, and co-creation workshops were conducted with 120 people. The aim of these interviews was to gain an in-depth understand of school-aged children and their families’ nutrition knowledge, attitudes, and practices, including social and cultural norms and behavioral determinants, and then use this information to co-create interventions, activities and materials targeted at supporting school-aged child nutrition. Analysis of the interviews revealed that dietary habits are both deeply personal and profoundly entwined by emotions and social norms, and that parents often gave in to their children’s demands for unhealthy foods and beverages due to their perception of what a ‘good parent’ looks like and the desire to see their child ‘smile’. These key insights were then shared during the co-creation workshops to develop behavior change interventions—ensuring that interventions were developed by the community, for the community.

Systems Social Marketing and Macro-Social Marketing: A Systematic Review

Background: The adoption of systems thinking within social marketing is illustrated by the emerging literature relating to systems social marketing and macro-social marketing. Systems social marketing and macro-social marketing signal a shift from singular level behavior change toward a more holistic, multilevel change mode of operandi for complex and wicked problems. In recognition of this broadening perspective, Truong et al. took the first steps to describe the relationship between systems thinking and social marketing through a critical appraisal. However, their analysis stopped short of defining systems social marketing and macro-social marketing, examining how the concepts have been applied, and the impact this has on our change methodologies. Focus: This article is related to research and evaluation of the social marketing field. Research Question: This study aims to (a) examine the causality looseness surrounding the descriptions of systems social marketing and macro-social marketing, (b) conceptualize systems social marketing and macro-social marketing, and (c) develop a taxonomy for classifying and interpreting the systems-based social marketing–related literature. Methods: Following best practice protocols, a systematic review was conducted to identify systems social marketing and macro-social marketing literature and interventions published prior to March 2020. Five databases were searched using a combination of relevant search terms. Results: Sixteen thousand and forty-seven title and abstracts were screened, resulting in 45 articles being reviewed, 8 of which were interventions. Analysis of the findings indicated both systems social marketing and macro-social marketing use nonlinear causality and seeks to understand the structural and behavioral dynamics in a system to leverage change. Moreover, the findings suggest that systems social marketing focuses on evolutionary dynamics and a “whole system in the room” approach, pursuing top-down, bottom-up iterative processes with macro-social marketing pursuing institutional dynamics and “inside the system” top-down processes. Importance to Social Marketing Field: This article is one of the first efforts to examine the inner anatomy of systems social marketing and macro-social marketing for causality and definitional clarity. In drawing a distinction between the two orientations, social marketers can begin to understand in what contexts and settings these perspectives are most applicable. Recommendations: The taxonomy and search strategy can be adopted in other reviews as they offer a rich and diverse basis for further conceptual analysis of systems-based social marketing–related literature. Limitation: Community-based prevention marketing, community-based social marketing, and community-led assets-based social marketing articles were excluded from this review. Hence, further research could include these approaches and uncover their features, analogies, and differences versus systems social marketing and macro-social marketing.

Creation of the Person-Centered Wellness Home in Older Adults.

Background and ObjectivesExtending the Patient-Centered Medical Home (PCMH) model into the community may address the poor linkage between medical clinics and underserved communities. Our first of three objectives was to determine if peer leaders and wellness coaches can be the relationship center of wellness care. We evaluated the Self-management Resource Center Small Group Programs (SMRCSGP), plus wellness coaching, as a booster intervention in older adults with chronic diseases. Second, we evaluated the role of personal health records (PHR) prototype as the linkage between the clinic and community. Using input from these two objectives, we lay the groundwork for the Person-centered Wellness Home (PCWH).Research Design and MethodsParticipants enrolled from five South Bronx New York City Housing Authority communities. We conducted a pragmatic, randomized controlled trial using two arms (n = 121): (1) SMRCSGP and (2) SMRCSGP plus wellness coaching initiated as a booster after SMRCSGP completion. Adjusted individual growth models compared the slope differences for outcomes. We conducted a social networking analysis on the ties between wellness coaches and participants. PCMH-certified physicians completed in-depth interviews on the PHR prototype. An adaptation from the consensus-workshop model summarized the priority PCWH items.ResultsThere was an improvement in self-reported physical functioning (2.0 T-score units higher, p = .03) by the wellness coaching group, but the groups did not differ on physical activity. From the social networking analysis, connections were stable over time with wellness-coaches and participants. The Consensus Conference identified eight major components of the PCWH.Discussion and ImplicationsWellness coaching post-SMRCSGP was a booster to physical function, an upstream outcome for physical activity. During the Consensus-Conference, community-based prevention marketing and personal navigators for connecting to a PCMH emerged as novel components. This supports future work in training community health workers as peer leaders to provide evidence-based programs and other PCWH components.

Using system dynamics modeling to evaluate a community-based social marketing framework

PurposeCommunity coalitions are an important part of the public milieu and subject to similar external pressures as other publicly funded organizations – including changes in required strategic orientation. Many US government agencies that fund efforts such as community-based social marketing initiatives have shifted their funding agenda from program development to policy development. The Florida Prevention Research Center at the University of South Florida (Tampa, Florida, USA) created community-based prevention marketing (CBPM) for policy development framework to teach community coalitions how to apply social marketing to policy development. This paper aims to explicate the framework’s theory of change.Design/methodology/approachThe research question was: “How does implementing the CBPM for Policy Development framework improve coalition performance over time?” The authors implemented a case study design, with the “case” being a normative community coalition. The study adhered to a well-developed series of steps for system dynamics modeling.FindingsResults from computer model simulations show that gains in community coalition performance depend on a coalition’s initial culture and initial efficiency, and that only the most efficient coalitions’ performance might improve from implementing the CBPM framework.Originality/valuePractical implications for CBPM’s developers and users are discussed, namely, the importance of managing the early expectations of academic-community partnerships seeking to shift their orientation from downstream (e.g. program development) to upstream social marketing strategies (e.g. policy change).

Applying Tools From Human-Centered Design to Social Marketing Planning

In this “Tools From the Field” paper, we report our experiences using human-centered design (HCD), a process for using innovation as a means of developing more effective marketing offerings. The context for our use of HCD tools was a partnership with a new community committee. We combined elements of our previous social marketing frameworks -Community-Based Prevention Marketing (CBPM) for Program Development; CBPM for Policy Development–into a version better suited to address complex, dynamic problems that require a whole-systems perspective. Our product development work for this next iteration of the CBPM framework incorporated several HCD tools adapted from the prolific design firm, IDEO. The HCD process consists of three phases: inspiration (e.g., learning from those that one is designing for), ideation (e.g., brainstorming and prototyping), and implementation (e.g., building partnerships and launching a business model). In this paper, we describe “tools” for the application of HCD within the context of rapidly prototyping and testing CBPM framework activities for use with our community committee partners; we provide practical advice for the use of these tools (“process points”); and we present a real-world application from development of our new CBPM framework (“tools in action”). Overall, the HCD tools from IDEO helped us see new opportunities for our framework, transform insights into actionable ideas, and increase the speed of producing a minimum viable product and gathering feedback on it from our customers. We believe that HCD tools are worth exploring when it comes to the social marketing planning process.

Applying Systems Science to Evaluate a Community-Based Social Marketing Innovation

In the United States, community coalitions are an important part of the public health milieu, and thus, subject to many of the same external pressures as other organizations—including changes in required strategic orientation. Many funding agencies have shifted their funding agenda from program development to policy change. Thus, the Florida Prevention Research Center created the Community-Based Prevention Marketing (CBPM) for Policy Development framework to teach community coalitions how to apply social marketing to policy change. The research reported here was designed to explicate the framework’s theory of change. We describe and demonstrate a hybrid evaluation approach: utilization-focused developmental evaluation. The research question was “What are the linkages and connections among CBPM inputs, activities, immediate outcomes, intermediate outcomes, and ultimate impacts?” We implemented a case study design, with the case being a normative community coalition. The study adhered to a well-developed series of steps for system dynamics modeling. Community coalition leaders may expect CBPM to provide immediate gains in coalition performance. Results from causal diagramming show how gains in performance are delayed and follow an initial decline in performance. We discuss the practical implications for CBPM’s developers—for example, importance of managing coalition expectations—and other social marketers—for example, expansion of the evaluation toolkit.

Community-Based Prevention Marketing for Policy Development

Community-based prevention marketing (CBPM) is a community-driven framework for program planning, which applies social marketing concepts and techniques to the development of health behavior interventions. Whereas community members who comprise an action committee or coalition set the goals and make programmatic decisions, social marketing provides the planning framework to guide program design, implementation, and evaluation. CBPM has guided successful initiatives to promote physical activity in both youth and adults, to increase safety eyewear use in agricultural settings, and to delay alcohol and tobacco initiation among youth. However, the emergence of evidence-based policy has fostered renewed interest in “upstream” approaches to health behavior change that, in the United States, have included community partnerships as an important tool for policy development. Unfortunately, these community partnerships have had variable success because of the lack of a systematic framework for identifying, selecting, tailoring, and promoting evidence-based policies. We describe the adaptation and application of CBPM to improve community capacity for identifying and promoting evidence-based policies. The resulting framework, CBPM for Policy Development, is comprised of the following eight steps: (1) build a strong foundation for success; (2) review evidence-based policy options; (3) select a policy to promote; (4) identify priority audiences among beneficiaries, stakeholders, and policy makers; (5) conduct formative research with priority audiences; (6) develop a marketing plan for promoting the policy; (7) develop a plan for monitoring implementation and evaluating impact; and (8) advocate for policy change. We provide a description of each step and an examination of the experiences and lessons learned in applying it to youth obesity prevention.

Adoption of Safety Eyewear Among Citrus Harvesters in Rural Florida

The community-based prevention marketing program planning framework was used to adapt an evidence-based intervention to address eye injuries among Florida's migrant citrus harvesters. Participant-observer techniques, other direct observations, and individual and focus group interviews provided data that guided refinement of a safety eyewear intervention. Workers were attracted to the eyewear's ability to minimize irritation, offer protection from trauma, and enable work without declines in productivity or comfort. Access to safety glasses equipped with worker-designed features reduced the perceived barriers of using them; deployment of trained peer-leaders helped promote adoption. Workers' use of safety glasses increased from less than 2% to between 28% and 37% in less than two full harvesting seasons. The combination of formative research and program implementation data provided insights for tailoring an existing evidence-based program for this occupational community and increase potential for future dissemination and worker protection.

Abstract B6: Social marketing intervention to increase HPV vaccine utilization among Hispanic girls: Preliminary data

Abstract Incidence and mortality rates from cervical cancer are higher in Hispanic women compared to non-Hispanic white women. The recently approved HPV (human papillomavirus) vaccine has been proven effective in preventing 70% cervical cancer cases (those caused by two types of high-risk HPV). This translational research study draws on Rogers’ Diffusion of Innovation theory to address the need to hasten the pace of diffusion of this new vaccine, especially among populations with high rates of cervical cancer. An academic-community partnership employed the methodology of community-based prevention marketing (CBPM) to develop a culturally appropriate, multilevel intervention aimed at increasing the utilization of the HPV (human papillomavirus) vaccine against cervical cancer among Hispanic girls. CBPM combines social marketing theories and techniques with community-based participatory research (CBPR) approaches for the development and implementation of public health interventions aimed at producing behavior change. In this presentation we will present the social marketing plan used in the intervention and preliminary data. The intervention uses a combination of Spanish-language media-radio, newspaper and printed brochures-to disseminate the messages throughout the community. A trained lay health promoter (promotora de salud) at Progreso Community Center receives phone calls to answer general questions about the vaccine and eligibility requirements for the VFC program, refers patients to appropriate locations to obtain the vaccine, and provides follow-up reminders. We present baseline intervention data on rates of HPV vaccine utilization by race/ethnicity and preliminary data on responses to the media campaign. The study contributes valuable knowledge about culturally and linguistically appropriate social marketing strategies for HPV vaccine use among Hispanics. Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B6.

Promoting Physical Activity Among Youth Through Community-Based Prevention Marketing

Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age) called VERB Summer Scorecard. Based on the national VERB media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. The VERB Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9-step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

Abstract 982: Increasing HPV vaccine utilization among Hispanic girls to reduce cervical cancer disparities

Abstract Incidence and mortality rates from cervical cancer are higher in Hispanic women compared to non-Hispanic white women. The purpose of this pilot study is to implement and assess a multilevel, culturally- and linguistically-appropriate social marketing intervention targeting the Hispanic population to increase utilization of the HPV vaccine among Hispanic girls ages 9-18 in Nashville/Davidson County, Tennessee. The specific aims are to (1) pre-test and disseminate culturally- and linguistically-appropriate media messages to promote use of the HPV vaccine in the target population; (2) provide information, referral and follow-up reminders to families to encourage initiation and completion of HPV vaccine series; and (3) assess the impact of the intervention by comparing changes in HPV vaccine utilization rates for Hispanic girls in partner clinics and in the state Immunization Registry. This pilot translational research study draws on Rogers’ Diffusion of Innovation theory. We employ the methodology of Community-Based Prevention Marketing, which combines social marketing theories and techniques with community-based participatory research (CBPR) approaches. The intervention uses a combination of Spanish-language media_radio, newspaper and printed brochures_to disseminate the messages throughout the community. A trained lay health promoter (promotora de salud) at Progreso Community Center receives phone calls to answer general questions about the vaccine and eligibility requirements for the VFC program, refers patients to appropriate locations to obtain the vaccine, and provides follow-up reminders. In this presentation we will present how formative research findings were used to develop the intervention and preliminary baseline intervention data. Targeted interventions to Hispanic communities such as this one to encourage use of a new cervical cancer vaccine could help eradicate ethnic disparities in cervical cancer. The study contributes valuable knowledge to the dearth of research on possible barriers for Hispanics to use this vaccine or about culturally- and linguistically-appropriate social marketing strategies for HPV vaccine use among Hispanics. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 982.

Impact of a Community-Based Prevention Marketing Intervention to Promote Physical Activity Among Middle-Aged Women

A physical activity intervention applied principles of community-based participatory research, the community-based prevention marketing framework, and social cognitive theory. A nonrandomized design included women ages 35 to 54 in the southeastern United States. Women (n = 430 preprogram, n = 217 postprogram) enrolled in a 24-week behavioral intervention and were exposed to a media campaign. They were compared to cross-sectional survey samples at pre- (n = 245) and postprogram (n = 820) from the media exposed county and a no-intervention county (n = 234 pre, n = 822 post). Women in the behavioral intervention had statistically significant positive changes on physical activity minutes, walking, park and trail use, knowledge of mapped routes and exercise partner, and negative change on exercise self-efficacy. Media exposed women had statistically significant pre- to postprogram differences on knowledge of mapped routes. No-intervention women had significant pre- to postprogram differences on physical activity minutes, walking, and knowledge of mapped routes.

A Theater-as-Education Project Discourages Tobacco and Alcohol Use

Theater has been used as an educational tool since the Great Depression era, and it is currently considered an effective tool for health promotion and reducing risk-taking behaviors among youth (Sequin & Rancourt, 1996; Starkel, 2001). For example, Emory University's EN-ACTE theater company, Planned Parenthood of Greater Iowa's Acting Out! Teen Theater Troupe, and Atlanta's professional Alliance Theater address a range of contemporary adolescent health issues, including drug and alcohol use, unintended pregnancy, date rape, and HIV infection (Alliance Theater, 2007; Rangus, 2007; Planned Parenthood of Greater Iowa, 2007). Theater projects are well suited for communicating prevention messages to youth audiences because they can depict real-life settings and characters who can change during the performance in different ways as the story unfolds. Such character portrayals and settings can offer accurate health information, dispel myths, and illustrate important refusal skills and other preventative practices. These qualities may increase the likelihood that audience members will adopt prevention behaviors. Furthermore, because theater productions communicate health messages to many individuals simultaneously, these messages may become topics of future conversations in classrooms as well as outside school among peers and, possibly, parents and siblings at home. Finally, by simulating dialogue, live theater may help alter social norms regarding adolescent risk behaviors (Starkel, 2001). Although theater-as-education may be effective for addressing a wide range of health and risk behaviors, previous programs that have used this strategy have experienced limitations. First, many programs fail to use a theoretical foundation, thereby ignoring principles that can be transferred to teaching and practice settings. Second, theater-as-education projects often lack systematic assessment of their impacts on audience attitudes, beliefs, and behaviors, so the effects of these programs are not well documented. Last, many theater-delivered programs fail to employ a community-based process, which limits their contextual validity. This article describes the development and assessment of the theater-as-education component of a prevention marketing campaign that addresses attitudes toward tobacco and alcohol use, the demonstration of refusal skills, and the clarification of norms regarding use of these products among young adolescents. This program addresses the limitations discussed above, and it provides a replicable model for developing a theater-as-education production for schools and communities to follow. Sarasota County Demonstration Project A coalition of professional and lay leaders in Sarasota County, Florida, collaborated with the Florida Prevention Research Center (FPRC) at the University of South Florida to conduct community-specific research on the local determinants of youth tobacco and alcohol use, and to develop, implement, and evaluate strategies to prevent youth from initiating use of these products. This initiative employed a framework known as Community-Based Prevention Marketing (CBPM), a community-directed social change process that applies marketing theories and techniques to the design, implementation, and evaluation of health promotion and disease prevention programs (Bryant, Forthofer, McCormack Brown, Landis, & McDermott, 2000). Using the results of the community-specific determinants research, the coalition developed a prevention marketing plan and multidimensional intervention strategies that became the Believe in All Your Possibilities prevention marketing campaign (Florida Prevention Research Center, 2007). One of the key strategies in the Believe in All Your Possibilities prevention marketing campaign was the creation and delivery of a theater production performed by youth. Local development of theater-as-education Data derived from youth, parents, and key community stakeholders (Figure 1) were the basis for the development and implementation of the local theater production and the overarching community-based prevention marketing campaign, Believe in All Your Possibilities. …

Using Community-Based Prevention Marketing to Improve Farm Worker Safety

Community-based prevention marketing (CBPM) combines a powerful planning framework, social marketing, with community organization principles to design behavior change programs. In southwest Florida, a coalition comprised of citrus workers and their employers, health providers, and academic researchers is using CBPM to identify occupational health issues among agricultural laborers, conduct community-based participatory research, and design culturally appropriate interventions. This article describes how this coalition was able to apply CBPM successfully to develop and implement an occupational safety program to prevent eye injuries among migrant farm workers. Lessons learned from this project and implications for designing and disseminating occupational safety programs for other agricultural workers are discussed.

Community-Based Prevention Marketing

This article describes the application and refinement of community-based prevention marketing (CBPM), an example of community-based participatory research that blends social marketing theories and techniques and community organization principles to guide voluntary health behavior change. The Florida Prevention Research Center has worked with a community coalition in Sarasota County, Florida to define locally important health problems and issues and to develop responsive health-promotion interventions. The CBPM framework has evolved as academic and community-based researchers have gained experience applying it. Community boards can use marketing principles to design evidence-based strategies for addressing local public health concerns. Based on 6 years of experience with the "Believe in All Your Possibilities" program, lessons learned that have led to revision and improvement of the CBPM framework are described.

Community-Based Prevention Marketing: The Next Steps In Disseminating Behavior Change

OBJECTIVES: To develop and evaluate a new community-based social marketing (CBPM) model. METHODS: CBPM is being piloted to prevent the initiation of smoking and alcohol consumption among middle-school students. The project's impact on behavioral outcomes and the community's ability to use CBPM to solve public health problems are being evaluated. RESULTS: Community members have demonstrated an unexpected level of interest in learning CBPM and applying its principles to program planning. CONCLUSIONS: Community control of the social marketing process has the potential to enhance program integration into existing community structures, making them more effective and sustainable. (Abstract Adapted from Source: American Journal of Health Behavior, 2000. Copyright © 2000 by the American Academy of Health Behavior) Junior High School Student Early Adolescence Juvenile Substance Use Substance Use Prevention Community Based Alcohol Use Prevention Tobacco Use Prevention 08-00

Community-Based Prevention Marketing

Community-Based Prevention Marketing