Social Marketing Interventions Research Articles

Formative Process Evaluation for Implementing a Social Marketing Intervention to Increase Walking Among African Americans in the Positive Action for Today’s Health Trial

Evaluating programs targeting physical activity may help to reduce disparate rates of obesity among African Americans. We report formative process evaluation methods and implementation dose, fidelity, and reach in the Positive Action for Today's Health trial. We applied evaluation methods based on an ecological framework in 2 community-based police-patrolled walking programs targeting access and safety in underserved African American communities. One program also targeted social connectedness and motivation to walk using a social marketing approach. Process data were systematically collected from baseline to 12 months. Adequate implementation dose was achieved, with fidelity achieved but less stable in both programs. Monthly walkers increased to 424 in the walking-plus-social marketing program, indicating expanding program reach, in contrast to no increase in the walking-only program. Increased reach was correlated with peer-led Pride Strides (r = .92; P < .001), a key social marketing component, and program social interaction was the primary reason for which walkers reported participating. Formative process evaluation demonstrated that the walking programs were effectively implemented and that social marketing increased walking and perceived social connectedness in African American communities.

Social Marketing as Transformational Marketing in Public Services

This article presents a case study of a social marketing intervention, developed as an innovative action research project for a Fire Service, to tackle the public service challenge of reducing the incidence of deliberate countryside fire-setting in certain communities. The case demonstrates the effectiveness of a social marketing approach to tackling an anti-social behaviour that had become a local social norm which conventional education-based campaigns had failed to change. The case also explores unexpected impacts that applying a social marketing approach had on the sponsoring Fire Service, acting to transform certain aspects of its operations and culture.

Theory and Model Use in Social Marketing Health Interventions

The existing literature suggests that theories and models can serve as valuable frameworks for the design and evaluation of health interventions. However, evidence on the use of theories and models in social marketing interventions is sparse. The purpose of this systematic review is to identify to what extent papers about social marketing health interventions report using theory, which theories are most commonly used, and how theory was used. A systematic search was conducted for articles that reported social marketing interventions for the prevention or management of cancer, diabetes, heart disease, HIV, STDs, and tobacco use, and behaviors related to reproductive health, physical activity, nutrition, and smoking cessation. Articles were published in English, after 1990, reported an evaluation, and met the 6 social marketing benchmarks criteria (behavior change, consumer research, segmentation and targeting, exchange, competition and marketing mix). Twenty-four articles, describing 17 interventions, met the inclusion criteria. Of these 17 interventions, 8 reported using theory and 7 stated how it was used. The transtheoretical model/stages of change was used more often than other theories. Findings highlight an ongoing lack of use or underreporting of the use of theory in social marketing campaigns and reinforce the call to action for applying and reporting theory to guide and evaluate interventions.

Critical social marketing: investigating alcohol marketing in the developing world

PurposeThe World Health Organization (WHO) has expressed concern regarding alcohol consumption and related harms in developing nations. Concomitantly a growing evidence base suggests that alcohol marketing influences drinking behaviours. The purpose of this paper is to explore how critical social marketing can help assess the nature of alcohol marketing, and the effectiveness of its regulation, in developing countries.Design/methodology/approachA sample of 14 alcohol marketing campaigns from India, Malawi, Malaysia, Nigeria, Philippines, Sri Lanka, and Thailand are assessed against the regulatory codes governing alcohol marketing in the UK.FindingsThe study found that alcohol marketing often contravened the UK regulatory codes. Critical social marketing offers a framework for research and analysis to assess the nature and impact of alcohol marketing, and to address alcohol related harms in developing countries.Research limitations/implicationsThis exploratory study is limited to a small convenience sample. Future research to systematically audit alcohol marketing, and consumer studies to assess its impact on drinking behaviours in developing nations would be welcomed.Practical implicationsFindings suggest that initiatives to monitor and effectively regulate alcohol marketing in developing nations should be explored by policymakers. The competitive analysis and insight generated by studies of this nature can aid development agencies in the design and implementation of alcohol social marketing interventions. The global alcohol industry and marketers should also be encouraged to act more socially responsible.Originality/valueThe paper offers insights into how the critical social marketing framework can be applied in practice, to inform social marketing activity in the upstream and downstream environment.

The Organizational Impacts of Managing Social Marketing Interventions

Since social marketing’s formal introduction in 1971, the field has advanced through employing innovations in marketing thought. Despite debates over whether or not marketing principles should be used to promote socially beneficial behaviors, the field has become successful at utilizing such practices to achieve its goals. However, even with these advancements, social marketing research has yet to fully consider how the use of traditional marketing practices in socially oriented settings can alter the way stakeholders perceive and interact with the organizations employing these tactics. This article examines how parallels between nonprofit management and social marketing research illustrate how socially oriented organizations can damage their legitimacy as change agents and community partners by not evaluating the true costs of employing marketing techniques. Both warnings and recommendations are provided to help the managers of social marketing efforts more effectively evaluate both the costs and benefits of their decisions.

Perceptions of the food shopping environment are associated with greater consumption of fruits and vegetables

The present study examined whether characteristics such as quality, selection and convenience are associated with dietary intake of fruits and vegetables independent of perceived costs in an inner-city, low-income population. Secondary analysis of baseline data from a social marketing intervention designed to change household dietary practices among parents of 3- to 7-year-old children. A community sample drawn from six low-income, primarily minority neighbourhoods in Chicago, IL, USA. From the parent study, 526 respondents completed the baseline survey and were eligible for inclusion. Of this number, 495 provided complete data on sociodemographic characteristics, fruit and vegetable consumption, perceptions of the shopping environment, perceived costs of fruits and vegetables, and food shopping habits. Logistic regression analysis showed that more positive perceptions of the food shopping environment were associated with greater consumption of fruits and vegetables. There was an increase of approximately twofold in the likelihood of consuming three or more fruits and vegetables daily per level of satisfaction ascribed to the shopping environment. This association was independent of perceived cost, store type and sociodemographic characteristics. Our data show that among a generally minority and low-income population, quality, selection and convenience are important determinants of fruit and vegetable consumption. Nutrition promotion campaigns that aim to alter the built environment by increasing access to fruits and vegetables should recognize that simply increasing availability may not yield beneficial change when characteristics of the shopping context are ignored.

Improving parents' child‐feeding practices: a social marketing challenge

PurposeThe purpose of this paper is to evaluate the ability of a social marketing intervention to provide families with specific nutrition information, stimulate family discussions on the topic of nutrition, and encourage parents to make changes in their child‐feeding practices.Design/methodology/approachA postcard intervention was administered to families with children aged five to 12 years at three primary schools in Western Australia. Approximately two months later, an evaluation questionnaire was administered to the three intervention schools and a control school.FindingsIn total, 229 usable questionnaires were returned, representing a 22 percent response rate. In the intervention schools, almost half of the respondents reported discussing the contents of the postcards with their children and a third reported giving the cards to their children to read. The intervention was successful in encouraging a majority (60 percent) of respondents to make at least one favourable change to their child‐feeding practices, in line with the recommendations provided.Originality/valueThe study demonstrated that a simple and cost‐effective social marketing intervention can encourage family discussions on the topic of nutrition and favourably influence parents' child‐feeding practices.

71. Social Marketing Intervention and Depression Treatment in Adolescent Mothers

More than than 400,000 live births occur to adolescents in the United States annually, and 50% of adolescent mothers experience symptoms of depression. Unfortunately, few adolescent mothers receive depression evaluation and treatment, which is a significant public health issue. Untreated depression impacts the adolescent's relationships, functioning at work and school, health care seeking behaviors, parenting abilities, and her development as well as the development of her child. Barriers to depression treatment in adolescent mothers include lack of knowledge of depression symptoms (literacy), negative attitude towards mental health treatment (attitude), perception that individuals with depression are stigmatized (subjective norms), lack of understanding of health resources that are available to her and under her control (perceived control), and lack of time.

Influencing behavioral change by customer engagement amongst youth

It is widely accepted that many social and health problems have underlying behavioral causes. Because these problems are rooted in human behavior, solutions to deal with them also lie in human behavior. This paper examines ways of integrating customer engagement in social programs to influence and initiate behavior change effectively with a special focus on youth. This work followed a theoretical deduction by use of a literature review. Social marketing places emphasis on behavior change, and one of the key challenges for social marketers is to ensure a perceived value for customers in taking up and maintaining positive behavior. If perceptions, beliefs, attitudes, and values influence behavior, then the central focus should be on the youth. Integrating youth is a prerequisite for effective social marketing programs and ultimately behavioral change. This approach will pave the way for effective brand positioning and brand loyalty in social marketing which has been lacking and requires more attention from researchers and policymakers. This paper outlines theoretical developments in social marketing that will increase the effectiveness of social marketing programs overall. Existing social marketing literature typically focuses on social marketing interventions and behavioral change. This paper uses customer engagement within a social marketing context so that social marketing programs are perceived as brands to which youth can relate.

The Second Phase of a Social Marketing Approach to a Successful Oral Cancer Case-Finding Pilot

This is the second phase of a successful social marketing intervention for mouth cancer detection. The objective is to implement a social marketing oral cancer pilot case-finding service for an at-risk population. Phase two enhanced the original project, which used specific awareness-raising techniques in a defined catchment population to engage with those at risk for oral cancer. It also encouraged them to seek early case-finding and diagnosis or elimination from follow-up in a uniquely designed case-finding/referral intervention based on social marketing techniques. Phase two features included on-street recruiting and mapping of the target audience. The total target population for the intervention was identified, and a significant proportion was reached and drawn into contact with the service. The system developed proved that it is possible to define, identify, and engage with a hard-to-reach target population at risk for a serious disease and draw significant numbers into case-finding/health service contact. This intervention illustrates the value of complex target population tracking systems, the value of using techniques to map target populations, the application of social marketing techniques in drawing in a hard-to-reach target audience, and how much social marketing is about the product or service, rather than just the communication strategy.

Early diagnosis of lung cancer: evaluation of a community-based social marketing intervention

BackgroundPoor UK lung cancer survival rates may, in part, be due to late diagnosis.ObjectivesTo evaluate the effectiveness of a mixed-method community-based social marketing intervention on lung cancer diagnoses.MethodsA public awareness...

Condom social marketing in sub-Saharan Africa and the Total Market Approach

Social marketing interventions are important in developing nations. Both increasing use and shifting users from receiving subsidised condoms need to be pursued using a Total Market Approach (TMA). This paper reviews the performance of social marketing through a cross-country comparison of condom use, equity and market share, plus a case study illustrating how TMA can be applied. Demographic and Health Survey data (1998-2007) provide condom use trends, concentration indices and sources of supply by gender for 11 African countries. Service delivery information and market research provide market share data for the same period. For the case study, two-yearly surveys (2001-09) are the source of condom trends, and retail audit data (2007-09) provide sustainability data. Among women, condom use with a non-marital, non-cohabiting partner increased significantly in 7 of 11 countries. For men, 5 of 11 countries showed an increase in condom use. Equity improved for men in five countries and was achieved in two; for women, equity improved in three. Most obtained condoms from shops and pharmacies; social marketing was the dominant source of supply. Data from Kenya were informative for TMA, showing improvements in condom use over time, but sustainability results were mixed and equity was not measured. Overall market value and number of brands increased; however, subsidies increased over time. Condom social marketing interventions have advanced and achieved the goals of improving use and making condoms available in the private sector. It is time to manage interventions and influence markets to improve equity and sustainability.

Social marketing interventions to increase HIV/STI testing uptake among men who have sex with men and male-to-female transgender women

Social marketing interventions have been shown to both promote and change many health-related behaviours and issues. As the HIV epidemic continues to disproportionately affect MSM and transgender women around the world, social marketing interventions have the potential to increase HIV/STI testing uptake among these populations. To assess the impact of social marketing interventions on HIV/STI testing uptake among men who have sex with men and transgender women compared to pre-intervention or control group testing uptake in the same population. We searched the following electronic databasesfor results from 01 January 1980 to the search date, 14 July 2010: Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, LILACS (Latin America and Brazil), PsycINFO, PubMed, Web of Science/Web of Social Science, Chinese National Knowledge Infrastructure (CNKI), and CQ VIP (China). We also searched for conference abstracts in the Aegis archive of HIV/AIDS conference abstracts and the CROI and International AIDS Society websites. In addition to searching electronic databases, we searched the following sources of grey literature: Australasian Digital Theses Program, Canadian Evaluation Society, Eastview: China Conference Proceedings, ProQuest Dissertations and Theses, and World Health Organization Library Information System (WHOLIS). We contacted individual researchers, experts working in the field, and authors of major trials for suggestions of any relevant manuscripts that were in preparation or in press. References of published articles from the databases above were searched for additional, pertinent materials. All languages were included in this search. Randomized controlled trials and controlled clinical trials that compared social marketing interventions with a control were included. Interrupted time series and pretest-posttest design studies (controlled or uncontrolled) that compared social marketing interventions with no intervention or a control were also included. Posttest-only studies and studies that combined pre-post data were excluded. Interventions that targeted at general public but did not include MSM or transgender women as a segment or did not have outcome data for an MSM or transgender segment were excluded. Two authors independently extracted data from each included study and assessed study quality. Meta-analyses were conducted to compare pre- and post-intervention and intervention and control group outcomes of HIV and STI testing uptake. Quality of evidence was assessed using the GRADE approach. Three serial, cross-sectional pretest-posttest study designs (one with a control group and two without) were included in the final analysis. Statistical pooling was conducted for two studies and compared to pre-intervention level testing uptake, which showed that multi-media social marketing campaigns had a significant impact on HIV testing uptake (OR=1.58, 95%CI = 1.40 - 1.77). However, the campaigns were not found to be effective in increasing STI testing uptake (OR=0.94, 95%CI = 0.68 - 1.28). Overall, risk of bias was high and quality of evidence was low. None of the studies were conducted in developing countries or included male-to-female transgender women. This review provided limited evidence that multi-media social marketing campaigns can promote HIV testing among MSM in developed countries. Future evaluations of social marketing interventions for MSM should employ more rigorous study designs. Long-term impact evaluations (changes in HIV or STI incidence over time) are also needed. Implementation research, including detailed process evaluation, is needed to identify elements of social marketing interventions that are most effective in reaching the target population and changing behaviours.

Reducing barriers to sun protection – Application of a holistic model for social marketing

Reducing high rates of sunburn occurrence, linked to the development of skin cancers, has been the focus of sustained social marketing campaigns in Australasia. Despite substantial investment in public health warnings, barriers to preventing sunburn and associated skin cancers remain. The purpose of this article is to illustrate through a holistic model of sunburn how social marketing interventions can be made at both the macro- and micro-environmental levels to minimise the remaining barriers to sun protection. This is achieved though a review of population studies that identify the barriers to preventable sunburn. Integration of the barriers suggests that a holistic approach is needed to understand sun protection behaviour among the general population. This approach supplements existing public health promotion approaches which tend to target an individual’s knowledge and attitude toward sun protection and tanning. From this holistic model of sunburn, the implications for social marketers and directions for future research are presented.

Evaluation of a social marketing intervention promoting oral rehydration salts in Burundi.

BackgroundDiarrhea is the second leading cause of death for children under five in Burundi; however, use of oral rehydration salts (ORS), the recommended first-line treatment, remains low. In 2004, PSI/Burundi launched a social marketing intervention to promote ORASEL among caregivers of children under five; the product was relaunched in 2006 with a new flavor. This study evaluates the intervention after the ORASEL relaunch, which included mass media and interpersonal communication activities. The study looks at trends in ORASEL use in Burundi and in behavioral determinants that may be related to its use.MethodsIn 2006 and 2007, PSI conducted household surveys among Burundian females of reproductive age (15-49). Both surveys used a two-stage sampling process to select 30 households in each of 115 rural and urban collines throughout the nation. Survey respondents were asked about diarrhea treatment-related behavior; key behavioral determinants; and exposure to the ORASEL intervention. Data were analyzed to identify trends over time, characteristics of ORASEL users, and associations between exposure to the intervention and changes in ORASEL use and related behavioral determinants.ResultsORASEL use among caregivers at their children's last diarrheal episode increased significantly from 20% in 2006 to 30% in 2007, and there were also desirable changes in several behavioral determinants associated with ORASEL use. Evaluation analysis showed that a higher level of exposure to the social marketing campaign was associated with greater use of ORASEL and with significant improvements in perceived availability, knowledge of the signs of diarrhea and dehydration, social support, and self-efficacy.ConclusionsORS use can be improved through social marketing and educational campaigns that make the public aware of the availability of the product, encourage dialogue about its use, and increase skills and confidence relating to correct product preparation and administration. Further interventions in Burundi and elsewhere should promote ORS through a variety of mass media and interpersonal communication channels, and should be rigorously evaluated in the context of the total market for diarrhea treatment products.

Different delivery mechanisms for insecticide-treated nets in rural Burkina Faso: a provider's perspective

BackgroundInsecticide-treated nets (ITNs) have been confirmed to be a very effective tool in malaria control. Two different delivery strategies for roll-out of ITN programmes have been the focus of debate in the last years: free distribution and distribution through commercial marketing systems. They are now seen as complementary rather than opponent. Acceptance of these programmes by the community and involved providers is an important aspect influencing their sustainability. This paper looks at how providers perceived, understood and accepted two interventions involving two different delivery strategies (subsidized sales supported by social marketing and free distribution to pregnant women attending antenatal care services).MethodsThe interventions took place in one province of north-western Burkina Faso in 2006 in the frame of a large randomized controlled ITN intervention study. For this descriptive qualitative study data were collected through focus group discussions and individual interviews. A total of four focus group discussions and eleven individual interviews have been conducted with the providers of the study interventions.ResultsThe free distribution intervention was well accepted and perceived as running well. The health care staff had a positive and beneficial view of the intervention and did not feel overwhelmed by the additional workload. The social marketing intervention was also seen as positive by the rural shopkeepers. However, working in market economy, shopkeepers feared the risk of unsold ITNs, due to the low demand and capacity to pay for the product in the community.ConclusionThe combination of ITN free distribution and social marketing was in general well accepted by the different providers. However, low purchasing power of clients and the resulting financial insecurities of shopkeepers remain a challenge to ITN social marketing in rural SSA.

Preventing High-Risk Drinking among College Students: A Social Marketing Case Study

Investigators implemented a social marketing intervention to reduce alcohol consumption at a large university in the southeastern United States. The objective was to decrease high-risk drinking and drinking and driving and to change the perception that alcohol use increases sexual opportunities among college students. Formative research revealed that high-risk college students associate undesirable social consequences with excessive drinking (e.g., embarrassing oneself, annoying peers, offending the other sex, or burdening friends). An intervention was developed in which the product was avoiding the social stigma associated with excessive alcohol consumption. Promotional materials illustrating the social repercussions associated with excessive alcohol use and promoting the advantages of moderating one's drinking were disseminated in popular student venues; price was raised by increased law enforcement; and place was addressed by providing alcohol-free alternative activities. Evaluation included a time-series design in which students completed an anonymous online standard alcohol and drug survey and reviewing campus records of drinking under the influence (DUI) citations, alcohol-related judicial violations, and emergency department transports for alcohol overdose. Self-reported high-risk drinking, drinking and driving, and the perception that alcohol facilitates sexual opportunity rates decreased 33%, 45%, and 21%, respectively. DUI violations, alcohol-related judicial violations, and student transports to the emergency department for alcohol overdose decreased 13%, 28%, and 37%, respectively. Programmatic goals and objectives were met. Social marketing interventions appear to be a promising and cost-effective means to reduce high-risk drinking and the associated consequences among college students. Addressing social ramifications appears to be more motivating than conveying the prevalence of high-risk drinking.

Strategies for the Social Marketing Mix: A Systematic Review

The marketing mix is a key component of social marketing providing one of the differential points in bringing about behavior and social change. There is a dearth of information regarding the strategies used for the mix in social marketing interventions. This systematic review identifies the strategies used in the social marketing mix, product, price, place, promotion, policy, and partnerships, and their associated outcomes, in health behavior change interventions. A systematic literature search was conducted for peer-reviewed articles published in English from 1990 to 2009 that reported social marketing interventions addressing disease prevention, cancer, heart disease, diabetes, HIV, STDs, reproductive health, physical activity, nutrition, and tobacco. Articles must have identified at least 3 of the Ps of the marketing mix, reported the evaluation, and met the 6 social marketing benchmarks criteria. Twenty-four studies describing 17 interventions met the inclusion criteria. The complete marketing mix was identifiable in 5 interventions. Strategies such as removing perceived barriers, using the Internet for placement, applying innovative promotion, involving communities, and supporting policies were identified as current practices. The results identified a number of strategies that showed potential for the marketing mix with important implications for practice.

The Opportunities and Challenges of School-Based Research for Social Marketers

Children and adolescents are often the primary target audience of social marketing campaigns and interventions. The prevalence of youth-directed campaigns has risen dramatically in the past decade, in part due to the increase in children's health problems (e.g., obesity, asthma, substance use). As a result, researchers increasingly approach schools and ask them to be collaborative partners in helping them to evaluate social marketing campaigns prior to more widespread dissemination. Just as social marketers must understand the facilitators of and barriers to behavior change in their primary target audience(s), schools must also be thoroughly understood and supported for collaborative success. While schools are a convenient and often effective channel for conducting youth-based social marketing evaluation research, partnering with schools can present some unique challenges. This article describes some of the issues social marketers should consider when working with schools on evaluation research.

Developing a Common Language for Using Social Marketing: An Analysis of Public Health Literature

The term social marketing has been used to describe a multitude of interventions that incorporate the use of traditional marketing techniques to promote a behavior that will improve the health or well-being of a target audience or of society as a whole. However, there is wide variation in the way social marketing is defined and used. This systematic review article examines how social marketing has been defined and applied to social problems within the public health literature from 2001–2006, by adapting a grading-system borrowed from evidence-based medicine and utilizing Kotler and Zaltman's definition of social marketing. Additionally, definitions of social marketing were identified in the reviewed articles. Identifying a common language in the description and design of social marketing interventions will benefit researchers and practitioners interested in social marketing as a behavior change approach.