The concept of exchange as well as that of value creation is a central concept in social marketing. Exchange is based on observations that we tend to change our behaviour when we perceive that it is in our interest to do so, either through rational choice or through a more subconscious process. Things and actions that make us feel better, safer, or more respected tend to be valued and have an impact on our behaviour. If we want to influence behaviour we need to understand what people value. We can then use this information to develop interventions, systems, products or services that people will want to engage with or use.
A key task in social marketing is to develop an ‘exchange proposition’ that sets out what people have to do and/or the cost of this action (costs may be economic, social, physical or psychological) in order to get the value that they want.
Sometimes these propositions do not appeal to people’s rationality; often they aim to influence people’s emotional subconscious. Exchanges may not always be positive. In some cases we may need to use negative exchanges.
Example: In some EU countries, unvaccinated children are denied access to school. This tactic is used to penalise parents who do not get their children vaccinated and encourage people to take up vaccination. Ethical concerns have been raised about denying children education when their parents refuse vaccination. .
Often it is also necessary to focus on the short-term benefits of recommended behaviours rather than focus on long-term benefits as people place more value on immediate gains rather than gains that they may get in the distant future.
Example: It may be more effective to put emphasis on the immediate benefits of being vaccinated, such as feeling safer and being a good parent rather than on the possible long-term benefit of not contracting a disease.
Four ‘forms’ of exchange
Social marketing programmes aimed at influencing behaviour can select one of the four primary ‘forms’ of exchange. These forms of intervention are defined by two main factors. First, whether the intervention uses rewards or some form of punishment to encourage a particular behaviour. Second, whether the approach seeks to influence cognitive decision-making or unconscious decision-making. The combination of these two factors creates four different possibilities: ‘Hug’ and ‘Nudge’ (related to providing rewards and incentives to target groups; e.g. parents, providers, etc. for desired behaviours) and ‘Shove’, and ‘Smack’ (related to providing punishments and disincentives to target groups for undesired behaviours) (see Figure bellow).
‘Hugs’ focus on:
High cognitive engagement and positive rewards for compliance; e.g. offering rewards or incentives for being vaccinated; such as, money , services, sweets.
‘Nudges’ focus on:
Low cognitive engagement and positive rewards for compliance; e.g. setting up a default scheme where vaccination is given to children in schools unless a parent takes the time to opt out. The ‘nudge’ here comes from requiring parents to take an active step not to get vaccination.
‘Shoves’ focus on:
Low cognitive engagement and punishment for non-compliance; e.g. children must have been vaccinated before they are allowed to attend school. Parents need to make sure they have been vaccinated and that they have an official record of it to show the school.
‘Smacks’ focus on:
High cognitive engagement and punishment for non-compliance; e.g. parents are fined or banned from taking their child to school if they are not vaccinated.
All these forms of intervention are legitimate public health strategies (see Figure 6). Often a combination of such approaches is needed to encourage compliance with public health guidance. The selection of which combination of interventions will depend on what actions literature and target audience research show are effective, acceptable, practical and financially feasible and sustainable.
© European Union