The social marketing ‘customer/citizen triangle’  is a visual way to highlight the key features of social marketing. Six key concepts are emphasised: Insight, Exchange, Competition, Audience Segmentation, Behaviour and Method Mix. The citizen/customer/patient is in the centre of the process and approach. These social marketing concepts are the necessary ingredients for successful social programmes that seek to influence behaviour and gain popular public support
The social marketing ‘customer/citizen triangle’ 
These social marketing concepts are derived from an evidence and experiential base about what works in the
commercial sector and in the development and delivery of public sector programmes designed to influence
behaviour for social good.
Key concept 1: Insight
Insights are ‘deep truths’ and understanding about why people act as they do. Insights are developed from formative research (Formative research gathers insights from end-users through dialogue and conversation and can include a combination of techniques such as focus groups, literature reviews, surveys, stakeholder discussions, partnership panels, media audits, in-depth and/or ‘intercept’ interviews (such as catching people in the hallway).), observational data, demographic data, service use data, problem or issue tracking data, and in the case of communicable disease programmes, epidemiological data. Social marketing is based on the development of deep insights into people’s lives, with a focus on what will or will not motivate or enable people to change behaviour, develop a new one, modify and/or sustain it in any given situation.
Social marketing is focused on identifying and developing actionable insights that can be used to select and develop interventions that will influence behaviour. These insight-informed interventions are subsequently tested through pilots and refined or rejected according to their utility.
Social marketing also undertakes situational analysis research that identifies external influences on behaviour such as environmental, economic, social and cultural factors. As indicated in Figure 4, social marketing analyses both problematic behaviour that needs to be changed and positive behaviours that need to be encouraged and supported. Both the enabling factors that exist and the environmental barriers people face in adopting the targeted behaviours are assessed. Social marketing works to develop interventions that remove or reduce barriers to positive health behaviours for example by reducing or removing costs associated with vaccine uptake. Social marketing also seeks to enhance enabling factors for example by promoting vaccine uptake as a desired social norm.
Incentives and barriers to behaviour change 
Measles vaccination case (b) – Gaining insights into Roma attitudes towards vaccination uptake 
In 2012, ECDC supported a project aimed at gaining insights from Roma parents and grandparents about their children’s low measles vaccination uptake levels and their attitudes towards healthcare providers (HCPs). A literature review, interviews and focus groups were utilised as data gathering techniques. The result, ‘Insights,’ about why people believed what they did and acted in the way that they did contributed to the development of a promotional strategy and a set of messages and recommendations to healthcare providers from so-called ‘hard-to-reach’ populations which were included in the ECDC Let’s Talk about Protection  vaccination guide for HCPs.
• know more about us.
• reframe ‘hard-to-reach’ as ‘poorly-reached’ health system failures.
• view immunisation as one part of larger health challenges.
• integrate us into mainstream programmes.
• involve us in all stages of programmes aimed at enhancing our inclusion and health.
• adapt governance and health systems to be more inclusive.
• support Health Mediators and other community health workers as they are critically important resources.
• be accessible and respectful.
• beware of incentives that could be viewed as bribes for compliance.
© European Centre for Disease Prevention and Control, 2014