Social marketing is a set of evidence and experience-based concepts and principles drawn from the field of marketing that provide a systematic approach to influence behaviours that benefit individuals and communities for the greater social good (see Figure 1). Like commercial marketing it is a fusion of science, practical ‘know how’ and reflective practice focused on continuously improving the effectiveness and efficiency of programmes. ‘Social Marketing seeks to develop and integrate marketing concepts with other approaches to influence behaviours that benefit individuals and communities for the greater social good’.
Making the case for social marketing
Numerous studies have shown that social marketing can be an effective approach to influencing behaviour in the field of public health. Social marketing approaches have been used for many years in designing, implementing and evaluating public health initiatives in the fight against HIV AIDS, malaria, influenza, diarrheal diseases and many other forms of communicable disease. Social marketing has also been effectively used to tackle noncommunicable disease challenges such as smoking and other social challenges such as environmental issues, safety and crime.
Social marketing approaches add value to public health programmes by providing systematic ways of actively engaging with end-users and a focus on behaviour change, relationship building, measureable objectives and integration of many intervention methods.
Many programmes are constructed by experts and policy planners who attempt to drive the behaviour changes they desire down through populations. This approach is influenced by political as well as by professional assessments of risk and solutions, but does not always include citizen/patient/consumer insight research. As a consequence the targeted people may misunderstand these interventions or view them as irrelevant and end up rejecting the proposed solutions. Social marketing approaches can be used to help engage end-users in the development, implementation and evaluation of policies and programmes. This is done by integrating insights from individuals, those that influence them (influencers) and other concerned people (stakeholders) into planning and implementation processes. This is further informed by social marketing research, evidence-based practice and the use of social-behavioural theories.
A focus on longer term behaviour change and relationship building
Many public health programmes are short term and focus their evaluation on process or outputs (e.g. number of vaccine information leaflets distributed) rather than changes in population behaviour (e.g. vaccination uptake). Applying social marketing approaches can help programmes enhance their focus on behavioural change outcomes. Social marketing is built on the understanding that behaviour change is a process not just an event and often requires sustained interventions over time. Social marketing also acknowledges that significant benefits can be gained in building long-term relationships, particularly when addressing issues like vaccination where trust has been shown to be a key element of compliance.
Social marketing recognises that what people know, and even people’s attitudes, do not always impact on their actual behaviour. It seeks to understand people’s motivations and needs as well as gain a better understanding of how the environments in which their actions take place influence behaviours. Social marketing, for example, looks at the behavioural impacts of various external influencers; such as, time constraints, convenience factors, social consequences, and competing behaviours (see Figure 2).
Transparent and measureable objectives
Many public programmes set either unrealistically ambitious goals that are not achievable in the short term or unclear measurable objectives. Social marketing identifies ways to develop transparent and measurable objectives that can aid evaluation and learning about what works and what does not. Social marketing is also concerned with the efficiency of behavioural change programmes as well as their efficacy. Intelligence gathered through the use of social marketing approaches can help inform managers and practitioners on the best way to spend budgets to realise the most impact for the smallest investment, what programmes to continue and expand and what programs to reduce or cut.
A full intervention mix
There are a limited number of programmes that utilise and coordinate a full intervention mix of education, support services, (re)design (i.e. changing system and environmental factors which promote or inhibit uptake of vaccination), regulation and control measures. Social marketing can help programmes identify and encompass a broader range of evidence-based and insight-driven interventions that have been shown to influence behaviour change among: individuals, organisations, social networks and social norms, communities, businesses, markets, and public policy.
Behaviour change intervention insights from social marketing research – selected examples.
Beliefs and values influence how people behave. Programmes should start by understanding people’s beliefs and attitudes and use these to inform the development of behaviour change services and products.
People often use mental short cuts and trial-and-error approaches to make decisions rather than ‘rational’ decision-making. Understanding these short cuts or heuristics (the process that enables a person to discover or learn something for themselves) should be used to develop interventions and new ‘scripts’ associated with the behaviour.
People can be ‘locked into’ patterns of behaviour and need practical help to break them or unfreeze current behaviour. Programmes that provide practical support to change, are easy to access and require small steps tend to be more effective.
Change in behaviour is usually a process not an event, and often requires several attempts before success. When delivering intervention programmes there is a need to be persistent, sustain interventions over time and offer multiple paths to success.
Interventions should also seek to support positive behaviour by maintaining a relationship with people that affirms their new behaviour and encourages them to build on it.
Social relationships and social support have a strong and persistent influence on behaviour. Working with and through key influencers improves the impact of behaviour change programmes. Use the power of group norms and behaviour to inform and engage people in change, let them know that others are changing.
People influence and are influenced by their physical, social and economic environments. There is a limit to a person’s capacity to change if the environment works against the desired change. Deliver programmes that tackle the underlying environmental, social and economic barriers to change as well as personal knowledge, attitude, motivational and emotional factors.
Regulations – rewards and punishments
The more beneficial or rewarding an experience, the more likely it is to be repeated. Maintaining positive behaviour can be assisted by reinforcement. Behavioural interventions should seek to reward desired behaviours and when appropriate penalise inappropriate behaviour.
People are often motivated to do the ‘right thing’ for the community as well as for themselves and their families. Getting people to accept that a desired behaviour is a norm in the community and one that is valued by others has been shown to be an effective change strategy.
© European Centre for Disease Prevention and Control, 2014