Social marketing: a critical appraisal

This article provides a critical analysis of the growing useof social marketing in the field of health promotion. In responseto a recent article by A. Hastings and G. Haywood (Health PromotionInternational, 6, 135–134), three questions are askedabout each of the proposed tenets of social marketing: are theseideas new? are they more effective than current health promotionpractices? and do they raise any particular ethical concerns?On each of these counts, the analysis suggests that the purportedbenefits of social marketing might not be as great as proponentsclaim. There are also some problematic unintended consequencesthat arise from the use of social marketing methods. The narrowfocus on individual behavior change and the potentially manipulativetechniques for inducing behavior change are of particular concern.The paper concludes with a call for further discussion aboutthe limits and potential iatrogenic side-effects of using socialmarketing strategies for health promotion.     

Understanding behaviour change in context: examining the role of midstream social marketing programmes

This research examines how midstream social marketing programmes that adopt a relational and community‐based approach create opportunities for individuals to make incremental changes to health behaviour. Specifically, it applies Bourdieusian theory to explore how interactions between community healthcare workers (CHWs) and members of the public generate impetus for change and foster individual agency for improved health. Qualitative interviews were carried out with members of the public and CHWs engaged in a Smokefree home and cars initiative. The findings suggest that although CHWs are challenged by resource constraints, their practices in working with individuals and families build trust and enable dialogue that bridges smoking‐related health insight with home logics. These interactions can promote individual agency with a transformative effect through small changes to smoking‐related dispositions, norms and practices. However, tensions with the habitus of other household members and other capital deficits can inhibit progress towards embedding new practices. The study concludes that interventions built upon community relationships show potential for addressing limitations of information‐focused campaigns but there is a need to also respond to key social structures relating to the field of action for new health dispositions to become embedded in practice.     

Social marketing: a critical response

This paper presents a response to Buchanan et al.'s critiqueof our previous paper ‘Social Marketing and Communicationin Health Promotion’ (Health Promotion International,6, 135–145). It examines their comments in five areas:consumer orientation, exchange, profitability, integrated approachand advertising. Our response takes issue with many of the pointsmade by Buchanan et al., and suggests that the authors havefailed to raise more legitimate and relevant questions aboutsocial marketing Ultimately, it concludes that Buchanan saysnothing to alter our original opinion that social marketingalong with other disciplines, does have the potential to makea useful contribution to health promotion.     

Social marketing and communication in health promotion

Communication is a central aspect of health promotion and theopportunity for mass communication makes the ‘media’a popular option amongst health promoters. The media in thiscontext includes any non-personal channels of communication,from leaflets to television commercials to teaching packs. Thesechannels can be employed directly using deliberately designedmedia materials. Alternatively, they may be used indirectlyby stimulating editorial interest and comment on a particularissue. This paper will make some suggestions for improving theuse of the media in health promotion. In seeking guidance about how to make best use of the media,health promoters can turn to a number of disciplines, includingeducation, medicine, social psychology and communication theory.Another obvious source of insights is commercial marketing,where purposeful media communication, most apparent in the formof advertising, is in continuous use. it is this source of advicethat we want to examine here. In recent years much has been written about the applicationof commercial marketing approaches to social issues-so calledsocial marketing. This paper will begin by examining the originsof ‘social marketing’. it will then discuss itskey concepts and consider how these might help health promoterscommunicate more effectively. However, to interest active health promoters, the discussionneeds to progress beyond ideas and concepts, beyond theory anddemonstrate practical benefits that social marketing can providein real life situations. The paper will therefore continue byexamining the case histories of a number of media based healthpromotion campaigns and illustrate how the most basic of socialmarketing insights, consumer orientation, has contributed tothem.     

A social work plan to promote HIV testing: A social marketing approach

Many people living with human immunodeficiency virus (HIV) do not know that they are infected. It is important for infected persons to get tested for HIV in order to be diagnosed and medically treated. HIV has no known cure, but it can be controlled and sometimes prevented with proper medical care. The social work profession has ideal positioning to be extraordinarily helpful in work that promotes HIV testing, leading to reducing then eliminating new HIV diagnoses. Social marketing interventions, along with audience segmenting are explained. Specific attention is given to two separate subjects—minority health disparities and impulsive and/or sensation seeking sex practices—to showcase the versatility of social marketing in the promotion of HIV testing. Further ideas about how social workers can participate in these interprofessional social marketing campaigns are provided.     

Selling health lifestyles: using social marketing to promote change and prevent disease

As part of its continuing mission to serve trustees and staff of health foundations and corporate giving programs, Grantmakers In Health (GIH) brought together grantmakers, researchers, and public health professionals on May 20, 2004 to discuss the application of social marketing principles to health promotion and chronic disease prevention. As a behavior change technique, social marketing has proven effective in motivating people to make the complex and difficult behavior changes that can improve health and reduce the risk of chronic diseases such as cardiovascular disease, cancer, and diabetes. The Issue Dialogue used the lens of tobacco prevention and cessation, physical activity, and healthy eating to examine how health grantmakers can use social marketing principles and techniques to encourage and support the adoption of healthier behaviors across the lifespan. This Issue Brief incorporates the information and ideas shared at the meeting with a background paper on social marketing that was prepared for participants who attended the Issue Dialogue. It starts with an introduction of social marketing concepts and provides a framework for assessing whether social marketing is an appropriate approach to use in addressing a particular issue. Subsequent sections: (1) describe both the social marketing communications process and techniques, using examples from campaigns developed by health grantmakers and others; (2) describe how social marketing can be used to promote policy change; (3) provide information on communication strategies that can complement social marketing; and (4) present opportunities for grantmakers.     

‘You just change the channel if you don't like what you're going to hear’: gamblers’ attitudes towards,and interactions with,social marketing campaigns

Objectives

To investigate how gamblers interact with, and respond to, downstream social marketing campaigns that focus on the risks and harms of problem gambling and/or encourage help seeking.

Methods

Qualitative study of 100 gamblers with a range of gambling behaviours (from non‐problem to problem gambling). We used a Social Constructivist approach. Our constant comparative method of data interpretation focused on how participants'' experiences and interactions with gambling influenced their opinions towards, and interactions with social marketing campaigns.

Results

Three key themes emerged from the narratives. (i) Participants felt that campaigns were heavily skewed towards encouraging individuals to take personal responsibility for their gambling behaviours or were targeted towards those with severe gambling problems. (ii) Participants described the difficulty for campaigns to achieve ‘cut through’ because of the overwhelming volume of positive messages about the benefits of gambling that were given by the gambling industry. (iii) Some participants described that dominant discourses about personal responsibility prevented them from seeking help and reinforced perceptions of stigma.

Conclusions and implications

Social marketing campaigns have an important role to play in the prevention of gambling risk behaviours and the promotion of help seeking. Social marketers should explore how to more effectively target campaigns to different audience segments, understand the role of environmental factors in undermining the uptake of social marketing strategies and anticipate the potential unforeseen consequences of social marketing strategies.     

Global environmental change: preventive measures to reduce the impact on human health

Awareness of the magnitude of worldwide climate change and theloss of biological diversity that may occur as the result ofpresent human activities is increasing. However, much needsto be done to reverse current trends and prevent unprecedentedglobal environmental changes which are expected to produce irreversibleresults, and to have profound implications for the health ofindividuals. This paper briefly reviews what is known aboutthe global environmental changes that are taking place and theirpredicted impact on human health. Some of the preventive measuresand activities in which public health professionals need toassume leadership roles in the critical years ahead are discussed.Our hope is to enliven a much needed dialogue among health professionalson the crucial issue of environmental survival in which preventionmay be the only viable solution.     

Intentions to use contraceptives in Pakistan: implications for behavior change campaigns

Background  

Since 1990-91, traditional method use has increased at a faster rate in Pakistan than modern method use. The importance of hormonal methods or the IUD has diminished and that of traditional methods has increased in the method mix. There is a need to identify factors motivating and deterring the adoption of specific family planning methods among married men and women in Pakistan.     

导入产品整体概念促进医疗服务营销

根据菲利普·科特勒的产品整体概念五个层次理论 ,本文对医疗服务产品整体概念的内涵和层次作了具体界定 ,并指出医疗机构应保证医疗服务的核心产品、完善形式产品、理解期望产品、拓展延伸产品、适时开发潜在产品 ,以增强竞争力     

Modeling emotion and behavior in animated personas to facilitate human behavior change: the case of the HEART-SENSE game

The goal of this research is to determine whether a computer based training game (HEART-SENSE) can improve recognition of heart attack symptoms and shift behavioral issues so as to reduce pre-hospitalization delay in seeking treatment. Since treatment delay correlates with adverse outcomes, this research could reduce myocardial infarction mortality and morbidity. In Phase I we created and evaluated a prototype virtual village in which users encounter and help convince synthetic personas to deal appropriately with a variety of heart attack scenarios and delay issues. Innovations made here are: (1) a design for a generic simulator package for promoting health behavior shifts, and (2) algorithms for animated pedagogical agents to reason about how their emotional state ties to patient condition and user progress. Initial results show that users of the game exhibit a significant shift in intention to call 9-1-1 and avoid delay, that multi-media versions of the game foster vividness and memory retention as well as a better understanding of both symptoms and of the need to manage time during a heart attack event. Also, results provide insight into areas where emotive pedagogical agents help and hinder user performance. Finally, we conclude with next steps that will help improve the game and the field of pedagogical agents and tools for simulated worlds for healthcare education and promotion.     

Social marketing improved the use of multivitamin and mineral supplements among resource-poor women in Bolivia

OBJECTIVE: To test the hypothesis that social marketing improves women's awareness and consumption of multivitamin and mineral supplements. DESIGN: Formative research and baseline and final surveys using a multistaged stratified cluster sample. SETTING: Department of Santa Cruz, Bolivia. PARTICIPANTS: Women 15 to 49 years old (n=1709 at baseline and n=1735 at final survey). INTERVENTION: Social marketing campaign using radio and television spots. MAIN OUTCOME MEASURES: Awareness and use of multivitamins, including VitalDía, the brand promoted as part of this social marketing campaign. ANALYSIS: Cross-tabulations to assess changes over time in awareness and use of multivitamins. Logistic regression analyses to identify determinants of multivitamin use. RESULTS: The campaign increased women's awareness and use of multiple supplements, including VitalDía. Awareness of multiple supplements nearly doubled among women with 6 to 8 years of schooling, tripled among women with 4 to 5 years of education, and more than quadrupled among women with less than 4 years of schooling. After 9 months of social marketing, 11% of women had taken VitalDía one or more times, 7% had taken it at least once in the last 3 months, and 4% had used it one or more times in the last month. Improvements in the use of VitalDía were evident for women of all socioeconomic and educational levels, with the greatest increases occurring in the least advantaged groups. Additionally, women who had a positive perception of the benefits of multivitamins were 1.7 times (95% confidence interval 1.2-2.3; P <.01) more likely than women who did not have a positive perception to ever use VitalDía, once the effects of social class were adjusted. CONCLUSIONS AND IMPLICATIONS: Social marketing of multiple supplements reached resource-poor women and can be used to bridge gaps in access, improve awareness of supplementation as an option, and increase the likelihood that women will try supplements.     

饮食环境对中国居民饮食行为及肥胖的影响

目的 运用系统文献综述法分析饮食环境对中国居民饮食行为与肥胖的影响。方法 在Cochrane Library、PubMed、Web of Science以及中国知网等电子文献数据库中利用“饮食环境”、“饮食行为”、“肥胖”和“中国”等关键词进行组合检索。结果 社区食物设施的可得性和可达性好,丰富了中国居民的饮食多样性,增加了卡路里、蛋白质、脂肪和碳水化合物等营养素的摄入,降低了蔬菜和水果等健康食品的摄入,但对肥胖的影响效果尚不一致。学校周边快餐店数量多会增加学生肥胖的风险,但学校周边食品店的政策管理规定可以减少儿童、青少年对含糖饮料、零食和快餐的摄入。结论 构建健康饮食环境是助力中国居民享有健康饮食的保障,但如何构建健康饮食环境仍需更多证据支持。     

How to change environmental conditions for health

Since the Lalonde report, contemporary public-health theory has given steadily more attention to the role of environments in influencing health status. Environments, both social and physical, influence health directly or through complex interactions with behavior, genetics and health-care systems. They are also important for public-health because environments are the complex systems through which people are both empowered and exercise their empowerment. If public-health professionals are to play a significant role in influencing environments for health, they need analytical instruments that enable them to link specific environmental conditions with the actions necessary to improve them. These instruments must also enable public-health professionals to identify points of leverage for stimulating key actors to take the actions necessary to make environments more promoting of health. This article first presents one such analytical instrument. Then, building on examples relating to socio-economic health inequities, the analytical instrument is applied to reveal how it can add value to health professionals' effectiveness in planning interventions for more health-promoting environments.     

儿童行为问题与学校环境关系的初探

目的 了解学校的环境条件是否对儿童行为问题的发生有影响。方法 对不同类小学的575名小学生使用Rutter儿童行为量表父母问卷进行儿童行为问题的调查，同时对他们的教室建筑条件进行卫生学调查、评价。结果 575名小学生中有行为问题为8．3％，男生12．8％多于女生3．8％(X^2＝15．072，P＜0．01)，重点学校10．7％多于一般校4．0％(X^2=7．705，P＜0．01)。在教室中所占面积少(＜1．10m^2／人)的小学生(10．3％)的行为问题多于占面积大的(5．3％)，小学生所坐桌椅形式中坐连桌连椅的行为问题最多10．1％(42／416)。结论 学校及其环境条件可能会影响小学生的心理健康。     

Using social marketing principles to guide the development of a nutrition education initiative for preschool-aged children

Within the field of nutrition education, social marketing has become a promising framework to systematically approach problems related to nutrition behavior. In 1997, the Colorado Nutrition Network began developing a social marketing campaign to promote healthful food choices among low-income Coloradans. A multifaceted formative evaluation plan that included focus groups, campaign concept pretesting, and a food frequency questionnaire was used to segment and scrutinize the target audience. The resulting pilot program was a blend of educational and marketing strategies targeting preschoolers that was implemented in Head Start classrooms. The 12-week intervention contained a narrow, behavior-based "try new foods" message, multiple nutrition education activities, and repeated opportunities to taste 13 novel foods. Key strategies used and findings from the formative evaluation process are presented herein in an effort to provide insight for nutrition educators interested in developing similar interventions.     

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.     

早期行为监测与干预促进婴幼儿健康人格发展研究

目的 探讨早期行为监测与干预对婴幼儿健康人格发展的影响。方法 选取2009年1月-2010年6月本院出生符合条件的健康儿童随机分为人格培养干预组(n=78)和普通对照组(n=80)。干预组接受全面系统的婴幼儿健全人格培养的早期行为监测及干预。普通对照组不接受任何相关指导训练。两组儿童在2.5~3.5岁时均采用幼儿人格发展趋向量表、中国城市幼儿情绪及社会性发展量表、家庭养育环境量表、儿童行为量表、气质量表进行评估。结果 干预组幼儿人格发展趋向及社会情绪、行为问题检出率与其他两组比较差异均有统计学意义(P均<0.05) 。干预组家庭养育环境的百分位数经干预后明显提升, 差异有统计学意义(P<0.05) 。结论 早期行为监测与干预可通过改善家庭养育环境及亲子互动而有效促进婴幼儿健全人格建立, 同时有利于婴幼儿社会情绪及社会行为的发展。