We embrace social marketing as a critical way of understanding the public's needs and wants, in order to drive change in awareness, attitudes and, ultimately, behaviour.
Health promotion uses a wide range of tools that all make a contribution to promoting health and wellbeing1 with social marketing playing an increasingly important role. Kotler and Zaltman describe social marketing simply as ‘the application of the principles and tools of marketing to achieve socially desirable goals.’2
Utilising the components of traditional marketing, social marketing allows health promotion programs to move beyond informing and increasing knowledge to influencing behaviours that benefit the health and wellbeing of individuals and communities.1
The use of social marketing within health promotion in Australia is well established,2 including noteworthy health campaigns which have successfully reduced the prevalence of smoking and skin cancer. However there have been significant changes in the way social marketing is applied to health promotion over the last 10 years.Professor Jeff French, Chief Executive at Strategic Social Marketing Ltd in the United Kingdom, says that the function of social marketing has expanded. “There has been a move away from a restrictive view of social marketing as being mainly focused on media message promotions and the promotion of products. There has also been a growing emphasis of focusing up-stream at the causal conditions of poor health and inequality,”3 said Professor French.
Professor French believes that a new emphasis on co-production of health solutions has led to a merging of social marketing with community development and engagement approaches.
Another international expert, Dr Craig Lefebvre from the University of South Florida, also identifies co-production or co-creation as an area of growing prevalence and importance. “The creative work continues to be inspiring as social marketers become more attuned to the realities of their customers and push back against top-down message machines of the past,” Dr Lefebvre said. “It is becoming clearer that people formerly known as audiences are not passive message receivers, but can be actively involved in the production and dispersion of messages, and be agents for change in their social networks, workplaces and communities,” he said.
Traditionally health programs have been influenced by political and professional assessments of risk and solutions, but now include citizen insight research. By integrating insights from audience research and behavioural theories and engaging individuals in co- development of programs, social marketing can help achieve behavioural change outcomes. Increasingly, social marketing benefits health programs by getting to the core of people’s motivations and the environmental context to understand and ultimately influence behaviours.
VicHealth CEO Jerril Rechter is supportive of the adoption of social marketing as an essential instrument in the VicHealth toolkit.
“We embrace social marketing as a critical way of understanding the public’s needs and wants, in order to drive change in awareness, attitudes and, ultimately, behaviour,”4 Ms Rechter said.
Dr Craig Lefebvre asserts that social marketing and health promotion are inextricably linked in their shared objectives to address the factors that influence health. “I used to begin every introduction to social marketing with an image of the Ottawa Charter. Too many social marketers and health promotion people forget that the key outcomes are more than just behaviour change or health system change,” Dr Lefebvre said.
Additionally social marketing adds value to programs by using its roots in marketing to develop measurable goals and objectives that can aid in the evaluation of campaign success.1 This level of evaluation capacity aligns with and complements the measurement of all health promotion work.
With a wealth of evidence around successful health promotion strategies, VicHealth has been trialling different approaches to advance health priorities. As part of this ongoing commitment to innovation, connections have been formed to harness national and international social marketing and behaviour change expertise.
"We are shifting from individual theories and behaviour change as the outcome, to using marketing with and by social networks and communities in making social change happen."
In March 2013 VicHealth announced its first Social Marketing Research Practice Fellow, Griffith University’s Dr Krzysztof Kubacki, allowing the opportunity to look at the effectiveness of social marketing campaigns.4
Earlier this year VicHealth convened an expert panel in social marketing. This group of Australian and International experts provided strategic advice and guidance to VicHealth’s future work in this area as well as sharing insights, discussing best practice, and considering the opportunities for VicHealth in the social marketing space in coming years.
In September 2012 David Halpern, Director of the United Kingdom’s Behavioural Insights Team, was appointed as the inaugural ‘Leading Thinker’ and worked with VicHealth to investigate how a behavioural insights approach can assist in the promotion of health.5
Dr Craig Lefebvre said that the while use of behavioural insights throughout health programs is an emerging trend, social theories for change are entering the planning, implementing and evaluation of programs. “We are shifting from individual theories and behaviour change as the outcome, to using marketing with and by social networks and communities in making social change happen,” he said.
The current pace of technology is bringing about new trends and challenges within health promotion and social marketing. A 2007 study by The Social Research Centre (Australia) found that the most widely used source of health information is magazines and newspapers, with only the 18 to 24 age group most likely to use the internet for health information.6 Cut to today and smart phones never leave our side. VicHealth’s 2015 survey of use of smartphone apps found that a quarter of Victorians have downloaded a health and wellbeing app and that two in five trust health and wellbeing apps for information about being healthy.7
This prevalence of mobile technology and a mobile-first approach increasingly being adopted by industries in their digital communication approaches are fundamentally impacting the way we interact, think and behave. Individuals are more connected and informed than ever before, and with the increase of wearable technology the empowerment this brings will only continue to increase.3
Professor Jeff French believes that one of the key challenges for health promotion is that it needs to be at the cutting edge of these changes in order to remain effective. “This will require investment and the development of new partnerships with content and platform providers. Social marketing will need to be informed by and employ web and mobile enabled fields such as social media and social data,”3 he said.
VicHealth social marketing campaignsVicHealth employs a rigorous process in the development of social marketing campaigns. Sarah Shiell, VicHealth Social Marketing Manager, said the process is focused on gaining insight and understanding into the factors that influence people’s behaviour, to shape messaging that can change this behaviour. “We conduct evidence or rapid reviews to learn from previous initiatives, and conduct formative research to understand what our target audience knows about a particular issue, where their knowledge gaps are, and what environmental and other factors they believe influence their behaviour,” she said. This information can then be used to divide the target audience into segments, and design communications that best address the specific needs of particular segments.
Sarah Shiell said the campaign concept and strategy development goes through a range of focus group testing phases. “We first test the campaign messaging, to check that the style and tone is relevant and effective for the audience, and then the campaign messages and central propositions,” she said. “We use the feedback from these testing phases to fine-tune and adjust the campaign.”
1 French, J & Franklin, A et al. 2014, Social marketing guide for public health managers and practitioners, European Centre for Disease Prevention and Control, Stockholm.
2 Donovan, R 2007, ‘The role for marketing in public health change programs’, Australian Review of Public Affairs, vol. 10, no. 1, pp. 23–40.
3 French, J 2015, personal communication, 7 November.
4 VicHealth 2013, VicHealth appoints five-year Social Marketing Research Fellow, viewed 12 November 2015, https://www.vichealth.vic.gov.au/search/vichealth-appoints-first-social-marketing-research-fellow.
5 VicHealth 2014, Leading Thinkers Initiative, viewed 12 November 2015, https://www.vichealth.vic.gov.au/search/leading-thinkers.
6 Pennay, D & Bateman, J 2007, Public Attitudes to Health and Disease Prevention, Victorian Health Promotion Foundation, Melbourne.
7 VicHealth 2015, VicHealth: caution needed when downloading health apps, viewed 15 November 2015, https://www.vichealth.vic.gov.au/search/vichealth-says-caution-needed-when-downloading-apps.
8 VicHealth 2015, Switch to water for health, viewed 14 November 2015, https://www.vichealth.vic.gov.au/media-and-resources/blog/switch-to-water-for-health.
9 Euromonitor International 2006, Country Sector Briefing – Carbonates, Euromonitor International Inc Australia, Chicago. Cited in VicHealth, The H30 Challenge Campaign Evaluation, viewed 14 November 2015, https://www.vichealth.vic.gov.au/search/h30-challenge-evaluation.
10 Australian Bureau of Statistics 2013, Australian Health Survey: physical activity 2011–12. Australian Bureau of Statistics, Canberra.
11 VicHealth 2014, A snapshot of Victoria’s alcohol culture, Victorian Health Promotion Foundation, Melbourne.
12 VicHealth (in press), Alcohol Cultural Change: No Excuse Needed Evaluation Report, Victorian Health Promotion Foundation, Melbourne.
13 VicHealth (in press), Evaluation of the Alcohol Cultural Change Campaign, Victorian Health Promotion Foundation.
The H30 Challenge
Nearly two-thirds of Victorians are classified as overweight.8
Contributing to this obesity epidemic is the nation’s love of sugar sweetened beverages. Australia is one of the top 10 countries for per capita soft drink consumption.9
As part of an integrated water initiative, the VicHealth H30 Challenge social marketing campaign encouraged Victorians to make a simple pledge to replace every sugary drink they would normally drink with water for 30 days. The campaign targeted 18 to 34 year olds, who are some of the highest consumers of sugary drinks.
The H30 Challenge campaign proved very effective in its objectives, having a positive impact on participants and their consumption habits. Participants in the Challenge well exceeded targets and included the target market of high consumers of sugar sweetened beverages. The campaign achieved short-term and intended behaviour change among participants, with those taking part not just reducing sugary drink consumption during the challenge but indicating they would continue to replace these drinks with water in the immediate future.Extensive post-campaign evaluation found:
- Campaign exposure of 24% among the target audience and key message take out of 50%.
- 53% of people who consume more than five sugar sweetened beverages per week indicated that they were motivated to switch to water after seeing the campaign.
- People who recognised the campaign were more likely than non-recognisers to be motivated to swap sugar sweetened beverages for water (53% vs 47%).
- 87% of respondents to the 30-day survey completed the Challenge.
Walk to School - Celebrating 10 years
Only around one in five Australian children meets the recommended one hour of physical activity every day.10 There is huge potential to integrate opportunities for children to be active in their daily lives and build healthy lifetime habits, such as walking or riding to school.
Celebrating ten years, the annual Walk to School campaign has been funded by VicHealth since 2006. The event is designed to raise awareness of the physical, environmental and social benefits of active travel (walking to school), and encourage school children to walk to and from school more often.
Since 2012, VicHealth has expanded the activity from one day to one month, developed an app incorporating games, engaged local councils through a grants program to fund local Walk to School activities, and developed partnerships to increase impact, message exposure and brand visibility.
In 2014, extensive post-campaign evaluation found:
- The average number of times children walked to and from school increased significantly over time – with children participating in the program statistically more likely to do so than those not participating.
- Overall carer attitudes (instrumental attitudes and effective attitudes) towards children walking to school are positive – with results suggesting that the Walk to School 2014 program changed subjective norms for the better among parents of participating children.
In 2015 Walk to School celebrated its 10th year. The campaign achieved outstanding participation results, well above the ambitious targets set. More than 108,000 students participated, an increase of 39% compared to 2014 results, and 620 schools participated, an increase of 24% compared to 2014 results.
Alcohol Culture Change
Alcohol consumption is firmly entrenched in Australian culture. The VicHealth survey A Snapshot of Victoria’s Alcohol Culture found that 67% of young Victorians report drinking at levels that put them at risk of injury from a single drinking occasion.11
In response, the Alcohol Culture Change Project aimed to address and change the way that 16 to 29 year olds interact with alcohol, through two phases of campaign activity.
Phase One – Name That Point – aimed to engage the target audience, recognising that for meaningful change to occur, the group embedded in the culture must be directly involved in attempts to reshape it. The website asked visitors to name and identify the point in the night ‘where clear thinking becomes clear drinking.’ Running from December 2013 to April 2014, the website achieved over 45,000 visits, over 143,000 hits on YouTube and received nearly 2,000 submissions.12
Phase Two – No Excuse Needed – was developed using key findings from the previous phase. No Excuse Needed ran from September 2014 to March 2015, using traditional and digital media to encourage and empower the target audience to refuse a drink in a social situation, if they did not want to continue drinking. The campaign employed humour to resonate with its audience, teamed with a clear call to action: “Join the 61% of young Victorians who don’t drink to get drunk.” It used additional marketing efforts during events such as the Spring Racing Carnival, Christmas, New Year’s, and summer music festivals.
The campaign achieved and succeeded in all its objectives, with the digital video being viewed over 1 million times and garnering an impressive 46% recognition rate among its target audience.
A third of those who had seen the campaign reported that they were consuming less alcohol as a result, and the same proportion of respondents took direct action after seeing the campaign – discussing the advertisement with friends or family, or seeking additional information on VicHealth or alcohol consumption.
A key impact of the campaign was its effect on those classified as ‘risky drinkers’, with positive attitudinal shifts among this cohort related to the acceptability of drunkenness, peer pressures related to drinking, and overall concern for Victoria’s drinking culture.13