1. Using Social Marketing Principles to Reach People with Limited Health Literacy― What Works Cynthia Baur, Ph.D. National Center for Health Marketing

2. Presentation Overview Consumers – Who are they? Reaching Consumers with Limited Health Literacy- Challenges/Barriers Health Marketing Using the Marketing Mix to Achieve Success- Outreach Opportunities

3. Who Uses Products and Services? Patients? Audience segments? People who need to change a health behavior? Consumers do. (This slide and next 4 slides courtesy of Todd Phillips, AED)

4. About Consumers They have choices. They make decisions. They evaluate based on needs and wants. They are not passive recipients of information.

8. 90 million 90 million Americans would have trouble with this.

9. Definitions Literacy “An individual's ability to read, write, and speak in English and compute and solve problems at levels of proficiency necessary to function on the job and in society, to achieve one's goals, and to develop one's knowledge and potential." (National Literacy Act of 1991) Health literacy “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” ( Healthy People 2010)

10. What is the Truth? Everyone has difficulty understanding health information at some point regardless of their literacy level. Contributing factors include: Complexity of information Unfamiliar scientific/medical jargon Demands of navigating healthcare system Stressful/unfamiliar situation Limited health literacy is not just a consumer problem, but also a “systems” problem

11. The Bottom Line Only 12 percent of adults have Proficient health literacy. In other words, nearly 9 out of 10 adults may lack the skills needed to manage their health and prevent disease. ( 2003 National Assessment of Adult Literacy Study)

12. What is the Connection between Social Marketing and Improving Health Literacy? Consumer Experience and the “do-ability” of our recommendations

13. Who Needs Extra Consideration? Some groups face additional challenges that require attention: Older adults Those who are poor People with limited education Minority populations Persons with limited English proficiency (LEP)

14. Challenges/Barriers Identifying consumers Communication Language barriers Cultural differences

15. Identifying Consumers You can’t tell by looking Limitations to using existing assessment tools No ‘gold standard’ for measuring health literacy (Parker et al., 1999 ).

16. Communication Information delivery Complexity of information Information processing/interpretation Individual communication/learning styles

17. Language Barriers Los estudios indican que una de las razones por las cuales los padres que hablan español no hacen uso de los centros de control de envenenamientos es la barrera del idioma. Research has shown that one reason Spanish-speaking parents do not utilize poison control centers is due to their fear of a language barrier 1. 1 Kelly N., et al. Effects of Videotape to Increase Use of Poison Control Centers by Low- Income and Spanish-Speaking Families. Pediatrics 2003; 111;21-26

18. Cultural Differences Cross-cultural gaps between professionals and customers Understanding differences in values, beliefs, practices, attitudes, traditions Lack of customer-centered services Experiences leading to distrust

19. How Do We Use Social Marketing to Achieve Success?

20. Health Marketing Health Marketing involves creating, communicating, and delivering health information and interventions using customer- centered and science-based strategies to protect and promote the health of diverse populations (CDC, 2005). A multi-disciplinary area of practice.

21. CDC Health Marketing Model Products: CDC’s Research, Science, Evidence- based- advice Products: CDC’s Research, Science, Evidence- based- advice Customers: “The Public” Individuals Institutions Communities US pops Global pops Customers: “The Public” Individuals Institutions Communities US pops Global pops Customers: Health profs Partners Customers: Health profs Partners Audience research, Formative research, Public engagement, Partner engagement Translating research to practice, Health communication and marketing )

22. Key Concepts of Health Marketing Focus on consumers Understand consumers’ needs and wants Influence action Marketing Mix- The four P’s Competing behaviors Exchange

23. Opportunity 1: Know the Customer Take a customer-centered approach Who will do what differently? –Who’s more at risk for poisoning? –What’s the Epi-data for your PCC service area? –Which target behaviors are most important? Who can you influence most effectively? What do they want and care about? What do they struggle with?

24. Audience Barriers/Benefits Barriers Consider real or perceived costs, access, confusion, inconvenience, beliefs, policies, program features, cultural practices, etc. that stand between your audience and the desired behavior Benefits Describe what your audience should perceive as the key benefit to taking the desired action Statement: If I (do the desired behavior), then I (get some benefit)

25. Opportunity 2: Offer a Better Product Involve your consumers How can you add simplicity? credibility? authenticity? How can you adjust your program/ system/relationships – not just your messages? Is the call-to-action easy to understand & process? Will it help people make better decisions about their health?

26. Opportunity 3: Improve Distribution Choose the right place and promotion strategies

27. Percentage of Adults with Below Basic or Basic Health Literacy Who Get Little or No Health Information From the Following Sources SourceBelow BasicBasic Internet85%70% Magazines64%47% Books or Brochures62%45% Newspapers59%51% Family or Friends47%40% Healthcare Providers 35%30% Radio or TV33%29% Source: National Center for Education Statistics, Institute for Education Sciences

28. Opportunity 3: Improve Distribution Choose the right place and promotion Develop/strengthen partnerships Lay health educators/Promotores Community-based workshops/Health fairs Community organizations/churches Hospitals (ED), clinics, medical facilities Retailers- WalMart, Lowes, Home Depot Do your consumers know why/how to obtain your services/products?

29. Evaluation starts with you How health literate is your work environment? Practices? Are your projects based on health literacy/health marketing principles/concepts? How likely is it that your consumers will be able to obtain, process, understand, and make decisions? Opportunity 4: Conduct Evaluation

31. Questions? http://www.cdc.gov/healthmarketing