1. A BRIEF INTRODUCTION TO SOCIAL MARKETING Michael Rothschild School of Business University of Wisconsin-Madison Wisconsin Center for Health Communication and Marketing March 29, 2007

2. TWO QUOTES TO DRIVE OUR THINKING “Role of government is to create opportunity; role of citizen is to seize opportunity” “Organize policy and strategy until self interest does what justice requires”

3. PUBLIC HEALTH BEHAVIOR MANAGEMENT Three major classes of strategic tools: Education / Communications / Messages Environmental Change / Social Marketing / Situational Prevention / Problem Oriented Policing / Outreach Enforcement / Force of law

4. COMMERCIAL AND PUBLIC HEALTH ISSUES ARE FUNDAMENTALLY DIFFERENT Commercial marketing appeals to immediate self interest Public health campaigns often ask for: Behavior that is opposite of self interest And may be opposite of current behavior And may never clearly benefit the person

5. COMMERCIAL AND PUBLIC HEALTH ISSUES ARE FUNDAMENTALLY DIFFERENT Commercial marketing works because Payback is explicit Both parts of transaction occur together Public health campaigns often offer: Vague payback In distant future

6. COMMERCIAL AND PUBLIC HEALTH ISSUES ARE FUNDAMENTALLY DIFFERENT Commercial marketing acknowledges: Consumer has free choice Consumer has power Competition in the marketplace Public health campaigns often neglect: The power residing in the consumer The competition inherent in free choice

7. SEGMENTING ON WILLINGNESS TO BEHAVE Easy to See or Convey Self Interest Need to See and Receive Benefits Can’t See and Can’t Convey Self Interest or Benefits EducationEnvirnmnt Marketin g Enforcement No/weak competition Unmanageable competition Passive/active Competition Prone to Behave as Desired Resistant to Behave as Desired Unable to Behave as Desired

8. SEGMENTING ON STAGES OF CHANGE AND WILLINGNESS TO BEHAVE ProneUnableResistant AwarenessEducation AttitudeEducationMktg,Educ Enforce,Educ Trial Behavior EducationMarketing Enforcement Repeat Behavior EducationMktg,Educ Enforcement

9. SEGMENTING ON MOTIVATION, OPPORTUNITY, ABILITY Behavior = f (M, O, A) Motivation: Self interest Group norms Opportunity Environment allows behavior Add benefits Remove barriers Provide incentives Ability Skills and proficiency

10. M OTIVATION O PPORTUNITY A BILITY yes no yes no

11. M OTIVATION O PPORTUNITY A BILITY yes no yes no prone to behave unable to behave resistant to behave unable to behave resistant to behave educationmarketingmarketing enforce enforce education marketing education marketing enforce

12. COMMERCIAL AND PUBLIC HEALTH ISSUES ARE FUNDAMENTALLY DIFFERENT Commercial marketing recognizes People’s desire for fun, easy, popular… Easy: fitting in with daily hassles Need to increase benefits; decrease barriers Public health campaigns often focus on: Stop doing what is fun, easy, popular Add a new hassle into hectic life

13. WHAT IS MARKETING? …Creating, communicating, and delivering value to customers… …Managing customer relationships… …Benefiting the organization and its shareholders. (American Marketing Association 2004) --also-- Achieving our goals by meeting the needs of others and providing benefit to those others.

14. CONDITIONS FAVORING THE USE OF EDUCATION, ENFORCEMENT AND MARKETING BASED ENVIRONMENTAL CHANGE STRATEGIC CLASSFAVORING CONDITIONS Education  there is little or no competition to the desired behavior (most people easily agree that childhood immunization is good),  the target is prone to behave as desired and is able to do so (most people will not drive while alcohol impaired),  motivation, opportunity and ability are all in place, so that benefits have been created and barriers have been minimized (childhood immunizations),  insufficient levels of awareness, knowledge or attitude exist (increasing intake of folate to reduce incidence of birth defects),  externalities (costs imposed on others by the actions of an individual) resulting from the undesired behavior are relatively low (littering). Enforcement  the target is resistant to behaving as desired (motorcycle riders must wear helmets),  competition is so intense that there is no set of benefits or messages that will change behavior (immunization is resisted for religious reasons),  externalities resulting from the undesired behavior are high (quarantines),  societal needs dominate over individual rights (drug abuse; speed limits),  a lack of homogeneity in the community leads to weak community bonds and few common goals. Marketing Based Environmental Change  the target has free choice to act in own self-interest,  the target does not have the opportunity to behave as desired (alcohol impaired driving may be the only way to get home from the tavern),  the target does not have the ability to behave (the target doesn’t know how to prepare produce),  the target is motivated to behave properly but is unable to do so (no safe playgrounds, or none that are easily accessible),  the practitioner is unlikely to have much power to force a behavior (managing binge drinking on college campuses),  competition is strong and a more favorable cost/benefit relationship needs to be developed (calorie-dense food tastes great),  the competition provides current benefits with future costs (smoking provides an immediate euphoric feeling but leads to many diseases).

15. TWO TYPES OF SOCIAL MARKETING CASES Most of the costs and benefits of all choices occur in short run Immediate and delayed costs and benefits accumulate over long run

16. MOST OF THE COSTS AND BENEFITS OF ALL CHOICES OCCUR IN SHORT RUN Ex: seat belt usage, binge drinking, driving after drinking Sequence of fairly independent events Low probability of long run cost or benefit Any result occurs immediately

17. DEVELOPMENTAL RESEARCH 7 focus groups with expert observers 11 focus groups with target Describing 21-34 single men What are they looking for? Why do they drink? Why do they drive after drinking? Why don’t they drive after drinking? Decision making processes of target In sum: Benefits, barriers, change behavior

18. DEVELOPMENTAL RESEARCH The target (Customer) Primarily 21-34 single guys, rural Blue collar and farm worker High AW and positive ATT re issues Competition has huge market share “I can drive myself home” Often no alternative way to get home Negative: lots of worry late in evening Our product capabilities (Company) A ride service unique to each community

19. WHY DO THEY DRIVE AFTER DRINKING? To get home Don’t want to leave car behind Hassle to get back to car in morning Alternatives are not available Social pressure; everybody does it To be cool Unaware of impairment; become fearless Low risk of getting caught; weak enforcement

20. A FEW OTHER KEY FINDINGS Different phases of evening To bar, between bars, back home Get target to bar without car Vehicles need to be appealing, cool Willing to pay for service

21. BRIEF SKETCH OF PROGRAM Rides to, between and home from bars Desirable vehicles and allow drinking Reasonable, but self sustaining fees Each community: Begins with our research and strategy Develops unique program for community

22. SOME RESULTS TO DATE 65,000 rides taken in parts of 5 rural counties covering about 2% of Wisconsin population 17% decrease in crashes in first year No increase in individual consumption All towns self-sufficient after 1 year Costs less to avoid crash than to clean up after Will add 2-4 counties per year WWW.ROADCREWONLINE.ORG 5 minute video Accident Analysis and Prevention

23. THE EXAMPLE FITS THE CONCEPTS (PART 1) Self interest: need to drink, but not to drive drunk Little power: laws are weak or not enforced Competition: impaired driving is acceptable AW, ATT but no BEH: want to behave, but unable to do so

24. THE EXAMPLE FITS THE CONCEPTS (PART 2) MOTIVATION, but no OPPORTUNITY or ABILITY: want to behave, but unable to do so Increase benefits: fun and easy; party without worry Decrease barriers: unavailable and uncool Fit into life: rides to, between, and home Creating and delivering value: new product

25. IMMEDIATE AND DELAYED COSTS AND BENEFITS ACCUMULATE OVER LR Ex: diet, exercise, smoking, drug and alcohol abuse Cumulative effect grows over series of small choices High probability of large long run implications “Bad” behavior: SR benefits, LR costs “Good” behavior: SR costs, LR benefits

26. OUR TYPICAL TARGETS Generally skewed toward: low education, low income Often underserved Community of health disparities Difficult environment

27. PREFERENCE REVERSALS: the tyranny of small decisions When SR is distant: LR > SR benefit When SR is closer: SR > LR benefit ex: 8am: Plan to exercise after work 4pm: Plan to watch TV after work Therefore: Immediate reward of competitive choice wins

28. POSSIBLE STRATEGIES We need to shift: Present and future Costs and benefits Of the various alternatives We need to: Increase immediate benefits Reduce short run barriers Fit into daily life processes

29. INCREASE IMMEDIATE BENEFITS OF “GOOD” BEHAVIOR Rewards for success Lower insurance premiums with exercise Awards for participation Social events around exercising Walking clubs at work, after work Programs during lunch Incentives for stairs, remote parking Incentives for buying healthy food Look better, feel better, more energy

30. REDUCE BARRIERS IN WAY OF “GOOD” BEHAVIOR Don’t know how to behave: Cooking classes, trainers, dieticians at work site Don’t have access: Healthy choices in vending machines and cafeteria Don’t have time: Precut vegies, salad in a bag Don’t have money: Discount programs with YMCA; subsidize healthy food choices Don’t have safe place: Lit paths at work and in neighborhood

31. PRIOR STATE OF WORLD Public health problem TOOLS USED TO OBSERVE STATE Epi research EARLY PUBLIC HEALTH MODEL: PRODUCT CONCEPT DOMINANT PUBLIC HEALTH MODEL: SALES CONCEPT SOCIAL MARKETING MODEL OF PUBLIC HEALTH: MARKETING CONCEPT SET GOALS DEVELOP ENVIRONMENTAL CHANGE STRATEGIES Based on epi research: DEVELOP ENVIRONMENTAL CHANGE STRATEGIES Based on epi research DEVELOP ENVIRONMENTAL CHANGE AND MESSAGE STRATEGIES Based on epi and consumer research EVALUATE RESULTS IMPLEMENT ENVIRONMENTAL CHANGE PROGRAM IMPLEMENT ENVIRONMENTAL CHANGE PROGRAM AND MESSAGES TOOLS USED TO OBSERVE CITIZEN Consumer research DEVELOP MESSAGE STRATEGIES Based on epi and consumer research TOOLS USED TO OBSERVE STATE AND CITIZEN Epi and consumer research

32. 8 IDEAS TO IMPROVE PUBLIC HEALTH THROUGH MARKETING Accommodate self interest Accommodate competitive marketplace Accommodate our lack of power Create benefits Reduce barriers Make benefits accessible Fit into daily processes and hassles of life Find partners with self interest

33. … AND, REMEMBER… People are rational They make their own best decisions Within their own view of world We need to understand these views And the processes leading to decisions We need to accommodate these views We do this by listening We do this with local coalitions We do his with partners