THE SOCIAL MARKETING EVIDENCE BASE: A WEB-BASED RESOURCE ON SOCIAL MARKETING EFFECTIVENESS IN GLOBAL HEALTH Shilpa Modi, Rebecca Firestone, Graham Smith, and Kim Longfield October 18, 2013 Evaluation 2013

PSI is a global health organization dedicated to improving the health of people in the developing world by focusing on serious challenges like a lack of family planning, HIV and AIDS, barriers to maternal health, and the greatest threats to children under five, including malaria, diarrhea, pneumonia and malnutrition.

What is social marketing, and how do we know if it works?

The Social Marketing Evidence Base (SMEB) is a web-based database of systematically reviewed literature on the effectiveness of social marketing in HIV/STIs, tuberculosis, reproductive health, malaria, and child survival.

Methods Social Marketing & Social Franchising Exposure to intervention Behavioral Factors Opportunity Ability Motivation Behavior Change Health Outcomes

Methods 425 Full-text articles screened for eligibility 883 Records after duplicates removed; 883 abstracts screened 42 Studies added from the 2011 search process 1663 Records identified in 2012 search process 43 studies included in the Social Marketing Evidence Base 382 Records excluded 458 Records excluded

Behavior Customer orientation Theory Insight Exchange Competition Segmentation Method mix Methods: Social Marketing Benchmark Criteria The National Social Marketing Centre’s Social Marketing Benchmark Criteria can be used as an evaluation tool for social marketing programs. How do we know that an intervention is social marketing?

 Eligible studies were assessed using a Strength of Evidence framework adapted from the Cochrane Handbook.  Each individual study was graded on measured outcomes, study design, generalizability, analysis, and whether the study was peer-reviewed or grey literature, for a maximum score of 6 Methods: Strength of the Evidence How convincing is the evidence of social marketing effectiveness?

What did we find?

Methods HIV/STIs, TB, & Reproductive Health Social Marketing Intervention Health, Behavior, & Behavioral Factor Outcomes Results

Health Areas Number of Studies Included Average SMBC Criteria Average SOE Score HIV & Other Sexually Transmitted Infections 2744 Tuberculosis 263 Reproductive Health & Family Planning 1754 Results

Social marketing can achieve: Changes in behavioral factors: attitudes towards condoms, knowledge of IUDs, client satisfaction Changes in behavior: condom use, contraceptive use, quality of care, use of services Changes in health outcomes: HIV incidence, unwanted pregnancy

8 studies demonstrated the effectiveness of social marketing in changing health outcomes, such as HIV incidence Results: HIV & STIs 20 studies demonstrated the effectiveness of social marketing in changing behavioral factors, such as knowledge & attitudes 18 studies demonstrated the effectiveness of social marketing in changing behaviors, such as condom use & safe injection practices

2 studies demonstrated the effectiveness of social marketing in case identification and 1 reported changes in the number of new cases of positive pulmonary TB Results: Tuberculosis

Results: Reproductive Health 1 study demonstrated the effectiveness of social marketing in decreasing unwanted pregnancy 10 studies demonstrated the effectiveness of social marketing in changing behavioral factors, such as knowledge, attitudes, and social norms 13 studies demonstrated the effectiveness of social marketing in changing behaviors, such as modern contraceptive use

 Potential publication bias  Did not fully specify types of populations or types of interventions (and comparisons) that were of interest in our review question  Did not limit or group interventions by study design  Studies were limited to those that labeled the assessed intervention as social marketing or social franchising, or that used social marketing terminology Limitations

 Influence decisions about in new programs  Influence decisions about successful programs  Forecast outcomes and gains in by focusing resources on interventions that are proven effective Discussion & Conclusion The SMEB can be used to: investments scaling-up efficiency

This database of social marketing interventions reveals:  Key gaps in the evidence base for social marketing interventions  The need for further investment in rigorous evaluation of social marketing programs More Evaluations. Better Evaluations. Process evaluations could identify what were the effective elements of each program so we can better determine how to scale up social marketing interventions

Questions? PSI Shilpa Modi T H S T R E E T, N W | S U I T E W A S H I N G T O N, D C P S I. O R G | T W I T T E R P S I H E A LT H Y L I V E S | B L O G : P S I H E A LT H Y L I V E S. C O M