Think about the most recent message you heard on TV. If you’re like me and watch a lot of sports it probably had something to do with going “All in for Week 1.” Alternatively, maybe you’re thinking about Importing from Detroit. Or maybe you want to see a day in the life of LeBron’s Samsung Note II. But how often do we see effective marketing of public health messages?
When it comes to public health, how much time do we spend promoting our message? Perhaps the only “public health” messages people see relate to two things: 1) phamarceuticals (although this varies by region) and 2) seasonal vaccination programs. The way advertisers think about messaging is markedly different to the way public health professionals think and thus how we convey information. Rather than talk about how to “communicate a health risk” maybe we should think about how to “market a message.” It’s a simple, but seismic shift.
Currently, we use a process known as Knowledge Translation. This is defined by the Canadian Institutes of Health Research as “the exchange, synthesis and ethically-sound application of knowledge—within a complex system of interactions among researchers and users—to accelerate the capture of the benefits of research for Canadians through improved health, more effective services and products, and a strengthened health care system.”In short, it’s based in science, evidence, and is undeniably an awesome step forward for making science accessible to the public and knowledge users. There are many ways to approach knowledge translation, and for an excellent overview of Knowledge Translation and their frameworks, check out this review by Sudsawad. But if we’re missing one thing, it’s making these programs catchy and memorable to non-scientists, which is where marketing and business training is invaluable. These are people who think very differently than scientists, and whose experience and perspectives can help our programs become even better and more effective.
This isn’t to say that people aren’t doing it already. There are some very effective public health advertisements that have been conducted, and those are what led to the genesis of this piece – when some campaigns are really good, you wonder why they all can’t be.
An example is the excellent ad campaign that Preventable conducted in British Columbia, Canada. They launched a number of guerilla public health ads (one of which is featured above), where they appealed at people’s sense of “invicibility” by putting up signs that said (among other things) “drowning only happens to other people” and “you probably won’t need a helmet today.” The message is simple, but very effective.
While this uses more “traditional” media, the ubquity of social media means you can attempt to create videos with the hope they will go viral. One of my favourites was the video above entitled “The Real Bears” where the Centre for Science in the Public Interest partnered with Grammy-winning artist Jason Mraz to create a (catchy) music video filled with information about soft drink consumption and its effects. Using the polar bears commonly associated with a large soft drink manufacturer, they talk about many of the health concerns associated with excessive soft drink consumption that have been shown in the scientific literature.
A third example is the Quit the Denial campaign recently launched by the Ontario Ministry of Health. Using Facebook and YouTube, they crafted an absolutely brilliant ad campaign targetting social smokers and the typical “excuses” social smokers make to differentiate themselves from regular smokers, where they draw parallels between social smoking and “social farting” or “social nibbling.” Using commonly heard justifications for being a social smoker – “I only smoke with friends” or “I never buy my own cigarettes” they created a very interesting ad campaign. It’s a great ad, and hits that sweet spot between informative and hilarious that makes it fantastic for viral marketing.
But that leads to the obvious criticism of these methods: Do they work?
One of the big problems is how do you actually evaluate these methods. For example, I found the “social farter” ad hilarious. I shared it on Twitter and Facebook, and many friends “liked” it, “shared” it, and “retweeted” it. But how many of those were social smokers to begin with? Did this actually lead to any behaviour change, or did it make social smokers feel marginalized and reinforce behaviours?
A recent review published in Tobacco Control by Durkin and colleagues sought to evaluate the role of “Mass Media Campaigns.” This study built off a previous study published by the National Cancer Institute and another study by Melanie Wakefield and colleagues. They did an analysis of population-based interventions and looked for measures of people who quit smoking pre- and post-intervention. Durkin and colleagues found:
There is strong empirical evidence that, within the context of comprehensive tobacco control programmes, MMCs (Mass Media Campaigns) can promote adult quitting and reduce adult smoking prevalence. Effectiveness may depend upon campaign reach, intensity, duration and the messages used.
Head-to-head comparative studies of message themes find that NHE (Negative Health Effect) messages, many of which feature graphic imagery and/or testimonial stories and elicit negative emotions, tend to perform well, compared with messages without such features.
While the above is positive, that’s not to say it always works. A study by Flynn and colleagues that focused on Grade 7-12 students found no effect of a mass media intervention. A systematic review of web-based interventions performed by Hutton et al. found that there was insufficient evidence to draw conclusions about their effectiveness, although they do suggest that their findings reveal important practices that can make future interventions more effective.
I’ll leave you with this quote from Tim Johnson, who was the Medical Editor for ABC News and wrote the foreword to the NCI report on The Role of the Media in Promoting and Reducing Tobacco Use:
Tobacco use is a social phenomenon largely propelled by mass media over the past century, led by tobacco industry professionals who constantly change strategies to reach their goals. They combine the resourcefulness of a proﬁ t-making industry with a changing media and regulatory landscape to sell a product that remains our greatest public health challenge. We will not remove tobacco from our society unless we are willing to understand the industry’s constantly changing tactics.
With the sheer amount of information available to us, and the plethora of avenues we have to disseminate that information, I wonder: should we be training PhD/MSc/MPH students in business and marketing methods in addition to knowledge translation frameworks we have developed? When we design interventions, should we design ads and campaigns incorporating a marketing perspective in addition to scientific principles? Or should we adapt our current frameworks and guidelines using principles of marketing that we, until now, may not have considered?
Thanks to Colleen W. and @alanaspira for help in preparing this piece.
Bala MM, Strzeszynski L, Cahill K. Mass media interventions for smoking cessation in adults. Cochrane Database of Systematic Reviews 2008, Issue 1. Art. No.: CD004704. DOI: 10.1002/14651858.CD004704.pub2. Available online here.
Davis RM, Gilpin EA, Loken B, Viswanath K, & Wakefield MA. The role of the media in promoting and reducing tobacco use. Health, 1998 98, 4302. Available online here.
Durkin S., Brennan E., Wakefield M. Mass media campaigns to promote smoking cessation among adults: an integrative review. Tob Control 2012;21:127-138 doi:10.1136/tobaccocontrol-2011-050345 Available online here.
Hutton, H. E., Wilson, L. M., Apelberg, B. J., Tang, E. A., Odelola, O., Bass, E. B., & Chander, G. (2011). A systematic review of randomized controlled trials: web-based interventions for smoking cessation among adolescents, college students, and adults. Nicotine & Tobacco Research, 13(4), 227-238. Available online here.
Sudsawad, P. (2007). Knowledge translation: Introduction to models, strategies, and measures. Austin, TX: Southwest Educational Development Laboratory, National Center for the Dissemination of Disability Research. Retrieved April, 14, 2008. Available online here.
Wakefield, M. A., Loken, B., & Hornik, R. C. (2010). Use of mass media campaigns to change health behaviour. Lancet, 376, 1261-71. Available online here.