On Social Marketing and Social Change

Donors vs Recipients OR Peer Networks

A perspective on networks that feeds into the ideas of a social marketing ecology.

The biggest network divide -- the one I think makes philanthropy so much less effective than it could be -- is the divide between so-called DONORS and BENEFICIARIES. I want to suggest that these terms are a little whacky.

I want to suggest that people who give money and people who have projects that need money need to rethink of themselves as a PEER NETWORK -- and that this small (but oh so difficult) step would instantly start a process of transformation... by funding organizations rather than networks and projects, philanthropists take away the incentive to work with others, learn from others and get the kind of feedback that helps non-profits see the unproductive ruts they have slipped into.

- June Holley at Network Weaving.

Development of a Global Social Marketing Community

I have written and talked about the need to develop a global social marketing community and organization (The Global Marketing Challenge) that could be crafted around the following ideals:

To continually improve the knowledge base and skill level of people who use social marketing in their professional activities to improve the health and social conditions of people around the world.

With the purpose of creating a set of experiences for program managers; policy-makers; program planners, evaluators and staff; implementing agencies; and investor and donor organizations that provide them with knowledge and tools to utilize social marketing to improve the health of poor and vulnerable populations.

Since then, with initial support from USAID through PSP - One, I have been meeting with people, sketching out ideas and testing them, and establishing a working relationship with Rare and their RarePlanet network site to weave together a proposal I am putting out here for you to review and comment on. You can view the presentation for a global social marketing network that includes background and rationale, features and benefits of the site, and screen shots from the existing rareplanet site.

The question that people raise when they see all of this is 'How does the social network site fit into an overall picture of social marketing?' 

Envisioning a social marketing ecology places the network into a larger framework of how this site could both anchor and support social marketing practitioners, a social marketing organization (or organizations), donors and investors in social marketing, experts/consultants, and academic institutions. This digital community (social network) should weave together the strands of social marketing that now exist. It should be the catalyst that brings them together, the glue that holds them together and the platform for innovation, improvement and expansion of the field. In the following diagram I identify 5 core elements of a social marketing ecology; these include

1.    A Social Marketing Organization (a global one that may have regional and country specific affiliates).

2.    Donors or Investors (Large organizations - public, private and NGO – that support and/or implement social marketing programs around the world. I prefer the latter term as I believe they should reasonably expect to see an ROI for investing in social marketing approaches to their causes and issues and we need to provide some of the tools to make this possible for them).

3.    Universities (and affiliated faculty, particularly those that sponsor or conduct social marketing education and research programs).

4.    Experts (individuals identified as offering value to social marketing organizations and program managers as consultants, trainers or in other roles).

5.    Social Marketing Practitioners (the people who are in the field doing the work of designing, implementing, evaluating and seeking funding for social marketing programs aimed at environmental, health and social causes and issues). These are the people who should be the ultimate beneficiaries of our efforts to design a social marketing ecology in which to work for they are the ones who will create the social impact and achieve the promises social marketing holds out as an innovative and unique approach to social change.

The diagram includes a set of arrows indicating what I think are the most salient sets of exchanges between these actors we should focus on. I do not presume that no other relationships can exist (for example, directly between experts and donors or universities); my point is to offer some parsimony while also focusing our attention on how a digital social network can intermediate some of these relationships and thus create networks of value, not maintain the current state-of-affairs where direct connections predominate and power and influence go to the most connected.

Each set of arrows has a box connected with it in which some of the more salient benefits that can be exchanged between two actors, but certainly not all of them, are identified. For instance, while there may be many different benefits to relationships among Investors (Donors) and Universities, funding for the development of academic and research programs is certainly a primary interest of universities. In turn, many of these investors may expect to benefit from such investments by being able to take early advantage of advances in knowledge and practice these academic and research projects produce and apply them to their other programs and portfolios.

Similarly, I have located each set of actors proximate to what I see as their most important transactions – experts next to the social marketing organization and practitioners for example. Most important for this concept of the social marketing ecology is that all actors have primary roles to play within the digital community to service the ultimate (social) benefits of increasing the capacity, innovativeness, effectiveness and efficiency of network members (social marketing practitioners) to achieve social impact. My point here is not to be exhaustive of the relationships and possible benefits among the actors, but to provide some clear targets for thinking through our marketing of the entire ecology to prospective constituents. I do know we need to get these right, especially for practitioners and investors.

My next steps are to approach potential investors to support further development of this social marketing network (all leads will be appreciated!). An equally important, and ambitious, step is to attract programs and people to get involved in the community - to stake their claim to becoming part of a social marketing community. When you review the slideshow, I believe the benefits for doing so will become clear. And then, let me know what you think of these ideas and how you would like to become involved.

You can leave comments here, at the slideshow, or at the social marketing wiki.

Does Anyone Have a Trusted Source?

I came across data from the General Social Survey via Frank Rich's op-ed piece today in the NYT. Nate Silver at FiveThirtyEight provides nice commentary on it so I won't repeat it here (and the Comments are worth studying too).  For those social marketing and communications people who attempt to figure out who are people's trusted sources of information (or see the chart for where your own organization stands), the trends and absolute values today are pretty sobering.

The Edelman 2009 Trust Barometer provides more validation of the fall of the organization:

• Nearly two-thirds of informed publics (62%) trust corporations less than they did a year ago.
• Only 38% said they trust business to do what is right -- a 20% plunge since last year -- and only 17% said they trust information from a company's CEO.

Other findings from the Trust Barometer find that people want government intervention to regulate industry or nationalize companies to restore public trust by a 3:1 margin. In the major Western European economies of the U.K, France, and Germany, three-quarters say that government should step in to prevent future financial crises (73%, 75%, and 74%, respectively); in the United States, not even half (49%) say that the free market should be allowed to function independently. Globally, the call for government intervention also extends to issues like energy costs, global warming, and access to affordable healthcare, as respondents, by at least a 2:1 margin, say government has the primary responsibility for solving these issues. But business must collaborate: Two-thirds (66%) expect business to partner with governments and advocacy groups to solve these issues [Ed Note: sounds like a popular endorsement of a Total Market Approach].

And the report also finds that people say they must hear something at least 3-5 times about a company before they believe it (positive or negative). Now that is food for thought!

A Public/Private Roundtable on Personalized Population Health

As part of the development of Healthy People 2020 national health objectives for the nation, The U.S. Department of Health and Human Services Roundtable on Personalized Population Health Planning Committee is convening a discussion of objectives with representatives from the government and private sector. You can participate remotely.

WHAT: An HHS Roundtable on Personalized Population Health across both the public and private sectors followed by a Healthy People 2020 objectives development discussion.

WHEN: Monday, March 30, 2009

• Roundtable (1pm EDT – 3pm EDT)
• Objectives development discussion (3:30pm - 4:30pm EDT)

WHO: The Private Sector - Intel, Qualcomm, Cicso, Google, Navigenics, 23 and Me, Stanford University, UCSD, Institute for the Future, Scripps Genomics Medicine Program, The California Institute for Telecommunications and Information Technology.
HHS – Office of the National Coordinator for Health Information Technology, Centers for Disease Control and Prevention, Office of Disease Prevention and Health Promotion, Personalized Health Care Program in the Office of the Secretary.

WHY: The private sector is fully engaged in developing, networks, products and services in anticipation of a world in which health IT is pervasive and the demands on the individual to manage his or her health care and health information could become daunting. The purpose of this Roundtable is to envision a future in which everyone benefits from real-time, personalized, evidence-based health guidance. This Roundtable and other discussions are part of the process of developing health communication and health IT objectives for Healthy People 2020 that will help us realize this vision of the future.

WHERE: The California Institute for Telecommunications and Information Technology, San Diego.

HOW: To listen in on the Roundtable and participate online RSVP to Brenda Bogley by COB Wednesday, March 25.The call-in details and url will be sent in a confirmation e-mail. Only 500 lines have been reserved on a first-come basis.

The Public Health Establishment Explores Social Media

The American Public Health Association seems to be in catch-up mode, and is now trying to quickly compile information about the use of social media by public health agencies and programs. The announcement is below. Let them know what they have been missing!

Blogs. Twitter. Facebook. RSS feeds. SMS texts. Wikis. These are just a few of the social media applications that are changing our world and redefining how we communicate information. To get a better idea of what this means for the public health and safety sector, the American Public Health Association is conducting a brief survey on the use of social media tools in risk communication, emergency response and public health. The data collected will provide information on what is currently being done and will serve to guide the creation of an upcoming report on social media best practices and strategy. Please take a few moments to let us know the degree to which you have used social media in your work. The questions aim to learn about your experiences using social media in public emergency situations, as well as in routine, non-emergency communications. The survey should take no more than five minutes of your time. Please respond by midnight on Wednesday, March 25, 2009.

Click here to begin.

They may also want to refer to these series of posts on social media, mobile thoughts and m-change. Those accounts of public health applications of social media could help provide some context for the report. I will reserve judgment on where the organization sits on the diffusion curve, but at least they are exploring it.

No I can't - 

Late Majority: the group of people who are most sensitive to peer pressure and norms, yet very cautious about change of any kind; they seek to minimize uncertainty of outcomes and want to see the proof of relative advantage locally – not read about it on web sites or see it on television.

Creating Radical Changes in HIV Risk Behaviors

…the radical behavioural change that is needed to reduce HIV transmission requires radical commitment. Prevention strategies will never work if they are not implemented completely, with appropriate resources and benchmarks, and with a view toward sustainability. The fundamentals of HIV prevention need to be agreed upon, funded, implemented, measured, and achieved. That, presently, is not the case.

These are the closing comments from a review of behavioral strategies to reduce HIV transmission by Tom Coates, Linda Richter and Carlos Caceres in The Lancet (full text available with free registration).

They argue that in the absence of any definitive research suggesting the primacy of one approach over another (and indeed, reject such simplistic analysis), a combination of strategies is needed that includes strong leadership and community engagement that are sustained over time.

Using the experiences of Uganda and the Mbeya region of Tanzania to illustrate the common factors that contribute to the success of behaviorally-based interventions to reduce HIV transmission:

Our findings indicate that substantial HIV reductions in Uganda resulted from public-health interventions that triggered a social process of risk avoidance manifested by [radical] changes in sexual behaviours….Second, a mix of communication channels disseminated simple and clear messages about several risk reduction and health-seeking options (eg, delay of onset of first intercourse, reduction in number of partners, condom use especially with non-primary partners, HIV testing, and treatment for sexually transmitted infections). One risk reduction strategy (eg, abstinence or partner reduction) should not be emphasised over another (eg, condom use), since people like choice and the mix of strategies is essential… Third, local involvement in message design, production, and dissemination was essential. In fact, one of the most energising activities in many strategies and campaigns for HIV prevention involves using the creativity and energy of people who are most affected by the epidemic to develop messages and strategies to motivate behavioural change.

They do not propose an exclusive reliance on behavioral methods. Rather they place these interventions within a larger framework of highly active HIV prevention activities.

They propose an ongoing, strategic approach to reducing incidence that focuses on multiple HIV risk behaviors that will vary among various population groups in which HIV is spreading (and call to mind the adage: know your epidemic).

Behavioural strategy aims might involve increased knowledge about how to protect oneself from HIV infection; stigma reduction; encouraging access to services (eg, methadone maintenance, HIV counseling and testing, diagnosis and treatment of sexually transmitted infections, use of antenatal and reproductive health services); improving attitudes toward safer sexual practices; delaying onset of intercourse; decreasing number of partners; reducing use of sex workers; increasing condom sales; recognition of early symptoms of sexually transmitted infections or HIV; recognition of the benefits and limitations of male circumcision for protection against HIV; disclosure of HIV serostatus; harm reduction strategies; how to access treatment for HIV; the importance of adherence to antiretroviral drugs; and so on. 

They underscore that HIV is ‘a social event’ that extends far beyond threat appraisal, knowledge and beliefs, intentions and social norms. Behavioral interventions should target a variety of social units including individuals, couples, families (especially for children), peer agents/educators, popular opinion leaders, social networks, social institutions (workplaces, prison, the military, faith-based organizations, and schools) and the community through mass media, social marketing, and community mobilization.

This call for a multifaceted approach has been echoed in the Disease Control Priorities Project’s paper on constructing an effective HIV prevention program [pdf].

It is essential for prevention packages to address both the biological and behavioral factors associated with transmission and the social and structural factors which can aid or impede the success of HIV prevention programming. For example, biomedical interventions (e.g., condom use, circumcision) should be integrated with behavioral approaches (e.g., voluntary counseling and testing, sexual behavior change) in a multi-component intervention. Simultaneously, structural interventions should address the underlying social, cultural, economic, physical, and policy aspects that can hinder prevention efforts. However, all components (biomedical, behavioral, and structural) must be clearly defined, replicable, and capable of being rigorously evaluated.

The DCPP paper also reiterates points that we have raised here:

Rigorous epidemiological methods for evaluating multicomponent prevention programs at scale have not yet been developed in detail. Large-scale comparison data of prevention interventions outside the trial setting are essential for future programs as they will provide “real world” glimpses into an intervention’s effectiveness.

Social marketing for behavior change, product access and distribution and improved health services quality and delivery can play a crucial role in translating these recommendations into effective prevention programs at the community and national level. In some cases the work has already begun. Let’s be sure to inform the policymakers and program managers around the world as to what works and what is not. And hopefully, with a pledge from President Obama to keep politics out of science, we can successfully implement what we know works, and can investigate what we need to know.

Social Sharing Comes to Personal Health Records

Sharing your personal health record with anyone you choose just became easier. Rather than paying for the copying of records, picking them up, and delivering them to another member of your health care team (whether they be a specialist, family member, home care provider or healthcare advocate), invite them to view it for up to 30 days. That is the innovation introduced this week by Google Health and flagged by Dana Blankenhorn at ZDNet Healthcare. 

Apart from reducing the price and increasing the convenience of coordinated healthcare to the consumer, the private sector's recognition of taking a consumer-oriented approach to health practices like the PHR is one that is sure to stir debate among privacy advocates and SHOULD force a reexamination of the misguided and unintentional consequences of HIPAA. It will also likely improve everyone's chances of receiving better quality medical care when everyone on the team knows not just the score, but the flow of the game.

One of the biggest obstacles to expanding the use of information technology (IT) in health care may be, ironically, the current narrow focus on how to stimulate its adoption. IT is a tool, not a goal. Success should not be measured by the number of hospitals with computerized order entry systems or patients with electronic personal health records. Success is when clinical outcomes improve. Success is when everyone can learn which methods and treatments work, and which don't, in days instead of decades.

More about health communication, health policy and health IT here.

And if you missed receiving what President Obama called the hottest ticket in town, Rebecca Adelman was live-blogging from the White House Forum on Health Reform today.

Social Marketing for Health in the Latino Community

An education opportunity notice:

The Latin American Cancer Research Coalition (LACRC) is sponsoring the Social Marketing for Health in the Latino Community course, which will be offered by the Georgetown University McDonough School of Business.  Professor Alan Andreasen, a leading social marketing practitioner and scholar, will teach the course from May 18 -- May 22, 2009.

This workshop is designed to provide both introductory and advanced training in applying the latest in social marketing concepts and tools from around the world. While emphasis will be on fundamentals of social marketing, there will be particular attention to Latino target audiences. This workshop will take a new approach to the field that will emphasize both upstream and downstream approaches to behavior change. We will look at how social marketing concepts and tools can be used to influence target audiences as well as policymakers, delivery partners, the media and others potentially involved in significant social change. Workshop sessions will be taught in English and will involve lecture-discussions, case analyses, one-on-one advice and instruction, and group exercises. Participants will have many opportunities to bring up issues they grapple with in their work, thereby customizing the program to fit their needs. To register for the course, please download the Summer School Application Form from:
http://summerschool.georgetown.edu/applications.html
and fax the completed application to: (202) 784-4386 ATTN: Claire Selsky by April 15, 2009. If you will audit the course, please write prominently in Part II, near the course number and name, "AUDIT."

If you are interested in receiving a scholarship for the course, please e-mail your application, resume and a 500-word max. essay discussing your interest in the course and how you plan to use this new information in your work, to Claire Selsky at [email protected] by April 15, 2009.  A limited number of scholarships are available (for audit only).