On Social Marketing and Social Change

12 Features for Successful Obesity Prevention and Control Programs

Rapid changes in dietary habits, coupled with a decline in levels of physical activity, have led to an increase in the prevalence of overweight and obesity in the US and around the world. The consequence of these changes has been an increase in noncommunicable diseases (NCDs). The challenge for health authorities is to benchmark their efforts to slow and eventually reverse these trends. What to benchmark to? I suggest to what has been found to work, not what fits into rhetorical frameworks.

In reviews of over 300 studies on the use of health communication, social marketing and community-based approaches to address health risk behaviors, especially poor dietary habits and increasing levels of physical activity, across a wide range of socio-demographic groups around the world, a number of lessons have been learned about what constitutes the more successful programs (Carins & Rundle-Thiele, 2014; Garcia-Marco et al, 2012; Snyder, 2007; Wakefield et al, 2010). I have added to their findings several other features that more recent experiences suggest can improve program effectiveness. Note that while many of these studies have focused on nutrition and physical activity behaviors, the ‘Ideal Features’ list below could be applied relatively well across efforts to change many different behaviors and address other wicked problems.

For your consideration and comment:

The Ideal Features of Social Change Programs (with links to previous posts)

1. Select and concentrate on priority groups
2. Identify the value each priority group finds in adopting healthier behaviors
3. Understand and address the incentives and costs of change – financial, opportunity, psychological, social, scarcity, etc
4. Design products, services and behaviors that fit people’s reality
5. Position the new behavior as more compelling, relevant, and potentially more valuable to people when they practice it, in comparison to the alternatives
6. Test program strategies and elements before implementation
7. Not rely only on mass communication campaigns
8. Increase access to information, places, food choices and services that reinforce desired behaviors
9. Locate a service, distribute a product, and create opportunities for members of our priority group to engage in healthier behaviors
10. Utilize community-based programs and citizen engagement to facilitate collaborations and create healthier environments and policies
11. Consider policies that include incentives and disincentives for specific dietary and physical activity behavior
12. Explore how social networks and social media can influence norms about, and diffusion of, healthier behaviors and lifestyles

References

Carins, J.E. & Rundle-Thiele, S.R. Eating for better health: a social marketing review. Public Health Nutrition, 2014; 17(7):1628-1639. 

Garcia-Marco, L., Moreno, L.A. & Vicente-Rodriguez, G. Impact of social marketing in the prevention of childhood obesity. Advances in Nutrition, 2012; 3:611S-615S.

Ogden, C.L., Carroll, M.D., Kit, B.K. & Flegal, K.M. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA, 2014; 311(8):806-814.

Snyder, L. (2007). Health communication campaigns and their impact on behavior. Journal of Nutrition Education and Behavior; 39(Suppl.):S32–S40.

The GBD 2013 Obesity Collaboration, Ng, M., Fleming, T., et al. Global, regional and national prevalence of overweight and obesity in children and adults 1980-2013: A systematic analysis. Lancet. 2014;384(9945):766-781.

Wakefield, M. A., Loken, B., & Hornik, R. (2010). Use of mass media campaigns to change health behaviour. Lancet; 376:1261–1271.

Creating Special Moments for Controlling and Preventing Obesity

Social marketers should note the Coca-Cola company announcement of its new 'One Brand' global marketing strategy yesterday in Paris. It's something worth taking a careful look at, especially if your work encompasses trying to change eating patterns, reduce consumption of sugar-sweetened beverages (SSBs) and/or tackle the wicked problem of obesity.

There are several points in their strategy that are useful to consider when developing social marketing and public health campaigns.

First: 'Drinking a Coca-Cola, any Coca-Cola, makes the moment special.' The intent here is not to worry so much about selling a specific brand (regular, diet, caffeinated or not). As long as it's a Coke, it's the right choice. Now think about how you talk about alternatives to unhealthy eating patterns, SSBs and other behaviors related to obesity prevention and control (such as physical activity). Does your program focus on just one behavior or several? Are they somehow connected with each other - or could be? Do any of those behaviors 'make a moment special?' If not, how do you expect to compete (short of trying to ban all Coca-Cola advertising)?

The 'One Brand' strategy is articulated as:

• Extends the global equity and iconic appeal of original Coca-Cola across the Trademark, uniting the Coca-Cola family under the world’s number one beverage brand.
• Comes to life in a global campaign - “Taste the Feeling” – that uses universal storytelling and everyday moments to connect with consumers around the world.
• Features the product at the heart of the creative, celebrating the experience and simple pleasure of drinking a Coca-Cola, any Coca-Cola.
• Underscores the Company’s commitment to choice, allowing consumers to choose whichever Coca-Cola suits their taste, lifestyle, and diet.

With obesity and SSBs becoming a global concern, are there ways of creating global equity and iconic appeal either with an existing brand (for argument's sake, such as the UN or WHO)? Thinking more locally, are there cities, states or countries that have invested in a 'brand' that could lead social marketing efforts in this space? If you don't think you have a brand, maybe you need to look around and find one that already exists in the minds of your priority group.

How can we use story-telling, not facts and certainly not fear appeals, to position options in the context of people's everyday moments? Again, not the facts, and not the typical exhortations to 'don't eat or drink that!' How do healthier choices connect with people around the world (what are some of the universal situations and experiences you could use to connect with people and not just communicate to target audiences)?

What are the 3-4 specific behaviors you could focus on that would help people celebrate their experiences and the simple pleasures of trying something different?

And finally, note that there is a commitment to choice (yes, as long as it's a Coke) - but the idea of choice is one that resonates with most consumers and is sadly one that too many public health people are abandoning.

But remember, it's not a 'healthy choice' that most people are looking for (the ones that want to make those choices don't need our programs). 

Many times I have talked about Coke's strategy of 'being within an arm's reach of desire' and how social marketers (and public health professionals) need to focus on distribution of, and access to, opportunities to engage in healthy behaviors.

... what if instead of focusing so much of our efforts on changing the rules (policies), we thought harder and more deeply about how other behaviors could make the moment even more special for people. Here's how Coke is doing it.