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Elizabeth W. Mitchell, PhD
Division of Birth Defects and Developmental Disabilities
June 13, 2011
Developing a National Social Marketing Plan for Preconception Health and Health Care: Perspectives from the
Consumer Workgroup
National Center on Birth Defects and Developmental Disabilities
Division of Birth Defects and Developmental Disabilities
Presentation Overview
Social marketing- what is it? Phases of a social marketing plan Status of the consumer workgroup’s social
marketing planning by phase Next steps
WHAT IS SOCIAL MARKETING?
Social marketing is:
"The application of commercial marketing technologies to the analysis, planning, execution, and evaluation of programs designed to influence voluntary behavior of target audiences in order to improve their personal welfare and that of society."
* Andreasen, AR. Marketing Social Change: Changing Behavior to Promote Health, Social Development, and the Environment. San Francisco, CA: Jossey-Bass; 1995.
Social Marketing Phases
4
1Problem
Description
2
MarketResearch
6
Implementation
5
Evaluation
Interventions
3
Market Strategy
Source: http://www.orau.gov/cdcynergy/demo/
PUBLIC HEALTH, SOCIAL MARKETING AND CONSUMER WORKGROUP
1
1Problem
Description
Social Marketing Phases
Defining the Issue - Public Health Perspective
Goal: To improve women’s health before pregnancy in order to optimize pregnancy outcomes
Pregnancy intention is associated with improved health behaviors and birth outcomes*
Shah PS, Balkhair T, Ohlsson, A, Scott F, and Frick C. (2009). Systematic Review. Matern Child Health J. Published online: 10 December 2009).
Key Challenges
Half of all pregnancies are not planned* Target audience has a wide age range (18-44)
and is diverse The list of PCH behaviors is long Messaging is challenging (language of PCH ;
time period for promoting behaviors is unclear) Health disparities
Finer LB, Henshaw SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health2006;38(2):90-6
Defining the Issue- Social Marketing Perspective
The social marketing process involves Identifying an effective marketing mix
• 5 P’s (product, price, promotion , place and partners)o What is the preconception health concept we are
trying to sell to consumers? (product)o What are the costs to consumers ? (price)o How should demand for preconception health and
healthcare (PCH & HC) to consumers be achieved? (promotion)
o Where should PCH & HC messages be promoted? (place)
o How can efforts be supported and sustained? (partners*)
Offering the customer clear and compelling benefits Minimal barriers And advantage over other options (competition)**
*Luca, Nadina Ralulca and Suggs, L. Suzanne (2010) ‘Strategies for the Social Marketing Mix: A systematic Review’, Social Marketing Quarterly, 16: 4, 122-149.
** CE Prue, KL Daniel. Social marketing: planning before conceiving preconception care. Matern Child Health J2006;10(5 Suppl):S79-84.
Defining the Issue- Consumer Workgroup Perspective
Responding to call to action Strategic planning (2010-11)• Revisited overarching goals• Developing an actionable multi-
organizational social marketing plan o Group attributes, gaps, needso Sustainable o Monthly calls among partners to work on
plan
RESEARCH TO INFORM SOCIAL MARKETING STRATEGY
2
2Market
Research
Social Marketing Phases
Market Research Conducted or Underway
Literature review (2009-2010) Materials evaluation (2009) Environmental scanning (2010) Partner assessments (2010 & 2011) Audience segmentation analyses (2009 &
2010) Focus groups (2010) Couple interviews (2010) Secondary data analysis- underway Concept development and testing (2011) Adcept development and testing- underway
Market Research (cont’d)
Literature review Synthesized research on PCH & HC by
audience (women, couples and clinicians) and by 4 P’s to inform formative research plan
Materials evaluation Analysis of consumer PCH materials to
understand what is being communicated, to whom, and with what clinical emphasis
Findings- D. Levis (CON1)
Market Research (cont’d)
Environmental scanning Web based assessments across range of areas
• PCH branding, target audiences, existing materials, tools and campaigns, focus area (preconception, pregnancy, general health etc.)
Among a number of sectors: insurance, media (TV, magazine), foundations, public health, advocacy, web, business
Provided insight into the landscape of PCH, partnership and dissemination opportunities
Market Research- Partner Assessments Two partner assessments conducted
(partner “P”) August 2010 and February 2011
Conducted in order to assess the attributes of the consumer workgroup in order to inform strategic planning, “center” social marketing planning efforts, assess gaps and opportunities
Focused on:• Each organization’s goals• Their audiences• Activities (research, evaluation, education, communication)• Opportunities/barriers• Partnerships• Desired role in a national social marketing plan
Created a partnership database
Market Research- Audience Segmentation Analyses
Purpose Explore how women of childbearing age can be
disaggregated into smaller groups so that effective and appropriate PCH social marketing interventions can be crafted
Market Research- Audience Segmentation Process
Determined byEpidemiology or
stratification data
Entire Population
Target Population Groupsi.e. Women of Childbearing
Age
Kirby Marketing Solutions
Market Research- Audience Segmentation Process
Determined byEpidemiology or
Stratification Data
Determined by Behavioral,
Theoretical, or Multivariate Data
Entire Population
Target Population Groupsi.e. Women of Childbearing
Age
AudienceSegments
Kirby Marketing Solutions
Market Research- Audience Segmentation Process
Determined byEpidemiology or
Stratification Data
Determined by Behavioral,
Theoretical, or Multivariate Data
Entire Population
Target Population Groupsi.e. Women of Childbearing
Age
AudienceSegments
IntendedAudience
Determined by Selection Criteria
Kirby Marketing Solutions
Market Research- Audience Segmentation Analyses
Data Porter Novelli’s HealthStyles survey (2007 & 2009)
Methods Classification and regression tree (C&RT) and Chi- square
automatic interaction detection (CHAID) to define factors most associated with level of pregnancy planning
Results Factors most associated with pregnancy planning**
• timing,* contraception, marital status*, income Insight into segmentation strategies
*Mitchell, E. W., Lewis, MA., Bann, C. et al. Formative Research on Preconception Health for Consumers. Poster presentation at the National Conference on Health Marketing Communication, Marketing and Media, August 11-13th, 2009, Atlanta GA
**Mitchell, EW. , Miracle-McMahill, H, Levis, D. Opportunities for Preconception Health Social Marketing among Women- A U.S. Consumer Perspective. Presented at the First European Congress on Preconception Health, October 2010, Brussels, Belgium
Market Research- Focus Groups
Purpose To learn more about women’s knowledge, attitudes, and beliefs about
PCH behaviors and services (4 P’s)• What do women know, think and believe about PCH & HC?• What does PCH as a term mean?• What are the motivators and barriers ?• How do we communicate with women about PCH & HC?
10 focus groups (N= 65) in Atlanta Segmented by pregnancy planning status (planner, non-planner,
interconception)• By low and middle SES
Findings- L. Squiers (CON1)
Market Research- Couple Interviews
Purpose To understand how couples consider, discuss, and support each other in
the context of PCH and related behaviors (4 P’s)• What do couples know, think and believe about PCH & HC?• What does PCH as a term mean to them?• What are the motivators and barriers for them?• How do we communicate with couples about PCH & HC?
Telephone interviews (N = 58 couples), ~5,000 screened Women 18-44 who were married or in committed relationship with a
partner who was willing to participate in the interview Segmented by pregnancy planning status (planner, non-planner,
interconception)• By low and middle SES
Findings- M. Lewis (CON1)
Market Research- Secondary Data Analysis
Additional data sources triangulated PRAMS (2004-2008) Growth from Knowledge/Mediamark Research and
Intelligence (2009-2010) • GFK/MRI- E. Mitchell (CON1)
Accumulation of data streams used to inform Segmentation recommendations Social marketing plan Dissemination opportunities
AUDIENCE SEGMENTS FOR SOCIAL MARKETING PLAN
Women of Childbearing Age- Planners and Non-Planners
Pregnancy Planners Women who intend to have a child in the next 1-2 years
Non-Pregnancy Planners Women who do not intend to have a child in the next 1-2
years Segmentation based on
Desire to make concepts and messages relevant • Increase attention and engagement in messages
Desire to reach the audience • What channels and why?
Planners are Contemplators
More likely to pay attention to and be receptive to messages about PCH In the “pregnancy mindset” May be starting to mentally prepare to get pregnant or
are actively trying to get pregnant Motivated by messages that focus on
Health of the baby Health of mother during pregnancy and delivery Prospect of enhancing fertility
Desire to be pregnant is a strong motivator to engage in PCH behaviors
Non-Planners are Pre-Contemplators
Lower levels of awareness of PCH Less likely to be receptive to messages
about PCH Pregnancy is not on their radar
Less likely to engage in and be motivated to engage in PCH behaviors (e.g., folic acid) Viewed as irrelevant to their current life More likely to engage in unhealthy lifestyle behaviors
(e.g., smoke) and question need to stop More likely to be receptive to messages
about overall healthy behaviors/lifestyle There is not a trigger event for non-planners to motivate
behavior change
Stages of Change
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395.
NON-PLANNERS
Pre-contemplation
Contemplation
Preparation
Action
PLANNERS
Short Term Communication Goals Planners
Increase awareness of PCH behaviors Increase awareness that there is a preconception time
period Increase awareness that what they do before they get
pregnant can affect the health of their baby Increase awareness about where to obtain information
about PCH Non-Planners
Increase awareness about being healthy (PCH) Increase awareness about contraception (RLP) Increase awareness about where to obtain information
about women’s health (PCH)
CREATIVE DEVELOPMENT AND TESTING
Market Research- Concept Development and Testing
Purpose (product “P”) Position PCH & HC (empowering, engaging, memorable) Create an overarching umbrella brand that can be used
by the CDC and partners• Link PCH to consumer values• A relationship between a product, service, or behavior and
its consumers • Creates a set of expectations in the mind of consumers
(brand promise) Create a vehicle for promoting PCH & HC
• One communication channel will reinforce another and increase credibility (among partners, health care providers, media, web etc.)
Market Research- Concept Development and Testing
Positioned PCH and HC A unique time (WOMAN’S WINDOW) An opportunity (CREATE YOUR FUTURE) An invitation (Baby YOURSELF, BABY yourself)
Market Research- Concept Development and Testing
Concept testing completed in May 4 focus groups (N = 32) in Atlanta
• Segmented by planning status (planners vs. non-planners)• Two age groups: 18-30 and 31-44• All low to middle income
Purpose Gauge women’s understanding, impressions and
attitudes toward concepts• Clarity, appeal, motivation (text, images and then PCH
context)
Market Research- Concepts, Adcepts and Testing
Findings Important feedback Creative executions (headline, tagline, images, text box)
• Making revisions to a “Woman’s Window” and “Baby Yourself”
• Developing one new concept “Create Your Future”- dropped
• Instead of inspiring respondents it evoked stress (school, career, financial)
Kaiser Women’s Health Survey (2008):“Approximately a quarter of women report feeling high levels
of stressfrom career (23%), and financial concerns (26%)”.
Market Research- Concepts, Adcepts and Testing
Next steps Analyze transcripts and develop creative
recommendations Develop adcepts (will include logo, more PCH
messaging) Test adcepts via on-line survey
• Nationally representative sample of women 18-44 years of age using a panel with an oversample of African American and Latina women (N=1200)
• Groups: o Non-planners (never intend or intend to have a baby in
more than 2 years)o Planners (intend to have a baby <2 years)
Early Winter 2011
MARKETING MIX AND ACTION PLAN
3
3Market
Strategy
Social Marketing Phases
PRODUCT
Literature review Materials evaluation Environmental scanningPartner assessments Audience segmentation analyses Focus groupsCouple interviewsSecondary data analysisConcept/Adcept testing
5 Ps Data Sources
Product Literature review Materials evaluation CWG input
Environmental scanningFormative researchConcept/adcept testingCWG input
Price Literature review Materials evaluation CWG input
Environmental scanningFormative researchSecondary data analysisConcept/adcept testing
Promotion Literature review Materials evaluation Environmental scanningCWG input
Partner assessmentAudience segmentation analyses Formative researchSecondary data analysis
Place Literature review Environmental scanningCWG inputPartner assessment
Audience segmentation analyses Formative researchSecondary data analysis
Partners Materials evaluation Environmental scanningPartner assessment
CWG input Formative researchSecondary data analysis
Social Marketing Phases
1Problem
Description
2
MarketResearch
Source: http://www.orau.gov/cdcynergy/demo/
Social Marketing Phases
4
1Problem
Description
2
MarketResearch
6
Implementation
5
Evaluation
Interventions
3
Market Strategy
Source: http://www.orau.gov/cdcynergy/demo/
NEXT STEPS
Next Steps
Finalize Marketing strategy, intervention, implementation and
evaluation plan (early 2012) Complete and disseminate PCH & HC social
marketing tools Audience profiles Brand support products (sample materials, logos etc.) Manuscripts and reports
Recruit additional partners
Thank You Project Team
Project teamConsumer WorkgroupCDC : Heidi Miracle-McMahill, MPH, MS;
Denise Levis, MA, PhD, Mindy BarringerRTI : Linda Squiers, PhD; Megan Lewis, PhD;
Molly Lynch, MPH; Karen Isenberg, MPH; Julia Kish-Doto, PhD; Rebecca Munch
AIR : Lori Agin, Mark Cohen, Lynda Bardfield, Jon Stapp,
Tom Hrabal, Martha Mater, Margarita Hurtado, PhD,
Tamika Owens, Allison Fratto
Questions?
On-line social marketing planning tool: http://www.orau.gov/cdcynergy/demo/
1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov
For more information please contact Centers for Disease Control and Prevention1600 Clifton Road NE, Atlanta, GA 30333Telephone, 1-800-CDC-INFO (232-4636)/TTY: 1-888-232-6348E-mail: [email protected] Web: www.cdc.gov
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Thank you
National Center on Birth Defects and Developmental Disabilities
Division of Birth Defects and Developmental Disabilities