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Harnessing the Power of Social Marketing to increase behavior change among college students
Rita DeBate, PhD, MPH, FAED, FAAHBAssociate Vice President Health & Wellness
Professor, College of Public Health
Research Team▼ Rita DeBate, PhD, MPH, FAED, FAAHB
AVP Health & Wellness; Professor, College of Public Health
▼ Diane Zanto, ARNPStudent Health Services
▼ Heidi Petracco, MSW, LCSWCounseling Center
▼ Nick Joyce, PhDCounseling Center
▼ Jennifer DiPrete, MPHCenter for Student Wellbeing
▼ Makenzie Schiemann, MSStudent Outreach & Support
▼ Amy Gatto, MPHDoctoral Research Assistant
▼ Gregor Rafal, BSGraduate Research Assistant
▼ Erica BahnwegUndergraduate Research Assistant
▼ Mary NicholasUndergraduate Research Assistant
▼ Sarah ShadayUndergraduate Research Assistant
▼ Chris Haywood, MSSocial Media Marketing
▼ Jennifer Bleck, PhD, MPHCo-Director, Center for Transdisciplinary Research in College Wellbeing and Success
Learning Objectives
▼ State the phases of the social marketing planning framework
▼ Describe the 4 Ps of the social marketing mix
▼ Create an example of a formative assessment to determine audience
segmentation and marketing mix and subsequent strategies and
channels
▼ Discuss how social marketing can be used to improve health promotion
program planning at your college/university
Social Marketing
A program planning process that appliescommercial marketing concepts and techniques to
promote voluntary behavior change
Facilitates the acceptance, rejection, modification, abandonment or maintenance of a particular
behavior by groups or individuals referred to as the target audience/priority population
Precede/Proceed Framework
Intervention Mapping Framework
Social Marketing1. Situation Analysis2. Select Target Audiences3. Select Objectives and Goals4. Analyze Target Audiences and the
Competition5. Develop Marketing Strategies6. Develop an Evaluation & Monitoring
Plan7. Develop an Implementation Plan8. Determine Budgets & Funding
sources
Mar
keti
ng
Min
dse
t
Consumer Research
Exchange Theory
Audience Segmentation
Competition
Marketing Mix
Marketin
g Min
dset
Marketing Mindset
Reminds marketers to: Offer benefits that the consumer really values---not what the public
health professional values Recognize that consumers often pay intangible costs such as time,
discomfort, stigma, etc. associated with changing behavior Acknowledge that everyone involved in the exchange, including
intermediaries, must receive valued benefit in return for their efforts
Exchange TheoryViews consumers acting primarily out of self-interest as they seek ways to
optimize value by doing what gives them the greatest benefits for the least cost
Marketing Mindset
Audience SegmentationSegments based on current behavior. Different marketing strategies are
developed for selected population & segments.*Reminds marketers to do segment research*
Marketing Mindset
Reminds marketers to ask:1. What products or behaviors/services compete with what we are
promoting?2. How do those benefits compare with those offered by competing
behaviors?
Answers enable us to offer the benefits that provide a sustainable competitive advantage that maximizes the products attractiveness to the consumer
CompetitionThe behavioral options that compete with public health
recommendations/services.
Marketing Mindset
So
cial
Mar
keti
ng
Fra
mew
ork Situation Analysis
Select Target Audience
Set Objectives/
Goals
Analyze Target Audience & Competition
Develop/Pre-test marketing strategies
Create Implementation
Plan
Develop Evaluation Plan
Determine Budget and
Funding
So
cial
Mar
keti
ng
Fra
mew
ork
How’s your Marketing Mindset?
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
1. I start by trying to get as full a picture of the everyday lives and concerns of the audience I am addressing.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
2. I invest time and effort in seeking to understanding the reasons why people do what they do and try to develop deeper insights about what moves and motivates them.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
3. I avoid blanket ‘one size fits all’ approaches and look at different ways that I can target and segment my audience – so I can tailor my approach more effectively.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
4. I make sure I set measurable behavioral goals and use these to guide development throughout with stages that are realistic and achievable for the audience concerned.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
5. I spend time really looking at what I am offering to people (to encourage and motivate behavior), the rewards that they will get, and ensure these are something that they value (and not just something I value).
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
6. I spend time trying to understand exactly what the competition is in relation to the relevant behavior and consider ways to tackle this.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
7. I look at the individual in their wider social context and work to address the factors that lie outside of their immediate control but which may directly affect their behavior.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
8. I work to ensure that all systems and services put in place for people are easily and readily accessible to them and wherever possible are fun and easy to be involved with, and wherever possible have socialbenefits too.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
9. Where I need to communicate things to people I check to make sure this is in a style, language and tone that is understood and appreciated by them.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
10. I always reflect on what I do and don’t assume because something may have worked for one audience it will automatically work for another.
In Theory In Practice
Rate yourself for each of the following statements using the following scale: 5=All of the time; 4 =Often; 3=Sometimes; 2=Rarely; 1=Never
11. I always measure the ultimate success of what I do by the extent to which it influences what people actually do (rather than just what they might know or believe).
In Theory In Practice
Let’sPractice
CA
SE
ST
UD
YC
AS
E S
TU
DY
CASE STUDYA problem is a gap between an acceptable or desirable state and the current state.
The Provost and the VP for Student Affairs and Student Success are asking all AVPs to provide plans that describe unit programming specifically targeted to address the
following program gap:• Desirable State:
• 91% USF full-time, FTIC freshman retention rate with a GPA≥2.0• 70% full-time FTIC 6-year graduation rate
• Current State: • 89% USF full-time, FTIC freshman retention rate with a GPA≥2.0• 66% full-time FTIC 6-year graduation rate
What specific programming will your unit develop to meet the charge of the VP and Provost?
1. Situation AnalysisQuestions RE: This Campaign
• What is the Epidemiological/Social Issue?
• What is the focus (behavior)?• What is the purpose?• What internal strengths will this
plan maximize?• What internal weaknesses will
the plan minimize?• What external opportunities will
you plan take advantage of?• What external threats will you
plan and prepare for?• What findings from prior and
similar efforts are noteworthy?
USF NCHA: MENTAL WELLBEING DX & TX
IN LAST 12 MONTHS:2014
%
2016%
+/-%
AnxietyDX
TX
10.9
74.8
12.6
70.3
+1.7
-4.5
DepressionDX
TX
8.5
83.7
9.1
77.0
+0.6
-6.7
Panic AttackDX
TX
5.8
62.9
7.6
64.3
+1.8
+1.4
InsomniaDX
TX
3.7
68.1
3.2
70.0
-0.5
+1.9
Other Sleep DisorderDX
TX
1.8
60.0
1.0
63.6
-0.8
+3.6
Other Mental Health ConditionDX
TX
1.9
90.9
1.9
66.7
--
-24.2
USF NCHA : MENTAL WELLBEING AND ACADEMIC PERFORMANCE
2014
%
2016
%
+/-
%
ANXIETY (HC 2020 TARGET=16.5%)
22.6 24.8 +2.2
DEPRESSION 14.2 14.7 +0.5
STRESS(HC 2020 TARGET=24.7%)
30.9 34.1 +3.2
RELATIONSHIP DIFFICULTIES 12.4 10.7 -1.7
CONCERN FOR FAMILY MEMBER/FRIEND 14.7 10.4 -4.3
SLEEP DIFFICULTIES(HC 2020 TARGET=18.0%)
21.9 21.8 -0.1
FINANCES 11.2 9.8 -1.4
WORK (HC 2020 TARGET=12.3%) 17.5 15.2 -2.3
USF NCHA: DEPRESSIVE SYMPTOMS
IN PAST 30 DAYS FELT:2014
%
2016%
+/-%
THINGS WERE HOPELESS 26.9 28.1 +1.2*
OVERWHELMED BY ALL YOU HAD TO DO 72.9 67.3 -5.6*
EXHAUSTED (NOT FROM PHYSICAL ACTIVITY) 67.8 64.4 -3.4*
VERY LONELY 35.9 37.1 +1.2*
VERY SAD 36.6 40.9 +4.3*
SO DEPRESSED IT WAS DIFFICULT TO FUNCTION 16.6 19.7 +3.1*
OVERWHELMING ANXIETY 35.1 37.5 +2.4*
OVERWHELMING ANGER 22.8 22.5 -0.3
SERIOUSLY CONSIDERED SUICIDE (PAST 12 MO) 7.2 10.0 +2.8*
ATTEMPTED SUICIDE(PAST 12 MO)
(HC 2020 TARGET=1.2%)
1.3 1.9 +0.6*
1
3
0
5 5
2
4 4 4
1
3
4 4
2
0
2
4
2
4
5
3
0
1
2
3
4
5
6
USF Baker Acts AY 2016-2017
Total Linear (Total)
USF NCHA : MENTAL WELLBEING AND ACADEMIC PERFORMANCE
2014
%
2016
%
+/-
%
ANXIETY (HC 2020 TARGET=16.5%)
22.6 24.8 +2.2
DEPRESSION 14.2 14.7 +0.5
STRESS(HC 2020 TARGET=24.7%)
30.9 34.1 +3.2
RELATIONSHIP DIFFICULTIES 12.4 10.7 -1.7
CONCERN FOR FAMILY MEMBER/FRIEND 14.7 10.4 -4.3
SLEEP DIFFICULTIES(HC 2020 TARGET=18.0%)
21.9 21.8 -0.1
FINANCES 11.2 9.8 -1.4
WORK (HC 2020 TARGET=12.3%) 17.5 15.2 -2.3
If a counseling center treats 500 students
30Dropouts
can be Averted
+1.2 Million Tuition
+3 Million Lifetime Earnings
1. Situation Analysis
Questions RE: This Campaign
• What is the Epidemiological/Social Issue?
• What is the campaign focus(behavior)?
• What is the campaign purpose?• What internal strengths will this
plan maximize?• What internal weaknesses will the
plan minimize?• What external opportunities will
you plan take advantage of?• What external threats will you plan
and prepare for?• What findings from prior and
similar efforts are noteworthy?
Epi/Social Issue• Improve retention and graduation rates
• Depressive symptoms and binge drinking predicted lower GPA and increased likelihood of dropping out
• Early discontinuation 3x more likely among students dx/depression• High prevalence of depression, anxiety, stress• Impediments to academic performance depression, anxiety, stress, sleep,
concern for friends and other• Increased referrals to SOCAT• Increased number of Baker Acts
Focus (behavior)• Help-seeking Behaviors
Purpose• Decrease mental health impediments to academic performance
Internal
Strengths Maximize
WeaknessesMinimize
• SOS, CC, SHS, CSW
• Provost support
• Retention rates• Graduation
rates• Baker Acts
External
Opportunities Threats
• More tuition revenue
• Florida LBR• E-mental health
• LBR not funded• increase #
student need
3. Select Target Aud.Questions
How do you describe your target audiencesfor your program/campaign in terms of:• Size• Problem incidence/prevalence/severity• Relevant variables
• Demographics• Psycho-social factors• Geographic• Behaviors• Stages of change, etc.
Which of these are your primary audiences?
Which are secondary audiences?
• Male students are more likely than female students to discontinue education at USF
• Males less likely to identify and seek help for mental health issues• Only 34% of USF CC clients were male• Undergraduate males less likely to recognize at-risk mental health issues
and problems• Males more likely to use alcohol and pills as coping mechanisms• Psychosocial factors:
• Identification with male gender…socially defined masculine traits• Perfectionism• Experiences of bias, oppression, discrimination, minority,
acculturation stress• Somatization of emotions• Poor social supports and/or conflict with social supports
• Absence of coping strategies• Poor access to resources• Younger age• Sleep difficulties, academic disturbances, skipping classes, decreased
motivation, cognitive problems
• Primary Target Audience: Undergraduate FTIC male students• Secondary Target Audience: Those on academic probation
What’s the Situation at your University?
• What is the Epidemiological/Social Issue?• What is the campaign focus (behavior)?• What is the campaign purpose?• Who is the primary target audience?• Who is the secondary target audience?
3. Set Objectives/GoalsQuestions
Behavioral Objective:What, very specifically, do you want to influence your target audience to do as a result of the campaign or project?
Knowledge Objective:Is there anything you need them to know, in order to act?
Belief Objective:Is there anything you need them to believe in order to act?
Goals:What quantifiable, measurable behavioral goals are you setting? Sub goals:Campaign awareness,Recall/responseChanges in KABChanges in behavioral intent
Target Audience Why or how?
OUR RESEARCH
SUGGESTS
THEORY
SUGGESTS
What are they doing? • Less likely to utilize
health services on
campus
• Using alcohol/drugs
as coping
mechanisms
• Transtheoretical
model
Why are they doing what
they are doing?
• Stigma
• Low mental health
literacy
• Information,
Motivation,
Behavioral Skills
Model
• Gender Role
Development
• Social Learning
Theory
How can we encourage
them to behave
differently or maintain
current/prevent old
behaviour?
• Increase mental
health literacy
• Theory of planned
behavior
3. Set Objectives/GoalsQuestions
Behavioral Objective:What, very specifically, do you want to influence your target audience to do as a result of the campaign or project?
Knowledge Objective:Is there anything you need them to know, in order to act?
Belief Objective:Is there anything you need them to believe in order to act?
Goals:What quantifiable, measurable behavioral goals are you setting? Sub goals:Campaign awareness,Recall/responseChanges in KABChanges in behavioral intent
Behavioral Objective• Obtain assistance/help for mental health impediments
(depression, anxiety, stress)Knowledge Objective
• Signs and symptoms of depression, anxiety, stress• USF resources• On-line resources
Belief Objective• Mental health problems common• Can improve mental health• Seeking help improves mental wellbeing
Goals • Increased use of Success & Wellness Coaching, Academic
Advocate• Increased use of group counseling, individual counseling, on-
line therapy• Sub-goals: Increased MHL, Increased peer referral to SOS,
decrease mental wellbeing impediments to academic performance
4. Analyze Target Audiences and the Competition
Questions Relative to theDesired Behavioral Objective and
Target Audience
What is the current behavior?
What do they currently know?
What benefits to they perceive?
What costs do they perceive?
What barriers do they perceive?
Questions Relative to the COMPETITION
What is/are the majorcompeting behavior(s)?
What benefits does your audience associate with these behaviors?
What costs does your audience associate with these behaviors?
• Knowledge of MH signs/symptoms
• MH Beliefs• Self-stigma Help
Seeking
• Age• Year• On/off campus• Probation• GPA• Major/Minor• International• Transfer
Normative Beliefs:MH Help-Seeking
Attitudes re: MH Help-Seeking
USF Resources (MH/Academic)
• Behavioral Health• Academic• Interpersonal
43.7
26.65
6.92
10.21
44.86
27.71
7.37
9.77
0
5
10
15
20
25
30
35
40
45
50
MHL MH Knowledge MH Beliefs MH Knowledge of Resouces
Undergraduate Graduate
Mental Health Literacy Sub-constructs among Male USF Students (n=1236)
43.7
8.17
19.31
12.5813.72
11.45
7.466.07
44.86
9.18
19.93
11.64
14.3112.66
8.477.02
0
5
10
15
20
25
30
35
40
45
50
MHL MH Attitudes NormativeBeliefs
Self-stigma help-seeking
Help-seekingimpact on self-
conficence
Intention to seekcare Behavior
Health
Intention to seekcare Academic
Issue
Intentions toseek care
DifficultiesSelf/Others
Undergraduate Graduate
Mental Health Literacy, Attitudes, Stigma, Norms, Help-Seeking Intentionsamong Male USF Students (n=1236)
Help-seeking Behavioral Intentions
Variable Behavioral Health Issues
Academic stressors
Interpersonal stressors
MHL ΒS.E.Β
.006
.007.029.043
.015
.024
Impact on Self-Confidence .086.182
.030
.021.006.004
Self-Stigma -.121*-.090
.055
.053.074**
.076
MH Attitudes .629***.348
.673***.489
.638***.491
Normative Beliefs .096**.082
.008
.008-.030-.035
*p<.05; **p<.01; ***p<.001 (one tailed test)
Help-seeking Behavioral Intentions
Variable Behavioral Health Issues
Academic stressors Interpersonal stressors
MH Knowledge ΒS.E.Β
.098*.072
.045
.044-.037-.038
MH Beliefs -.052-.039
.070*.069
.098**.101
MH Resource Knowledge -.017-.013
-.004-.004
.003
.003
Impact on Self-Confidence .104.056
.021
.015-.016-.012
Self-Stigma -.077-.057
.036
.036.024.025
MH Attitudes .610***.338
.678***.493
.657***.505
Normative Beliefs .075.064*
.070
.069-.008-.009
*p<.05; **p<.01; ***p<.001 (one tailed test)
Interviews• 30 male undergraduate students (segmented by STEM)
• 3 vignettes representing male students with depression, anxiety, and stress• What are they experiencing? (Probe to identify signs from vignette)• What would you do? (Probe to identify competition and
intermediaries)• What if you had a friend with those symptoms what would you tell
them to do?• Usability
• WellTRACK• Silvercloud
3. Set Objectives/GoalsQuestions
Behavioral Objective:What, very specifically, do you want to influence your target audience to do as a result of the campaign or project?
Knowledge Objective:Is there anything you need them to know, in order to act?
Belief Objective:Is there anything you need them to believe in order to act?
Goals:What quantifiable, measurable behavioral goals are you setting? Sub goals:Campaign awareness,Recall/responseChanges in KABChanges in behavioral intent
Intrapersonal Behavioral Objectives• Recognize signs and symptoms of emotional distress• Ask self if these signs/symptoms affecting activities of daily living• Do something to get assistance for improving emotional distress
Interpersonal Behavioral Objectives• Recognize signs and symptoms of emotional distress in others• Ask if these signs/symptoms affecting activities of daily living• Do something that will assist person in getting assistance
Recognize ASK Do
KnowledgeObjectives
• Know warning signs of emotional distress (ED)
• Know that ED is common
• Know how to self-evaluate warning signs
• Know how to evaluate signs in others
• Know campus resources• Know coping strategies• Know difference between
self and professional help• Know that tx is likely to be
short term• Know that tx is effective
BeliefObjectives
• ED is not a weakness• ED can happen to anyone• You are not alone in
experiencing ED• You are not crazy when
experiencing ED
• They will not be judged• It is ok to experience ED• It is socially acceptable to
evaluate warning signs• You are in control of ED
• Getting help will help• They will not be judged• Emotional feelings will be
validated and understood• Getting help is not a sign of
weakness• Getting help is common
What consumer data can you collect to learn more about your target
audience and competition?
5. Develop Marketing Strategies via Marketing Mix
Product• Core Product: Benefits of desired behavior
• Actual Product: The desired behavior
• Augmented Product: Tangible objects/services• Are there any new tangible objects that will be included in program and campaign
efforts?• Are there any improvements that need to be made to existing tangible objects?• Are there any new services that will be included in program and campaign efforts?• Are there any improvements that need to be made to existing services?
We must offer them the benefit that THEY VALUE
Traditional 4Ps
PRICEThe cost from the consumer point of view or sacrificed exchange
from the promised benefits• Monetary• Intangible: diminished pleasure, embarrassment, loss of time,
psychological hassle• What is/are costs for abandoning current behavior?• What is/are costs for adopting new behavior?
Consumer prefers to pay more for “value added”
Traditional 4Ps
PLACEDistribution of goods and the location of service encounters.
• Action outlets• Where will you encourage and support your target audience to
perform the desired behavior and when?• Where and when will the target market acquire any related tangible
objects?• Where and when will the target market acquire any associated service?• Are there any enhancements that would increase the appeal of the
location?
• Intermediaries: Others that can facilitate the change processMake Access Convenient
Traditional 4Ps
PROMOTIONKey messages that you want your campaign
to communicate to target audiences• What do you want them to know and to believe?• What specific actions to you want your target audience to take
as a result of this campaign?• What benefits will you promise?• What communication style and tone will be used?• What media types and vehicles be used?
Traditional 4Ps
PEOPLE• Individuals on marketing activities• Individuals on customer contact• Recruitment• Culture/image• Training and skills• Incentives
Additional Ps
PROCESS• Customer focus• Unit-led• IT-supported• Design features• Research and development
Additional Ps
PHYSICAL EVIDENCE• Staff contact experience of brand• Product packaging• On-line experience
Additional Ps
5. Develop Marketing Strategies via Marketing Mix
5. Complete an implementation plan
5. Complete an implementation plan
5. Complete an implementation plan
5. Develop a plan for evaluation and monitoring6. Determine budgets and find funding sources
How could Social Marketing help with implementation and evaluation
of one of your programs?
Will you Harness the Power of
Social Marketing to increase behavior change among your students?
Rita DeBate, PhD, MPH, FAED, FAAHBAssociate Vice President Health & Wellness
Professor, College of Public Health