Social marketing intervention proposal

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FACULTY OF HEALTH AND LIFE SCIENCES
MASTER OF PUBLIC HEALTH (MPH)
MANAGING HEALTH IMPROVEMENT
THROUGH SOCIAL MARKETING.
MODULE CODE: AC7027
SUMMATIVE ASIGNMENT
MODULE TUTOR: DR RICHARD LEE.
Mark achieved 74%
WORD COUNT: 3,300
Table of Contents
TOPIC ………………………………………………………………………………………………………………………………………. 2
INTRODUCTION…………………………………………………………………………………………………………………………. 3
CONCEPTS OF SOCIAL MARKETING………………………………………………………………………………………………. 4
THEORIES OF BEHAVIOURAL CHANGE ………………………………………………………………………………………….. 4
ISSUES TO BE ADDRESSED…………………………………………………………………………………………………………… 5
AIM …………………………………………………………………………………………………………………………………………. 5
OBJECTIVES………………………………………………………………………………………………………………………………. 5
SOCIAL MARKETING PLANNING TOOLS ………………………………………………………………………………………… 6
STRENGTHS AND LIMITATIONS OF SOCIAL MARKETING………………………………………………………………… 13
CONCLUSION ………………………………………………………………………………………………………………………….. 14
REFERENCES……………………………………………………………………………………………………………………………. 15
TOPIC
Social marketing intervention proposal to influence handwashing in young school children in
Abuja, Nigeria.
INTRODUCTION
Over the years, infectious diseases has become a great Public Health issue globally but mostly in
developing countries; this necessitated the advent of health interventions through health
promotion to mitigate some of the behaviours that encourage the spread of these diseases;
Hence, the introduction of hand washing as an essential step in the prevention of diarrhea
diseases; This behaviour is remarkably arduous to influence in a population (World Health
Organisation (WHO), 2006). Several interventions are on-going to improve hand hygiene but they
are mostly single improvement actions which had minimal effect in influencing adherence by the
population, and this motivated Public Health experts to recommend implementation of
multifaceted intervention techniques such as Social marketing with the aim of achieving an
improved outcome (Naikoba and Hayward 2001; Whitby et al. 2007). However, there has been
debate on the most effective multifaceted approaches.
Social marketing is a complex intervention strategy used in addressing Public Health issues by
exploring people’s behaviours, social or behavioral models/theories, audience insights, exchange
for value, marketing mix (product, price, place and promotion), competitions, and development
of rapport with target audiences (Andreasen, 2003). Thus, social marketing experts suggests that
these social marketing concepts is necessary in any social change intervention program
(Andreasen, 2003). However, a benchmark criterion was developed to guide researchers,
managers and social marketeers to evaluate the quality of marketing interventions (National
Social Marketing Centre, United Kingdom, 2019).
The term social marketing was first used in 1971 by Philip Kotler and Gerald Zaltman; and they
defined social marketing as a “design, implementation, and control of programs calculated to
influence the acceptability of social ideas, involving considerations of product planning, pricing,
communication, distribution and market research”. However, this definition and its concepts has
undergone several revisions based on field experience over the past years. According to French
and Blair-Stevens (2010), social marketing is a marketing method used apace with other concepts
and techniques to realise a set behavioural targets, for the betterment of the population. It is the
application of commercial marketing technologies, scoping, planning, implementation and
evaluation of interventions aimed at influencing voluntary behaviour of a targeted population,
for an improved health and wellbeing (Andreasen, 1995). Based on the different definitions by
different writers, there are recurring themes such as Influence, Behaviour, social good and
customer/target audience.
CONCEPTS OF SOCIAL MARKETING
Social marketing-based interventions are currently being used all over the world by policymakers
and practitioners to address various behavioural issues (French and Blair-Stevens 2010; Hasting,
2007). Social marketing considers two major factors while evaluating any social marketing
initiatives; these are deep understanding of costumer insight, focus on realising and sustenance
of specific behaviours (French and Blair-Stevens 2010). However, customer triangle was
developed to highlight, understand and promote major features of social marketing; these
features/concepts underpinning social marketing includes customer insight (orientation),
audience segmentation, exchange, competition, behaviour (goals and theories), intervention and
market mix (French and Blair-Stevens 2010). These core concepts of social marketing also
referred to as benchmark criteria will be applied and discussed further in this proposal.
THEORIES OF BEHAVIOURAL CHANGE
A knowledge on the use of behavioural theories is essential, as it serves as a support in the
development and implementation of social marketing interventions as well as improving the
effectiveness (French and Blair-Stevens 2010). According to Siegel et al. (2007), Theories of
behavioural change aids in scoping and selection of target audience and set realistic goals and
objectives. This view of theories is supported by Goldberg (1997), who also posited that these
theories helps in evaluation of an intervention before it is rolled out. Thus, theories are defined
as underpinning ideas and understanding of complex issues, getting insights and key factors
influencing them; then approaching them in a more systematic way (French and Blair-Stevens
2010; Donovan and Henley, 2010). However, these theories should be used systematically and
with caution because of its oversimplification of real situations which do not represents reality
to scale (Hasting, 2007). Some of these behavioural theories of change includes; Transtheoretical
model, Theory of Planned Behaviour, Social Cognitive Theory, and Health Belief model. These
models have overlapping concepts, therefore the need to synthesis them strategically depending
on the issues and interventions (French and Blair-Stevens 2010; Donovan and Henley, 2010). One
of these theories would be used in this proposal for the planning of an effective intervention.
ISSUES TO BE ADDRESSED
Diarrheal diseases cause about 2195 child mortality every day and accounts for 1 in 9 child death
all over the world, making it the second leading cause of death in children from lower income
countries (CDC, 2015). However, studies have revealed that 42% to 47% reduction in diarrhea
cases can be achieved by hand washing with soap and water (CDC,2016). Hence, interventions
and promotion of hand washing is estimated to prevent one million deaths from diarrheal
diseases (Curtis and Cairncross, 2003).
Some of the diarrheal diseases include salmonellosis and cholera; hand washing gets rid of most
of these diarrheal disease-causing bacteria, viruses and parasite from the hand. The mode of
transmission of diarrheal diseases is mostly from person to person contact or via fecal-oral routes
mainly via contaminated hands (Tulchinsky, 2009). Hand washing is essential in prevention of
infectious diseases; however, lack of access to soap and water has been a major challenge in
developing countries (CDC,2016). Hence, effective handwashing interventions require education
and promotion of behavioural changes in cultural and social settings.
AIM- Influencing handwashing in young school children in Abuja Nigeria.
OBJECTIVES
-To reduce the incidence of childhood diseases through the Influence of handwashing in young
children school children.
– A reduction in child mortality rate as a result of diarrhea diseases.
SOCIAL MARKETING PLANNING TOOLS
The planning tools underpins the entire social marketing interventions; however, this varies
depending on the type and complexity of behavioural issues being tackled. These planning tools
are empirical resources that helps in the development and analysis of cases; also serves a guide
in the social marketing intervention planning process (Ong and Blaire- Stevens, 2010).
There are several planning models and tools examples are Total Process Planning (TPP), CDC
social marketing planning, turning point model and ‘STELa’ model are the most commonly used
planning tools. However, Total Planning Process provides a comprehensive and practicable
structure for managing the planning process, highlighting core stages required to develop and
deliver interventions, and these stages makes it simpler for beginners in social marketing
whereas the other planning tools is complex and may pose challenges for a new social marketeer
(Ong and Blaire- Stevens 2010). Thus, for the purpose of this proposal the TPP planning
framework would be applied.
TOTAL PROCESS PLANNING FRAMEWORK
Effective intervention requires developing teams for different parts of the intervention example
setting up a product- management team (Kotler, 1989). TPP draws learning from established
programme, project planning methods and approaches, behavioural interventions and social
marketing-related intervention planning; it provides a framework by which some of complexities
of behavioural challenge can be addressed with available resources in a particular social context
(Ong and Blaire- Stevens,2010).
There are five primary stages of TPP framework- these are Scoping, Developing, Implementing,
Evaluating and Follow-up (French and Blair-Stevens, 2010). These stages of TPP framework would
be used in the course of this proposal.
SCOPING
This is the first stage of TPP, and it is defined as the most essential single stage in any social
marketing intervention involving the development of stakeholders, planning of project, data
collection and taking decisions which would lead to the development stage of an intervention to
with hope of strong impact (Merrit and Reynolds, 2010). There are 3 phases of scoping in social
marketing and this proposal would be planned based on that.
PHASE 1
Steering group: This group would be formed. These are people who would support throughout
the process of the social marketing project and ensure effective delivery of interventions. About
4 to 5 people would be involved in the steering group, this would include fellow social
marketeers, researchers, school councils and hygiene officers. There would be a monthly meeting
with the steering group when the goals, project plan, budget and guiding timescales would be
discussed. It would be ensured that there is an agreement and communication amongst the
group members concerning the project plan.
Secondary market research: This is used to get an insight about target audience, competitions,
issues to be addressed and previous attempts to curb the issue (Merrit and Reynolds, 2010;
French and Blair-Stevens 2010). Existing data would be collected from published literatures in
journals, Websites, newspapers, consumer surveys, national statistics and government
departments to get the existing knowledge of the target audience, issues and interventions.
Demographic data, psychographic and behavioural data would be collected to aid understand
targets’ lifestyle.
A qualitative research would be carried out to get audiences attitudes and perceptions towards
the perceived behavioural change. However, the drawback would be finding a qualitative
research, which is difficult, as it is not always indexed as well as quantitative research (Dixonwood et al. 2001).
Identification of the target audience (s): This would be done using the secondary data collected
and would be further segmented with more research in the knowledge and behavior of the target
audiences. Analysis of consumer’s behavior would be sorted using the Social Cognitive Model
(SCM).
SCM is utilised in social marketing interventions to have an insight on the consumer’s behaviorconsumer orientation on price, product, place, promotion and factors that facilitate nor hinder
acceptance of intervention (East,1997).
Stakeholders: These are people who would be involved in the planning process and assist to
ensure effective delivery of interventions and behavioural change. The key stakeholders would
be identified and used in planning the intervention based on their relationship with target
audience and their insight on the behavior of interest. In this intervention, parents of the young
school children, grandparents, teachers, head teachers, school councils, director of children’s
services, healthy school coordinators minister for health and health protection specialist.
SWOT analysis: This would be used to develop an intervention plan based on already extracted
information. SWOT is a structured method of analyzing the internal factors (strength and
weaknesses) and external factors (opportunities and threats); aimed at identifying competitions,
taking advantage of available opportunities, identifying weaknesses and offsetting them and
identifying potential threats to the project (Reynolds and Merrit, 2010).
Based on the outcome of the SWOT analysis, a plan will be developed by the steering group and
stakeholders to address the strength, weaknesses, opportunities and threats identified.
PHASE 2
Primary research: This would be done to fill in gaps from the secondary research and helps to
get more insight of the target audience. “this consists of information collected for the specific
purpose at hand for the first time” (Kotler and Lee, 2008, p.77). A qualitative research would be
carried out using a semi-structured interview with an open-ended questioning technique
(Donovan and Henley, 2003, p.122). This would be used to answer questions such as
-Why young children do not wash their hands after defecation?
-What they know about causes of diarrhea diseases?
-Why the resources for hand washing is not available in schools?
-How they would perceive a new change?
Data analysis: This would involve listening to transcripts and identifying recurring themes;
however, some analyzing software can be used in addition to analyse lengthy transcripts.
Analysing Competitions: Competitions are defined as a group of people offering the same
products and services in commercial market; however, in social marketing, it is the present and
desired behavior of the target audience (Kotler et al., 2002). Analysis of the current programmes
targeting the same audience with similar strategy would be done and partnerships may be
considered.
PHASE 3
Segmentation of target audience: This would involve narrowing the target audience to a focus
segment and tailoring the marketing mix to specifically to them. This would be done by selecting
people with similar characteristics.
Each group will need similar support to change their behavior; Thus, prioritise will be given to the
groups that might be targeted and a segment would be selected based on most affected by the
issue, most feasible to reach and key secondary audience. This would be further classified as;
Demographic characteristics:
Sex- girls and boys
Age- 6yrs to 16years
Education- primary school and high school
Family size- immediate and extended family
Geographic characteristics:
Region- Nigeria
City- Abuja
Behavioural characteristics:
Occasions- regular or social
Convenience
Usage rate
Readiness to change
Psychographic characteristics:
Social class- all social class groups
Attitudes
Lifestyle
Primary audience
Parents
Class teachers
Grandparents
School heads
Older siblings
Secondary audience
Young school children between 6years and
16years of age
The secondary audience in this intervention is the group that requires the behavioural change
but they lack the capacity to take certain decisions and make choices; thus the need for primary
audience who are directly close to them and would ensure the effectiveness of the intervention
process and outcome. So, both groups would be targeted simultaneously.
DEVELOPMENT STAGE
At this stage, behavioural goals and insights in the intervention would be developed using the
marketing mix with pre-testing evaluation of the relevant audience. ‘The marketing mix’ also
known as the 4P’s (Price, Product, Place and Promotion) are the principal marketing techniques
used in actualising social marketing goals (McCarthy, 1960).
Product: This is the desired behavior and benefits of adherence to the behavior (Merrit, 2010).
The product of this intervention is handwashing to prevent diseases in the young and reduce
childhood mortality rate. Provision of wash hand basins and soaps in schools. However, there are
debates on improving existing products instead of developing new ones making social marketing
a mere ‘sales’ (Merrit et al., 2009). Thus, schools with already existing hand hygiene facilities
would have the facilities improved and new ones would be developed in schools with none.
Price: According to Merrit, (2010) this is the cost and challenges the target audience may pay to
change to the promoted behavior; it can be monetary and non-monetary (stress, psychological,
time and emotional). Handwashing soap would be given out free to schools and how the target
audience perceives the cost would be analysed. However, the benefits must outweigh the cost.
Exchange theory: This is an essential concept when considering price. It is defined as “the
exchange of resources or values between two or more parties with expectation of some benefits”
(MacFadyen et al., 1999).
Place: This is where the target audience would be receiving and performing the desired behavior,
receive a tangible objects and services (Kotler et al., 2002). A handwashing area would be
designated in each classroom and in toilets, so that it would be convenient for them to perform
desired behaviour.
Promotion: This is the act of enabling people to have an increased control over their health and
having awareness of the determinants with the goal of improving their health (WHO, 2019). The
product would be made known to the target audience through. Dissemination method would be
by advertising, sponsorship and personal selling.
Health promotion approaches: These are approaches that would be used to promote the desired
behaviour (Sparks, 2009).
Preventive approach (primary prevent approach) – television advertisement that promotes hand
washing
Education approach – enabling people to make an informed choice by creating awareness by
teaching them the importance of hand washing.
Behaviour change approach – through campaigns to persuade handwashing.
These chosen approaches for promotion of intervention is according to the Tannahill’s model of
health promotion model which has three core areas – health education, Disease prevention and
Health protection (Tannahill,1985).
Evaluation– It is important to evaluate at the promotion stage before rolling out intervention,
this would help to identify the discrepancies between ‘what people say they want and what they
want’. Expert and field review pre-testing method of health promotional material would be usedthis allows ‘buy-in’ from key stakeholders (Siegel and Doner, 2004). This would be done by issuing
self-administered questionnaires to the key stakeholders.
IMPLEMENTATION STAGE
This is the stage of executing and actively managing marketing actions (Merrit, 2010). In this stage
the intervention plan would be launched, implemented, progress monitored, spotting risks and
opportunities and modification of intervention components based on feedback. This stage is
three phases;
Phase 1
1. Organisational clearance and stakeholders’ buy-in would be sorted for.
2. Staffs would be trained to prepare them for the intervention before the campaign is rolled
out.
3. Resources would be sourced and allocated; teachers and school heads would be
informed.
4. Campaign objectives and implementation plan would be shared amongst the staffs and
key stakeholders.
Phase 2
1. Opportunities would be spotted and any change in plans would be discussed with key
stakeholders.
2. Budgets and resources would be kept on track.
Phase 3
This involves evaluations to improve the interventions. This is done in two forms,
1. Process-evaluation- This would involve comparing of actual implementation with the
planned implementation allowing amendments to be made (Siegel and Doner, 2004).
2. Evaluation- this would be done using the mass media monitoring methods. A clipping
service would be subscribed, this scans newspaper and listens to news daily. A
quantitative analysis of the clipping would be done.
Dissemination of findings: This is used to spread the outcomes of interventions both positive and
negative outcomes. The outcomes would be published on websites, databases and presentations
at conferences.
Ethical considerations: There would be thorough use of safeguards such as pre-testing of
interventions and identification of negative effects and swift rectification of the negative effects
before launch.
EVALUATION STAGE
At this stage the progress, impact, strengths and weaknesses of the intervention would be
assessed and ideas on how and where to improve would be identified (McVey et al., 2010).
Quantitative research would be conducted through an attitude awareness survey and data
collected via event monitoring.
FOLLOW-UP STAGE
Information from the evaluation would be analysed for successes and failures of the intervention
and then communicated to the key stakeholders and funders, so that subsequent development
can draw knowledge from it.
STRENGTHS AND LIMITATIONS OF SOCIAL MARKETING
Marketing is perceived by the public as being complicated due to its tendency of duplication.
According to Hastings et al., (2011), social marketing has the propensity of replicating
interventions which are already in existence and not developing new ideas/intervention; thus,
flooding Public Health with unsavoury practices. Social marketing is more of campaigns which are
individualised in its intervention approaches, neglecting the relevance of social and economic
factors as a major determinant of health (Wallack et al., 1993:23). Ethical issues are challenges in
social marketing by using legislations to regulate and influence people’s behaviours; this has been
found to be neglected in social change model and mostly in public health interventions (Donovan,
2009). However, social marketing has a proven track record of effectiveness in targeting peoples’
behaviour (Kotler, 2011) and ethical issues can be addressed by answering all the ethical
questions about a chosen intervention and strategies (French, 2010).
CONCLUSION
People’s behaviour have a great influence on their health and wellbeing. This proposal is aimed
at providing interventions through social marketing to influence target audience behaviours by
promoting handwashing. Most developing countries (Nigeria) are facing several health
challenges associated with poor hygiene example diarrhea disease due to lack of basic
infrastructures and this has led to an increase in child mortality rate in these regions. Despite ongoing public health interventions, childhood diarrhea diseases have remained a threat to Nigeria.
Hence, the purpose of this project, to promote handwashing amongst young school children with
an objective of achieving health improvement and reduction in child mortality.
This proposal also presents social marketing as a conceptual framework that could inform and
improve handwashing promotion programs. Social marketing as a multifaceted approach has
achieved successes with some public health issues such as unhealthy diet and tobacco usage
(Gordon et al., 2006). However, there is need to encourage the application of social marketing in
diverse settings for thorough testing of the effectiveness of the approach.
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