A systematic review of social marketing effectiveness

Differences in the perception of a mass media information campaign on drug and alcohol consumption

The two-month mass media campaign in Belgium on drug and alcohol consumption "Alcohol and other drugs. The facts and fictions" initiated in January 2008 has been evaluated shortly after by a phone survey. This article reports some indicators on the public awareness of the campaign, and the differences in the perception according to age groups and education levels.

About 1,000 respondents (n = 1,002) accepted to participate in the campaign evaluation. Response rate is 37.1%. Global perception of the campaign - measured by the capacity to identify the campaign adequately - is 18.8%. This perception varies between age groups and education levels: 30% of the youngest age group (14-35 yrs) have seen the campaign, 13% of people aged 56 and over (p<0.001). The lower the education level, the lower the probability to have seen the campaign (11% in the lowest group, 25% in the highest one, p<0.001).

Among the respondents who have seen the campaign, newspapers are the most often cited media for the oldest age groups. Inversely, young people have mainly identified the campaign on street boards or on post cards.

The privileged type of media is also function of the education level. People belonging to the lowest educational level report more often to have seen the campaign on TV (85% vs 51% in the highest group, p<0.01), while the reverse is true for seeing the campaign via the newspapers or the street boards.

The results indicate that there are socio-economic variations in the perception of the campaign. In health promotion, reaching lower socio-economic groups still remains a real challenge. Channels for such campaigns have to be carefully chosen to reach their target groups and ask to be complemented with community based interventions.

Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol

This paper reviews the evidence for the effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol, in the areas of education and information, the health sector, community action, driving while under the influence of alcohol (drink-driving), availability, marketing, pricing, harm reduction, and illegally and informally produced alcohol. Systematic reviews and meta-analyses show that policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing alcohol-related harm. Enforced legislative measures to reduce drink-driving and individually directed interventions to already at-risk drinkers are also effective. However, school-based education does not reduce alcohol-related harm, although public information and education-type programmes have a role in providing information and in increasing attention and acceptance of alcohol on political and public agendas. Making alcohol more expensive and less available, and banning alcohol advertising, are highly cost-effective strategies to reduce harm. In settings with high amounts of unrecorded production and consumption, increasing the proportion of alcohol that is taxed could be a more effective pricing policy than a simple increase in tax.

Global alcohol policy and the alcohol industry

PURPOSE OF REVIEW

The WHO is preparing its global strategy on alcohol, and, in so doing, has been asked to consult with the alcohol industry on ways it could contribute in reducing the harm done by alcohol. This review asks which is more effective in reducing harm: the regulatory approaches that the industry does not favour; or the educational approaches that it does favour.

RECENT FINDINGS

The current literature overwhelmingly finds that regulatory approaches (including those that manage the price, availability, and marketing of alcohol) reduce the risk of and the experience of alcohol-related harm, whereas educational approaches (including school-based education and public education campaigns) do not, with industry-funded education actually increasing the risk of harm.

SUMMARY

The alcohol industry should not be involved in making alcohol policy. Its involvement in implementing policy should be restricted to its role as a producer, distributor, and marketer of alcohol. In particular, the alcohol industry should not be involved in educational programmes, as such involvement could actually lead to an increase in harm.

Session 5: Nutrition communication Obesity and social marketing: works in progress

Internationally, socio-economic trends reinforce the complex physiological mechanisms that favour positive energy balance, leading to an accumulation of excess body weight and associated metabolic disorders. This so-called ‘obesogenic environment’ is characterised by increasing accessibility and affordability of energy-dense foods and declining levels of physical activity. In the face of such rapidly-rising obesity rates there is general consensus that strategies to address trends in weight gain must go forwards in the absence of complete evidence of cause or effective prevention strategy. Thus, strategy implementation and evaluation must contribute to, as well as be informed by, the evidence base. Social marketing research and practice has a track record that strongly indicates that it can contribute to both the evolving knowledge base on obesity and overweight control policy and the development of effective intervention strategies. Social marketing draws pragmatically on many disciplines to bring about voluntary behaviour change as well as requisite supporting policy and environmental change. Key objectives include: generating insights into the drivers of current behaviour patterns; important barriers to change; client-oriented approaches to new desirable diet and lifestyle choices. Social marketing recognises that target clients have the power to ensure success or failure of obesity control policies. Social marketing seeks to identify genuine exchange of benefits for target adopters of behaviour change and the advocates of change, and how they may be developed and offered within an appropriate relevant context. Social marketing adopts a cyclical approach of learning, strategic development and evaluation, and therefore is well placed to integrate with the multi-disciplinary demands of obesity prevention strategies.

Low back pain media campaign: no effect on sickness behaviour

OBJECTIVE

To evaluate the effect of a media campaign on popular beliefs about LBP, and eventual changes in sick leave, imaging examinations, and surgery.

METHODS

Quasi-experimental telephone survey of 1500 randomly chosen people before, during, and after a media campaign in two Norwegian counties, with residents of an adjacent county as the control group. Data on sickness absence, surgery rates for disc herniation and imaging examinations on LBP in the area were collected at the same intervals.

RESULTS

The campaign led to a small but statistically significant shift in beliefs about LBP in the general public. In particular, beliefs about the use of X-rays, and the importance of remaining active and at work, seemed to have changed in response to the campaign messages. However, this change in attitude and understanding of the condition did not lead to any corresponding change in sickness behaviour.

CONCLUSIONS

Although the media campaign seemed to somewhat improve beliefs about LBP in the general public, the magnitude of this was too small to produce any significant change in behaviour.

PRACTICE IMPLICATIONS

A media campaign on LBP should not be limited to small areas and low-budget. A much larger investment is needed for a media campaign to have sufficient impact on public's beliefs on LBP to lead to altered sickness behaviour.