A systematic review of social marketing effectiveness

Toward Tailored and Targeted Communication for the Promotion of Firearm Safety: A Qualitative Study With Firearm Retailers

Firearm injury is a major yet understudied public health issue in the U.S. This qualitative study explored firearm retailers' perspectives to inform messaging and communication approaches to promote firearm safety among the gun owning population. Semi-structured interviews were conducted with 17 retailers at a single gun shop in Texas. Thematic analysis identified key themes related to (1) audience segmentation, (2) appropriate use of language, and (3) trusted messengers and modalities for the communication of firearm safety information. This formative work provides practical insights to optimize public health messaging in this arena and ultimately reduce firearm injuries. Overall, this study provides valuable insights to guide the development and implementation of evidence-based, social marketing efforts aiming to promote firearm safety across various gun-owning audiences.

Social marketing and mass media interventions to increase sexually transmissible infections (STIs) testing among young people: social marketing and visual design component analysis

INTRODUCTION

Globally, sexually transmissible infections (STIs) continue to disproportionately affect young people. Regular STI testing is an important public health strategy but remains low among this age group. Raising awareness of testing is an essential step and requires effective interventions designed for young people. To inform the development of effective interventions that promote STI testing among young people, we conducted a systematic literature review to describe the social marketing and visual design components commonly found in STI testing interventions and explore associations of these components with intervention effectiveness.

METHODS

We used a systemic review methodology to identify peer-reviewed articles that met pre-defined inclusion criteria. Social marketing and visual component analyses were conducted using structured data extraction tools and coding schemes, based on the eight key social marketing principles and 28 descriptive dimensions for visual analysis.

RESULTS

18 studies focusing on 13 separate interventions met the inclusion criteria. Most interventions used photograph-based images, using conventionally attractive actors, positioned centrally and making direct eye contact to engage the viewer. The majority of interventions featured text sparingly and drew on a range of tones (e.g. serious, humorous, positive, reassuring, empowering and informative) and three interventions used sexualised content. Four articles explicitly stated that the interventions was informed by social marketing principles, with two explicitly referencing all eight principles. Around half of the articles reported using a formal theoretical framework, but most were considered to have theoretical constructs implicit in interventions materials. Four articles provided detailed information regarding developmental consumer research or pre-testing. All articles suggested segmentation and development of materials specifically for young people. Explicit consideration of motivation and competition was lacking across all articles. This study found that there were some design elements common to interventions which were considered more effective. High social marketing complexity (where interventions met at least seven of the 11 criteria for complexity) seemed to be associated with more effective interventions.

CONCLUSIONS

Our findings suggest that the incorporation of social marketing principles, could be more important for intervention effectiveness than specific elements of visual design. Effective and systematic use of social marketing principles may help to inform future evidence-informed and theoretically based interventions and should be employed within sexual health improvement efforts.

Opportunities to Improve Awareness of Antimicrobial Resistance Through Social Marketing: A Systematic Review of Interventions Targeting Parents and Children

Lack of knowledge from parents concerning the appropriate use of antimicrobials leads to poor treatment choices and mismanagement of antimicrobials for their children. Social marketing (SM) strategies have the potential to help parents access useful information on the appropriate use of antimicrobials. Still, its application in interventions targeting antimicrobial/antibiotic resistance awareness is minimal. This study explores the use of SM in antimicrobial/antibiotic awareness campaigns (AACs) to identify opportunities for SM approaches in developing future communication interventions targeting parents and children. We conduct a systematic review of interventions targeting parents and children between 2000 and 2022. Articles meeting the selection criteria were assessed against social marketing benchmark criteria (SMBC). We identified 6978 original records, 16 of which were included in the final review. None of the articles explicitly identified SM as part of their interventions. Twelve interventions (75%) included 1 to 4 (out of 8) benchmark criteria, while four (25%) had 5-8 benchmarks in their interventions. Of the interventions with less than four benchmark criteria, six studies (50%) reported a positive effect direction outcome, and six studies (50%) reported negative/no change direction on the outcome of interests. Meanwhile, all interventions with five or more SMBC resulted in a positive effect direction in their outcomes. In this review, the use of SM has shown promising results, indicating opportunities for future antimicrobial resistance (AMR) interventions that incorporate social marketing benchmark criteria to improve intervention outcomes.

Nutrition and Food Literacy: Framing the Challenges to Health Communication

Nutrition and food literacy are two important concepts that are often used interchangeably, but they are not synonymous. Nutrition refers to the study of how food affects the body, while food literacy refers to the knowledge, skills, and attitudes necessary to make informed decisions about food and its impact on health. Despite the growing awareness of the importance of food literacy, food illiteracy remains a global issue, affecting people of all ages, backgrounds, and socioeconomic status. Food illiteracy has serious health implications as it contributes to health inequities, particularly among vulnerable populations. In addition, food literacy is a complex and multidisciplinary field, and there are numerous challenges to health communication that must be addressed to effectively promote food literacy and improve health outcomes. Addressing food illiteracy and the challenges to health communication is essential to promote health equity and improve health outcomes for all populations.

Nudging Consumer Behavior with Social Marketing in Portugal: Can Perception Have an Influence over Trying Insect-Based Food?

Social marketing campaigns are widely used to inform, educate, communicate, and promote healthy behaviors that add benefits to the individual, but also to society and the environment. Considering the low cost and high quality of insect-based food, this research aims to identify the main factors which can be used by social marketing campaigns to help people to try new foods, such as insect-based food. Although it is considered an important alternative to protein, there are a few countries that have not experienced it. In many Western countries, insect-based food is perceived as being disgusting. Neophobia is also a barrier to trying these foods. The main goal is to analyze if social marketing campaigns might influence perception (familiarity, preparation, visual, and information). Our model proves this assumption because we obtained high path coefficients, indicating that perception influences social beliefs, individual beliefs, and consumption intention. Thus, they will increase the consumption intention.

Understanding the system dynamics of obesity-related behaviours in 10- to 14-year-old adolescents in Amsterdam from a multi-actor perspective

Introduction and Methods

To develop an understanding of the dynamics driving obesity-related behaviours in adolescents, we conducted systems-based analysis on a causal loop diagram (CLD) created from a multi-actor perspective, including academic researchers, adolescents and local stakeholders.

Results

The CLD contained 121 factors and 31 feedback loops. We identified six subsystems with their goals: (1) interaction between adolescents and the food environment, with profit maximisation as goal, (2) interaction between adolescents and the physical activity environment, with utility maximisation of outdoor spaces as goal, (3) interaction between adolescents and the online environment, with profit maximisation from technology use as goal, (4) interaction between adolescents, parenting and the wider socioeconomic environment, with a goal focused on individual parental responsibility, (5) interaction between healthcare professionals and families, with the goal resulting in treating obesity as an isolated problem, and (6) transition from childhood to adolescence, with the goal centring around adolescents' susceptibility to an environment that stimulates obesity-related behaviours.

Discussion

Analysis showed that inclusion of the researchers' and stakeholders' perspectives contributed to an understanding of how the system structure of an environment works. Integration of the adolescents' perspective enriched insights on how adolescents interact with that environment. The analysis further showed that the dynamics driving obesity-related behaviours are geared towards further reinforcing such behaviours.

Partnerships supporting policies: A social marketing case study of mask supply solutions in South Korea during the COVID-19 pandemic

Background

South Korea was one of the first countries to experience a large outbreak of COVID-19. Early on, public health authorities recommended mask wearing as one of the main preventive measures against the virus. Compared to people in other countries, most South Koreans were willing to follow this recommendation. However, during the early stages of the pandemic, panic buying and vendor hoarding led to a nationwide mask shortage. The problem that needed to be solved was not to change the public's behavior but rather to make masks more available to them.

Case description

To stabilize mask supply and demand, the South Korean government implemented a distribution system that limited mask purchases to two per person per week, in a 5-day rotation determined by birth year. The places designated for selling masks included pharmacies, post offices, and marts that had access to data about registered South Korea residents who had and had not bought their allotted masks. Despite this system, supply problems persisted. In different regions of the country, population density and demand varied, and some pharmacies sold out their stocks of masks earlier than others. Recognizing that people needed a more effective system for finding masks, the government made mask inventory data available to companies and the general public. Three weeks later, about 200 mask apps and web services had been launched. Supplies of masks quickly stabilized, and people could more easily find and buy them. In addition, pharmacies were able to sell out their stocks of masks more efficiently.

Conclusion

The South Korean case of mask demand and distribution during COVID-19 illustrates how all six of the social marketing components (policy, supplemented by products, price, place, promotion, and partnerships) need to be coordinated for effective mitigation of infectious disease. In particular, this case highlights the importance of public-private partnerships among the government, production companies, retailers, and members of the general public.

An explorative study of psychological and social factors impacting littering behavior in Vietnam

Littering is a worldwide problem and Vietnam is one of the most affected countries. To enact change, not only individual cognitive determinants but also social and natural-, or environment-related variables should be taken into consideration. Although there is a large body of literature researching littering, most researchers do not distinguish the level of these factors. Thus, this research aims to investigate the interactive mechanism of these different level factors influencing the intention of the Vietnamese to stop littering, with the multi-level social-ecological model used to guide model building. The data were collected through a self-reported online questionnaire and the Partial Least Squares Structural Equation Modelling (PLS-SEM) method was employed to examine the proposed conceptual framework. The results indicated that perceived behavioral control and connectedness to nature are the two main factors influencing the Vietnamese people's intention to stop littering. Multi-group analysis results suggested the moderating effects of injunctive and descriptive norms. This research proposed a new conceptual framework and achieved unique insights into littering behavior in Vietnam, which could benefit and guide behavioral change experts, academics, and practitioners to design appropriate marketing strategies/campaigns to reduce littering.

Effect of psychosocial interventions on risky driving behaviours among offender drivers by using simulated and real driving: study protocol for a non-randomised controlled trial

BACKGROUND

Risky driving behaviour including anger while driving has led to millions of global road traffic crashes, thousands of mortalities and injuries. These losses are much more in middle-income countries, such as Iran. This paper explains methods of data collection in a controlled trial study for evaluating the effect of psychosocial interventions on risky driving by using simulated and real driving.

METHODS

This non-randomised controlled trial study will include 180 offender drivers. They will refer to the simulation laboratory by traffic police after their driving licences were suspended. At baseline, all participants will fill five questionnaires including demographic, Driving Anger Scale, Driving Anger Expression Scale, Spielberger's Anger and Manchester Driving Behavioural, and then they will be tested with a driving simulator. Afterwards, they will be allocated to one of three-intervention training arms (mindfulness, meta-cognition and social marketing) or a control arm without any training. Risky driving behaviours will be assessed in three follow-ups after intervention. The primary outcome of interest will be driving offences, recorded by traffic police in two time points: at 6 months and 1 year after the intervention.

DISCUSSION

This study examines the effect of three interventions in reducing driving offence. The results can end in a new therapeutic training or a new legislation that should be added to current obligatory training for getting driving licence and can lead to long-term safe driving among Iranian drivers. Future research is recommended to study the cost-effectiveness of these interventions in actual driving in Iran.

TRIAL REGISTRATION NUMBER

UMIN000039493.

Ante La Duda, Pregunta: A Social Marketing Campaign to Improve Contraceptive Access during a Public Health Emergency

During the 2016-2017 Zika virus outbreak, preventing unintended pregnancy was recognized as a primary strategy to reduce adverse Zika-related pregnancy and birth outcomes. To increase awareness and uptake of contraceptive services provided through the Zika Contraception Access Network (Z-CAN) in Puerto Rico, a multi-strategy campaign called Ante La Duda, Pregunta (ALDP) was developed. The principal aim was to increase awareness of Z-CAN services, which included same-day access to the full range of reversible contraceptives at no cost to women living in Puerto Rico who choose to delay or avoid pregnancy during the 2016-2017 Zika virus outbreak. Using diverse strategies, ALDP increased exposure to and engagement with the campaign in order to raise awareness of Z-CAN services in Puerto Rico. The ALDP social marketing campaign played an important role in the overall Z-CAN effort. Of all the strategies utilized, Facebook appears to have reached the most people. While the importance of a social marketing campaign communicating to raise awareness and create demand has long been known, through the ALDP campaign efforts, it was shown that an effective campaign, built on formative research, can be developed and implemented rapidly in an emergency response situation without compromising on content, quality, or reach.

The social marketing paradox: challenges and opportunities for the discipline

This paper contributes to emerging discourse about the ongoing challenges and opportunities of social marketing as a discipline. The paper presents a qualitative perspective on existing challenges faced by social marketing and offers suggestions for addressing these challenges. Nine semi-structured interviews with social marketing academics and practitioners from six different countries were conducted. Thematic analysis was used to analyse and interpret the qualitative data. The study provides insight into existing challenges for social marketing, classified into three key themes according to their position within or outside of the discipline: 1) poor branding of the discipline as an internal challenge, 2) competing disciplines as an external challenge, and 3) overall reach of the discipline, seen as both an internal and external challenge. The findings suggest that social marketing needs to overcome poor branding issues to sufficiently address external challenges. We conclude by arguing for a more robust marketing of the discipline. While scholars have identified the challenges and opportunities for social marketing as a discipline, they have paid little attention to examining these challenges from the viewpoint of expert practitioners and academics. This paper presents a nuanced contextual understanding of the identified challenges through a qualitative perspective and explores how social marketing can overcome these challenges.

Influential social marketing interventions in physical activity promotion

Purpose

The purpose of this paper is to identify and rank the influential social marketing factors for physical activity promotion.

Design/methodology/approach

A descriptive-survey approach is used in this study. First, the influential social marketing factors for physical activity promotion were determined through the review of theoretical foundations and literature. The factors with a >0.7 content validity index (CVI) value, based on the experts' opinion, were selected. A total of 23 individuals participated in the study, including sports marketing experts and members of physical activity committees of Iranian sports federations, and they were selected purposively. The study data were collected using a pairwise comparison questionnaire and analyzed using the DEMATEL-based analytic network process (DANP) method.

Findings

In this study, a total of 17 influential social marketing factors were identified and categorized in 5 dimensions: product, price, place, promotion and partnership. Based on DEMATEL-based analytic network process (DANP) results, the “promotion” with the weight of 0.212 was the most important dimension and “providing inexpensive sports services” with the weight of 0.096 was the most important social marketing factor influencing the promotion of the physical activity.

Originality/value

The results highlight the importance of sport for all services expenses and costs in promoting physical activity. Thus, the results can be the basis for policies regarding social marketing to promote physical activity.

Impacts of the National Your Brain Matters Dementia Risk Reduction Campaign in Australia Over 2 Years

BACKGROUND

The number of people living with dementia is rising globally due to population aging. Mass media campaigns which aim to reduce the risk of people developing dementia have been conducted across many countries, but few have reported evaluation findings.

OBJECTIVE

The present study investigated the impact of the Your Brain Matters dementia risk reduction campaign in Australia.

METHODS

The campaign was evaluated by observational cross-sectional surveys of 1000 Australian adults aged 18-75 years before and 24 months after delivery. The national campaign utilized multiple media channels to promote messages about the importance of brain health and reducing the risk of dementia. Dementia risk reduction knowledge, confidence, intentions and actions were measured at baseline and follow-up, and analyzed 2019-2020.

RESULTS

Earned television and radio were the most common exposure channels. The proportion of people who understood that it is beneficial to take action to reduce dementia risk before middle age increased (54.1% to 59.4%, OR 1.20 95% CI: 1.01-1.44). There was also an increase (28.5% to 32.8%, OR 1.30, 95% CI: 1.07-1.59) in the proportion who reported taking action to improve brain health. There was no improvement in knowledge about vascular risk factors, or confidence to reduce personal dementia risk.

CONCLUSION

The findings showed some receptivity and positive responses to messages about the benefits of taking action to reduce the risk of dementia. The campaign demonstrated the potential for generating news coverage about this issue, which should highlight the preventive benefits of vascular health behaviors.

Social Marketing Intervention to Engage Older Adults in Balance Workshops for Fall Prevention: A Multicenter Quasi-Experimental Protocol Study

Background: Falls affects one of three people after 65 years old, and it can lead to serious consequences. Scientific evidence point out that physical exercise is the most efficient way to prevent falls among older adults.

Objective: The main objective of this study is to determine if a social marketing program can increase the attendance rate of people aged 60 and over at group balance workshops.

Methods: This quasi-experimental multicenter study is being conducted in three French Regions (Loire, Haute-Loire and Rhône) over a period of 18 months. The Social Marketing Campaign will be done in three ways. Firstly, a Communication Campaign will take place in the two Test Areas but not in the Control Area. Secondly, flyers have been designed to be distributed by local partners. Finally, conferences for older people will be organized in the areas of intervention in order to reach the target audience for the program. The study will include people aged 60 and older who want to participate in the Balance Program.

Results: The Crédit Agricole Loire/Haute-Loire Foundation funded the study and the Jean Monnet University of Saint-Etienne reviewed it. The Ethics Committee of the University Teaching Hospital of Saint-Etienne approved and peer-reviewed it on September 6, 2019, under Reference Number IRBN622019/CHUSTE.

Conclusion: The results of this first study will demonstrate whether or not social marketing for promoting group balance workshops in the elderly will increase their attendanceship in adapted physical activity sessions, especially those that prevent falls.

Clinical Trial Registration:https://clinicaltrials.gov/ct2/show/NCT04136938, identifier NCT04136938.

Policy and Food Consumption: What Nutrition Guidelines Are Swiss Children Meeting and What Determines Adherence?

Objectives: To describe the adherence of the children to the Swiss Society for Nutrition (SSN) dietary guidelines, assess determinants of adherence, and compare these findings with a previous study in the same population.

Methods: Data from 312 children ages 5–12 were collected through a survey and a 2-day food record. The associations of children- and parent-related factors with adherence of the children to guidelines were assessed by logistic regression analyses.

Results: SSN guidelines were not met for any food category, although there were improvements: vegetables (4.5% in this study vs. 0% in the previous study), sweets, snacks, and soft drinks (SSD) (12.5 vs. 9.5%), and fruit (45.5 vs. 10.4%). Higher Body Mass Index (BMI) in children was associated with higher adherence to guidelines for protein intake. Higher parental BMI was associated with higher adherence to vegetables. Parental lower educational level was associated with higher adherence for cereal.

Conclusion: Despite improvements since the last eating behavior assessment in this population, children consume too little fruit, vegetables, cereal, and milk and dairy products, and too much SSD and proteins. Further efforts are needed to promote healthy eating to children and achieve adherence to guidelines.

Culturally tailored tobacco control: Aboriginal community perspectives in Sydney, Australia

INTRODUCTION

A community-based project was developed to support quit attempts and denormalise smoking in Aboriginal communities. This qualitative study evaluates the effectiveness of project strategies, messages and the partnership process, and explores impacts observed by Aboriginal community members, complementing findings from a quantitative evaluation.

METHODS

The study comprised five focus groups (40 participants) and 14 in-depth interviews (with 15 community members). Data were analysed thematically by manual and NVivo software methods.

RESULTS

Results demonstrate that the project attracted community attention, was well recalled and messages were considered convincing and persuasive. Participants reported being more likely to quit and to discuss smoking with family and friends, and noticed that many people were quitting. Participants observed an increase in asking people not to smoke in the home and fewer people smoking at events, but noted that many smokers struggled to stay quit. The partnership and participation of Aboriginal Health Workers were viewed as crucial.

CONCLUSION

The qualitative findings reinforce quantitative evaluation findings suggesting that the project contributed to denormalising smoking and motivating quit attempts.

SO WHAT

The evaluation provided insight into how the project changed attitudes and motivated community members to make quit attempts and provided ideas to meet the ongoing challenge.

A Social Marketing Intervention to Improve Treatment Adherence in Patients with Type 1 Diabetes

This research explores if a social marketing intervention model based on social representations theory and the health belief model can generate changes regarding treatment adherence and improve patient self-efficacy. As a pilot, a test-retest field quasi-experiment was designed to evaluate the intervention model with type 1 diabetes (T1DM) patients of families with 8- to 17-year-old children. The intervention model was designed to clarify misconceptions, increase awareness of the benefits of following doctors' treatments and improve patients' self-efficacy. In-depth interviews were carried out to gain a richer understanding of the intervention's effect. The pilot intervention generated a favourable change in shared misconceptions, individual health beliefs, glycaemic control and declared treatment adherence. This paper contributes to the social marketing literature and public health by providing early support for the theoretical assumptions regarding the role of shared misconceptions in physiological and behavioural outcomes for patients with T1DM. Contrary to previous studies, instead of only focusing on individual beliefs, this study incorporates shared beliefs between patients and caregivers, generating more comprehensive behavioural change.

Social marketing-based interventions to promote healthy nutrition behaviors: a systematic review protocol

BACKGROUND

Diet-related non-communicable diseases (NCDs) are rapidly increasing worldwide and constitute one of the leading causes of mortality and morbidity. Improving population diets can play an important role in preventing and managing the diseases. Effective and efficient interventions are needed to promote healthy eating behaviors among people. The objective of this review will be to evaluate the effectiveness of social marketing-based interventions to promote healthy nutrition behaviors.

METHOD

The following electronic databases will be searched from January 1990 onwards: PubMed/MEDLINE, EMBASE, Web of Science, and CENTRAL. We will include randomized and non-randomized trials, quasi-experimental studies, observational studies (e.g., cohort, cross-sectional, and before and after studies) evaluating the social marketing-based intervention. The primary outcomes will be nutritional behaviors. Secondary outcomes will include the quality of life, nutritional status, and weight status. Two reviewers will independently screen all citations, full-text articles, and abstract data. The study methodological quality (or bias) will be appraised using an appropriate tool. If feasible, we will conduct random-effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., age, sex, and socio-economic condition).

DISCUSSION

This study will summarize the evidence regarding the interventions' components, implementation methods, and effectiveness of interventions based on the social marketing framework to promote healthy nutrition behaviors. This review can provide policymakers with the information needed to make decisions and plan to promote healthy eating behaviors and understand the factors influencing the implementation of these programs.

SYSTEMATIC REVIEW REGISTRATION

CRD42020163972.

Le marketing social et les nudges, les outils efficaces du changement de comportement

De nombreux problèmes sociétaux et de santé requièrent des changements de comportement des populations. L’information et l’injonction ne suffisent pas à obtenir de tels changements de manière durable. Le marketing social et les nudges proposent des méthodes alternatives et complémentaires pour changer les comportements en se fondant sur une réflexion et des méthodes rigoureuses issues des sciences sociales.

A Systematic Scoping Review of Media Campaigns to Develop a Typology to Evaluate Their Collective Impact on Promoting Healthy Hydration Behaviors and Reducing Sugary Beverage Health Risks

Interventions to discourage sugary beverages and encourage water consumption have produced modest and unsustainable behavioral changes to reduce obesity and noncommunicable disease risks. This systematic scoping review examined media campaigns to develop a typology to support healthy hydration nonalcoholic beverage behaviors. Our three-step methodology included the following: (1) review and summarize expert-recommended healthy beverage guidelines; (2) review six English-language electronic databases guided by PRISMA to describe existing campaign types by issue, goal and underlying theory; and (3) develop a media campaign typology to support policies, systems and environments to encourage healthy hydration behaviors. Results showed no international consensus for healthy beverage guidelines, though we describe expert-recommended healthy beverage guidelines for the United States. Of 909 records identified, we included 24 articles describing distinct media campaigns and nine sources that defined models, schemes or taxonomies. The final media campaign typology included: (1) corporate advertising, marketing or entertainment; (2) corporate social responsibility, public relations/cause marketing; (3) social marketing; (4) public information, awareness, education/ health promotion; (5) media advocacy/countermarketing; and (6) political or public policy. This proof-of-concept media campaign typology can be used to evaluate their collective impact and support for a social change movement to reduce sugary beverage health risks and to encourage healthy hydration behaviors.

A systematic review of interventions to increase breakfast consumption: a socio-cognitive perspective

OBJECTIVE

Regular breakfast skipping is related to unhealthy dietary behaviours, such as consuming an overall poorer quality diet and lower rates of physical activity, both of which are linked to a higher BMI. Adolescent breakfast skippers struggle with mental focus, sleep issues and lower grades. Solutions that can be implemented to overcome breakfast skipping are needed.

DESIGN

A systematic literature review was undertaken to identify programmes that aimed to increase breakfast eating. Following the PRISMA framework, studies were sourced to examine details of behaviour change, evidence of theory use and other important programme learnings and outcomes.

SETTING

Breakfast consumption empirical studies published from 2000 onwards.

PARTICIPANTS

Nineteen empirical studies that aimed to improve breakfast eating behaviour.

RESULTS

Out of the nineteen studies examined, ten studies reported an increase in breakfast consumption frequency for the entire study group or subgroups. Seven studies found no change, one was inconclusive and one observed a decrease in breakfast frequency. Positive changes to the dietary quality of breakfast were observed in five of the studies that did not observe increased frequency of breakfast consumption. Only six studies reported using theory in the intervention.

CONCLUSIONS

This evidence review points needed to extend theory application to establish a reliable evidence base that can be followed by practitioners seeking to increase breakfast eating rates in their target population.

Mixed-methods process evaluation of SafeTea: a multimedia campaign to prevent hot drink scalds in young children and promote burn first aid

Objectives

SafeTea is a multifaceted intervention delivered by community practitioners to prevent hot drink scalds to young children and improve parents’ knowledge of appropriate burn first aid. We adapted SafeTea for a national multimedia campaign, and present a mixed-methods process evaluation of the campaign.

Methods

We used social media, a website hosting downloadable materials and media publicity to disseminate key messages to parents/caregivers of young children and professionals working with these families across the UK. The SafeTea campaign was launched on National Burns Awareness Day (NBAD), October 2019, and ran for 3 months. Process evaluation measurements included social media metrics, Google Analytics, and quantitative and qualitative results from a survey of professionals who requested hard copies of the materials via the website.

Results

Findings were summarised under four themes: ‘reach’, ‘engagement’, ‘acceptability’ and ‘impact/behavioural change’. The launch on NBAD generated widespread publicity. The campaign reached a greater number of the target audience than anticipated, with over 400 000 views of the SafeTea educational videos. Parents and professionals engaged with SafeTea and expressed positive opinions of the campaign and materials. SafeTea encouraged parents to consider how to change their behaviours to minimise the risks associated with hot drinks. Reach and engagement steadily declined after the first month due to reduced publicity and social media promotion.

Conclusion

The SafeTea campaign was successful in terms of reach and engagement. The launch on NBAD was essential for generating media interest. Future campaigns could be shorter, with more funding for additional social media content and promotion.

Mass media and communication interventions to increase HIV testing among gay and other men who have sex with men: Social marketing and visual design component analysis

Mass media and communication interventions can play a role in increasing HIV testing among gay, bisexual and other men who have sex with men (GBMSM). Despite the key role of social marketing principles and visual design within intervention development of this type, evidence is limited regarding interventions’ social marketing mix or visual design. As part of a systematic review, intervention content was assessed using social marketing theory and social semiotics. Data were extracted on the nature of the intervention, mode of delivery, use of imagery, content and tone and the eight key characteristics of social marketing. Data were synthesised narratively. Across the 19 included studies, reference to social marketing principles was often superficial. Common design features were identified across the interventions, regardless of effectiveness, including: the use of actors inferred to be GBMSM; use of ‘naked’ and sexually explicit imagery; and the use of text framed as statements or instructions. Our results suggest that effective interventions tended to use multiple modes of delivery, indicating high social marketing complexity. However, this is only part of intervention development, and social marketing principles are key to driving the development process. We identified consistent aspects of intervention design, but were unable to determine whether this is based on evidence of effectiveness or a lack of originality in intervention design. An openness to novel ideas in design and delivery is key to ensuring that evidence-informed interventions are effective for target populations.

Social marketing interventions to promote physical activity among 60 years and older: a systematic review of the literature

BACKGROUND

Falls are a significant source of morbidity in people aged 65 and over, affecting one in three people in this age group. The scientific evidence indicates that physical activity is the most effective method for preventing falls among seniors. Although public health professionals often use social marketing to design and plan successful interventions, its use to promote physical activity and prevent falls among older people remains low. This article aims to provide a new systematic literature review of social marketing interventions promoting physical activity and targeting people aged 60 and over.

METHODS

Following CRD's guidance and PRISMA guidelines, we searched between January 2008 and July 2019 for relevant articles in five primary databases using predefined search and inclusion criteria. Two independent reviewers analysed the selected articles to identify evidence of the seven social marketing benchmark criteria, defined by experts in the field as the common elements that contribute to social marketing success.

RESULTS

The final review included nine studies. Of the studies selected, three specifically targeted over 60-year-olds, whereas the others segmented the population into several age-based subcategories, including over 60-year-olds. Eight studies highlighted positive results for the participants with an increase in participation or an increase in physical activity level. None of the nine studies selected for this systematic review implemented the entire social marketing approach.

CONCLUSION

Few published interventions use the seven social marketing criteria. Further research is required to encourage uptake and inclusion in successful social marketing interventions to increase program effectiveness in this target population.

A Scoping Review of Foci, Trends, and Gaps in Reviews of Tobacco Control Research

INTRODUCTION

The burden of disease associated with tobacco use has prompted a substantial increase in tobacco-related research, but the breadth of this literature has not been comprehensively examined. This review examines the nature of the research addressing the action areas in World Health Organization's Framework Convention on Tobacco Control (FCTC), the populations targeted and how equity-related concepts are integrated.

METHOD

A scoping review of published reviews addressing tobacco control within the primary prevention domain. We searched PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Educational Resources Information Centre, and PsycInfo from 2004 to 2018.

RESULTS

The scoping review of reviews offered a "birds-eye-view" of the tobacco control literature. Within the 681 reviews meeting inclusion criteria, there was a strong focus on smoking cessation targeting individuals; less attention has been given to product regulation, packaging, and labeling or sales to minors. Equity-related concepts were addressed in 167/681 (24.5%); few were focused on addressing inequity through structural and systemic root causes.

CONCLUSION

This analysis of foci, trends, and gaps in the research pursuant to the FCTC illustrated the particular action areas and populations most frequently addressed in tobacco control research. Further research is needed to address: (1) underlying social influences, (2) particular action areas and with specific populations, and (3) sustained tobacco use through the influence of novel marketing and product innovations by tobacco industry.

IMPLICATIONS

This scoping review of the breadth of tobacco control research reviews enables a better understanding of which action areas and target populations have been addressed in the research. Our findings alongside recommendations from other reviews suggest prioritizing further research to support policymaking and considering the role of the tobacco industry in circumventing tobacco control efforts. The large amount of research targeting individual cessation would suggest there is a need to move beyond a focus on individual choice and decontextualized behaviors. Also, given the majority of reviews that simply recognize or describe disparity, further research that integrates equity and targets various forms of social exclusion and discrimination is needed and may benefit from working in collaboration with communities where programs can be tailored to need and context.

Motivating Military Trainee Healthy Eating: Insight from Two Sites

This paper investigates eating behaviours and motivations of early career military trainees from two pathways (officer cadets and army recruits) to understand whether, and to what extent, healthful eating behaviours were present, and what motivates eating in general and healthful habits specifically. The study also sought to understand whether groups need strategies that are pathway specific or are transferrable across different trainee populations. Participants were recruited via email to complete an online survey and through in-person invitations to ensure a diverse cross section of trainees (n = 195) and recruits (n = 297). Two-step cluster analysis revealed three distinct segments with education, opportunity and motivation being the most important variables within a wider multivariate segment formation and stepwise linear regression was performed to identify the most optimal model with the least number of predictors for each segment. The ideal model for the uninterested segment contained nine predictors, seven predictors for the Breakfast skippers segment and eight predictors for the Weight conscious segment. This study found that there is room for improvement in the eating habits of military trainees across military training pathways. Eating motivations, and their associations with healthful eating habits, indicate a need for strategies that are broader than instilling or reinforcing health motivations. Strategies that can be implemented to support healthful eating for military trainees include provision of food preparation and cooking skills training, coupled with provision of social support and environments that facilitate healthful eating. Furthermore, three distinct segments were discovered within the trainee population, indicating that strategies for positively changing trainees’ eating behaviours may not need to be pathway specific, rather it may be possible to introduce the same group of segmented strategies across both pathways. Future research directions and limitations are outlined.

Results of a Mass Media Campaign in South Africa to Promote a Sugary Drinks Tax

BACKGROUND

In South Africa, the increased consumption of sugary drinks has been associated with increased obesity rates. Mass media campaigns can play a crucial role in improving knowledge, shifting attitudes, and building support for government action on reducing sugary drink consumption. No study to date has evaluated the effectiveness of mass media campaigns on the health harms of sugary drinks in South Africa.

OBJECTIVE

The purpose of this study was to evaluate the impact of a mass media campaign on knowledge and attitudes around sugary drinks and on public support for a proposed tax on sugary drinks in South Africa.

METHODS

The "Are You Drinking Yourself Sick?" campaign aired in South Africa from October 2016 to June 2017 to shift attitudes toward sugary drinks, build personal risk perceptions of the health harms of consuming sugary drinks, and build public support for a proposed tax on sugary drinks. Campaign impact was measured in representative cross-sectional household surveys of adults ages 18 to 56. The surveys were conducted just prior to the launch of the campaign (N = 1000), from October 7 to 10, 2016, and immediately following its conclusion (N = 1000), from July 12 to 21, 2017. Campaign impact was assessed by comparing changes from the pre-campaign to the post-campaign period on key outcome indicators. In addition, the effect of campaign awareness was analyzed in logistic regression analysis of the post-campaign data.

RESULTS

The campaign was recalled by 55% of survey respondents, and 78% of campaign-aware respondents said that the campaign's main message was "drinking sugary drinks can make you sick." There were significant changes from the pre- to the post-campaign period in knowledge that sugary drink consumption can lead to obesity and related health problems and that sugary drinks contribute toward the obesity problem in South Africa. Campaign awareness was also significantly associated with increases in knowledge about the harms of sugary drinks, and in particular, on government action, including the proposed tax on sugary drinks.

DISCUSSION

Media campaigns are an effective intervention for obesity prevention. In addition to improving knowledge and shifting attitudes, media campaigns can effectively build public support for strong government action and therefore must be a component of a comprehensive obesity prevention approach.

Social marketing interventions for the prevention and control of neglected tropical diseases: A systematic review

BACKGROUND

Social marketing is an approach to behavior change that contributes to disease prevention and control. This study aimed to understand how social marketing interventions have addressed neglected tropical diseases (NTDs). It examined the characteristics, breadth of coverage, and outcomes of social marketing interventions focused on the prevention and control of these diseases.

METHODOLOGY/PRINCIPAL FINDINGS

Studies published in any language between January 1971 and April 2017, targeting at least one of the 17 NTDs prioritized in the World Health Organization (WHO) NTD Roadmap were considered. Included studies had interventions that applied both, at least one core social marketing concept, "social behavioral influence", and one social marketing technique, "integrated intervention mix", described in the Hierarchical Model of Social Marketing. This review is registered with PROSPERO CRD42017063858. Twenty interventions, addressing eight NTDs, met the inclusion criteria. They focused on behaviors related to four of the five WHO public health strategies for NTDs. Most interventions incorporated the concepts "relationship building" and "public / people orientation focus", and the technique "insight-driven segmentation". All the interventions reported changing behavioral determinants such as knowledge, 19 reported behavior change, and four influenced health outcomes.

CONCLUSION/SIGNIFICANCE

Evidence from this study shows that social marketing has been successfully used to address behaviors related to most of the five public health strategic interventions for NTDs recommended by the WHO. It is suggested that social marketing interventions for the prevention and control of NTDs be grounded on an understanding of the audience and adapted to the contexts intervened. Building stakeholder relationships as early as possible, and involving the publics could help in reaching NTD outcomes. Elements of the intervention mix should be integrated and mutually supportive. Incorporating health education and capacity building, as well as being culturally appropriate, is also relevant. It is recommended that ongoing discussions to formulate the targets and milestones of the new global Roadmap for NTDs integrate social marketing as an approach to overcome these diseases.

The gender responsiveness of social marketing interventions focused on neglected tropical diseases

Background: Gender is a determinant of health that intersects with other social stratifiers to shape the health and well-being of populations. Despite the recognition of gender in the global health agenda, limited evidence exists about the integration of gender considerations in interventions, including social marketing interventions, for the prevention and control of neglected tropical diseases. Social marketing is an ethical approach to behavior change aiming to benefit individuals, communities, and society. Since behaviors are gendered and affect disease transmission and healthcare patterns, one would expect social marketing interventions to be gender responsive.Objective: This study aims to understand the extent to which social marketing interventions focusing on neglected tropical diseases are gender responsive.Methods: This study uses data from social marketing interventions collected in a systematic review, this study examined 20 interventions addressing eight neglected tropical diseases in 13 countries. A modified version of the World Health Organization Gender Assessment Tool (GAT) was used to determine the gender responsiveness of the interventions, which was complemented by coding for intersectional sex and gender data. These results are presented in 12 themes.Results: One schistosomiasis intervention implemented in China was assessed as gender responsive. It was not possible to answer many questions from the GAT due to limited data reported in the publications describing the interventions. Despite this, strengths and limitations were found in all the interventions in relation to the use of sex and gender concepts, the disaggregation of data, the consideration of environmental factors, and the involvement of women or men in the different stages of the interventions.Conclusions: Many interventions showed positive actions towards gender responsiveness. However, only one was classified as gender responsive. Others failed to supply enough data for assessment. Recommendations about how sex and gender could be integrated into social marketing interventions are provided.

How to meet reuse and preparation for reuse targets? Shape advertising strategies but be aware of "social washing"

Preparation for reuse (PfR) is a fundamental waste management practice that is second only to prevention in the waste hierarchy. The paper, building on advertising literature, investigates how to leverage the pro-social nature of this option for giving products that have become waste a second life. To examine how advertising strategies based on emotional, functional or combined stimuli can be used to increase intention to buy these items, we carried out an experiment on 507 actual visitors a PfR items shop run by a social cooperative in Northern Italy. We found that, depending on consumers' social involvement, both emotional and functional stimuli based on the social impact of preparation for reuse tend to outperform functional stimuli and have a positive impact on brand attitudes by shaping attitudes to advertisements. Purchasing behaviour has a positive impact on attitudes toward the PfR organization and moderates the effect of emotional and combines stimuli on attitudes toward the advertisement. Since emotional stimuli can be freely used by both legitimated and opportunistic companies, the former should seek to preserve their value proposition by making it easier for consumers to recognise actually trustworthy organizations. This is possible combining the use of advertisements with the development of solid customer relationships. To this end, awareness campaigns, closer relationships with stakeholders and third-party verifiable standards and certifications should be considered to reduce the risk of "social washing" in the current second-hand market context.

Enhancing cyber security behavior: an internal social marketing approach

Purpose

Understanding the behavioral change process of system users to adopt safe security practices is important to the success of an organization’s cybersecurity program. This study aims to explore how the 7Ps (product, price, promotion, place, physical evidence, process and people) marketing mix, as part of an internal social marketing approach, can be used to gain an understanding of employees’ interactions within an organization’s cybersecurity environment. This understanding could inform the design of servicescapes and behavioral infrastructure to promote and maintain cybersecurity compliance.

Design/methodology/approach

This study adopted an inductive qualitative approach using in-depth interviews with employees in several Vietnamese organizations. Discussions were centered on employee experiences and their perceptions of cybersecurity initiatives, as well as the impact of initiatives on compliance behavior. Responses were then categorized under the 7Ps marketing mix framework.

Findings

The study shows that assessing a cybersecurity program using the 7P mix enables the systematic capture of users’ security compliance and acceptance of IT systems. Additionally, understanding the interactions between system elements permits the design of behavioral infrastructure to enhance security efforts. Results also show that user engagement is essential in developing secure systems. User engagement requires developing shared objectives, localized communications, co-designing of efficient processes and understanding the “pain points” of security compliance. The knowledge developed from this research provides a framework for those managing cybersecurity systems and enables the design human-centered systems conducive to compliance.

Originality/value

The study is one of the first to use a cross-disciplinary social marketing approach to examine how employees experience and comply with security initiatives. Previous studies have mostly focused on determinants of compliance behavior without providing a clear platform for management action. Internal social marketing using 7Ps provides a simple but innovative approach to reexamine existing compliance approaches. Findings from the study could leverage proven successful marketing techniques to promote security compliance.

The Effectiveness of Social Marketing Interventions to Improve HIV Testing Among Gay, Bisexual and Other Men Who Have Sex with Men: A Systematic Review

HIV testing is central to biomedical HIV prevention, but testing among men who have sex with men remains suboptimal. We evaluated effectiveness of mass media and communication interventions to increase HIV testing and explored patterns between study type, internal validity and intervention effectiveness for the first time. Five databases were searched for articles published between 2009 and 2016 using standard MeSH terms. Eligible studies were quality appraised using standard checklists for risk of bias. Data were extracted and synthesised narratively. Nineteen studies met inclusion criteria; 11 were cross-sectional/non-comparative studies, four were pre/post or interrupted time series, three were randomised controlled trials (RCTs) and one was a case study. Risk of bias was high. Five cross-sectional (two graded as high internal validity, one medium and two low) and one RCT (medium validity) reported increased HIV testing. Further work is required to develop and evaluate interventions to increase frequency and maintenance of HIV testing.

Community Understanding of Contraception During the Zika Virus Outbreak in Puerto Rico

In response to the Zika virus outbreak in Puerto Rico (2015-2016), the Zika Contraception Access Network (Z-CAN) was established to provide same-day access to the full range of reversible contraception at no cost to women. Formative research was conducted to inform the development of a communication campaign about Z-CAN. Ten focus groups with women and men, aged 18 to 49 years, in Puerto Rico were conducted to collect data on contraception awareness, use, and decision making during the Zika outbreak, as well as culturally appropriate messaging and outreach strategies. Thematic analysis was conducted using the constant comparative method. Data showed that there was community awareness regarding Zika in Puerto Rico. However, it was not a motivating factor in contraception decision making; instead, economic factors were the major drivers. Most participants preferred to receive information on contraception, potential side effects, and where to access contraceptive services via Internet-based channels and health care providers. Based on these findings, the Ante La Duda, Pregunta [When in Doubt, Ask] campaign was launched to promote awareness of Z-CAN services among those who chose to prevent pregnancy during the Zika outbreak. Our results underscore the importance of conducting formative research to develop communication initiatives, while also demonstrating that it is feasible to perform these activities as part of an emergency response.

Consumer Neuroscience and Digital/Social Media Health/Social Cause Advertisement Effectiveness

This research investigated the use of consumer neuroscience to improve and determine the effectiveness of action/emotion-based public health and social cause (HSC) advertisements. Action-based advertisements ask individuals to 'do something' such as 'act', 'share', make a 'pledge' or complete a 'challenge' on behalf of a brand, such as doing 'something good, somewhere, for someone else'. Public health messages as noncommercial advertisements attempt to positively change behavioural intent or increase awareness. Australian health expenditure was $180.7 billion AUD (Australian dollars) in 2016/17 with $17 million AUD spent on government health campaigns. However, evaluation of health advertisement effectiveness has been difficult to determine. Few studies use neuroscience techniques with traditional market research methods. A 2-part study with an exploratory design was conducted using (1) electroencephalography (EEG) using a 64 channel EEG wet cap (n = 47); and (2) a Qualtrics online psychometric survey (n = 256). Participants were asked to make a donation before and after viewing 7 HSC digital/social media advertisements and logos (6 action/emotion-based; 1 control) to measure changes in behavioural intent. Attention is considered a key factor in determining advertising effectiveness. EEG results showed theta synchronisation (increase)/alpha desynchronisation (decrease) indicating attention with episodic memory encoding. sLORETA results displayed approach responses to action/emotion-based advertisements with left prefrontal and right parietal cortex activation. EEG and survey results showed the greatest liking for the ManUp action/emotion-based advertisement which used male facial expressions of raw emotion and vulnerability. ManUp also had the highest increased amount donated after viewing. Lower theta amplitude results for the International Fund for Animal Welfare (IFAW) action/emotion-based advertisement indicated that novel (possessing distinct features) rather than attractive/conventional faces were more appealing, while the rapid presentation of faces was less effective. None of the highest peak amplitudes for each ad occurred when viewing brand logos within the advertisement. This research contributes to the academic consumer neuroscience, advertising effectiveness, and social media literature with the use of action/challenge/emotion-based marketing strategies, which remains limited, while demonstrating the value in combining EEG and neuroscientific techniques with traditional market research methods. The research provides a greater understanding of advertising effectiveness and changes in behavioural intent with managerial implications regarding the effective use of action/challenge/emotion-based HSC communications to potentially help save a life and reduce expenditure on ineffectual HSC marketing campaigns.

Evaluating an Aboriginal tobacco social marketing project in Sydney, Australia

INTRODUCTION

A partnership between three Aboriginal Community Controlled Organisations and a mainstream health service was formed to develop, implement and evaluate a comprehensive and culturally appropriate social marketing project which aimed to encourage smokers to quit smoking. The project also supported quit attempts and promoted denormalisation of smoking.

METHODS

The project was evaluated through baseline (n = 427) and follow-up (n = 611) surveys carried out face-to-face with Aboriginal and/or Torres Strait Islander participants 18 years and older recruited through convenience sampling at community events and venues during 2010-2011 and 2015.

RESULTS

The proportion of participants who had made one or more quit attempts increased significantly between baseline and follow-up surveys (54%, 101 out of 187; vs 64%, 189 out of 297; P < 0.05). Participants who had intended to quit within 6 months (AOR, 3.29; 95% CI 1.90-5.68; P < 0.01); and participants disagreeing with the statement "I don't mind if people smoke inside my home" (AOR, 1.74; 95% CI 1.06-2.84; P < 0.05) were significantly more likely to have made one or more quit attempts compared to the respective reference groups.

CONCLUSION

Study findings demonstrate that the project was associated with increased quit attempts. Intention to quit and attitude were found to be the predictors of making a quit attempt. SO WHAT?: Many studies suggest the need to denormalise smoking; this study demonstrated both change in attitudes and an increase in quit attempts. It is recognised that many quit attempts may be needed for long-term smoking cessation.

Perceived benefits and barriers of walking among overweight and obese adults

The current study aimed to explore perceived barriers and benefits of walking of overweight and obese adults. Fifteen face-to-face, semistructured interviews were conducted. Content and thematic analyses were used. Findings revealed that informants were aware of more benefits from walking than barriers. Gaining health and fitness, losing weight, the opportunity to walk in a group, and setting goals and sharing achievements were more sited benefits of walking. Confusion about walking guidelines and walking location perceived as barriers to walking. The findings of this study would be applied to develop walking intervention.

Factors influencing recruitment to a randomised placebo-controlled trial of oral naltrexone and extended release implant naltrexone: Qualitative study

AIMS

To understand the influences on recruitment to the Naltrexone Enhanced Addiction Treatment (NEAT) study, a randomised placebo-controlled trial of extended-release naltrexone (XR-NTX) implants for opioid use disorder (OUD), to learn lessons for the design and conduct of similar future research.

METHODS

29 face-to-face, semi-structured qualitative interviews were conducted with patients recruited to NEAT (n = 6), patients not recruited (n = 11), researchers who designed the trial (n = 5), and staff who delivered the trial (n = 7). The social marketing mix was used as a framework to guide the data analyses.

RESULTS

Dimensions of the 7Ps of the social marketing mix - product, price, place, promotion, physical environment, people, and processes all influenced recruitment to the NEAT trial. Among other things, the potential to receive a naltrexone implant (product); the provision of transport passes and shopping vouchers (price); clear verbal explanations (promotion); familiarity of the trial setting (physical environment); and approachable, friendly and informative trial delivery staff (people) positively influenced recruitment. Whereas, wanting a less medical approach to recovery (product); the perceived time, physical, and psychological costs of taking part (price); service ideological opposition to naltrexone in recovery (place); inaccessible written information (promotion); the location and nature of the trial setting (physical environment); a lack of knowledge about implants (people); and the blind allocation and potential of placebo (processes) deterred people from joining the trial.

CONCLUSIONS

Qualitative research informed by the social marketing mix as an analytical framework yielded detailed insights into understanding the factors and circumstances that influenced recruitment to the NEAT trial. Our findings have implications for the planning and implementation of future addiction trials, especially trials of extended-release formulations.

Memphis FitKids: implementing a mobile-friendly web-based application to enhance parents' participation in improving child health

Background

Child obesity is a major public health challenge, increasing the risk of chronic medical conditions such as type 2 diabetes, metabolic syndrome, and hypertension. Among U.S. states, Tennessee has one of the highest rates of child obesity. Emerging communication technologies can help to deliver highly disseminable population-level interventions to improve health behavior. The aim of this paper is to report the implementation and the evaluation of the reach of Memphis FitKids, a web-based application, intended to promote healthy behaviors for families and children.

Methods

A community-level demonstration project, Memphis FitKids, was developed and implemented in Tennessee’s Greater Memphis Area. This application (www.memphisfitkids.org) was designed for parents to assess their children’s obesity risk through determinants such as weight, diet, physical activity, screen time, and sleep adequacy. A built-in “FitCheck” tool used this collected information to create a report with tailored recommendations on how to make healthy changes. A Geographic Information Systems component was implemented to suggest low-cost neighborhood resources that support a healthy lifestyle. A social marketing framework was used to develop and implement FitKids, and a Community Advisory Board with representatives from community partners (e.g., the YMCA of Memphis, the Pink Palace Family of Museums, and the Memphis Public Library) supported the implementation of the project. Five kiosks distributed in the community served as public access points to provide a broad reach across socioeconomic strata. Presentations at community events and the use of Facebook facilitated the promotion of FitKids. Website traffic and Facebook usage were evaluated with Google Analytics and Facebook Insights, respectively.

Results

In Tennessee, 33,505 users completed 38,429 FitCheck sessions between July 2014 and December 2016. Among these, 6763 sessions were completed at the five kiosks in the community. FitKids was presented at 112 community events and the social media posts reached 23,767 unique Facebook users.

Conclusions

The Memphis FitKids demonstration project showed that web-based health tools may be a viable strategy to increase access to information about healthy weight and lifestyle options for families. Mobile-friendly web-based applications like Memphis FitKids may also serve health professionals in their efforts to support their clients in adopting healthy behaviors.

Electronic supplementary material

The online version of this article (10.1186/s12889-018-5968-6) contains supplementary material, which is available to authorized users.

Fruit and Vegetable Intake of US Hispanics by Food Store Type: Findings from NHANES

This study examined fruit and vegetable intake by food store type shopped among US Hispanics. Using National Health and Nutrition Examination Survey 2011-2012 data, T test and chi-square tests examined differences between Hispanic consumers by food store type. Negative binomial regression analyses estimated associations between fruit and vegetable intake and food store type. Hispanics who only purchased fruits and vegetables from convenience stores were younger and more likely US born. They reported lower intakes of fruit and vegetables than individuals who purchased these foods from supermarket/grocery stores. Those who primarily purchased fruits and vegetables from supermarkets/grocery stores consumed 0.92 (p < .001) greater fruit cup equivalents and 0.26 (p = .001) greater vegetable cup equivalents than those who only purchased from convenience stores. Research on the influence of shopping in multiple food store types is needed to develop targeted in-store intervention strategies to encourage healthier food purchases. Results provide support for policy-level research such as minimum stocking requirements for healthy foods in convenience stores.

Capacity building and social marketing promotes healthy lifestyle behaviour in an Australian Aboriginal community

OBJECTIVE

We explored the effectiveness of a project targeting an Australian Aboriginal community.

DESIGN

A collaborative approach included stakeholder interviews, an intercept survey, observations and Facebook insights.

SETTING

Gippsland encompasses 41 557 km2 of Victoria and has an Aboriginal population of around 4000.

PARTICIPANTS

Five stakeholders from local Aboriginal health/sports organisations were interviewed at 6 and 18 months. A total of 49 Aboriginal persons aged 16 years or more, who lived in Gippsland, were surveyed at a community event. Facebook engagement involved 933 people over a 4-week period.

MAIN OUTCOME MEASURES

Reach was assessed at 6 and 18 months using Facebook likes and video views. Survey measures addressed campaign awareness, recall and attitudinal and behavioural change.

RESULTS

The project provides organisations with skills development, social media production and online resources promoting sports and community events. Stakeholders and survey respondents valued local content, positive stories and awareness-raising elements. Two campaigns developed by state and regional organisations were adapted using locally developed social media with campaign messages. After 18 months, there were 2592 video views and 1738 likes. Forty-seven (69%) of the eligible attendees at the community event completed the survey. Thirty-three (70%) had seen the campaign; 20 (61%) subsequently thought about changing their behaviour and 13 (39%) changed their behaviour.

CONCLUSION

The model was mutually beneficial. Partner organisations enabled project access to local events and project staff supported organisational development and event promotion. Social marketing engaged the community and prompted positive behaviour change. Formative work that is undertaken centrally might be useful for organisations to adapt for local campaigns.

Social marketing nutrition education for low-income population

As access to healthy food (or lack thereof) could be considered a social justice issue, social workers should be concerned about this issue and willing to collaborate with colleagues of various disciplines to address it. This study was a formative evaluation conducted to understand best practices, recommendations, and feasibility of a social-marketing-based nutrition education program tailored to the needs of adults with limited income. The authors report findings from focus groups conducted with Cooperative Extension Agents (CEAs) and region coordinators (n = 45) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) (n = 69) eligible participants to inform the development of a social marketing nutrition intervention for SNAP-Ed in Georgia. Barriers to healthy eating included cultural preferences, costs of healthy food, lack of time, and lack of availability. Social marketing has a potential to deliver effective and efficient SNAP-Ed targeted to large, limited-resource Georgians. Segmenting the low-income population based on geographical location as well as best methods for outreach can allow tailored messages to meet identified needs, lifestyles, and other variables that make these individuals most likely to respond to the program. Food security and nutrition education are topics of concern for all health care professionals interested in addressing complex health issues of many low-income adults.

Does additional support provided through e-mail or SMS in a Web-based Social Marketing program improve children's food consumption? A Randomized Controlled Trial

Background

The FAN Social Marketing program was developed to improve dietary and physical activity habits of families with children in Ticino, Switzerland. The aim of this study was to examine if the effects of the program on children’s food intake differed by intervention group.

Methods

Effects of the FAN program were tested through a Randomized Controlled Trial. The program lasted 8 weeks, during which participants received tailored communication about nutrition and physical activity. Families were randomly allocated to one of three groups, where the parent received the intervention by the Web (G1), Web + e-mail (G2) or Web + SMS (G3). Children in all groups received tailored print letters by post. Children’s food consumption was assessed at baseline and immediate post intervention using a 7-day food diary. Generalized linear mixed models with child as a random effect and with time, treatment group, and the time by treatment interaction as fixed effects were used to test the impact of the intervention.

Results

Analyses were conducted with a sample of 608 children. After participating in FAN the marginal means of daily consumption of fruit changed from 0.95 to 1.12 in G1, from 0.82 to 0.94 in G2, and from 0.93 to 1.18 in G3. The margins of the daily consumption of sweets decreased in each group (1.67 to 1.56 in G1, 1.71 to 1.49 in G2, and 1.72 to 1.62 in G3). The change in vegetable consumption observed from pre to post intervention in G3 (from 1.13 to 1.21) was significantly different from that observed in G1 (from 1.21 to 1.17).

Conclusions

A well-designed Web-based Social Marketing intervention complemented with print letters can help improve children’s consumption of water, fruit, soft drinks, and sweets. The use of SMS to support greater behavior change, in addition to Web-based communication, resulted only in a small significant positive change for vegetables, while the use of e-mail in addition to Web did not result in any significant difference.

Trial registration

The trial was retrospectively registered in the ISRCTN registry (ID ISRCTN48730279).

Electronic supplementary material

The online version of this article (10.1186/s12937-018-0334-1) contains supplementary material, which is available to authorized users.

Selling Innovations Like Soap: The Interactive Systems Framework and Social Marketing

Despite the popularity and noted utility of Wandersman and colleagues' (2008) Interactive Systems Framework, the literature currently provides a primary focus on delivery organizations' and supportive stakeholders' capacities and strategies to implement innovations, presenting a critical gap in understanding. Unfortunately, reflective of a larger void in community dissemination and implementation efforts, there is a more limited focus on the dissemination of innovations. This paper presents the social marketing literature as a supplement to the Prevention Synthesis and Translation System (PSTS), the system responsible for dissemination. The study and practice of innovation synthesis and translation is examined in the literature; and based on the conclusions drawn, social marketing theory is used to provide a systematic approach to improving dissemination within the Interactive Systems Framework. Specifically, three gaps related to the PSTS are identified in the literature that align with and can be filled using social marketing. Social marketing is defined and presented as a supplement by providing theory and practices, within a systems context, for effectively communicating and influencing change. By blending social marketing with the Interactive Systems Framework, the aim is to improve the understanding of strategic communication and its role in the effective dissemination, and subsequent implementation, of innovations.