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A Guide to Health Promotion through Social Marketing 1 A Guide to Health Promotion through Social Marketing 2 An initiative of the Australian Sports Commission The views in this publication are those of the author and not necessarily the Australian Government. 3 Contents Introduction7 What is social marketing? 8 Why is behaviour change important? 10 The basics of social marketing 12 14 steps to developing social marketing strategies & materials 16 Step 1: Define the issue Step 2: Know your audience Step 3: Understand the situation Step 4: Work with others Step 5: Choose who to target Step 6: Outline your behavioural goals Step 7: Choose your communication channels Step 8: Develop strategies and communication messages Step 9: Plan how to track progress and measure impact Step 10: Prepare an action plan Step 11: Create materials Step 12: Seek feedback, pre-test and adjust Step 13: Deliver and monitor Step 14: Measure impact and make adjustments 18 20 21 22 24 26 27 28 30 31 32 33 34 35 Online resources 36 Resources and guides provided by the Australian Sports Commission 40 References42 4 5 Introduction This guide will assist you to understand social marketing and to use various strategies that support and motivate healthy behaviours among certain groups of people. Active You may like to inform particular groups about non-communicable diseases (NCDs) and encourage them to be more physically active to reduce their risk. Or you may want to advertise a local sporting event in the community, a new facility or service, or to boost membership in a sporting organisation to make participation in sport or other physical activities easier. This guide will assist you achieve these goals by offering a simple step-by-step process to develop strategies and communication materials that support and motivate healthy behaviors through TV, radio, posters, brochures, social media, or whatever other creative methods you might want to employ. Unfortunately, it's common for people to think social marketing is beyond their skills, resources, budgets and timelines. The aim of this guide is to emphasise that regardless of the challenges you or your organisation face, applying effective social marketing strategies is always possible. It can even make your work more productive, effective, and rewarding. This guide provides a basic introduction to offer guidance and support for your social marketing efforts, to set you in the right direction, and to place a few simple concepts, tips, steps, and prompts in your back pocket to help you along the way. 7 What is social marketing? Social marketing is one way of understanding why people act as they do and then using this knowledge to motivate and support them to modify or maintain positive behaviours. Adopting a social marketing approach involves combining a range of strategies to make healthy behaviours easier and more appealing, as well as developing communication materials that motivate and support these healthy behaviours. Google 'social marketing' and you will get a confusing array of definitions, concepts, and terms; enough to scare anyone away. But it helps to know that most of us are exposed, for better or worse, to some form of marketing almost every day. Coca-Cola, McDonalds, and Nike, for example, all use sophisticated and well-tested marketing techniques to encourage people to do what they want them to do: purchase their products. Typically, this requires a combination of carefully crafted posters, TV and radio spots, billboards, newspaper advertisements, websites, media, or promotional events. It also involves reducing various barriers affecting their customers to ensure their products are affordable, easy to purchase, and always available. Put simply, social marketing borrows from and adds to some of the most effective concepts and techniques of commercial marketing to motivate and support behaviours that benefit individuals and communities. So instead of selling soft-drinks, hamburgers, and shoes, social marketers are more likely to develop strategies and communication materials that promote better health, equity, mental wellbeing, and community development. And when addressing potential barriers to their audience adopting healthy behaviours, they are more likely to ensure their strategies have been modified to meet the needs and interests of particular groups of people, including the disadvantaged, minority groups, or people living with disabilities. Guided by ethical principles, social marketing aims to put people and community first. 8 Social Why is behaviour change important? Understanding and promoting behaviour change lies at the heart of social marketing. Behaviour change refers to human actions that transform or modify over time. While always complex and often unpredictable, one useful way of viewing behaviour change is as a series of stages that people move through. Social marketing draws upon various techniques and strategies to motivate and support certain groups of people to shift their position on this behavioural change continuum — from a state of not knowing and not caring to that of concerned and motivated, and from committed and planning to actively changing and maintaining their behaviours. Of course, behaviour change is never a simple process of moving from one stage to the next. People can slip back through stages before potentially moving forward again, such as joining a sports team but dropping out, or planning to exercise every morning but becoming demotivated. Also, behaviour change does not always follow a shift in awareness and attitudes. Sometimes the reverse occurs. For example, a man participating in a Zumba class for the first time might find himself motivated to learn more about the health benefits of being active after a positive experience. In short, no single model can capture and predict the complexity of human behaviour and its transformation over time. 10 Stages of Behaviour Change: Example of an individual's knowledge, attitude or behaviour Stage Don’t know, Don’t care Unaware and unconcerned that a lack of physical activity increases one's risk of developing NCDs. Stage Aware & Informed Aware of NCDs and that physical activity is one way to reduce one's personal risk. Stage Concerned & Motivated Supports the view that physical activity will reduce one's risk of developing NCDs and is motivated to change their behaviour. Stage Committed & Planning Seeks out opportunities and makes plans to be physically active. Stage Actively Changing Being physically active. Stage Maintaining Change Is physically active for extended periods of time and plans to stay active in the future. Nevertheless, considering these stages of behaviour change helps us to respond to the needs, understandings, motivations and barriers of different groups of people. Some people, for example, may be aware and informed about the importance of changing their behaviour but do not believe that the proposed action will be effective in reducing their risk. Others may be concerned and motivated to change their behaviour but lack confidence in their personal capacity to make this change because of a number of barriers or a lack of role models in their community. And some may be actively participating in the desired behaviour but are at risk of discontinuing their activities because of a lack of sociable, fun and affordable activities in their community. So, with this in mind, we can see that different strategies are going to be needed for people at an early stage of change compared to those at a later stage. These are known as stage-matched strategies. Strategies focusing on people in Stage 1, for example, may focus on raising awareness of the harms of being physically inactive and ensuring people understand their level of personal risk. Strategies focusing on people in Stage 4, on the other hand, may focus on making it easier for people to participate in sporting events in their community as a way to get active. And sometimes you can use different strategies within your campaign to match the needs of certain sub-groups within your target audience who may be at different stages. In short, knowing where the people you want to reach with your social marketing strategies are situated in this behaviour change process is key to designing an effective social marketing campaign. Let's look at some other features of a social marketing approach. 11 The basics of social marketing Social marketing can be viewed as both a way of thinking and a way of doing. Later we will focus on the doing; for now, let's look at five key concepts that define social marketing. 12 Change 1. Specific behavioural goals Health Social marketing is more than just raising awareness and increasing knowledge. It is also about having an impact on human behaviour. Social marketers set specific behavioural goals; for example, "to increase the percentage of women aged 18-24 in rural areas being physically active for at least 150min a week by 15% between 2015-2020". Specific behavioural goals ensure an initiative has meaning and direction, and that achievements can be measured. 2. Putting people and community first Social marketing aims to promote and support behaviours that benefit individuals and the community. In the health sector this typically involves promoting health and reducing health inequalities. Importantly, the 'benefit' should always reflect the experiences, needs, motivations and barriers of the audience targeted by the initiative. 3. Insight Social marketing, like commercial marketing, focuses on what people do, why they do it, what and who influences them, their needs, and their motivations and barriers. With this in mind, social marketers seek to develop insight into their target audience and the various factors that support healthy behaviours or compete with them. This insight is what makes social marketing possible and effective. 4. Audience segmentation While it's tempting to communicate to everyone all at once, one-sizefits-all approaches have shown to be much less effective than targeting certain groups of people who share particular characteristics, understanding, lifestyles, interests, needs, motivations, and barriers. This process of identifying different sub-groups within a population is known as audience segmentation and it is a central feature of any social marketing strategy. We'll learn more about audience segmentation in Step 5. 5. Strategic and evidencebased A common mantra among social marketers is to "do nothing…make no posters, no t-shirts, no pamphlets, no videos, no caps, no websites" until you have thought about and planned exactly what you are going to do. This involves clarifying why your approach is the best one among other options based on good research, what behaviours you want to influence and support, who you are reaching and why, the people and resources required to make it all happen, and how you will measure your progress and impact. This is sometimes referred to as developing a ‘program logic’, which is really just another way of explaining in simple terms why you believe that what you are planning to do will be effective in achieving its objectives with the target audience. Getting to the point at which you feel confident you can develop and implement strategies and communication materials that support and motivate healthy behaviours can seem a little overwhelming, until you realise that it's all possible by following a few simple steps. 15 14 steps to developing social marketing strategies & materials: 16 Knowing where to start when you decide to 'do' social marketing can be tricky. And it's likely you are concerned about your lack of staff, funding, skills, or resources. Here's 14 steps to give you some ideas, tips, and prompts to set you in the right direction and to give you confidence that, despite the challenges you face, applying effective social marketing strategies is always possible. Keep in mind that these steps overlap and do not neatly follow one another. You will find yourself commencing a few steps simultaneously and jumping back and forth between them when necessary. Think of them as different toolboxes that will need to be re-opened and shuffled through at various stages of your project. 17 1 Research Example Step 1: Define the issue A good place to start before developing your strategies and materials is to clarify the issue you are hoping to address. Some of the following questions might help: • What is happening? • What needs to happen to improve the situation? • What will happen if nothing is done? • What behaviours can we focus on? • What models or theories are relevant to this issue? You won't be able to answer these questions on your own, so you'll need to draw upon a mix of research carried out by others (secondary research) and yourself (primary research). Despite their names, secondary research is typically conducted before primary research. In short, secondary research lays the groundwork while primary research fills in the gaps. Secondary research might include looking at national strategy documents, reports by international organisations and government agencies, census data, text-books, journal articles, and project evaluations. Primary research, on the other hand, might involve conducting your own surveys, focus groups, interviews, and community observations. Put simply, both secondary and primary research allows you to find accurate and reliable answers to each of your questions. Now is a good time to commence writing a summary of your thoughts, research, and discussions with others. Your notes should include a list of actions and will expand as you progress through the next steps. 18 Where to start? These days, secondary research often begins on the Internet. To ensure you only get what you need, narrow your search to include websites that are well known and reliable; for example, the World Health Organization, the United Nations, Government departments, and respected research institutions. For more trustworthy sources of information, type 'edu' and 'gov' into your internet search or use Google Scholar. When unsure, check your findings by looking at multiple sources or by seeking advice from local experts. And if you can't find what you need online, don't forget there is always the old-fashioned way of visiting your local library or requesting printed reports from relevant institutions. Primary research can seem daunting. To put you in the right direction, begin by emailing, phoning or dropping by the office of individuals that share your interest in the issue. These people will give you a better idea of who to include in interviews, focus groups and surveys. There are many free how-to-guides available online to assist you. For example, Google "health compass, how-toguide, formative research" or visit www.thehealthcompass.org Questions Research Answers What is happening? Secondary: World Health Organization report on cause of death and disability, national census data. Primary: Interviews and focus group discussions with health experts. An increasing number of people in the community are being affected by NCDs What needs to happen to improve the situation? Secondary: Project evaluations of successful initiatives, national strategy documents. Primary:Surveys distributed to health experts and opinion leaders. People could make healthy lifestyle changes to reduce their risk of developing NCDs What will happen if nothing is done? Secondary: World Health Organization report, journal articles, national census data. Primary:Interviews with health experts. More people will acquire a disability or die, the economy will suffer, and social inequalities will increase. What behaviours can we focus on? Secondary: Project evaluations of successful initiatives, national strategy documents. Primary:Interviews and focus group discussions with health experts. Increasing physical activity through sport and other active recreational activities. What models or theories are relevant to this issue? Secondary: Journal articles, text-books. Primary:Emailing and phoning academics to request their advice. Ecological model of factors influencing physical activity; Stages of change model; Theory of learned helplessness. 19 2 3 Step 2: Know your audience Your audience refers to those who you intend to reach and influence through your strategies and communication materials. Effective social marketing involves seeing the world from your audience's point of view and understanding why they behave the way they do. Here are some questions to assist you in gaining this perspective: • Who does the issue affect most? • How do these people behave? • What and who affects their behaviour? • What are their experiences, beliefs, and needs? • What motivates them? • What barriers do they face regarding the behaviour you are trying to influence? • What behaviours are they adopting that are competing with the behaviours you want to influence? • What issues relating to minority groups, the disadvantaged, or persons living with disabilities need to be considered? Again, draw upon a mix of secondary and primary research to guide your investigation and add your findings to the notes you commenced writing in Step 1. Ensure key insights are discussed with your team and incorporated into the planning and development of materials later on. Step 3: Understand the situation Considering equity Understanding the experiences, needs, understandings and opinions of minority groups, the disadvantaged, and people living with disabilities from the outset is vital. Reaching out to individuals and organisations representing each of these groups is the best place to start. In doing so, you might learn that persons living with disabilities have higher rates of NCDs in your community because their access to health services is very poor. Or that individuals who identify as transgender have not felt welcome to participate in sporting events because they have been turned away from both male and female teams. Or perhaps people living in remote locations are often unaware of health promotion campaigns because they receive most of their information by radio rather than TV and print media. Understanding and responding to the unique challenges of certain people and sub-groups within your audience will help to ensure your project is inclusive. People never live their lives in isolation from their environment and the influence of other people. A woman motivated to get active may be prevented from exercising because of a fear of being bitten by dogs on her street, the judgment of others, commitments at work and at home, or because of a lack of safe footpaths in her area. Some of these factors may have been revealed when you sought to understand a range of possible audiences. Now it's time to look more closely at what influences behaviour. Consider some of the following factors: • Political (laws, policies, regulations, taxes) • Social (family, technology, education, inequalities, employment, crime, media) • Cultural (norms, practices, obligations) • Personal (knowledge, beliefs, attitudes, confidence) • Physical (infrastructure, facilities, location, transport, safety, weather) Again, draw upon a mix of secondary and primary research to guide your investigation and add your findings to your notes. TIP To access a free how-to-guide on situational analysis, Google "health compass, how-to-guide, situational analysis" or visit: www.thehealthcompass.org TIP To access a free how-to-guide on audience analysis, Google "health compass, howto-guide, audience analysis" or visit: www.thehealthcompass.org At this stage, it's unlikely you will know exactly who you want to target. Not to worry; this step is simply about exploring various possible audiences. Narrowing down on a particular audience will come later. 20 It's worth keeping in mind that social marketing is effective not only in influencing the behaviours of individuals but also in changing policies, mobilising community debate and action, and addressing structural barriers in the community. So remember to identify strategies and approaches that look beyond the individual level that you can integrate into your initiative. 21 4 Step 4: Work with others No single person or organisation has all of the skills and knowledge to plan, develop, and deliver social marketing materials. In fact, by now you might have met some people with whom you can discuss your research and guide your planning, or at least been exposed to the work of others through secondary research. Through learning from the experiences, knowledge, and skills of others and inviting relevant people and organisations to collaborate, your project will become more productive, efficient, and effective. A common risk of not consulting with others is that your strategies and communication materials may duplicate or conflict with existing projects. Not only does this waste time, funding, and resources, it may confuse and overwhelm your target audience, leading them to turn away altogether. Not consulting with others may also mean you miss opportunities to build upon past achievements and to collaborate with other organisations doing great work. A social marketing strategy to promote bicycle riding, for example, will be more effective if it works with the local council to construct bike paths, with commercial retailers to import affordable bikes into the community, and with bicycle clubs to provide insight into your target audience and to organise community events to support the campaign. These people and organisations are known as your 'stakeholders', and by working closely with them throughout your project, your chances of reaching your goals with your available funding and resources are greatly improved. To clarify who your stakeholders are, consider the following: • Who knows most about your audience, their behaviours, and what influences them? • Who is involved, or has been involved, in similar initiatives and can share their lessons-learnt or perhaps collaborate with you to build on their achievements? • Whose skills, support and approval do you need to make the project successful? • What other individuals or organisations (including private sector companies) currently have an influence on the behaviours of your audience, either positively or in competition with your objectives? • Which representatives from minority or disadvantaged groups can you consult to ensure your materials reflect their needs? 22 Adapting materials in low-resource settings Partnering to reach children with disabilities through football Close to zero staff, few training opportunities, poor and outdated equipment, uncompromising deadlines, and little funding can make the task of developing campaign materials seem impossible. Fortunately, however, starting from scratch is rarely necessary if you can find campaign materials (posters, animations, TV spots, scripts) produced elsewhere that can be adapted to your local setting. Just Play was launched in 2011 across the islands of Fiji to promote physical activity through football among primary school children. Just Play, designed and implemented by Oceania Football Confederation, aimed to not only address issues relating to NCDs, poor nutrition, and gender equity, but also stigma and discrimination affecting children with disability. Start by identifying social marketing initiatives throughout the world or in your region that are relevant to the behaviours you are focusing on. Rank each project according to their impact and the ease in which their materials can be adapted to your local context by translating text, adding images of local people and settings, and adjusting other details to make them more suitable to your campaign objectives. You should always contact those involved in developing the original materials to request their permission for a local adaption. Most of the time you will find these people and organisations more than willing to lend their knowledge, resources, and skills to ensure your adaption is a success. In fact, some organisations actively seek to make this process of adapting successful campaigns in other countries as easy and affordable as possible, such as World Lung Foundation’s Mass Media Resource for tobacco control campaigns (http://www. worldlungfoundation.org) The Just Play team recognised the need to partner with a range of local, regional, and international stakeholders that specialised in disability and that could advise and support their efforts to make football more inclusive to all children. The team reached out to special schools around Fiji and worked closely with the Fiji Paralympic Committee to ensure their sporting activities were tailored to the needs of children with disability and that volunteers were trained in modifying sports. These partnerships also allowed Just Play to develop strategic campaigns that addressed negative perceptions towards people with disability in the wider community. Funding and technical support was provided by the Australian Sports Outreach Program, UNICEF Pacific, Oceania Football Confederation, and a range of local sporting clubs and associations to ensure adequate training, equipment and resources were provided to those implementing the campaign on the ground. Through partnering up with local, regional and international stakeholders, the Just Play team designed and implemented a variety of fun and effective ways to include children with disability in football activities and to reduce stigma and discrimination in the community. Create a list of your stakeholders, including experts, department heads, community organisations, service providers, community leaders, media outlets, private sector companies, minority representatives, and donors. Take note of their relevance to the project, and consult with them regularly at every stage of your project. It's also a good idea to revisit your previous steps with your stakeholders to review, revise, and expand upon your existing research. 23 5 Step 5: Choose who to target By now you may have a rough idea of who your audience might be. Of course, people within any population can differ enormously according to their age, gender, ethnicity, location, income, education, abilities, experiences, attitudes, and beliefs. Also recall that certain groups of people are located at different stages of readiness for behaviour change, from 'Don't Know, Don't Care' to 'Concerned and Motivated', and from 'Committed and Planning' to 'Maintaining Change'. While it's tempting to reach as many people as possible, communicating the same message to everyone regardless of their differences and hoping for the same result will likely fail. Research tells us that targeting specific segments of the population with materials tailored to their unique needs, motivations, and experiences will have the greatest impact. Guided by your research so far, and also the insights of your stakeholders, consider different segments and choose who you will target. The TARPARE method can guide this process of prioritising different audience segments for your initiative: T: What is the total number of people that can be targeted? AR: What proportion of the segment is considered at-risk? P: To what extent can the segment be persuaded? A: Can the segment be easily accessed? R: What resources are needed to reach the segment? E: Has equity been considered to ensure minority groups or the disadvantaged are reached? These questions will allow you to consider various audience segments that might be more or less likely to change their behaviours following your investment of resources. Let's say, for example, you decide to focus on five factors: gender, location, age, current level of physical activity, and commitment to being more active. You might consider the following segments: • Gender: Male/Female • Location: Urban (Good access to services)/ Rural (Poor access to services) • Age: 18-24/25-34/35-44/45+ • Current level of physical activity: Less than 150min a week (Low) / 150-300min a week (Medium) / More than 300min a week (High) • Commitment to being more active: Don't Know, Don't Care (Low) / Concerned and Motivated (Medium) / Committed and Planning (High) • Guided by the TARPARE method, you might decide to target: • Males living in urban areas aged 25-34, active less than 150min a week, concerned about their health and motivated to be more physically active; or • Females living in rural areas aged 18-24, active less than 150min a week, committed and planning to increase their physical activity. 24 Targeting at-risk women through netball in Tonga Kau Mai Tonga: Netipolo (Come on Tonga, Let’s Play Netball!) was launched in 2012 to provide fun, social and easy opportunities for women to reduce their risk of developing NCDs through sport. Adult women were selected as the target audience following research and careful strategic planning by a team from the Australian and Tongan governments, as well as various partner organisations in the Tongan community. Through their secondary research, the team learned that obesity affected more women than men in Tonga, with about 75 per cent being obese compared to 56 per cent of men. They also found that Tongan women were much less active than men, with the vast majority failing to meet the recommended 150 minutes a physical activity a week. Based on this research, the team identified a segment of the female population that could be considered at high risk of developing NCDs. To learn more about this audience segment and the issues they faced, the team conducted primary research to listen to what women had to say themselves. Through these discussions, the team learned that local women faced a number of cultural, social, and financial barriers to being active. Many, for example, commented that sporting activities in the community were often tailored for and dominated by men. Others talked of the lack of sporting events and facilities in their villages, competing demands at home, and embarrassment relating to exercising in public. The good news, however, was that the vast majority of the women the team spoke with were highly motivated to be more active if fun, social, and affordable opportunities were made available in their community. Following their research and discussions with local women, the team identified their target audience as adult women at risk of developing NCDs motivated and looking for opportunities to be more physically active. Mass media campaigning with posters, brochures, TV and radio materials were used to create excitement about being active through sport among target audiences. This created additional demand for free netball activities that were being run by the Tonga Netball Association in villages. The availability of these netball activities ensured the desired behaviour change was supported. Guided by the TARPARE method, you might decide to target: • Males living in urban areas aged 25-34, active less than 150min a week, concerned about their health and motivated to be more physically active; or • Females living in rural areas aged 18-24, active less than 150min a week, committed and planning to increase their physical activity. TIP To access a free how-to-guide on audience segmentation Google “Health Compass, how-to-guide, audience segmentation” or visit www.thehealthcompass.org Now that you have selected your target audience, you can tailor your materials to their specific needs, experiences, motivations, and barriers. It's a good idea to revisit Steps 1–4 to conduct more specific research into your segmented target audience and to invite other relevant stakeholders to be involved. 25 6 7 Step 6: Outline your behavioural goals Step 7: Choose your communication channels It's time to figure out exactly what you want to achieve by listing some specific behavioural goals. Without these goals, your project will quickly lose focus and your materials and strategies are unlikely to be effective. When developing behavioural goals make sure they are SMART, that is: • Specific to your target audience and their setting • Measurable against key indicators of progress and impact • Appropriate to your target audience and the local setting • Realistic given your funding, resources, skills, and timeframe • Time-bound, with a specific end-date for the project set It's likely your target audience receives and engages with information in a number of ways. Also keep in mind that many people do not have access to certain communication channels because it is not affordable, they live in remote locations, they do not have the necessary skills or language, or because they live with a disability. For this reason, using a range of communication channels will greatly enhance the reach and impact of your campaign. Here are some channels you may want to consider: Your SMART goals may look something like the following: • Increase the percentage of men in rural areas aged 25-34 doing at least 150min of physical activity a week from 15% to 25% by March 2018; or • Increase the percentage of female adolescents 12–17 years of age in urban areas doing at least 300min of physical activity a week from 30% to 45% by November 2017. Of course, you will need to consider how you are going to know whether or not you have been successful in reaching your goals. More on this in Step 9. 26 Don't rush it Pressure from stakeholders, enthusiasm among staff, and advice from experts can lead to a situation in which people feel impatient to 'do something' as soon as possible. In this environment, the previous steps can be rushed or bypassed altogether. This typically leads to poor quality, illresearched, and ineffective strategies and materials that will only confuse and mislead your audience and waste everyone's time and money. If you find yourself in this situation, discuss your concerns with your team and stakeholders to clarify what needs to be adjusted before the project can progress. Make sure all those involved in your project are aware of how long the development of a good social marketing approach will take, and what steps you will follow to ensure your work is effective. Ensuring good communication regarding project timeframes can help avoid missed deadlines and frustrated program partners. • Television • Radio • Brochures and posters • Billboards and banners • Car and bus stickers • Newspaper advertisements • Press releases • Newsletters • Online (websites, YouTube, Facebook, Twitter, Instagram) When choosing your channels, ask the following: • To what extent is each • What are the advantages channel appropriate, and disadvantages of relevant, accessible, and each channel? affordable to your target audience, including minority and disadvantaged groups? • Telephone calls and mobile phone messaging • Loudspeakers • Face-to-face communication • How can multiple channels be used to complement one another? Are your materials appropriate, accessible, and inclusive? It's important that your materials reach a range of audiences regardless of their age, gender, sexuality, location, ethnicity or language. You also need to consider if the materials you produce are accessible to people with disabilities. Developing partnerships with representatives from minority, disadvantaged, or disabled people's organisations from the outset will put you in contact with people who can guide you in this process. It may be suggested, for example, that you use multiple communication channels, translate content into other languages, use large and simple fonts, include visual prompts to complement written content, or add subtitles to TV programs. Each of these adjustments will ensure your materials are more appropriate and accessible to all members of your target audience. Equally important will be to ensure your materials feature positive representations of people with a range of identities, backgrounds, and abilities to ensure all audience members feel invited and welcome to participate in your initiative. To access a step-by-step guide to improving the accessibility of your materials, Google "Federation of Disability Sport, access for all, inclusive communications" or visit: www.ausport.gov.au/participating/disability or www.playbytherules.net.au/ 8 Step 8: Develop strategies and communication messages We can make this step a little easier by dividing it into two parts: (1) developing social marketing strategies and (2) developing communication messages. When developing social marketing strategies, begin by asking: • Why is the target audience not currently adopting a certain healthy behaviour? • How can I work with my stakeholders to reduce barriers affecting this behaviour to make it easier and more appealing? • How can I increase the capacity of my audience to adopt this healthy behaviour? • What changes to the environment are needed to motivate and support this behaviour? • What lessons can I learn from previous initiatives that share my behavioural goals? Through asking these questions you might decide to include a low-impact sport in your campaign to address concerns among older women of being injured. Or you may work with village leaders to ensure sports grounds are kept clean and mowed so people motivated to get active can use them. Or maybe you have learned from organisers of a past initiative that running an aerobics session early in the morning rather than in the mid-day sun will increase participation. Considering these issues and making the necessary adjustments means you are thinking and acting strategically, greatly increasing the effectiveness of your project. Now that you've made progress with your social marketing strategy, you can turn to your communication messages. If you had just a few seconds with your target audience, your communication messages are what you would share with them. In just a few words, they must grab the attention of your audience and tell them exactly what they should do and why. Often messages will consist of a short and memorable catch-phrase and, if necessary, a slightly longer sub-phase that directs your audience to a specific action. • Get active now! Be active at least 30 minutes a day five times a week to stay healthy. • Get Healthy, Get Happy! Sign-up to our free badminton club and have fun while getting healthy. • Move for life! It's never too late to get healthy, be active in whatever way you can. • NCDs are Killing us. Protect yourself against chronic diseases by being active at least 30 minutes a day five times a week. 28 Never forget your audience Each of those involved in funding, planning or implementing a social marketing campaign will have their own understandings, opinions, and experiences. Some might be particularly keen to be innovative or creative, while others may wish to borrow from other campaigns they like. However, if the experiences, needs and understandings of the target audience are not prioritised above all else, your materials will not be effective among the very people the campaign seeks to influence. Never forget your audience. Be highly selective when choosing your communication messages. Providing too many messages can overwhelm or confuse your target audience. Also remember to be very clear about what you are asking people to do. If your campaign is promoting more than one behaviour change, your audience may not know what to prioritise and decide to do nothing at all. Finally, you will need to tailor your messages to the specific characteristics, understanding, lifestyles, interests, needs, motivations, and barriers of your target audience. Think about some of the following questions: • What is the most important information to communicate? • What attitudes and behaviours need to be promoted and maintained? • What kind of messages will appeal most to your audience (rational, financial, family-focused, emotional, threatening, positive, comical)? • What specific actions are you seeking to trigger through these messages? • Can you foresee any negative reactions or confusion regarding your messages? • Are your messages short, clear, simple, specific, factual, appropriate, relevant, and accessible? By the end of this step you should have some strategies and messages ready to present to stakeholders for their feedback and to pre-test with target audiences. We'll get to this in Step 12. 29 9 10 Step 9: Plan how to track progress and measure impact Step 10: Prepare an action plan Whether you are printing 30 posters for a handful of community centres or launching a national mass media campaign using TV and radio that will reach thousands, you'll want to know whether your project is progressing according to plan and if you are reaching and positively influencing your target audience in line with your objectives. It's time to figure out how everything you have learned and planned so far can translate into meaningful action on the ground. Your action plan answers the question: How can I make this happen? Here are a few questions to get you started: • Who will need to be involved during each stage of the project? • When, how, and by whom will strategies be implemented and communication materials be developed and distributed? • How much funding is needed and where will it come from? • How will the campaign complement and build upon other strategies now and in the future? • Why is your strategy the most effective, appropriate, and affordable one? • Who will do the monitoring and evaluation? • What are the potential risks and barriers and how will they be addressed? You might think your project was a total failure because you only had enough funding to air your TV spots for three days when, in fact, it positively influenced the behaviours of thousands because it was uploaded and shared on YouTube and Facebook. Or perhaps you thought your poster campaign was a huge success but, in truth, it reached and affected few because the posters were left out in the rain and ruined. You'll never know what happened and what needs to change in the future unless you track your progress and measure impact. And don't forget those funding your work typically expect to see results. A monitoring and evaluation plan is an important part of any project, and will help you measure and demonstrate the success of your work. Periodic independent evaluations are also very useful, and an important part of a strong monitoring and evaluation approach. TIP: For smaller projects, a monitoring and evaluation plan can be developed and implemented in-house with a bit of planning. To access a user-friendly guide to track your progress and measure impact, Google "step by step guide, M&E plan, evaluation toolbox" or visit http://evaluationtoolbox.net.au For sports organisations trying to measure the success of health promotion efforts, a suggested monitoring approach is attached to this guide, and can be found at https://secure.ausport.gov.au/clearinghouse/home. 30 By the end of this step, you should have a clear plan of action to create, implement, monitor and evaluate your campaign with your available funding, staff, resources, and timelines. Your action plan should be easily summarised and explained to stakeholders in the form of a short report, presentation, or verbal pitch. You will need their approval before you move onto the next phase. If you fail to gain their support, revisit the previous steps and explore what needs to change before revising your action plan and seeking approval again. TIP: For a simple guide to writing and implementing an action plan, Google “Ctb, ku, develop action plans” or visit: http://ctb.ku.edu And to access a guide to assist with learning the basics of budgeting, Google “C-hub online, budgeting basics” or visit www.c-hubonline.org 31 11 12 Step 11: Create materials With all of the work you have done so far, it's amazing to think that so many start at this step and ignore the rest. But your hard work will pay off considering you are now in an excellent position to develop strategies and materials that are well-researched, targeted, grounded in audience insight, supported by stakeholders, and linked with other strategies being implemented. The primary goal of this step is to draw upon everything you have come to learn so far to develop strategies that support and motivate the behaviour you are promoting and to create materials (branding, posters, brochures, TV and radio spots, billboards, websites, social media pages) that are: • Attractive to grab the attention of your audience and keep them engaged. • Comprehensible enough to be easily understood and remembered. • Accurate, based on well-researched evidence and expert advice. • Persuasive in motivating and supporting positive behaviours. • Appropriate to the local context and the issues being addressed. • Targeted to the unique needs of your audience, promoting personal identification. • Accessible to all people within your target audience regardless of their minority status, disabilities, or disadvantages. Again, for large-scale campaigns it's likely you will need to seek assistance from professional graphic designers, filmmakers, or web developers. This will require you to write a creative brief to ensure all of the research and strategy development you have done so far guides the materials they produce. TIP: To access a free how-to-guide on writing a creative brief, Google “Health compass, how-to-guide, creative brief” or visit www.thehealthcompass.org If you are implementing a smaller campaign and wish to develop your own materials on a shoestring budget, you can find a list of websites that contain case studies, tutorials, how-to-guides, and tool-kits at the end of this guide. 32 Step 12: Seek feedback, pre-test and adjust Audience before creativity Making adjustments to materials can often be difficult if you disagree with the views and opinions of your stakeholders or the target audience. While it might be tough, be prepared to let go of some elements of the project that, while creative, clever and seemingly important, are not supported by insight into what will move and motivate your audience most effectively. It's time to invite your stakeholders and some members of your target audience to provide their feedback on your work so far. This will allow you to select the best strategies, materials, and messages among various options and to make necessary adjustments to ensure they have the greatest impact. When seeking feedback from stakeholders, present your strategies, materials, and messages without expressing your own opinion and encourage an open discussion against the benchmark criteria of being attractive, comprehensible, accurate, persuasive, appropriate, targeted, and accessible. It's also a good time for experts to double-check the accuracy and appropriateness of your content and for representatives from minority groups and disabled people's organisations to advise if any further changes are needed to make your strategies and materials more accessible. Pre-testing involves presenting your messages and materials to members of your target audience to check that your assumptions are appropriate and if changes are required to increase their impact. This is a very critical stage in the development of communication materials. Health experts have the technical knowledge to confidently write content that is scientifically accurate and to provide recommendations for actions based on this evidence. However it is only through pretesting that you can understand how your target audience reacts to your materials, what messages are actually being communicated to them, and if your strategy is likely to influence their behaviour. TIP: Pre-testing for large-scale campaigns will need to be conducted by an independent and professional research team. For smaller campaigns, however, pre-testing can be conducted in-house. Google “health compass, how-to-guide, pre-testing” or visit the following website to access a user-friendly guide to conducting pre-testing sessions: www.thehealthcompass.org After summarising and analysing stakeholder feedback and pre-testing results, make the necessary adjustments to your strategies and select the final set of communication materials to be distributed to your target audience. Once the final changes have been made, seek approval from senior management and, if appropriate an ethics committee, to commence implementing your strategies and delivering your materials to your target audience according to your action plan. 33 13 Step 13: Deliver and monitor Your strategies and communication materials are now reaching your target audience and, you hope, having a positive influence on their behaviour. But before you can figure out whether or not your campaign is having an impact, you need to ensure everything is progressing according to plan. Consider the following: • Is the delivery of materials on time and within budget? • Are staff, stakeholders and partners fulfilling their responsibilities according to the action plan? • Are strategies being implemented as planned? • How effectively are communication materials reaching the target audience, how frequently are they being exposed to campaign messages, and what is the quality of delivered materials? • Have any challenges or opportunities arisen? • What feedback are you receiving from audience members and stakeholders? • Are the needs of the target audience changing? Through monitoring the delivery of materials and strategies you can identify issues and address them as they arise. Let's say, for example, your radio spots are only being run once a day instead of the planned three times a day. You'll need to call the radio station to remind them to stick to the agreed-upon broadcast schedule. Or perhaps the sports hall in which an event you have promoted through posters is being held has been double-booked. You'll need to work with your stakeholders to find an alternative venue and to inform your audience of the change. Monitoring your progress will also allow you to take advantage of opportunities. You might learn, for example, that your campaign has triggered much discussion and sharing on Facebook. In response, you can increase your Facebook posts to further boost interest and engagement. Or perhaps journalists have requested more information about the campaign and are asking for people to interview. Responding to these opportunities as they arise will greatly enhance the reach and impact of your campaign. 14 Step 14: Measure impact and make adjustments You have reached the final stage in which, having implemented your strategies and delivered your communication materials according to your action plan, you learn whether what you did had an impact. Regardless of whether you contracted a professional research team or carried out your own evaluation, you will want answers to the following questions: • What has your project achieved or not achieved? • To what extent were your behavioural goals met? • What worked or didn't work, and why? • Were there any unintended impacts of the project? • What lessons can be passed onto others doing similar work? • What adjustments need to be made to increase the impact of future initiatives? It's vital that you communicate your findings to your stakeholders and the broader community, whether through face-to-face meetings, reports, conference presentations, journal articles, or press releases. Gaining feedback, both positive and negative, from others will clarify what adjustments need to be made for future initiatives. It will also allow you to pass lessons onto others who wish to build on your achievements. TIP: Facebook, YouTube, and Twitter all provide excellent, free, and user-friendly data packages to track the popularity and engagement of your campaign among your audiences. For guidance on using Social Media for health promotion, Google "CDC, health communication, social media toolkit" or visit: www.cdc.gov/healthcommunication 34 35 Social Change Online resources Social marketing in a low-resource setting can be challenging. Fortunately, a number of how-to-guides, toolkits, tutorials, and forums can be found online to assist you. Here are a few. Social marketing and health communication • The Health Compass: www.thehealthcompass.org • C-Hub Online: www.c-hubonline.org • John Hopkins Center for Communication Programs: http://ccp.jhu.edu/resources • The Big Pocket Guide to Using Social Marketing for Behaviour Change (National Social Marketing Center): http://www.thensmc.com/sites/default/files/Big_pocket_ guide_2011.pdf • Social Marketing Guide for Public Health Programme Managers and Practitioners (European Centre for Disease Prevention and Control): http://ecdc.europa.eu/en/ publications/Publications/social-marketing-guide-public-health.pdf Design • www.behance.com • www.pinterest.com • www.canva.com • https://designschool.canva.com Social media and online content • www.sm4good.com • www.cdc.gov/socialmedia • www.wix.com • www.squarespace.com Film and radio • www.nofilmschool.com • www.lynda.com • www.bbc.co.uk/academy/ production/radio Monitoring and evaluation • www.google.com/forms/about/ • www.surveymonkey.com • www.evaluationtoolbox.net.au Accessibility • www.adcet.edu.au/inclusive-teaching/working-withstudents/communication-tips/ • www.efds.co.uk/resources/case_studies/2697_ access_for_all_efds_inclusive_communications_guide 38 39 Resources and Guides provided by the Australian Sports Commission 40 • Research on the Barriers and Enablers to Physical Activity in the Pacific: https:// secure.ausport.gov.au/clearinghouse/Library/archive/digital_archive/asc_programs/ australian_sports_commission_programs_-_international/Research_on_the_Barriers_ and_Enablers_to_Physical_Activity_in_the_Pacific.docx • Social Marketing Style Guide for Tonga: https://secure.ausport.gov.au/clearinghouse/ Library/archive/digital_archive/asc_programs/australian_sports_commission_ programs_-_international/Social_Marketing_Style_Guides_for_Tonga.pdf • Social Marketing Style Guide for Samoa: https://secure.ausport.gov.au/clearinghouse/ Library/archive/digital_archive/asc_programs/australian_sports_commission_ programs_-_international/Social_Marketing_Style_Guide_for_Samoa.pdf • Social Marketing Style Guide for Fiji: https://secure.ausport.gov.au/clearinghouse/ Library/archive/digital_archive/asc_programs/australian_sports_commission_ programs_-_international/Social_Marketing_Style_Guide_for_Fiji.pdf • Social Marketing Style Guide for Nauru: https://secure.ausport.gov.au/clearinghouse/ Library/archive/digital_archive/asc_programs/australian_sports_commission_ programs_-_international/Social_Marketing_Style_Guide_for_Nauru.pdf • Monitoring and Evaluation Guide for Physical Activity Promotion in Sports: https:// secure.ausport.gov.au/clearinghouse/Library/archive/digital_archive/asc_programs/ australian_sports_commission_programs_-_international/Monitoring_and_ Evaluation_Guide_for_Physical_Activity_Promotion_in_Sports.docx 41 References Andreasen, A.R. (2006). Social marketing in the 21st century. Sage: Thousand Oaks, CA. Centers for Disease Control and Prevention (CDC). (2011). Social marketing made simple: A guide for creating effective social marketing plans. US department of Health and Humans Services, Centers for Disease Control and Prevention: Atlanta, GA. http://www.cdc.gov/healthcommunication/pdf/cdcynergylite.pdf European Centre for Disease Prevention and Control (ECDC). (2014). Social marketing guide for public health managers and practitioners. ECDC: Stockholm. http://ecdc. europa.eu/en/publications/Publications/social-marketing-guide-public-health.pdf French, J., Blair-Stevens, C., McVey, D. & Merritt, R. (2010). Social marketing and public health: Theory and practice. Oxford University Press: Oxford. Carroll T. (2000). Population health social marketing: A model for comprehensive social marketing campaign development. Commonwealth Department of Health and Community Services: Sydney, NSW. National Centre for Social Marketing. (2011). Big pocket guide to using social marketing for behaviour change. Department of Health and National Consumer Council: London. http://www.thensmc.com/sites/default/files/Big_pocket_guide_2011.pdf O’Sullivan, G.A., Yonkler, J.A., Morgan, W., & Merritt, A.P. (2003). A field guide to designing a health communication strategy. Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs: Baltimore, MD. http://ccp.jhu.edu/ documents/A%20Field%20Guide%20to%20Designing%20Health%20Comm%20 Strategy.pdf Sport for Development and Peace International Working Group (SDP IWG). (2008). ‘Sport and health: Preventing disease and promoting health’. In harnessing the power of sport for development and peace: Recommendations to governments. SDP IWG: Toronto. http://www.un.org/wcm/content/site/sport/home/unplayers/memberstates/ sdpiwg_keydocs World Health Organization & UNICEF. (2012). Communication for behavioural impact (COMBI): A toolkit for behavioural and social communication in outbreak response. World Health Organisation: Geneva. http://www.searo.who.int/entity/emerging_ diseases/ebola/atoolkit_for_behavioural_and_social_communicationin_outbreak_ response.pdf 42 Goals An initiative of the Australian Sports Commission The views in this publication are those of the author and not necessarily the Australian Government.