Social marketing

Social marketing

Social marketing has been one of the approaches that has carried forward the premises of diffusion of innovation and behavior change models. Since the 1970s, social marketing has been one of the most influential strategies in the field of development communication.

The origins of social marketing hark back to the intention of marketing to expand its disciplinary boundaries. It was clearly a product of specific political and academic developments in the United States that were later incorporated into development projects. Among various reasons, the emergence of social marketing responded to two main developments: the political climate in the late 1960s that put pressure on various disciplines to attend to social issues, and the emergence of nonprofit organizations that found marketing to be a useful tool (Elliott 1991). Social marketing was marketing's response to the need to be “socially relevant” and “socially responsible.” It was a reaction of marketing as both discipline and industry to be sensitive to social issues and to strive towards the social good. But it was also a way for marketing to provide intervention tools to organizations whose business was the promotion of social change.

Social marketing consisted of putting into practice standard techniques in commercial marketing to promote pro-social behavior. From marketing and advertising, it imported theories of consumer behavior into the development communication. The analysis of consumer behavior required to understand the complexities, conflicts and influences that create consumer needs and how needs can be met (Novelli 1990). Influences include environmental, individual, information processing, and decision-making. At the core of social marketing theory is the exchange model according to which individuals, groups and organizations exchange resources for perceived benefits of purchasing products. The aim of interventions is to create voluntary exchanges.

In terms of its place on the “family tree” of development communication, social marketing did not come out of either diffusion or participatory theories, the traditions that dominated the field in the early 1970s. Social marketing was imported from a discipline that until then had little to do with modernization or dependency theories, the then dominant approaches in development communication. Social marketing grew out of the disciplines of advertising and marketing in the United States. The central premise of these disciplines underlies social marketing strategies: the goal of an advertising/marketing campaign is to make the public aware about the existence, the price, and the benefits of specific products.

Social marketing's focus on behavior change, understanding of communication as persuasion (“transmission of information”), and top-down approach to instrument change suggested an affinity with modernization and diffusion of innovation theories. Similar to diffusion theory, it conceptually subscribed to a sequential model of behavior change in which individuals cognitively move from acquisition of knowledge to adjustment of attitudes toward behavior change. However, it was not a natural extension of studies in development communication.

What social marketing brought was a focus on using marketing techniques such as market segmentation and formative research to maximize the effectiveness of interventions. The use of techniques from commercial advertising and marketing to promote social/political goals in international issues was not new in the 1970s. Leading advertising agencies and public relations firms had already participated in support of U.S. international policies, most notably during the two wars in drumming up domestic approval and mobilization for war efforts. Such techniques, however, had not been used before to “sell” social programs and goals worldwide.

One of the standard definitions of social marketing states that “it is the design, implementation, and control of programs calculated to influence the acceptability of social ideas and involving consideration of product planning, pricing, communication, distribution, and marketing research” (Kotler and Zaltman 1971, 5). More recently, Andreasen (1994, 110) has defined it as “the adaptation of commercial marketing technologies to programs designed to influence the voluntary behavior of target audiences to improve their personal welfare and that of the society of which they are a part.” Others have defined it as the application of management and marketing technologies to pro-social and nonprofit programs (Meyer & Dearing 1996).

Social marketing suggested that the emphasis should be put not so much on getting ideas out or transforming attitudes but influencing behavior. For some of its best-known proponents, behavior change is social marketing's bottom line, the goal that sets it apart from education or propaganda. Unlike commercial marketing, which is not concerned with the social consequences of its actions, the social marketing model centers on communication campaigns designed to promote socially beneficial practices or products in a target group.

Social marketing's goal is to position a product such as condoms by giving information that could help fulfill, rather than create, uncovered demand. It intends to “reduce the psychological, social, economic and practical distance between the consumer and the behavior” (Wallack et al, 1993, 21). The goal would be to make condom-use affordable, available and attractive (Steson & David 1999). If couples of reproductive age do not want more children but do not use any contraceptive, the task of social marketing is to find out why and what information needs to be provided so they can make informed choices. This requires sorting out cultural beliefs that account for such behavior or for why people are unwilling to engage in certain health practices even when they are informed about their positive results. This knowledge is the baseline that allows a successful positioning of a product. A product needs to be positioned in the context of community beliefs.

In the United States, social marketing has been extensively applied in public information campaigns that targeted a diversity of problems such as smoking, alcoholism, seat-belt use, drug abuse, eating habits, venereal diseases, littering and protection of forests. The Stanford Three-Community Study of Heart Disease is frequently mentioned as one of the most fully documented applications of the use of marketing strategies. Designed and implemented as a strictly controlled experiment, it offered evidence that it is possible to change behavior through the use of marketing methodologies. The campaign included television spots, television programming, radio spots, newspaper advertisements and stories, billboard messages and direct mail. In one town the media campaign was supplemented by interpersonal communication with a random group of individuals at risk of acquiring heart disease. Comparing results among control and experimental communities, the research concluded that media could be a powerful inducer of change, especially when aligned with the interpersonal activities of community groups (Flora, Maccoby, and Farquhar 1989).

Social marketing has been used in developing countries in many interventions such as condom use, breast-feeding, and immunization programs. According to Chapman Walsh and associates (1993, 107-108), “early health applications of social marketing emerged as part of the international development efforts and were implemented in the third world during the 1960s and 1970s. Programs promoting immunization, family planning, various agricultural reforms, and nutrition were conducted in numerous countries in Africa, Asia and South America during the 1970s…The first nationwide contraceptive program social marketing program, the Nirodh condom project in India, began in 1967 with funding from the Ford Foundation.” The substantial increase in condom sales was attributed to the distribution and promotion of condoms at a subsidized price. The success of the Indian experience informed subsequent social marketing interventions such as the distribution of infant-weaning formula in public health clinics.

According to Fox (N.D.), “problems arose with the social marketing approach, however, over the motives of their sponsors, the effectiveness of their applications, and, ultimately, the validity of their results. The social marketing of powdered milk products, replacing or supplementing breastfeeding in the third world, provides an example of these problems. In the 1960's multinational firms selling infant formulas moved into the virgin markets of Asia, Africa and Latin America. Booklets, mass media, loudspeaker vans, and distribution through the medical profession were used in successful promotion campaigns to switch traditional breastfeeding to artificial products. Poor people, however, could not afford such products, and many mothers diluted the formula to make it last longer or were unable to properly sterilize the water or bottle. The promotion of breast milk substitutes often resulted in an erosion of breastfeeding and led to increases in diarrheal diseases and malnutrition, contributing to the high levels of infant mortality in the third world.”

Critics have lambasted social marketing for manipulating populations and being solely concerned with goals without regard for means. For much of its concerns about ethics, critics argue, social marketing subscribes to a utilitarian ethical model that prioritizes ends over means. In the name of achieving certain goals, social marketing justifies any methods. Like marketing, social marketing deceives and manipulates people into certain behaviors (Buchanan, Reddy & Hossain 1994).

Social marketers have responded by arguing that campaigns inform publics and that they use methods that are not intrinsically good or bad. Judgments should be contingent on what goals they are meant to serve, they argue. Moreover, the widely held belief that marketing has the ability to trick and make people do what otherwise they would not is misinformed and incorrect. The reluctance of people to tailor behavior to the recommendations of social marketing campaigns, and the fact that campaigns need to be adjusted to socio-cultural contexts and morals are evidence that social marketing lacks the much-attributed power of manipulating audiences. If a product goes against traditional beliefs and behavior, campaigns are likely to fail.

Social marketing needs to be consumer oriented, and knowledgeable of the belief systems and the communication channels used in a community (Maibach 1993). Products need to be marketed according to the preferences and habits of customers. Market research is necessary because it provides development specialists with tools to know consumers better and, therefore, to prevent potential problems and pitfalls in behavior change. This is precisely marketing's main contribution: systematic, research-based information about consumers that is indispensable for the success of interventions. Marketing research techniques are valuable for finding out thoughts and attitudes about a given issue that help prevent possible failures and position a product.

For its advocates, one of the main strengths of social marketing is that it allows to position products and concepts in traditional belief systems. The inclination of many programs to forgo in-depth research of targeted populations for funding or time considerations, social marketers suggest, reflects the lack of understanding about the need to have basic research to plan, execute and evaluate interventions. They argue that social marketing cannot manipulate populations by positioning a product with false appeals to local beliefs and practices. If the desired behavior is not present in the local population, social marketing cannot deceive by wrapping the product with existing beliefs. When a product is intended to have effects that are not present in the target population, social marketers cannot provide false information that may resonate with local belief systems but, instead, need to provide truthful information about its consequences. For example, if “dehydration” does not exist as a health concept in the community, it would be ethically wrong for social marketing to position a dehydration product by falsely appealing to existing health beliefs in order to sell it. That would be deceptive and manipulative and is sure to backfire. The goal should be long-term health benefits rather than the short-term goals of a given campaign (Kotler and Roberto 1989).

Theorists and practitioners identified with participatory communication have been strong critics of social marketing. For them, social marketing is a non-participatory strategy because it treats most people as consumers rather than protagonists. Because it borrows techniques from Western advertising, it shares it premises, namely, a concern with selling products rather than participation. To critics, social marketing is concerned with individuals, not with groups or organizations. They also view social marketing as an approach that intends to persuade people to engage in certain behaviors that have already decided by agencies and planners. It does not involve communities in deciding problems and courses of action. The goal should be, instead, to assist populations in changing their actions based on critical analysis of social reality (Beltrán 1976, Diaz-Bordenave 1976). According to participatory approaches, change does not happen when communities are not actively engaged in development projects and lack a sense of ownership.

Social marketers have brushed aside these criticisms, emphasizing that social marketing is a two-way process and that it is genuinely concerned about community participation. As Novelli (1990, 349) puts it, “the marketing process is circular.” This is why input from targeted communities, gathered through qualitative methods such as focus groups and in-depth interviews, is fundamental to design campaign activities and content. Social marketing is premised on the idea of mutual exchange between agencies and communities. Marketing takes a consumer orientation by assuming that the success of any intervention results from an accurate evaluation of perceptions, needs, and wants of target markets that inform the design, communication, pricing, and delivery of appropriate offerings. The process is consumer-driven, not expert-driven.

Also, social marketing allows communities to participate by acting upon health, environmental and other problems. Without information, there is no participation and this is what social marketing offers. Such participation is voluntary: Individuals, groups, and organizations are not forced to participate but are offered the opportunity to gain certain benefits. Such explanation is not satisfactory to participatory communication advocates who respond that social marketing does not truly involve participation. More than a narrow conception of participation, they argue, social marketing offers the appearance of it to improve interventions that are centralized. Social marketing's conception of participation basically conceives campaigns' targets are “passive receivers,” subjects from whom information is obtained to change products and concepts.

After three decades of research and interventions, the lessons of social marketing can be summarized as follows (Chapman Walsh et al 1993):

Persistence and a long-term perspective are essential. Only programs with sustainable support and commitment have proven to have impact on diffusion of new ideas and practices, particularly in cases of complex behavior patterns.

Segmentation of the audience is central. Some researchers have identified different lifestyle clusters that allow a better identification of different market niches.

Mapping target groups is necessary. Designers of interventions need to know where potential consumers live, their routines, and relations vis-à-vis multiple messages.

Incentives foster motivation among all participants in interventions.

The teaching of skills is crucial to support behavior change.

Leadership support is essential for program success.

Community participation builds local awareness and ownership. Integrating support from different stakeholders sets apart social marketing from commercial advertising as it aims to be integrated with community initiatives.

Feedback makes it possible to improve and refine programs.Health promotion and health education

The trajectory of health promotion in development communication resembles the move of social marketing and diffusion of innovation, from originally gaining influence in the United States to being introduced in interventions in developing countries. The same approaches that were used to battle chronic diseases, high-fat diets, and smoking in the United States in the 1970s and 1980s, were adopted in development interventions such as child survival and other programs that aimed to remedy health problems in the Third World.

As it crystallized in the Lalonde report in Canada in 1974 and the U.S. Surgeon General's 1979 Healthy People report, health promotion was dominated by the view that individual behavior was largely responsible for health problems and, consequently, interventions should focus on changing behavior. It approached health in terms of disease problems (rather than health generally), namely, the existence of lifestyle behaviors (smoking, heavy drinking, poor diet) that had damaging consequences for individual, and by extension, social health (Terris 1992).

The prevalent view was that changes in personal behaviors were needed to have a healthier population. Although the idea that institutional changes were also necessary to achieve that goal made strides, health promotion remained focused on personal change at the expense of community actions and responsibility. A substantial number of studies were offered as conclusive evidence that personal choices determined changes in health behavior, and were positively related with new developments that indicated the decrease of unhealthy practices.

This highly individualistic perspective was initially criticized in the context of developed countries for “blaming the victim” and ignoring social conditions that facilitated and encouraged unhealthy behaviors. It gave a free ride to larger social and political processes that were responsible for disease and essentially depoliticized the question of health behavior. To its critics, individual-centered health promotion ignores the surrounding social context (poverty, racism) in which individual health behaviors take place as well as the fact that certain unhealthy behaviors are more likely to be found among certain groups (Minkler 1999, Wallack and Montgomery 1992). They pointed out that the overall context needed to be considered both as responsible and as the possible target of change.

Recent understandings of health promotion such as the one promoted by the World Health Organization have moved away from individualistic views by stressing the idea that individual and social actions need to be integrated. The goal of health promotion is to provide and maintain conditions that make it possible for people to make healthy choices.

Health education is an important component of health promotion. It refers to learning experiences to facilitate individual adoption of healthy behaviors (Glanz, Lewis & Rimer 1990). The evolution of health education somewhat mirrored the evolution of the field of development communication. Health education was initially dominated by conventional educational approaches that, like modernization/diffusion models, were influenced by individual behaviorist models that emphasized knowledge transmission and acquisition as well as changes in knowledge, attitudes and beliefs. Later, theories and strategies that stressed the importance of social and environmental changes gained relevance. This meant that both health education and health promotion became more broadly understood. Health education includes different kinds of interventions such as conventional education, social marketing, health communication, and empowerment actions (Steston & Davis 1999). Consequently, a vast range of activities such as peer education, training of health workers, community mobilization, and social marketing are considered examples of health education interventions.

Health promotion became no longer understood as limited to educational efforts and individual changes. It also includes the promotion of public policies that are responsible for shaping a healthy environment. The goal of health promotion is to facilitate the environmental conditions to support healthy behaviors. Individual knowledge, as conceived in traditional approaches, is insufficient if groups lack basic systems that facilitate the adoption of healthy practices. The mobilization of a diversity of social forces including families and communities is necessary to shape a healthy environment (Bracht 1990, Rutten 1995).

The emphasis on social mobilization to improve general conditions does not mean that behavior change models are absent in health promotion but, rather, that they need to be integrated among other strategies. Still, the behavior change model has incorporated the idea that interventions need to be sensitive to the education and the choices of receivers (Valente, Paredes & Poppe 1998), understanding the interests at stake, using social marketing technique to know individuals better, and the role of the community in interventions.

keywords: change theories

social change