1. Social Marketing: The 4 P’s and their application to breastfeeding campaigns

2. Tutorial Breakdown Brief history of Social Marketing Themes, features, and applications of Social Marketing Cultural Norms and Social Marketing 4 P’s (Marketing Mix) Case Studies National WIC Breastfeeding Promotion Plan Loving Support Campaign Be A Star Campaign

3. Learning Objectives To understand the key themes of social marketing and the potential applications of social marketing techniques within the field of public health. To analyze the “Marketing Mix” and understand the importance of integrating product, price, place, and promotion in order to maximize campaign effectiveness. To evaluate examples of successful breastfeeding campaigns in order to examine the application of the 4 P’s and necessary components of a social marketing campaign.

5. Social Marketing Key Themes Research and Evaluation are the key components The primary focus is on the consumer For social marketing to be an effective strategy, it is critical to learn what people want or need rather than persuading individuals to buy a good Marketing talks TO the consumer, not about the product

6. Essential Features It is a distinct discipline within the field of marketing It is for the good of society as well as the target audience It relies on the principles and techniques developed by commercial marketing

7. Applications Social marketers typically attempt to encourage their target audience to partake in four types of behavior change Accept a new behavior (e.g., Breastfeeding) Reject a potentially undesirable behavior (e.g., Smoking) Modify a current behavior (e.g., Increased Exercise) Abandon an undesirable behavior (e.g., Drinking and Driving) 4 Major areas where social marketing techniques are utilized: Health Promotion, Injury Prevention, Environmental Protection, and Community Mobilization

8. Social Marketing approaches to influence behavior… Downstream Approach or horizontal perspective- addresses barriers/benefits on the individual level Midstream Approach-attempts to reach individuals who have the ability to influence others in the target community including family members, co-workers, friends and neighbors Upstream Approach- attempts to alter policies, regulations, and laws to influence societal behavior change

9. Cultural Norms and Social Marketing Social Marketing Campaigns are affected by social, cultural, and regulatory environments Campaigns must take these factors into account in order to maximize effectiveness Formative research (e.g., focus groups, surveys, interviews, etc.) is a necessary component of designing a social marketing campaign

10. Taking into account social, cultural, and environmental norms… Examples: Anti-hepatitis B campaign in China Anti-HIV/AIDS Case study in Mexico Anti-Dengue Fever campaign in Singapore

11. 4 P’s of Social Marketing “The genus of modern marketing is not the 4 P’s, or audience research, or even exchange, but rather the management paradigm that studies, selects, balances, and manipulates the 4 P’s to achieve behavior change. We keep shortening the marketing mix to the 4 P’s…It is the mix that matters the most.” –Bill Smith, Academy for Educational Development 4 P’s- Product, Price, Place, Promotion Must be developed simultaneously or as a “mix” not as isolated strategies

12. PRODUCT Concrete physical products, services, practices, AND intangible ideas (most often the case in the field of public health) People must believe that there is a problem, and that the product being offered is a good solution to that problem

13. PRICE What the consumer must do in order to attain the social marketing product The price of a product an be monetary, involve time and effort, require the consumer to give something up, or involve discomfort or condemnation

14. PLACE This describes the way that the product reaches the consumer Intangible product: Important to make decisions about the best channels in which to reach consumers Channels can include doctors offices, mass media campaigns, shopping malls….etc.

15. PROMOTION The use of advertising, public relations, promotions, media advocacy, personal selling, and entertainment channels The focus is on generating and sustaining the demand for the product Promotion channels include television, internet, radio, posters, pamphlets, direct mail, DVD’s, billboards, newspapers, etc….

16. Additional “P’s” of Social Marketing Publics- External and Internal groups involved in the social marketing intervention Partnership-Collaboration with other community organizations in order to increase accessibility and demand Policy- Using media advocacy to encourage policy change Pursestrings- Where will you get the money for your program? Who are the stakeholders involved? What information do the stakeholders expect/require?

17. Social Marketing and Breastfeeding “Normalizing the concept” 4 P’s of marketing breastfeeding Product- Breastfeeding Price- emotional, psychological, physical, and social costs of breastfeeding Place- The best area/venue for a media campaign Promotion- how messages should be disseminated to cause change

18. Case Studies: Examples of effective social marketing campaigns that improved attitude and increased behavior surrounding appropriate breastfeeding practices

20. Secondary target audience: mothers, husbands, and boyfriends of pregnant women as well as WIC nutritionists, clerical staff, and prenatal care providers

23. National WIC Breastfeeding Promotion Project Place Focused on reaching the diverse environments in which mothers, their friends, and relatives obtain infant care information Targeted hospital environments and homes Promotion Variety of methods- legislative, policy, and organizational development, media and grassroots advocacy, professional training and education, peer counselor programs, and direct advertising. Developed a campaign message that used emotional appeal, conveyed a positive, congratulatory tone, and was communicated through family spokespersons.

25. Breastfeeding rates at 6 months went from 20.4% to 32.2% after a year of the programs operation.http://www.social-marketing.org/success/cs-nationalwic.html

26. “Loving Support Campaign” Important aspect of the National WIC Breastfeeding Promotion Campaign was a strong focus on encouraging support for breastfeeding from family members, spouses, and friends Support from the pregnant woman's mother increased from 35.2 percent to 53 percent. Support from the pregnant woman's husband or boyfriend increased from 47.7 percent to 53 percent. Support from the pregnant woman's friends or other relatives increased from 48.8 percent to 51.1 percent. Support from the pregnant woman's prenatal health care provider increased from 62.4 percent to 83.8% and from WIC employees from 81.9 percent to 92.5 percent.

27. Be A Star Campaign Target population: Young moms throughout Central Lancashire, England Formative research revealed that decisions on breastfeeding were strongly influenced by the attitudes and opinions of peers and family members. Campaign focuses on key influencers in the mom’s lives including their parents, their partners, their friends, and their baby. Objectives: 1. Improve peer support for expecting young moms 2. Improve understanding and acceptance of breastfeeding within the community. 3. Improve association between positive values(pride, confidence, and beauty) and breastfeeding practices

28. Product: Breastfeeding Price: Costs were identified as negative attitudes and opinions of peers/family members on breastfeeding, lack of support, and lack of understanding Place: Doctors offices, libraries, hospitals, and Sure Start Centers Targeted buses, shopping centers, and other locations where research indicated young moms spent time

29. Promotion: Leaflets - Hints, tips and advice about breastfeeding The Be A Star Blog-Featuring news articles, advice about breastfeeding, and local support information Local radio and outdoor advertising- In key areas such as in shopping centers or inside buses Newspapers for Dads- Designed specifically for the partners of the target audience Community engagement pack- Developed to encourage local retailers, cafe’s, and community venues to become breastfeeding friendly

31. Campaign promotion has spread from 1 primary care trust (local organization providing primary care services) to 15 primary care trusts throughout England

32. Has improved breastfeeding rates nationwidehttp://www.beastar.org.uk/archives/46#more-46

33. Conclusions A key element of social marketing is integration of product, price, place, and promotion and these four components are critical to consider when designing a social marketing campaign. Formative research in order to understand social, cultural, and environmental norms of the target audience is imperative when designing a social marketing campaign to alter behavior. “Normalizing the concept” of breastfeeding is vital in order to improve perceptions of and behaviors surrounding breastfeeding practices

34. References Andreason, A. R. (1995). Marketing Social Change: Changing behavior to promote health, social development, and the environment. San Francisco, CA: Jossey-Bass. Bartick, M. (2006). Breastfeeding is normal: An urban breastfeeding advertising campaign inspired by the tobacco industry. Paper presented at the APHA 13th Annual Meeting and Exposition, Boston, MA. Beasley, A., & Amir, L. H. (2007). Infant feeding, poverty and human development. International Breastfeeding Journal, 2, 14. Center for Disease Control (CDC). (2000). Media and Social Marketing. The CDC Guide to Breastfeeding Interventions. Retrieved from http://www.cdc.gov/breastfeeding/pdf/BF_guide_6.pdf Cheng, H., Kotler, P., and Lee, N.R. (2009). Social Marketing for Public Health: An Introduction. Sudbury, MA: Jones and Bartlett Publishers. Evan, D. (2010). Social Media Marketing: The Next Generation of Business Engagement. Indianapolis, IN: Wiley Publishing, Inc.

35. References, cont. Hammon, B. (2008). Be A Star Campaign. Retrieved from http://www.beastar.org.uk/archives/46#more-46 Hausman, B. L. (2008). Women's liberation and the rhetoric of "choice" in infant feeding debates. International Breastfeeding Journal, 3, 10. Kotler, P., and Zaltman, G. (1971). Social Marketing: An approach to planned social change. Journal of Marketing, 35(3), 3-12. Kotler, P., and Levy, S.J. (1969). Broadening the Concept of Marketing. Journal of Marketing, 33(1), 10-15. Lindenberger, L. (2000). Success Stories: National WIC Breastfeeding Promotion Project, Social Marketing Institute. Retrieved from http://www.social-marketing.org/success/cs-nationalwic.html Mattson, M., & Basu, A. (2010). The message development tool: a case for effective operationalization of messaging in social marketing practice. Health Mark Q, 27(3), 275-290. Welford, H. (2008). Breastfeeding gets image overhaul, Society Guardian. Retrieved from http://www.guardian.co.uk/society/2008/apr/08/healthyoungpeople

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