Social marketing - Health Promotion

The writings of a sixteenth century French teenager may seem a stretch for a public health

readership, but Etienne de la Boetie's treatise on Voluntary Servitude explains why unjust

systems prevail and how they can be changed. They prevail, he shows, because we let

them (the losers always vastly outnumber the winners); and they change when we retract

our permission (as Ghandi demonstrated). These vital insights have inspired progress

down the centuries e the enlightenment philosophers, the French Revolution, Tolstoy, the

American civil rights movement as well as the Indian struggle against the British Empire. In

an era when widening inequalities have become all too apparent, and the harm this does to

the commonweal much better understood, this paper argues that La Boetie's analysis

retains all its power and can inspire a new vision for public health.

 

In conclusion, if the aim of corporate marketing is to

encourage obedience, to get us to do as the marketer says, that

of public health has to be more than simply saying ‘no, do as

we say’. It must be about enabling people to question current

assumptions, understand the manipulative power structures

these entail and withdraw their collaboration; about replacing

obedience, not with another form of obedience, but with

disobedience.

“We should be proud of Social Marketing for having promoted social good across all continents by overcoming the stigma that the word ‘Marketing’ carries with it” a strong sentiment by Giuseppe Fattori, Professor in Social Marketing at the University of Bologna.

Giuseppe shares his thoughts on the impact of social marketing during a time of change taking place in the world.

#socialmarketing #marketing

Marketing 4.0 is the sequel to our widely-recognized concept of Marketing 3.0, which calls for brands to touch the human spirit. Marketing 4.0 is based on intricate observation and analysis of the paradoxes in view of the digital technology boom. We explain how online meets offline, why style must be complemented with substance, and why Machine-to-Machine is incomplete without Human-to-Human.

Digital technology is increasingly moving at the heart of most modern businesses today. As OECD states, digital economy is fast percolating a wide range of industries, from bank­ing, energy and transportation to media and health. No wonder thus how often we hear of the word ‘dis­ruption’ in the context of business.

McKinsey has jotted down 12 major innova­tions capable of disrupting conventional businesses, including mobile internet, the internet of things (IoT), cloud tech, and 3D printing, among others. All these disruptive technologies are not ground-breaking; for some, their technology life­ cycles have spanned decades of R&D. But their real, tangible impact on businesses on a commer­cial scale has increased manifold in recent years, partly as a result of the influx of various supporting technologies.

Inevitably, disruptive tech is closely eyed by businesses world over, imploring companies to revisit their business models, adjust value propo­sitions for their products and services, and reform sales practices and marketing approaches. In the midst of all this, several innovation -related dilem­mas face businesses today. Let’s take mobile internet as an example. Handheld smartphone devices have brought about unparalleled connectivity and opened up numerous opportunities for marketers to reach out to their smarter customers. At the same time, the growing concern on smartphone addiction is alarming – a study by Przybylski and Weinstein of the University of Essex shows how mobile phones are increasingly hurting relationships.

As digital economy booms and smartphones become more ingrained in consumers’ lifestyles – deeply influencing their attitudes and behaviors – consumers will increasingly look for the perfect mix of tech that makes their lives easier, comple­ments their goals of self-actualization and nurtures a deeper sense of ‘doing good’. Marketers need to brace up for this transition and adaptation period in the run up to a fast-developing digital economy. They need novel marketing approaches, which would help them anticipate and leverage on these unprecedented disruptive innovations.

Abstract

Social marketing is a commonly used strategy in global health. Social marketing programmes may sell subsidized products through commercial sector outlets, distribute appropriately priced products, deliver health services through social franchises and promote behaviours not dependent upon a product or service. We aimed to review evidence of the effectiveness of social marketing in low- and middle-income countries, focusing on major areas of investment in global health: HIV, reproductive health, child survival, malaria and tuberculosis. We searched PubMed, PsycInfo and ProQuest, using search terms linking social marketing and health outcomes for studies published from 1995 to 2013. Eligible studies used experimental or quasi-experimental designs to measure outcomes of behavioural factors, health behaviours and/or health outcomes in each health area. Studies were analysed by effect estimates and for application of social marketing benchmark criteria. After reviewing 18 974 records, 125 studies met inclusion criteria. Across health areas, 81 studies reported on changes in behavioural factors, 97 studies reported on changes in behaviour and 42 studies reported on health outcomes. The greatest number of studies focused on HIV outcomes (n = 45) and took place in sub-Saharan Africa (n = 67). Most studies used quasi-experimental designs and reported mixed results. Child survival had proportionately the greatest number of studies using experimental designs, reporting health outcomes, and reporting positive, statistically significant results. Most programmes used a range of methods to promote behaviour change. Programmes with positive, statistically significant findings were more likely to apply audience insights and cost-benefit analyses to motivate behaviour change. Key evidence gaps were found in voluntary medical male circumcision and childhood pneumonia. Social marketing can influence health behaviours and health outcomes in global health; however evaluations assessing health outcomes remain comparatively limited. Global health investments are needed to (i) fill evidence gaps, (ii) strengthen evaluation rigour and (iii) expand effective social marketing approaches.

Why health inequalities are a concern for social marketing. Health inequalities are systemic and avoidable unjust differences in health and wellbeing between groups of people or communities. Health inequality in England is already acute: males and females living in the most deprived areas can expect to have 19 fewer years of good health, compared with the least deprived, which means that, for 25 million people living in the more deprived areas of England, healthy life expectancy is lower than the current state pension age. People who are worse off are also less likely to have the financial and social resources to improve things for themselves. By contrast, wealthier (and, often healthier) people are more likely to actively seek out and engage with health information. We therefore need to focus our marketing programmes, and target tightly, to ensure they reach where they are most needed. This is not just about income and social class, although these are powerful; health inequality is also affected by ethnic and racial disparities, sexuality, gender and geography. Health inequality is a gradient, which means that it is not only the most deprived who suffer inequality: all but the wealthiest are affected.

Hardly a tweet goes by these days without talking to some aspect of a wicked, sustainable or commons problem causing uproar and ripples around the world. Power has shifted to individuals armed with smart phones and global access. Activist groups, lobbyists, social enterprises and non-governmental organisations (NGOs) are plentiful, with increased ability through the internet and social media. By comparison, policy makers, governance entities and regulators are experiencing decreasing budgets and limited staffing resources. Whether it is climate change, obesity, conflict, or the impact of our purchasing decisions, our planet and societies face many intractable problems which involve and affect numerous people, groups and organizations with the same people, groups and organizations sharing some responsibility for action.Stakeholders and their engagement have never been more important in an increasingly interconnected world. Stakeholder engagement with problems that are ill defined, complex and dynamic in nature go beyond individual behavioural change for social value, societal welfare and transformation. Engagement is collaboration, empowerment and direct active participation through ALL stages of your social marketing work. It goes significantly beyond just asking stakeholders for their opinions. Stakeholders ‘framing’ the situation, stakeholders being ‘agents of change’ and ultimately, stakeholders ‘co-creating value’ are core to a healthier future for all of us.

The digital revolution has catalysed many changes in the way society functions, these range from instant news alerts to virtual reality gaming. The rise of technology has also boosted the healthcare industry in unimaginable ways. 70% of healthcare organizations worldwide will invest by 2018 in technology including apps, wearables, remote monitoring and virtual care. Earlier this month the FT reported that an app that identifies when a patient’s health is deteriorating by their log of symptoms and delivers a report, has helped to prolong the lives of cancer sufferers. This is by no means an isolated case, with medical technology improving exponentially.

Health technology may be improving in leaps and bounds but this is not without investment. Galen Growth has estimated that venture funding in healthtech start-ups was over $5B last year. In fact, in mid-June CNBC reported that FundRx and angelMD are connecting wealthy doctors with medical startups. The high level of investment in the industry appears to be paying off, with Deloitte’s report on digital heath in the UK stating that the global healthtech industry could be worth up to £43bn by 2018.

MAPPING THE COMMUNITY

We were very interested in seeing which individuals, brands and publications were leading the social media debate around health tech, so we analysed over 812K tweets mentioning the key words: HealthTech OR ((Health) AND (Tech OR Technology)) or “digital health” OR digitalhealth from Jan 1st – June 25th 2017. We then identified the Top 100 most influential individuals, brands and publications leading the discussion.

Below is a network map showing recent interactions with the number one influencer John Nosta. This map was created with our Influencer Relationship Management software (IRM). If you are interested in learning more about identifying, managing and engaging with influencers click here to get in touch!

A survey of Italian infectious disease physicians working with HIV, conducted in 2015 but only published this July, reveals that at that time there was still considerable scepticism about HIV pre-exposure prophylaxis (PrEP).

The study data were collected in April and May 2015, two months after the results of the PROUD and IPERGAY studies were announced, but a year before the European Medicines Agency (EMA) approved PrEP.

At this point, the attitudes of the physicians polled – who form a substantial proportion of Italian doctors working with HIV – appeared to be in transition or even contradictory. While over half of them considered that health authorities had an ethical obligation to prescribe PrEP if needed, less than 30% thought it should be paid for by the national healthcare system. And while over 60% said that at least one of their patients had asked about PrEP, only a third said they were “familiar” with it.

In Italy, HIV treatment is conducted primarily by infectious disease physicians in HIV care centres based in hospitals. At the time of the survey there were 153 HIV Care Centres in Italy altogether but the questionnaire was sent to doctors in 50 centres with more than 500 patients each. The mean number of patients in Italian HIV care centres was in fact at that time 624, with a small number of large centres (HIV patient numbers ranging from 17 to 6526). It was assumed at this time that PrEP would also be dispensed by experienced HIV physicians, an assumption 63% of survey respondents agreed with.

 

Chi decide le politiche sanitarie non lo fa in base alle prove disponibili. Se ne parla da anni ma non si fanno passi in avanti. Per risolvere la questione o anche solo per migliorarla, è necessario passare da un’ottica di disseminazione delle informazioni sui risultati della ricerca a un modello non lineare ma bidirezionale. Il flusso delle informazioni deve prevedere un’interazione costante tra chi fa ricerca e chi dovrebbe implementarne i risultati nella programmazione delle attività dei servizi sanitari. Da parte del decision-maker dovrebbe esserci un’indicazione frequente e puntuale dei propri bisogni informativi, capace di orientare le attività di ricerca e, almeno in certa misura, dare indicazioni pratiche sulle modalità di restituzione alla politica degli output della ricerca.

Pharma is well-versed in communicating with patients. From simple patient leaflets to full blown patient support programs and nationwide disease awareness campaigns, the industry has been directly serving up health messages to patients since the first days of aspirin marketing.

But there’s a parallel world that’s been going further than serving up health messages to patients. A world that pharma seldom dabbles in – despite there being huge cross over in aims when it comes to making people healthier – the world of social marketing.

 

By exploring how social marketers think, and why this is different to commercial marketing, pharma can unlock tried-and-tested ways to bring measurable value to their patients. In this article on outcomes-based patient engagement, we give you a short overview of the social marketing basics.

Abstract

 

Over many years public health has developed impressive data-gathering systems related to mortality, morbidity, and health sector utilization. However, we have invested much less time and effort in developing methodologies to generate deep understanding of the wants, fears, needs, motivations, and barriers people face that either enhance or detract from their ability to live healthy lives.

 

In short, we are fantastic at counting the sick and the dead but much less adept at understanding the living.  The fundamental shift from an approach through which solutions are derived principally by public health specialists and policy experts utilizing limited forms of evidence and data towards a more inclusive model that is also influenced by a deep contextual understanding of what target audiences know, believe, value, and say will help them. A more inclusive model supported by a deep understanding of the science, methodologies, and technologies could be applied to develop deliver and evaluate more successful public health programmes.

 

This fundamental shift includes the coordinated use of all forms of intervention that will help and enable people to adopt and sustain health behaviours to prevent disease, promote wellness, and reduce the impact of both infectious and chronic diseases. Social marketing’s focus on measurable returns on investment and respectful co-production of solutions with citizens is an approach that many governments and public health organizations are trying to bring about. Social marketing (read this freely available chapter) is also attractive to governments and public health organizations because of its emphasis on deep citizen insight and population segmentation, enabling the development of interventions that can respond to a broad diversity of needs of specific subgroups within increasingly diverse communities in many countries.

  Developed by a 13-member working group chaired by Professor Jeff French (ESMA) over the past two and half years, the Global Consensus paper represents a broad agreement about the fundamental concepts and central principle of social marketing.  The consensus definition of Social Marketing: 

Social Marketing seeks to develop and integrate marketing concepts with other approaches to influence behaviour that benefit individuals and communities for the greater social good. Social Marketing practice is guided by ethical principles. It seeks to integrate research, best practice, theory, audience and partnership insight, to inform the delivery of competition sensitive and segmented social change programmes that are effective, efficient, equitable and sustainable.

Americans spend a lot of money on prescription drugs. Drug spending could reach as high as $610 billion by 2021, and the price of medications continues to rise. That’s why it’s increasingly important to encourage doctors to prescribe generic options—which are as effective as brand names, but much less expensive. These efforts were unsuccessful for some time at Penn Medicine, the University of Pennsylvania’s health system, but in May 2016 Penn became one of the best-performing generic prescribers in the country. Seemingly overnight, the health system went from prescribing 75 percent generic medications to 98 percent. Among the top 75 drugs, this saved $32 million over two and a half years.

“Vorrei che la campagna elettorale non fosse sui vaccini”, scrive Matteo Renzi su Facebook mentre rilancia il post di un suo candidato, il medico Roberto Burioni, auto-proclamatosi campione della scienza contro i barbari no-vax. E così, con questo post, Renzi contribuisce a fare in modo che la campagna elettorale sia sui vaccini, posizionandosi sul latoopposto a Luigi Di Maio e Matteo Salvini.

Le uscite di Burioni – e Renzi – sui vaccini, a difesa della scelta del ministro della Salute Beatrice Lorenzin di estendere il numero divaccini obbligatori, a me suscitano sempre qualche disagio. Ho l’impressione che siano molto dannosi alla causa – giusta – che vogliono difendere, cioè ribadire l’importanza della scienza e del metodo scientifico contro le certezze da web e l’equivalenza tra punti di vista documentati e chiacchiere da ciarlatani.

Per stare al caso specifico oggetto della polemica di Burioni: di morbillo si moriva e ora non si muore più, anche e soprattutto per merito dei vaccini. Basta guardare il grafico qui sotto tratto da un recente rapporto di Istat e Unicef sulla mortalità infantile in Italia da morbillo. Su questo non si discute.

Una copertura complessiva del 96,6%, che oltrepassa abbondantemente la soglia di sicurezza del 95% indicata dall’Organizzazione mondiale della sanità (Oms), e in alcune province tocca addirittura punte del 99%. È quella raggiunta in Emilia-Romagna, al 30 giugno 2017, tra i bambini nati nel 2015, per la vaccinazione contro difterite, tetano, poliomieliteed epatite B, a poco più di sei mesi dall’approvazione (novembre 2016) della legge regionale che ne ha introdotto l’obbligatorietà per l’iscrizione al nido. Una situazione molto diversa rispetto al 2015, quando si toccò il minimo storico del 93,4% di bimbi vaccinati al 24esimo mese, e il 2014, quando per la prima volta si scese sotto il 95%, facendo registrare il 94,7%, con un minimo poco al di sopra dell’87% in alcuni territori.

Supera la copertura del 95% anche il vaccino contro pertosse ed emofilo di tipo B (per cui è prevista l’obbligatorietà dalla legge nazionale), e pneumococco (tra quelli fortemente raccomandati). Percentuali in ripresa, ma leggermente più basse, per i bimbi nati nel 2014: un aumento molto significativo riguarda l’MPR (il vaccino contro morbillo, parotite e rosolia), passato dall’87,2% di dicembre 2016 al 90,7% di giugno 2017, e l’antimeningococco C: dall’87,7% al 91,7%.

Sulla base dei dati inviati dalle singole Ausl, il Servizio Prevenzione collettiva e Sanità pubblica dell’assessorato regionale alle Politiche per la salute ha messo a confronto, sia per i nati nel 2015 che per quelli del 2014, i numeri dei vaccinati al 31 dicembre 2016 e al 30 giugno 2017, a distanza appunto di poco più di sei mesi dall’approvazione della legge regionale.

 

Last winter’s flu vaccination programme in the over-65s was ineffective, according to new data from Public Health England (PHE).1

Provisional estimates show that for all age groups combined, the vaccine effectiveness against influenza A and B was 39.8% (85% CI 23.1 to 52.8). But for the over-65s, the principal target of the campaign, effectiveness was −6.3% (CI −95.5 to 42.0).

PHE said that the failure of the campaign in older people meant that better vaccines were needed for them. “It is increasingly recognised that the current generation of flu vaccines often work less well in the elderly, likely because of factors such as the weaker immune systems in this population,” a statement said in response to questions from The BMJ . “Nonetheless, over a number of years, …