Contemporary Issues in Social Marketing [1 ed.] 9781443864220, 9781443850247

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Contemporary Issues in Social Marketing

Contemporary Issues in Social Marketing

Edited by

Krzysztof Kubacki and Sharyn Rundle-Thiele

Contemporary Issues in Social Marketing, Edited by Krzysztof Kubacki and Sharyn Rundle-Thiele This book first published 2013 Cambridge Scholars Publishing 12 Back Chapman Street, Newcastle upon Tyne, NE6 2XX, UK British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Copyright © 2013 by Krzysztof Kubacki, Sharyn Rundle-Thiele and contributors All rights for this book reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. ISBN (10): 1-4438-5024-1, ISBN (13): 978-1-4438-5024-7

TABLE OF CONTENTS

List of Tables ............................................................................................ viii List of Figures............................................................................................. ix Contributors ................................................................................................. x Acknowledgements .................................................................................. xxi Introduction ................................................................................................. 1 Krzysztof Kubacki and Sharyn Rundle-Thiele Part I: Social Marketing Challenges Chapter One ................................................................................................. 6 From the Periphery to the Core: Embedding Social Marketing in the Strategic DNA of All Social Programmes Jeff French Chapter Two .............................................................................................. 21 Challenges Facing Behaviour Change Interventions: A Social Marketing Perspective on Communicating Sustainability and Climate Change Science Lynne Eagle, Peter Case and David R. Low Chapter Three ............................................................................................ 41 Identifying Key Criteria as Predictors of Success in Social Marketing: Establishing an Evaluation Template and Grid (ETG) Audrey Robinson-Maynard, Julia Meaton and Ray Lowry Chapter Four .............................................................................................. 59 Social Marketing: Immunizing against Unethical Practice Stephen S. Holden and Damian Cox

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Part II: Social Marketing Theorizing Chapter Five .............................................................................................. 78 From Reductionism to Holism: How Social Marketing Captures the Bigger Picture through Collaborative System Indicators Patricia McHugh and Christine Domegan Chapter Six ................................................................................................ 95 Decision Framing and the Role of Commitment in Social Choice: Implications for Social Marketing and Communications Katherine C. Lafreniere and Sameer Deshpande Chapter Seven.......................................................................................... 111 A Services Approach to Social Marketing Programs Rebekah Russell-Bennett, Josephine Previte, Danielle Gallegos, Charmine E.J. Hनrtel, Geoff Smith and Robyn Hamilton Chapter Eight ........................................................................................... 141 Maintaining Behavioural Change in Social Marketing: Exploring Drivers of Repeat Use of Services Instrumental to Social Goals Lisa Schuster Part III: Social Marketing in Use Chapter Nine............................................................................................ 158 Is Social Norms Marketing Effective? A Case Study in Domestic Electricity Consumption Tim Harries, Ruth Rettie and Matt Studley Chapter Ten ............................................................................................. 173 OPAL: Using a Social Marketing Approach to Reducing Childhood Obesity Lisa Weir and Jo Williams Chapter Eleven ........................................................................................ 195 Syke: Using Social Branding to Change Culture and Reduce Teen Smoking Jeffrey W. Jordan, Scott Turner and Mayo Djakaria

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Part IV: Current Issues and Future Challenges Chapter Twelve ....................................................................................... 216 Social Marketing: Current Issues and Future Challenges Sharyn Rundle-Thiele, Krzysztof Kubacki, Cheryl Leo, Denni Arli, Julia Carins, Timo Dietrich, Janet Palmer & Natalia Szablewska

LIST OF TABLES

Table 2-1: Summary of functional literacy levels in Australians aged 15–74 years (2006) ..................................................................... 33 Table 3-1: Andreasen’s (2002) benchmarks, with explanations ............... 43 Table 3-2: Twelve case study campaigns ................................................. 46 Table 3-3: The ‘Grid’. Qualitative analysis of 12 case studies in relation to the 19 benchmarks. Y = Yes; N = No. (Cases as set out in Table 3-2) ............................................................ 51 Table 3-4: Benchmarks mainly used by successful campaigns ................ 53 Table 3-5: Four benchmarks and their statistical significance to success .... 54 Table 5-1: The reductionistic systems approach ....................................... 81 Table 5-2: The holistic systems approach................................................. 83 Table 6-1: Summary of possible situations in the SBI model................. 103 Table 7-1: Application of S-D logic’s foundational premises to social marketing .......................................................................................... 115 Table 7-2: Implications for future planning using S-D logic foundational premises. ...................................................................... 132 Table 9-1: Messages displayed on graphs for members of the social norms group ...................................................................................... 162 Table 9-2: Demographic characteristics of the experiment sample (%) .... 163 Table 9-3: Regression analysis of receipt of feedback onto proportional change in consumption ..................................................................... 164 Table 9-4: Regression analysis of type of feedback onto change in consumption .................................................................................. 165 Table 9-5: Linear regression of type of feedback onto number of emailed graphs downloaded ......................................................... 166 Table 10-1: Exchange analysis ............................................................... 184 Table 10-2: Competition analysis ........................................................... 186 Table 11-1: Comparison of alternative v. non-alternative youth responses to survey at baseline and follow-up .................................. 207 Table 12-1: Current issues and future challenges ................................... 231

LIST OF FIGURES

Figure 1-1: Strategic and operational social marketing .............................. 9 Figure 1-2: Four-step model for embedding social marketing ................. 12 Figure 1-3: Citizen and social marketing input into social policy development and delivery ................................................................... 15 Figure 1-4: Strategic social marketing ...................................................... 17 Figure 2-1: Peattie and Peattie’s (2003) diagram of competing influences on behaviour adoption and maintenance ........................... 24 Figure 2-2: AIDA model on the impact of communication on behaviour ....................................................................................... 25 Figure 2-3: Integrative model of behavioural prediction and change (IB model) ........................................................................................... 27 Figure 4-1: James Gillray’s 1802 cartoon highlighting vaccination fears .. 65 Figure 5-1: Collaborative systems integration .......................................... 85 Figure 5-2: Collaborative system indicators in social marketing ............. 89 Figure 6-1: The social behaviour influence (SBI) model ....................... 101 Figure 7-1: Classification of social marketing services .......................... 113 Figure 7-2: The social marketing service mix ........................................ 117 Figure 7-3: The medicalized servicescape of blood donation................. 120 Figure 7-4: Branded mobile donor van ................................................... 121 Figure 7-5: MumBubConnect brand, website and text messaging service .............................................................................................. 130 Figure 9-1: Example of a graph sent to a participant in the social norms condition ..................................................................... Centrefold Figure 10-1: OPAL logic model .................................................. Centrefold Figure 10-2: OPAL’s planning framework .................................. Centrefold Figure 10-3: OPAL’s categories for exchange ....................................... 184 Figure 10-4: Examples of OPAL’s water theme in promotional materials ................................................................................. Centrefold Figure 11-1: Syke shirt designs: ‘Die Old’ and ‘Tobacco Companies Tortured Animals’.................................................................. Centrefold Figure 11-2: Syke direct mail featuring an interview with an alternative rock band, a promotion for a future event, pictures from past events and an anti-tobacco advertisement ......................................... Centrefold Figure 11-3: Change in smoking behaviours (alternative rock youths v. non-alternative rock youths) ......................................................... 206

CONTRIBUTORS

Denni Arli, PhD is currently a Lecturer at the Department of Marketing, Griffith Business School, Griffith University, Australia. His research interests include corporate social responsibility, consumer ethics, social marketing and the impact of religiosity on consumption. He has coauthored articles (published or forthcoming) in Journal of Business Ethics, Journal of Asia-Pacific Business, Social Responsibility Journal and International Journal of Consumer Studies. Julia Carins is part of the Nutrition and Food Group within the Defence Science and Technology Organisation (DSTO); and is a PhD Candidate at Griffith University, Queensland, Australia. She has been involved in many Defence nutrition projects, including investigation of the behavioural aspects of ration pack eating, development of prototype ration packs and determination of food acceptability. Her research interests are the behavioural aspects of eating, food preferences, food attitudes and eating patterns. Julia’s PhD research is investigating the application of social marketing principles to encourage healthy eating by Australian Defence Force personnel. Peter Case, Professor of Management and Organization Studies, James Cook University, Townsville. His research interests encompass corporate social and environmental responsibility, leadership ethics and behaviour change in organizations. He served as general editor of Culture & Organization (2007-10) and is currently a member of the editorial boards of Leadership, Leadership & Organizational Development Journal, Business & Society Review and the Journal of Management, Spirituality and Religion. Publications include The Speed of Organization (2006: CBS & Liber), John Adair: the Fundamentals of Leadership (2007: Palgrave) and Worldly Leadership (2012: Palgrave). Belief and Organization is due to appear later this year under the Palgrave Macmillan imprint. Damian Cox, (B.A.(Hons), Ph.D.) is an Associate Professor, Philosophy at Bond University. He studied science and philosophy at the Australian National University before taking a doctorate in philosophy at the University of Melbourne. He has held positions in philosophy at Edith

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Cowan University and University of Queensland, before joining Bond University in 2006. Damian Cox has published widely in philosophy, including in the areas of metaphysics, epistemology, philosophical theories of truth, moral philosophy, philosophical psychology, environmental ethics and professional ethics. Sameer Deshpande, PhD is an Associate Professor of Marketing in the Faculty of Management and a member of the Centre for Socially Responsible Marketing at the University of Lethbridge, Canada. Over the past 15 years Sameer has worked on numerous social marketing research projects. These have included understanding application of marketing principles to promote a variety of behaviours including responsible alcohol use among college students, alternative rides to reduce driving after drinking among young adult men, alcohol abstinence among pregnant women, hand hygiene among healthcare workers, and condom use among men of reproductive age. In addition to conducting research and publishing its findings in academic journals, Sameer has also conducted training programmes and offered consultancy on social marketing topics to nonprofit, government, and corporate sector in India, Canada, Australia, U.S., and U.K. Timo Dietrich is a PhD candidate with Griffith University and lectures Social Marketing at Southern Cross University. His doctoral research focuses on how to change binge drinking behaviours of Australian teenagers and his general research interests center on behaviour change. In his home country of Germany, Timo achieved a Bachelor degree in Business Administration, and worked as a Corporate Relationship Manager. After 5 years of sharpening his skills in business development, marketing, and relationship management, Timo moved to Australia and completed a Master degree in International Business, graduating with a first class honours. Mayo Djakaria, MPH serves as Behaviour Change Officer at Rescue Social Change Group, a behaviour change agency headquartered in San Diego, CA. She received her B.A. at Brown University with a double major in Sociology as well as Public and Private Sector Organizations. Pursuing her passion in health communications, she earned a Masters in Public Health from Columbia University. Mayo currently leads various social marketing interventions focused on tobacco use and/or obesity prevention among youth and young adults. She leads a passionate and dedicated team of social change professionals with a strong strategic

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vision and solid evidence-based approach, developing award-winning programs that truly cause impact. Christine Domegan, B. Comm, MBS, PhD is a Senior Lecturer in Marketing at the National University of Ireland, Galway. As Research Cluster Leader for Social Innovation and Policy within the Whitaker Institute, Christine researches Behavioural Change and Social Innovation through Social Marketing and associated concepts of value co-creation, stakeholder and systems theory, partnerships and a capacity to act at population, community and individual levels. Taking a multi-disciplinary lens with partners in the UK, Europe, and the USA, she combines Social Marketing with service learning research and teaching, bringing a civic engagement dimension to her work. Her current EU and national research work embraces recycling, health (e.g. positive aging; health literacy and diabetes), Sea for Society and science in society. Christine teaches Social Marketing at undergraduate and postgraduate levels in Ireland and the UK, including extensive PhD supervision, as well as topics such as Marketing Research and Marketing Analytics. Lynne Eagle, Professor of Marketing at James Cook University. Research interests include marketing communication effects and effectiveness, including: trans-disciplinary approaches to sustained behaviour change, the impact of persuasive communication on children, and the impact of new, emerging and hybrid media forms and preferences for / use of formal and informal communications channels. She has published in a wide range of academic journals, including the Journal of Advertising and European Journal of Marketing, led the development of both Marketing Communications and Social Marketing texts and contributed several book chapters for other texts as well writing commissioned social marketing expert papers and presenting numerous research papers at international conferences. She is on the editorial board of several journals. Jeff French, PhD is a recognised global leader in the theory and application of health promotion and social marketing having published over 90 chapters, articles and books. Jeff is a visiting professor at Brighton University and a Fellow at Kings College University London. Jeff was the Director of Communication and Policy at the Health Development Agency for five years. In 2005 Jeff led the national review of social marketing and set up the National Social Marketing Centre in England. In 2009 Jeff became the CEO of Strategic Social Marketing Ltd. Jeff is a Board member of CREDOS the advertising industry think-tank and a member of

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the Editorial Board of five professional Journals. Jeff is the organiser of the World Social Marketing Conference and a member of the International Social Marketing Association Executive Committee and an Executive Member of the European Social Marketing Association. Jeff has worked on behaviour change and social policy programmes in over thirty countries. Danielle Gallegos, PhD is an Associate Professor in Nutrition and Dietetics in the School of Exercise and Nutrition Sciences at Queensland University of Technology Australia with a PhD in the sociology of food. She is an Advanced Accredited Practicing Dietician. Danielle is involved in teaching public and community nutrition and undertaking research in areas of social justice. Her research interests are broad, encompassing the intersection of food, identity and ethnicity, and the socio-cultural aspects of food choice generally. Her special areas of interest are working to improve access to nutrition information, improving access and availability to food across the whole community and supporting breastfeeding through the use of innovative technologies. Danielle has published in the areas of breastfeeding, food security, social marketing and the sociology of food in a wide range of formats. She is an experienced evaluator and undertakes consultancies for government and non-government organisations. Robyn Hamilton is a national director of the Australian Breastfeeding Association, and was the state president of Queensland Branch from 20072009. She has been a community educator since 2000, breastfeeding counsellor since 2002, and has worked with mothers through a variety of roles at local group level. She was a writer for the Association’s accredited Certificate IV in Breastfeeding Education, and a steering committee member for its reaccreditation. Robyn is a librarian by profession and has worked in the public sector for over 20 years. As a director she is responsible for the ICT portfolio and brings her information management background to her volunteer role. She is also a director on the board of the Australian Breastfeeding Association’s retail subsidiary Mothers Direct. Tim Harries, a Senior Research Fellow at Kingston University, UK, has a background in social psychology, human geography and social research methods. Tim has degrees from York University and London School of Economics, a PhD from Middlesex University and before coming to Kingston University in 2011, completed research fellowships at King’s College London and the UK’s Department for Environment (Defra). He has experience of IT R&D (British Petroleum Research Centre and

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Trustees Savings Bank), policy design and applied public policy research. Currently, Tim runs CHARM, a suite of experiments that use digital technologies to investigate ways of influencing sustainability and health behaviours. He is also Co-Investigator on a project that is developing digital means to encourage business continuity planning in the face of flood risk, and is Chief Investigator on a study into the potential roles of smart-phone technologies in the self-management of type-1 diabetes. Charmine E.J. Härtel, PhD is Head of the Management Cluster and Chair of Human Resource Management and Organisational Development at UQ Business School. She is recognised internationally as a leading expert in industrial and organisational psychology with particular expertise in wellbeing, workplace design, diversity and social inclusion and the leadership and management strategies underpinning positive work environments. She has won numerous awards internationally for her research, including five awards for innovation in organisational practice, and is President of the Australian and New Zealand Academy of Management. Stephen S. Holden, (B.Sc.(Hons), MBA, Ph.D.) is an educator/researcher currently holding adjunct positions with Bond University and Southern Cross University. He has published a wide range of social marketing research projects (anti-smoking, drink-driving, over-eating, public health, road safety) both for government agencies and in academic journals around the world. He has also completed a large number of marketing research projects in health including vaccinations for pharmaceutical companies. His current research interests include portion-size effects, meta-analysis, social marketing and ethics. Jeffrey W. Jordan is President and Founder of Rescue Social Change Group, a behavior change marketing company. His passion for social change began in high school when he volunteered for an anti-tobacco group. Observing the lack of effective social marketing services, he started Rescue Social Change Group when he was 17 years old. While growing Rescue SCG, Jeff studied Marketing for his undergraduate degree and received a Master’s in Experimental Psychology from the University of California, San Diego. Today, Jeff has led Rescue SCG’s growth to four offices in the US and managing over a dozen behavior change programs around the country, tackling issues such as tobacco, obesity and violence.

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Krzysztof Kubacki, PhD is a Social Marketing Research Practice Fellow (VicHealth) and a Senior Lecturer in Marketing at Griffith University. He has been involved in academic and market research for over 10 years, he has published over 35 journal articles and book chapters. The broad area of his research interests could be defined as “cultural consumption” and includes projects exploring areas such as relationship between marketing and cultural industries, influence of national culture on national brand, and cross-national comparisons between consumers in the European Union. Weaved throughout his research is an interest in the relationship between social marketing and consumer culture, with his most recent work focussing on alcohol consumption among young people. Katherine C. Lafreniere is Marketing Director at Firestone Restaurant and Bar and is responsible for the lead generation and revenue for the franchise. Prior to Firestone, she was a Research Associate in the multidisciplinary research project titled, Water: Making do with what we have, on behalf of the University of Lethbridge and Alberta Innovates. She obtained her Bachelor of Management Degree in 2009 and Master of Science (Management) Degree in 2011 from the University of Lethbridge. Her research interests in the marketing area include decision making and consumer choice models; and applying social marketing thought to a variety of environmental issues. Cheryl Leo, PhD is a marketing lecturer with Murdoch University. Her research interests are in the areas of social marketing and services marketing, specific to service employee and deviant behaviours. Cheryl’s work has been published in Journal of Marketing Management, Journal of Business Research and Journal of Nonprofit and Public Sector Marketing. David R. Low, Head of School and Professor of Business at James Cook University. He has a wide variety of both industry and academic senior management and boardroom experience. His research interests include Cross Cultural Issues; Country of Origin Studies; Ethnicity, Social Media, Social Marketing, Market Orientation, Firm Performance, E-Marketing; Innovation, SME’s and the use of technology in business value chains. David has recently co-edited a book on E-Novation and Web 2.0. He has supervised to completion a number of HDR students and teaching interests include E-Marketing, International Marketing as well as Marketing Management.

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Roy Lowry, a qualified doctor and dentist completed formal training in public health and became an NHS consultant in 1990. He was senior lecturer in dental public health at the University of Newcastle upon Tyne. He was on the specialist registers for medical and dental public health and is a Fellow of the Faculty of Public Health. He has published over 50 articles in the learned press. He was the training director for public health in the Northern Region an examiner for the Faculty of Public Health. Now retired, he now devotes most of his working time to social marketing with his own dedicated website. http://www.drlowrysocialmarketing.co.uk/ Patricia McHugh, B.Comm, MBS has just completed a doctoral research fellowship with the Marketing Discipline at the J.E. Cairnes School of Business and Economics at the National University of Ireland, Galway. Patricia is part of an academic group where social marketing is a key component of research and teaching. Her doctoral research focused on the development and measurement of process indicators for science communication using social marketing and innovation theory. Although her indicator research has been applied to science, it is relevant and applicable to marketing systems, macro management, value networks, and collaborative partnerships across health, education and environmental conservation. Patricia's doctoral research was made possible due to the generous support of the Whitaker Institute and PRTLI4 funding in Ireland. Julia Meaton, PhD is interested in the development of resilient and sustainable communities. She has researched this from planning, land use and transport angles as well as from organisational perspectives. She has researched environmental management in the corporate and community sectors and has also explored resource management issues in Africa, most notably regarding forest management in Ethiopia. She is particularly interested in drivers and barriers to sustainable environmental management, and the role of institutions and individuals in facilitating or barring change. Janet Palmer is a Research Assistant with Social Marketing @ Griffith and a PhD Candidate at Griffith University. Her research explores proenvironmental behaviour at the workplace and social marketing's ability to create sustained behaviour change in an occupational setting. She was awarded the Griffith Business School Postgraduate Research Scholarship (GBSPRS) and the DVC (Research) International Postgraduate Research Scholarship (DVRIPRS). Janet holds a BBA from the University of New

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Brunswick, Canada and an International MBA (Honours) from Griffith Business School. Josephine Previte, PhD is a lecturer in the UQ Business School at The University of Queensland. Her research focuses on social marketing and a critical marketing analysis of gender, technology, and marketplace behaviours. Her research has appeared in journals such as Journal of Marketing Management, European Journal of Marketing, Journal of Nonprofit & Public Sector Marketing and Journal of Macromarketing. Josephine has also been involved in conducting a range of consultancy projects with non-profit organisations and government departments implementing social marketing campaigns, as well as being involved in evaluating the impact of digital technologies on regional and rural communities. Ruth Rettie is a professor of Social Marketing at Kingston University in the UK. Her background is interdisciplinary and includes philosophy, an MBA and a PhD in sociology. She joined Kingston University after ten years as a brand manager for Cadbury, Kraft and Unilever. Her research includes social theory, ecommerce, user interaction in new media, the influence of technological design on social interaction, and sustainable development. Ruth is director of the Behaviour and Practice Research Group at Kingston Business School, and Principal Investigator on CHARM, a sustainability project that investigates the impact of feedback on performance and Smart Communities, a community based action research project on energy demand reduction. She is a Co-ordinator on the Digital Economy Sustainable Society Network+. Audrey Robinson-Maynard is a former Divisional Manager in Local Government, Social Services Children Assessment Services and budget holder for that service. She holds various qualifications in Social Work and Management. Audrey gained a BA from the University of Huddersfield and her MSc from London Guildhall University, London. She is at present completing a PhD in Social Marketing at the University of Huddersfield. Audrey has been, and still is, actively involved in setting up and the progressing of Community Organizations, from hostels for homeless young people to after school clubs. She has been involved in many community research projects and has published work relating to Child Care and the law.

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Associate Professor Sharyn Rundle-Thiele leads a talented team of researchers at Social Marketing @ Griffith (http://www.griffith.edu.au/ business-government/social-marketing-griffith). Sharyn's research interests centre on behaviour change and social marketing. She currently works with SA Health, Queensland Catholic Education Commission, Defence Science and Technology Organisation and VicHealth. Sharyn is President of the Australia and New Zealand Marketing Academy and co-editor of the Journal of Social Marketing. Rebekah Russell-Bennett, PhD is Professor in Marketing in the school of Advertising, Marketing and Public Relations at Queensland University of Technology, Australia with a PhD in marketing. She researches in the field of services marketing in both the commercial, nonprofit and government sector. Rebekah has published in journals such as European Journal of Marketing, Journal of Business Research, Journal of Marketing Management, Journal of Services Marketing, Health Marketing Quarterly, Journal of Brand Management and Industrial Marketing Management. Rebekah is president of the Australian Association of Social Marketing and has extensive industry collaborations with organisations such as Queensland Department of Health, Australian Breastfeeding Association, Australian Red Cross Blood Service, Queensland Catholic Education Commission and Queensland Department of Transport. Lisa Schuster is currently undertaking her PhD within the QUT Business School at Queensland University of Technology (QUT), Australia. Her research focus is in the area of services in social marketing and consumer behaviour. Her qualifications include a Bachelor of Business (Honours) degree (First Class) from QUT, from which she published in the area of consumer responses to mobile phone services. She has also presented and published her research in several peer-reviewed international and national conferences, where she has received two ‘Best Paper’ awards. Geoff Smith, PhD is Senior Research Fellow in Donor and Community Research, within the Research and Development Division of the Australian Red Cross Blood Service. Donor and Community Research at the Blood Service is a targeted research program examining donor retention, recruitment, motivation, and community attitudes toward blood and plasma donation. Geoff directs a team who run an array of projects in partnership with a number of Australian and overseas University research teams including Queensland University of Technology, University of Melbourne and Ohio University, USA. A major focus for Geoff is to

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develop research findings into cost effective operational change to support the Blood Service in better understanding and retaining existing donors, and to inform strategies used to recruit new donors. Geoff has previously worked in other organisations in the non-profit sector including the Cancer Council Victoria and Australians Donate (Organ and Tissue Donation). Matt Studley's PhD research at the University of the West of England, Bristol (UWE) investigated the use of Genetic Based Machine Learning to learn the optimal control of physical robots in problems with multiple objectives, a technique that was later applied in the area of Chemical Computing. He has worked in research and development in the telecommunications, e-business, investment and finance sectors in many European countries, the USA, and Australia, and currently leads the undergraduate Robotics Programme at UWE. Dr Studley has run several high-profile public engagement projects bringing robotics issues to the attention of the public, including the internationally-recognised 'Heart Robot' project. He is currently involved in applying distributed sensing to change domestic electricity consumption using approaches from social psychology and sociology, and working with industrial partners on ways to use distributed energy storage to improve UK energy security. Natalia Szablewska, PhD is a Lecturer in Law at the School of Law and Justice, Southern Cross University. Her professional experience includes working in a Human Rights NGO in Moscow (Russian Justice Initiative), the Solicitors Regulation Authority, the Welsh Assembly Government, the British House of Commons, the Welsh Centre for International Affairs and the David Davies Memorial Institute of International Studies (UK). Her main research interests are in public international law, international humanitarian law and international human rights law. Scott Turner, PhD is Research Director at Rescue Social Change Group a behaviour change marketing company. His work has focused on the social, personal, and policy influences of behaviour in many contexts. Specifically, he has designed and executed studies that investigate occupational choice, perceptions of advertising, advertising awareness, drug choice, purchase decision, quality of life, and tobacco consumption. His work in public opinion polling and survey methods has influenced several large-scale studies in the United States as well as public policy regarding military recruiting.

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Lisa Weir is currently with the South Australian Government as joint Social Marketing Manager for OPAL (job share with Jo Williams). Lisa has an Applied Science (Sports Science) degree and a degree in Public Health together with over 20 years’ experience in health promotion. Lisa has worked in Australia and overseas in the government and non-profit sector addressing issues such as injury prevention, alcohol, cancer prevention and early detection and healthy weight. She has worked across a broad number of settings including workplaces, community sports clubs, schools and local government. In her current role Lisa’s main interests are in ensuring social marketing best practice is applied to OPAL and that social marketing principles can be applied at the local community level to assist with behaviour change. Jo Williams is currently with the South Australian Government as joint Social Marketing Manager for OPAL (job share with Lisa Weir). OPAL is South Australia’s largest single investment in childhood obesity prevention. Jo has an Applied Science degree and fifteen years’ experience working across a wide range of health campaigns within the charity, not for profit and government sectors. Six years were spent in London managing Cancer Research UK’s “SunSmart” campaign and the National Asthma Campaign’s “Be In Control” diagnosis campaign. Jo’s current interest is in workforce development around social marketing, working to integrate a social marketing approach across the frameworks of community development and socio-ecological theory of OPAL.

ACKNOWLEDGEMENTS

Cover art by William Riggins, Rescue Social Change Group, USA.

INTRODUCTION KRZYSZTOF KUBACKI AND SHARYN RUNDLE-THIELE

The 2012 International Social Marketing conference was hosted by the Griffith Business School’s Department of Marketing from June 27-29 2012 at the beautifully located Southbank campus of Griffith University, Brisbane, Australia. The conference attracted 68 submissions from 17 countries, exploring a very broad range of social marketing issues, theoretical perspectives and practical case studies. For many of the social marketing researchers and practitioners who met, some for the first time, in Brisbane, the conference became the starting point for another journey – the journey to deliver their work to a much wider social marketing audience. While organizing the International Social Marketing Conference, the idea to develop a book including some of the most exciting work presented in Brisbane in June 2012 was born. We are writing this introduction almost one year later. Among many other activities, the past year has allowed the group of authors presented in this book to further develop the ideas presented at the International Social Marketing 2012 conference into a full paper for inclusion in this book. The process has included a full review process following submission of the first chapter for review in late 2012. As editors, we are excited to reach the final point where the work of some of the leading social marketing scholars and practitioners will see the daylight. We see this book not only as tangible evidence of all the stimulating conversations which happened in Brisbane a year ago, but above all as a contribution to a rapidly growing discussion about the role of social marketing and its contribution to the contemporary societies. Contemporary Issues in Social Marketing aims to capture the complexity of the field by offering an eclectic range of studies, from theoretical contributions, through critical reflections, to practical applications. Much of the work presented in this book is set in the context of some of

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our most challenging social issues, including (but not limited to) sustainability and climate change, electricity consumption, mental health, cancer screening, blood donation, breastfeeding, the global obesity epidemic, and tobacco use. While some of the empirical research is set in a fixed range of contexts, the ideas extend to the field of social marketing and we encourage the concepts that are presented in this book to be applied to the full suite of behavioural problems that our societies are currently facing. The book is divided into three main sections: section one outlines some of the challenges facing social marketing, section two explores new approaches to social marketing, and the final section showcases three examples of social marketing interventions. In the opening chapter, Jeff French explores how to embed social marketing as one of the key elements of social policy development. Social marketing has the potential to contribute to the process at several levels, from gathering and facilitating citizens’ insights, through developing behavioural objectives and the selection of interventions, to impact evaluation and the assessment of social initiatives. The chapter by Eagle, Case and Low provides an example of how the complexity of social issues and the messages and discussions surrounding them can represent one of the challenges facing social marketers. Taking sustainability and climate change as an example, they offer a discussion of the main factors which need to be taken into account when designing social marketing communications. In the following chapter, based on the analysis of 12 social marketing case studies, Robinson-Maynard, Meaton and Lowry provide an evaluation of 19 social marketing benchmark criteria and their contribution towards the success of social marketing interventions. In the final chapter of the first part of the book, Holden and Cox provide a highly critical perspective on some of the unique ethical challenges facing social marketing practitioners. Their discussion, located within the case of immunizations, offers a deep reflection on the meaning of one of the key social marketing constructs – the social good. The chapter by McHugh and Domegan explores the relationship between reductionistic linear systems and dynamic holistic systems in identifying solutions to complex social problems, while in the next chapter Lafraniere and Deshpande extend our understanding of the individual decision-making process for social issues by proposing a social behaviour model. In the following chapter, Russell-Bennett and colleagues focus on the role of the services mix for achieving behavioural change. Using three social marketing projects – which target behaviours in the areas of

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breastfeeding, blood donation and breast cancer screening – they show the potential of service theories to inform social marketing thinking. Continuing in the same vein, in the final chapter of this part the drivers behind maintaining behavioural change in social marketing are explored by Schuster in the context of mental health. Her research points towards the importance of service experience, relevance, ease of use and location in influencing repeat behaviour. The chapter by Rettie, Harries and Studley presents a discussion of the role of the social norms approach in influencing behaviours in domestic electricity consumption. Social norms marketing seeks to influence behaviours by challenging perceptions of ‘normal’ behaviour. The Rettie, Harries and Studley experiment shows that an inclusion of social norms information in feedback to consumers has the potential to increase their engagement, yet does not significantly influence their electricity consumption. The chapter by Weir and Williams presents South Australia’s OPAL (Obesity Prevention and Lifestyle) initiative, which promotes healthy eating and physical activity in communities; the initiative is now in its fourth year, and is being trialled in 20 intervention communities. The Weir and Williams case study takes us through the background, planning and execution stages of the first phase of the intervention, which successfully reduced the consumption of sugarsweetened beverages among children in intervention communities. The final example of a successful social marketing campaign is presented by Jordan, Turner and Djakaria, who detail the power of branding to facilitate culture change. Using experiential marketing, brand ambassadors, endorsements, traditional and social media and direct mail the Syke campaign achieved a significant reduction in tobacco use among alternative rock youth. In the final chapter of the book, we invited a group of colleagues who were involved in the 2012 International Social Marketing conference to share their reflections on social marketing and the work presented in this book. The outcomes cover a list of six issues which we feel will be critical in the future development of our discipline. We hope that this book will offer a contemporary understanding of social marketing based on the insights of social marketing experts from across the globe, and that the ideas presented will inspire a new generation of social marketing academics and practitioners to contribute to both practical and theoretical developments within the discipline. Finally, we

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Introduction

wish to thank the many authors who worked to achieve deadlines set throughout the book development process, and the reviewers who so willingly gave us their time and expertise to assist with the double-blind peer review process for the book. Your time, energy and insights have greatly enhanced the quality of the work presented.

PART I: SOCIAL MARKETING CHALLENGES

CHAPTER ONE FROM THE PERIPHERY TO THE CORE: EMBEDDING SOCIAL MARKETING IN THE STRATEGIC DNA OF ALL SOCIAL PROGRAMMES JEFF FRENCH

The need for citizen-centric social policy development We have seen significant changes in the human condition over the last 20 years. There are at least seven billion people in the world now, but in every region, with the exception of Africa, populations are starting to age1. We know that human-driven global warming 2 is an issue, and we will continue to experience a major global economic downturn and an increased threat from nuclear purification. On the positive side, however, we have experienced an unprecedented period of economic growth and wealth creation, and we continue to witness an ongoing technological communications revolution leading to ‘always on, always connected’ citizens and a general positive improvement in global health (UNICEF, 2011) and literacy (UNESCO, 2012). The rise of citizen empowerment driven by economic development, improved health literacy and technology is leading to the development of what Sandel3 describes as not only new forms of government, but also new kinds of citizenship. The relationship between the governed and governments is changing rapidly to one that is characterized by more dialogue, more joint responsibility and the coproduction of solutions to social challenges. Clarke et al. (2007) argue that this new relationship is informed by the increasing expectation for more 1

http://www.un.org/esa/population/publications/worldageing19502050/ http://www.nature.com/nclimate/journal/vaop/ncurrent/full/nclimate1783.html 3 th 4 July 2009 A new politics of the common good. M Sandel. http://www.bbc.co.uk/programmes/b00lb6bt 2

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literate and wealthy citizens to be treated with respect and attention. People want governments and their agencies to emulate many of the customer-centric approaches that are now routine in the commercial sector. People’s consumer and market experience leads to sets of expectations about higher levels of service quality from public institutions. People, especially those living in advanced liberal democracies, want governments to inform them, consult with them, incentivize good behaviour, and do less disincentivizing and banning when it comes to social policy interventions (IPSOS Morri, 2010).

Beyond information and compulsion, towards social value Rothschild’s (1999) famous social marketing article entitled ‘Sticks and Promises’ made the case for governments to go beyond just using the law and information as the default options to bring about desired changes in behaviour for social good. Rothschild advocated the use of marketing thinking to assist the development of more value-based propositions to citizens, in order to persuade them to adopt positive social behaviours. The creation of value (Bagozzi, 1975) the importance of service (Grönroos, 2007) and the relationship-building function and process of marketing (Gummesson, 1987) are all now well established in commercial sector marketing, but much less so in social policy, social programme delivery, and, to some extent, in social marketing. Social marketing must now apply all of these three key concepts, but especially value creation, through what French (2011) calls ‘forms’ and ‘types’ of interventions in order to influence and enhance both social policy formulation, social strategy development, and the delivery of social programmes. One of the central pieces of added value that social marketing can bring to the social policy development and implementation arena is the concept of value creation. Value creation can be stimulated through the use of both rational offers, such as conditional cash payments for socially responsible behaviour, and offers that appeal to more intuitive rapid cognition, such as the design of road systems that slow traffic. Value can also be developed via socially sanctioned and supported disincentives, including fines or exclusions such as not allowing unvaccinated children to attend school. What is key in relation to the selection and implementation of such approaches is that insight and understanding about what citizens feel, say and do is taken into account when selecting individual interventions, or any mix of interventions. If social development programmes are not supported and valued by citizens they

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will ultimately, and sometimes very rapidly, fail to deliver the desired social improvement and may even cause unintended social backlash (for example, the riots witnessed in Turkey during June 2013 in response to the demolition of a civic park to be replaced by retail outlets). One of the biggest hurdles to the application of marketing principles in social policy development and programme implementation is the misinterpretation and major under-utilization of marketing. Social marketing is often viewed as a second-order task in many public-sector policy and strategy development circles. Even when social marketing is applied, it is most often seen as a set of techniques that can be used to improve the delivery of social programmes, but not as an essential component of policy development strategy analysis. Thus, before social marketing can bring value to the policy table, we need to consider how it can best be embedded into the policy-making and strategy-developing process, as well as in the development of specific campaigns and programmes.

From the periphery to the core One of the challenges faced by every social marketer is how to embed social marketing in the heart of the organization they work for, and to sustain its influence on the organization’s strategy over time. This is true for government, state, regional and local public institutions. Without an acceptance of the principles of social marketing and the need to build them into the DNA of social policy, the social marketer is forever playing a game of peripheral influence and disconnected social marketing project delivery. While it is not a bad thing to attempt to convince organizations on a project-by-project basis to apply a social marketing approach, it is a recipe for getting stuck in a reactive, and/or ‘add-on’, mode of operation. The probable impact of such an approach is that the potential of social marketing’s contribution to social policy and strategy delivery will be greatly diminished. There is a need, as a core part of social marketing practice, to advocate ‘Strategic Social Marketing’ (French & Blair-Stevens, 2010). Others have called this approach macro-social marketing (Wymer, 2011; Domegan 2008; Kenny & Parsons 2012), or up-stream social marketing (Stead et al., 2007). In essence, all these authors – and many others – make the case for applying a more strategic approach and moving beyond a view of social

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marketing aas a second-orrder operation nal delivery coomponent, to seeing it as a core parrt of all sociall policy and sttrategy. A straategic social marketing m approach iss focused onn shaping thee nature of tthe social po olicy and subsequent strategy, as well w as makin ng a contributi tion to the sellection of specific tactics, such as information giving or seervice design n and the managemennt and executiion of operatiional deliveryy, not only in terms of what is donee, but also how w it is deliverred (Figure 1- 1, which illusstrates the four levels of governm mental and not-for-profit n policy selecction and developmennt, strategy development, tactical selecction and op d perational managemennt and deliveryy). Social marrketing princiiples can be applied a at all of thesee levels. For ease of desccription, the term ‘strateg gic social marketing’ iis used in this chapter to reffer to the total al contribution n of social marketing principles acrooss all four lev vels, and the teerm ‘operation nal social marketing’ is used to indicate the application of social marketing m principles inn the areas of o tactical sellection and ooperational programme implementattion.

Poliicy Strategy TTactics Op peratio ons

Operational Social S i l Marketing

Strategic Social Marketing

Figure 1-1: Sttrategic and opeerational social marketing

The firstt challenge, thhen, is to embeed social markketing into the cultural and technical DNA of social s organizzations. The ssecond challenge is to build a case for sustainingg a focus on social s marketiing principles as a core part of all ffuture strateggic planning, and operationnal delivery, of social programmess.

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Embedding social marketing into public policy strategy tactics and operational delivery There are now some good examples from around the world of how to get social marketing to be taken seriously by public sector organizations and governments, and embed it into policy and strategic process. The core social marketing principles of citizen-centric working, social exchange, insight, completion analysis and action, behavioural goal setting, segmentation and intervention, mixed together with a systematic planning and management process, are being shown to add value to social programme development and implementation. The experience pioneered by Mintz and colleagues in Canada (2005) to embed social marketing principles into Health Canada, the development of a national social marketing strategy in the UK between 2004–2009 (French & Mayo 2006), the inclusion of social marketing standards within the new American 2020 health strategy4, the inclusion of social marketing as core principles in the French EPODE programme5, and the Netherlands JOGG programme6 and the inclusion of social marketing in the new WHO Europe health 20/20 programme 7 are all good examples of how social marketing can be successfully embedded into the strategy of social programmes. From talking with the leaders of these programmes and reading their accounts, three key lessons can be identified and applied when seeking to embed social marketing programmes as an integral part of all social programmes. 1. Understand what matters to your policy and strategist customer: In this case, the customers are those who control the policy and strategy-making procedure, and those who will be responsible for programme delivery. There is a need to be precise about what these customers care about. Politicians in most countries want to do a good job and be recognized for it so that they, or their party, will be re-elected. Most senior policy makers and planners are focused on these two issues but are also often too driven by performance management systems to care about efficacy and effectiveness, as well as public perception. Delivery-level staff are often concerned about the fit of any new intervention with existing practice and their capacity and capability to deliver. They 4

http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=18 http://www.epode-european-network.com/en/ressources-center/224-een-recommend ations.html 6 http://www.epode-european-network.com/en/een-news/227.html 7 http://www.epha.org/a/4288 5

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also often want to be engaged in the intervention development process so that their experience and tacit understanding of situations can be used to develop more effective interventions. These are some of the concerns and issues that need to be addressed when setting out a plan to use social marketing within organizations. Andreasen’s (2006), benefits, costs, others and selfassurance, BROCOS model can be a useful starting point for such an analysis. 2. Build compelling stories and keep promoting them: This involves creating a narrative that politicians, policy makers and professionals can understand and value. They should also be able to use the narrative to persuade others. For example, one of the most effective ways that was discovered in the UK to get a government minister to become a champion for social marketing was to get a local project to invite them to come and see such a project at work in a community. This was incredibly effective in getting them to appreciate the principles of social marketing and increased their desire to promote its uptake. This experience also gave ministers a real story that they could tell to others. It is also important to keep refreshing and repeating this narrative with new examples, until it becomes part of the everyday language of the key advocates. 3. Build a set of required standardized processes: One of the best ways to ensure the continued application of social marketing principles is to develop, as an early task, a set of systems that require social marketing principles to be applied. These systems can range from budgetary systems that require applicants to show that they are applying the principles before budgets are allocated, through to national training programmes, sets of auditable standards and guidance on issues such as segmentation, planning, and evaluation. Examples of such systems are the National Occupational Standards for Social Marketing in the UK8 and the Health 2020 Social Marketing competency programme targets in the US9. The uptake and use of quality standards is something that politicians, policy makers and professional associations can be asked to champion. 8

http://www.ukstandards.co.uk/nos-search/Pages/SearchResults.aspx?k=Sales&r= suite%3D%22Social%20Marketing%22 9 http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=18

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Of thesee three lessonss, the most im mportant is thee first. The onlly way to persuade poolicy makers, strategists and d professionaals is to conviince them that social m marketing cann help them solve s the challlenges that they t face. Social markketing should not be presen nted as a new w and addition nal set of challenges tthat policy maakers and practitioners neeed to accept iff they are to create moore effective and efficientt social prograammes. Rather, social marketing nneeds to be positioned as part of thee solution th hat senior managers, ppoliticians andd practitioners can use to help them so olve their problems. A As part of this process, there may be a neeed for those who lead social policyy developmennt, or the sociaal marketers w who are assistiing them, to undertakee an organizattional diagnosstic on how m marketing orien ntated the current orgaanizational cullture is. Figurre 1-2 sets outt the four stag ges of this assessment and developpment process. The first stage is foccused on developing a thorough picture of ju ust how userr-centric (or not) the organizationn or team is, and, if necesssary, creating a new vision n of what needs to be done. The seecond stage of the embeddding process iss focused on developinng a clear plaan about how to move the oorganization to t a more citizen- or uuser-centric cuulture and sett of systems iin order to deeliver the social markeeting plan. Thhe third stage consists c of alll those actionss that will be required to deliver the change and embed e social m marketing prin nciples in the organizaation. The finaal stage is abo out entering innto a continuo ous cycle of review annd improvemeent. Figure 1-2: Foour-step model for embedding g social marketiing

Asseess

D Develop a plan

Recoggnize the need tto change Make the case Creatte vision Engagge teams Consideer risks and rew wards

Identify the gap and objectives Develop capacity Allocate resources

Make the chan nge

Developp systems

Review R & improve

Recognize success

Impleement Reinforce Devvelop proceedures

Incremental improvement

Monnitor Tackle pproblems

Reward good practice

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Sustaining social marketing within public sector organizations A second challenge associated with embedding social marketing within organizational systems and culture is to buttress social marketing that has been built into the operating core of organizations from disruption associated with administration or managerial change. One of the facts of life within any organization is that people and strategies change. Some things come into fashion, while others go out. This shift can be down to logical factors such as new evidence, increased experience about better ways to do things, new imperatives such as the need to save money, or because of ideological, emotional or political reasons. How do we go about increasing the chances that social marketing will withstand the inevitable changes that will follow? One of the key protective actions is to use ongoing proactive dialogue with politicians, policy makers and practitioners regarding the rationale and evidence for the continued application of social marketing as a key component of policy, strategy and operational delivery. The case needs to set out for the efficiency and effectiveness of applying social marketing; this is an appeal to the head. As new evidence emerges or is commissioned, the information should be used to reinforce the appropriateness of applying social marketing. Tracking and evaluation data should also be fed back to policy makers and practitioners to ensure they are aware of the impact that applying a social marketing approach is delivering. This line of argument, however, also needs to be supplemented by a more emotional appeal that focuses on the ideological positioning of social marketing as a reflection of a citizen-centric approach to social programme delivery, emphasizes mutual responsibility as well as social cohesion, and is a marker of a responsive public service. A further line of argument relates to what Levitt (1960) called ‘marketing myopia’. Levitt sets out with great clarity the need to look beyond products and services to the actual business you are in, and how you are adding value. The example Levitt uses to illustrate his point is the decline of the US railroad sector, which occurred partly because the train operators thought they were in the railroad business, rather than in the people and goods transportation business. The same challenge confronts social marketers when seeking to persuade politicians and policy makers about the need to sustain a social marketing approach as part of social programme development and delivery. Those who advocate the application of marketing principles in social policy development and programme delivery should, if we take

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Levitt’s advice, not be in the business of selling social marketing as a ‘product’ or ‘service’, for its own sake. Rather, such advocates should be in the business of helping politicians, policy makers, strategists and practitioners to devise more effective, efficient, relevant and citizenempowering approaches to social improvement. The offer needs to position social marketing as a key part of the solution to many social policy challenges. The strategic mission is to get social marketing principles built into the programme in a sustained way, rather than to have the words ‘social marketing’ appear in every social policy strategy document.

Implications for governments and citizens Citizens want to be part of the process of creating solutions to social challenges. The increasing development of citizen involvement processes by governments is a manifestation of this phenomenon. Co-production, codesign, and co-delivery are all approaches to tackling social issues that are gaining momentum. It has also been argued by Clarke et al. (2007) and Sandel (2009) that citizens have a responsibility to press for social policy development processes that are transparent, and evidence- and insightbased, and to be given access to the budgets being deployed and the evaluation results of these programmes. The engagement of citizens in the selection of priority policy areas, the development and selection of forms and types of intervention, and the opportunity to assist with intervention implementation and evaluation, are all rights that citizens are demanding. Figure 1-3 sets out how citizen input can assist the policy strategy and operational implementation of social programmes. Figure 1-3 also indicates that social marketing principles can assist in the process of citizen engagement and co-development. According to Cottam & Leadbeater (2004), citizens, whist clearly not experts in social marketing or other forms of social intervention, can bring to the process of coproduction insights about what will and will not work, and how best to design and deliver interventions.

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Figure 1-3: Citizen and social marketing input into social policy development and delivery

The drive for the co-production of solutions to social challenges means that governments and their executive agencies need to gear their capacity and capability up to enable such a process to flourish. This means developing more social marketing capacity and capability within governmental and not-forprofit agencies. However, in many places it is still the case that government policy exhibits many of the following eight characteristics: 1. High cost and poor return on investment (ROI) and value for money (VFM) 2. Crude understanding of behavioural change theory and processes 3. Focused on cure (symptoms alleviation) rather than prevention (causes and/or determinants) 4. Silo working and interdepartmental competition leading to inefficiency 5. Short-term planning and budgeting and lack of long-term strategic planning 6. Insufficient investment in scoping and development 7. Lack of outcome-based budgeting 8. Poorly articulated aims and objectives and poor or incongruent evaluation

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Through its systematic analysis and intervention development process, social marketing necessitates that all of these eight characteristics be addressed, and their influence diminished. It needs to be accepted, however, that applying all eight social marketing consistency criteria (French, 2012) is a big ask. What is more important is that social policy planners at the very least address all of the features of social marketing and seek to apply as many as possible, especially the key concepts of value creation, citizen-centric planning and the setting of clear, measurable behavioural indicators. If we accept that the job of governments is essentially to support people and enable them to live a satisfying and happy life, they need to assist citizens in creating the conditions and social relationships that enable them to achieve this goal. As well as this facilitator role, governments and other civic institutions need to ensure that people have security and safety, and the material necessities for health and wellbeing. Governments also have to encourage and regulate markets so that they produce net social good, as well as material wealth. To do this, they need to understand people’s needs and wants and develop supportive services based on this understanding, and incentivize service providers to deliver measurable value in an efficient and effective way. Social marketing is a key tool that can assist in all of these tasks. Figure 1-4 sets out four clusters of processes that social marketing can add to the social policy selection, strategy development process, tactical and operational management, and operational delivery and management associated with all social programmes. Figure 1-4 illustrates how social marketing can help the social policy development and the strategy selection process. Input from citizens regarding what policy imperatives exist and how to prioritize among these is a process that most politicians use when developing their manifestos. Social marketing can assist at this formulation stage, but also via the refinement of manifesto commitments into more developed working policy proposals. As indicated earlier in this chapter, one of the key weaknesses of many social policies is the lack of clear objectives and congruent behavioural evaluation targets. As illustrated in Figure 1-4, social marketing can assist with the collection and analysis of citizens’ understanding, views, needs and behaviour. Through this process, social marketing can also assist in the development of clear behavioural objectives using behavioural modelling and completion analysis based on theory, insight data, situational analysis, evidence and assessments of

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existing praactice. Social marketing can also help ppolicy makers with the developmennt of targeted intervention strategies s conssisting of the optimum mix of inteerventions. Fiinally, social marketing hhas a role to o play in assisting onngoing policcy and strateegy developm ment through h impact evaluation aand the assessm ment of return n on social invvestment. Figure 1-4: Sttrategic social marketing m

Inputs citizen insight into policy and strategy s development

Inputs intto behaviour target settin ng, segmentatiion and competitio on analysis

Stra ategic So ocial Mark keting

Informs the selection of intervention tyypes and form ms

Contribu utes citizen input intto strategic revie ew and perfo ormance mana agement

Conclusions Social m marketing shoould be pushing against ann open policy y door in terms of thee needs of pooliticians and d policy makeers. Policy makers m are faced with a raft of difficcult social policy issues, m most of which h relate to the behavioour of citizenns, and are searching forr more effecctive and efficient waays to tackle these compleex problems. Social marketing has many of thee answers to developing better b program mmes to addrress these issues basedd on a set of tested t principlles that can heelp define and d develop effective pollicies and straategies, as welll as better opeerational interrventions. Social markketing also reflects the id deological staance of mostt modern

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democratic societies with its citizen-centric approach, which is supported by evidence, insight and data. Social marketing’s systematic and transparent planning and evaluation approach also makes it a natural fit with modern policy development and strategic planning for social good. However, it will not be sufficient to just wait for politicians and policy makers to discover social marketing and then beat a path to the door of those who believe in the added value of social marketing to assist them. Embedding and then sustaining social marketing as a core element of all social programmes will only be achieved if social marketers apply some of their marketing thinking to this challenge to proactively embed social marketing in the policy core. Kotler often says in his presentations that the first job of a marketer is to market marketing to non-marketers. In a similar way the first job of the Social Marketer is to market Social Marketing to non-Social Marketers’. Those who advocate the application of marketing principles as a key strategic element of social programmes have, as a first key task and duty, the job of marketing the added value of social marketing to politicians, policy makers, and those responsible for social programme strategy.

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Bibliography Andreasen, A. 2006, Social Marketing in the 21st Century. Sage. California. Bagozzi, R. 1975, The Journal of Marketing, 39 (4), 32-39 Clarke, J., Newman, J., Smith, N., Vidler, E. & Westmorland, L. 2007, Creating Citizen-consumers Changing Publics and Changing Public Services, Sage. Cottam, H. & Leadbeater, C. 2004, Red Paper 1. Health Co-creating services. The Design Council . London. French, J. & Mayo, E. 2006, It’s our health. National Social Marketing Strategy. National Consumer Council. London. French, J. & Blair, Stevens. C. 2011. Using Social Marketing to develop policy, strategy and operational delivery. Chapter 5 in Social Marketing and public health, theory and practice. Ed French J. Oxford University. French, J. 2011, “Why nudging is not enough. Journal of Social” Marketing, 1(2). —. 2012, Social Marketing Consistency Criteria. Updated version of the 2009 Benchmark criteria. Strategic Social Marketing. Grönroos, C. 2007. Service Management and Marketing: Customer Management in Service Competition (3rd edn), John Wiley & Sons, Chichester. Gummesson, E. 1987, ‘The New Marketing—Developing Long Term Interactive Relationships’, Long Range Planning, 20(4), 10–20. Ipsos, M. 2010, “National Health? Citizens’ views of health services around the world”, http://www.ipsosmori.com/esearchpublications/ publications/1395/National-Health-Citizens Kenny, A. &Parsons, A. 2012, “Macro-Social Marketing and Social engineering: a systems approach”, Journal of Social Marketing, 2(1), 37- 51. Levitt, T. 1960, “Marketing Myopia Harvard Business Review”, 38. July – August: 29-47. Mintz, J. 2005. “Social Marketing in Health Promotion, the Canadian Experience”, http://www.hc-sc.gc.ca/ahc-asc/activit/marketsoc/socmarhcsc/experience_e.html#Unit Rothschild, M. Carrots 1999, “Sticks and promises: A conceptual framework for the management of public health and Social behaviours”, Journal of Marketing, 63, 24-37. Sandel, M. 2009, “A New Citizenship The Reith lectures”, http://www.bbc.co.uk/programmes/b00kt7rg

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Stead, M, Hastings, G. & McDermott, L. 2007, “The meaning, effectiveness and future of Social Marketing”, Obesity reviews (2007) 8 (Suppl. 1) , 189–193 UNESCO, 2012 “Adult and youth literacy. Fact Sheet No 20. Sep 2012”. http://www.uis.unesco.org/FactSheets/Documents/fs20-literacy-day2012-en-v3.pdf UNISEF, 2011 “UNISEF annual report 2010”. UNISEF Wymer, W. 2011, “Developing more effective Social Marketing strategies”. Journal of Social Marketing. 1(1), 17.31.

CHAPTER TWO CHALLENGES FACING BEHAVIOUR CHANGE INTERVENTIONS: A SOCIAL MARKETING PERSPECTIVE ON COMMUNICATING SUSTAINABILITY AND CLIMATE CHANGE SCIENCE LYNNE EAGLE, PETER CASE AND DAVID R. LOW

Introduction Sustainability and climate change constitute major challenges to current lifestyles (Peattie & Peattie, 2009). It is suggested that ‘the world has three choices in dealing with climate change: mitigation, adaptation and suffering’ (Moser, 2012: 165). Continued pursuit of economic growth based on exploiting finite resources is unsustainable. Considerable focus has been placed on the international mitigation of effects, particularly in the short term (Carrico & Riemer, 2011); adaptation, particularly at the local level, has not received the same focus (Urwin & Jordan, 2008). While the potential effects of climate change and the need for sustainability have been largely, though not universally, accepted, there is a lack of clarity and clear communication with regards to what action should be taken, and by whom, to adapt to these challenges. There appears to be an expectation that persuasive communications-based strategies will be employed to address climate change threats (Corner & Randall, 2011). Here, we provide an analysis of the context and discuss the factors that should be taken into account in designing effective sustainability and climate change adaptation interventions.

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Attitude–behaviour gap and the information deficit concept Lack of knowledge (‘information deficit’) is claimed to cause misconceptions and apathy (Owens & Driffill, 2008), and is an impediment to both attitude and behavioural change (Costello et al., 2009). Information is necessary, but does not of itself provide sufficient conditions for behavioural change; a gap between reported attitudes towards environmental issues and actual behaviours has been well documented (Ockwell et al., 2009; Lorenzoni et al., 2007). Attitude change is necessary (Moser, 2010) but complex, as attitudes are multi-faceted and interact with a number of other factors that influence behaviour, especially norms (Fishbein & Capella, 2006) and self-efficacy (Fishbein, 2008). Attitude change alone may be ineffective in achieving sustained behavioural change, as this ignores social, environmental, structural and institutional barriers to change (Ockwell et al., 2009). Behavioural change, or lack of it, may be driven by factors such as financial constraints (Lorenzoni et al., 2007). A further barrier may be a perception that changing one’s own behaviour will not make any difference in the face of the magnitude of potential climate change impacts (Semenza et al., 2008). Information-based interventions are thus unlikely to change behaviours.

Assumption of ‘spillover effects’ and current communication concerns Policy makers assume that ‘spillover effects’ will occur, whereby behaviours performed in one setting will automatically lead to changes in another (Barr et al., 2011), and that small behavioural changes will lead to larger ones, though neither of these happens automatically (Corner & Randall, 2011). One form of pro-environmental behaviour may be seen as compensating for other environmentally detrimental behaviours; i.e. spillover effects may be negative rather than positive (Mazar & Zhong, 2010). Communication that focuses on single behaviours, such as recycling, is thus unlikely to affect other potential sustainability actions. There are concerns regarding the effectiveness of science communications, and the ability of communication receivers to implement change (Nerlich et al., 2010). Climate change science communication is claimed to result in ‘islands of knowledge in a sea of ignorance’ (Meinke et al., 2006: 101).

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Based on these critiques, it is reasonable to conclude that there is also a need for saliency, legitimacy and credibility in the communication of climate change science. Other factors that make comprehension difficult for non-experts include: (a) the invisibility of climate change causes; (b) the lack of immediacy in terms of effects; (c) the complexity of issues and uncertainty regarding local impacts; (d) disbelief about the impact of collective action; and (e) the efficacy of any individual action in mitigating climate change effects (Moser, 2010; Nerlich et al., 2010).

Message sources The public learns about climate change science largely through mass media news (Boykoff & Roberts, 2007). Consumers integrate messages from numerous sources, and may incorporate material such as word-ofmouth, news stories and other non-marketer-originated material, as well as personal experience and situational factors (Finne & Gronroos, 2009). Intervention developers must work in an environment in which they no longer control all communications. For example, within social networks, marketers cannot control the direction or outcome of discussions; anyone can post opinions, and readers may find it difficult to assess the relative credibility of claims (Campbell et al., 2011). What is clear is that any behaviour change messages will not occur in isolation; instead, changes will be subject to a range of competing messages and social encouragement or discouragement, including peer and family influences, and perceived and actual behavioural norms. Competing behavioural influences are depicted in Figure 2-1.

Influence of news media and counter-messages Media coverage of issues presents several additional challenges. The media is assumed to provide the accurate and uncritical information transmission of ‘facts’, yet there is evidence of sensationalism, amplification of risks and emotional appeals through a focus on exceptional cases and speculation regarding worst-case scenarios (Breakwell, 2010), the magnification of issues in the interest of newsworthiness, and alarmism when reporting on climate change topics (O’Neill & Nicholson-Cole, 2009; Eraut & Segnit, 2006).

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Figure 2-1: Peattie and Peattie’s (2003) diagram of competing influences on behaviour adoption and maintenance

Counter-messages are distributed by interest groups who promote ‘climate change scepticism’ and risk denial. These messages are influential in developing public attitudes (Boykoff & Boykoff, 2004). The media can negatively affect climate change communication by giving equal time to climate change warnings and competing/dissenting views in the interests of journalistic fairness. By giving equal time to climate change warnings and dissenting views, they reinforce perceptions of uncertainty and create confusion (Boykoff & Boykoff, 2004). Thus, the media’s impact may not be in line with consensus expert opinion or public interest.

Communications theory deficiencies Behavioural theories provide valuable insights into the potential drivers of, and barriers to, behavioural change, but are of limited assistance in developing communications strategies. As Fishbein & Capella (2006, S14) observe:

Challenges Facing Behaviour Change Interventions

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Behavioural theories do not tell us how best to design messages so that they will be attended to, accepted, and yielded to. We would argue that this is the role of theories of communication.

This presents a challenge, as traditional communications theories, such as hierarchy of effects models, no longer offer complete explanations of communication processes. For example, the AIDA model (Figure 2-2), which was originally developed a century ago (Barry & Howard, 1990), is of limited relevance to the contemporary communication context. Figure 2-2: AIDA model on the impact of communication on behaviour

Awareness

Interest

Desire

Action

Models such as this were predicated on marketer-originated and controlled, one-way information flow, and became prominent during an era in which mass media were dominant and the prevailing belief was that advertising was strongly persuasive. Such models acquired the status of accepted wisdom, in spite of considerable evidence that, even before the Web 2.0 era, they were not universally applicable (Jones, 1990). In order to understand the impact of new electronic media, especially social media, we contend that a new marketing communication research agenda is required that can investigate the following factors: x How do individuals and groups use traditional and new media, individually and in combination, to gather information and inform opinions that shape behaviour? x How well do traditional communications models and theories describe, explain or enable prediction of persuasive communication processes in the 21st century, particularly for new media forms with user-generated content? x Can we develop an integrated model of communication effectiveness, for both traditional and new communication contexts? x How can interactive media and consumer-generated content influence desirable behaviours?

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x How can this knowledge be used in developing and implementing interventions aimed at sustained behavioural change? This will require the use of research techniques in addition to those used for traditional media analysis, such as those deployed in the emerging fields of ‘webometrics’/‘web analytics’, ‘infodemiology’ and ‘infoveillance’. These methodologies offer opportunities and means for analysing how people interact with computer-mediated information, as well as other information users (Thelwall et al., 2005). Webometrics/web analytics uses quantitative analysis techniques to study the construction and use of web-based information resources (Bjorneborn & Ingwersen, 2004). Infodemiology studies of the distribution and determinants of information and communication patterns (Eysenbach, 2009). It can identify changes in information and communication patterns via social media that may be symptoms of changes in a population’s health or attitudes (Wilson & Brownstein, 2009). These techniques could have significant value in understanding both positive and negative information flows, and adapting communication responses appropriately. Infoveillance uses infodemiology data for surveillance, such as by identifying surges of misinformation or fear (Eysenbach, 2002), to enable communications to focus on countering possible negative effects. These techniques are being used in a range of areas, including public health (Boulos et al., 2010) and sustainable development (Galaz, 2009). There is a need to re-examine the relevance of traditional communication theories for the 21st-century environment, together with newer – but, in the climate change context, largely untested – models. Approaches may include the technology acceptance model (tam), the innovation diffusion model (Premkumar & Bhattacherjee, 2008) and hybrid models that combine the TAM with more widely known behavioural change models, such as the theory of planned behaviour (Ajzen, 1991) and its more recent iteration the integrative model of behaviour prediction and change (Fishbein & Capella, 2006). This latter model (Figure 2-3) shares many attributes with its predecessors, explaining behavioural change as the outcome of behavioural intention, and understanding behavioural intention as the outcome of social norms and an individual’s attitude-specific behaviour. Perceived behavioural

Challenges Facing Behaviour Change Interventions Figure 2-3: Integrative model of behavioural prediction and change (IB model)

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control (PBC) accounts for variance where the individual lacks complete control over their behaviour, and is therefore unable to change. A recent further addition has been the re-categorization of norms into ‘injunctive’ (what is perceived as being approved or disapproved) and ‘descriptive’ (what appears to be actually occurring) components (Hennessy, 2010). Interventions that stress descriptive norms may not be effective if they reinforce the belief that challenges are too big for individual actions to have any impact on resolving them (Cialdini, 2007). The integrative model places more stress on the influence of background factors compared to its predecessors, including, importantly, the role of intervention activity and media exposure. Different segments may be driven more strongly by attitudinal factors, normative influences or perceived self-efficacy; i.e. the ability to change behaviour and sustain that change, indicating that different strategies may be needed for different segments (Smith-McLallen & Fishbein, 2008). For example, a behaviour that is attitudinally driven in one population or culture may be normatively driven in another (Fishbein & Capella, 2006). In the environmental and climate change fields, the use of the TPB and other related theories has been descriptive rather than analytical; therefore its power as a predictive tool has yet to be tested (Kollmuss & Agyeman, 2002).

Improving communication effectiveness and message framing Intervention communications aims to increase the strength of beliefs that will increase positive behaviours, and reduce the strength of beliefs that promote negative behaviours, as beliefs related to positive actions will carry more weight as determinants of attitudes, norms, self-efficacy and intentions (Fishbein & Cappella, 2006). A key consideration is whether messages should be framed in terms of potential losses or gains to an individual. No one single framing approach is applicable across all intervention types. Where interest and involvement in an issue is low, positive messages appear to be more effective, whereas the reverse is true for high-interest and involvement conditions (Donovan & Jalleh, 1999). If individuals cannot see the immediate relevance of climate change issues to themselves, material relating to adaptation will not be perceived as being of high interest. The uncertainty of climate change impact (Adger et al., 2009) means that the outcomes of individual actions are also uncertain; people are reluctant to act in response to information that contains ambiguity or uncertainty (Morton et al., 2011). While positive framing

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fosters greater self-efficacy, in health contexts it can have a boomerang effect if the message conflicts with pre-existing knowledge, attitudes and beliefs (Wolburg, 2006). We have been unable to locate any studies that have tested for these effects within climate change/environmental contexts. Those who respond positively to fear-based interventions are better educated, more affluent, and better able to respond to persuasive messages (de Hoog et al., 2005). However, the effectiveness of fear appeal may erode over time, or lead to heightened anxiety (Guttman & Salmon, 2004). For climate change and environmental protection messages, fear is effective only when the related messages convey personal relevance and a sense of personal vulnerability. Effectiveness is also enhanced when the personal salience of messages is coupled with ways of building or reinforcing self-efficacy, and presenting low-cost solutions and support (Spence & Pidgeon, 2010).

Edutainment and disaster/apocalyptic narratives: a form of fear appeal Hollywood movies have frequently used disaster and apocalyptic narratives to portray the potential impact of climate change. Eraut and Segnit (2006) suggest that apocalyptic narratives distance people from problems, and, through a lack of provision of viable actions, reinforce beliefs that the problem is too large for individuals to solve, thereby rendering them counterproductive. For example, The Day After Tomorrow portrayed an ‘abrupt and catastrophic transformation of the Earth’s climate’ as a result of climate change (Lowe et al., 2006: 435). It raised awareness of climate change issues, but also increased anxiety about environmental risk. Audiences struggled to separate fact from fiction and, as a consequence, belief in the likelihood of extreme events was actually reduced; this can be partially attributed to a lack of information provision in terms of what action audiences could take to mitigate climate change effects (Lowe et al., 2006). The Age of Stupid depicted the future world radically altered by climate change. It was initially reported in a survey of movie-goers to have increased concern about climate change, but these effects did not persist (Howell, 2011). While 60% of respondents indicated that they were enacting at least one pro-environmental behaviour as a result of exposure

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to the film, the actions reported were primarily those requiring minimal effort, time or financial commitments. Eraut & Segnit (2006) suggest that apocalyptic narratives distance people from problems, and, through a lack of provision in terms of viable actions, reinforce beliefs that the problem is too large for individuals to solve. Combined with preliminary evidence of audience responses to the films discussed above, it would seem reasonable to conclude that disaster narrative fear appeals can be counterproductive.

Reactance and boomerang effects The theory of psychological reactance originated in the 1960s (Ringold, 2002), and states that perceived threats to personal freedom may be resisted. People may become motivated by the perceived threat, rather than its actual consequences, to assert their freedom and control of their own decision making. A further danger is that awareness of attempts to manipulate behaviours may result in the behaviours themselves becoming more attractive; this ‘forbidden fruit’ problem has been evident, for example, in tobacco cessation programmes targeting adolescents (Sussman et al., 2010). Engaging in threatened behaviour is a means of reestablishing freedom. Reactance effects are strongest when the threatened freedom is perceived as important and the affected individual perceives that their ‘counterforce’ efforts will enable them to reassert personal control. (Hellman & McMillin, 2000). In terms of persuasive communication, such as that aimed at reducing energy consumption or increasing recycling, reactance may generate actions that resist or are opposite to those desired, and explain why some interventions may not be effective and may produce effects contrary to those intended (Swim et al., 2009).

Unrealistic optimism/personal risk denial Additional challenges to effective communication of risks from climate change relate to issue disengagement, unrealistic optimism, bias and denial of personal risk, in which individuals estimate their own risk of negative outcomes as being lower than the wider population (O’Neill & NicholsonCole, 2009). Failure to act on risk information, as well as resistance to change, weakens communication impact (Nisbet & Gick, 2008).

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Protection motivation theory (Floyd et al., 2000) helps to explain why some responses may be maladaptive and result in a reinforcement of existing behaviours, rather than positive behavioural change. Information is evaluated in terms of: (a) the potential magnitude and severity of threats; (b) personal vulnerability; (c) personal cost; and (d) the likely efficacy of taking action. Where the threat is not seen as potentially severe and an individual does not feel personally vulnerable, the threat will be disregarded. If an individual feels that they cannot take effective action, or that the costs are high, the individual may not react despite seeing the threat as severe. Maladaptive responses may include apathy, denial, anger and counterproductive behaviours, such as buying a fuel-inefficient SUV in anticipation of environmental challenges, rather than a more fuelefficient vehicle (Moser & Dilling, 2004).

Trust and legitimacy Trust and legitimacy are important potential barriers or enablers of communication effectiveness. While government sources are more trusted than those of industry (Maibach, 2008), there is a growing body of research that demonstrates declining trust in government sources (Berry et al., 2009). Source expertise is known to directly influence the perceived credibility of a message (Blackstock et al., 2010), and evaluation of the credibility of information has moved from a passive acceptance of authority-based information to judgements based on the synthesis of input from multiple sources, including consumer/news media (Lankes, 2008). According to Gifford (2011), lack of trust leads to both reactance and risk denial. There is therefore a clear need to determine what the trusted information sources for different population segments are, and what implications follow if their messages are discovered to be incorrect. There is also a need to understand the relative effects of material obtained from online sources on the credibility of material obtained from all other sources, both traditional and computer-technology based, and, importantly, on espoused behavioural intentions versus enacted behaviours (Hu & Sundar, 2010). In addition, the continuous systematic evaluation of all aspects of official interventions should be developed, particularly those enabling information sharing across all stakeholder sectors (Mirhaji, 2009), together with the impact of lobby groups and climate-sceptic activity on attitudes and behaviours.

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Community capacity Communities themselves may vary widely in terms of their ability to adapt to change (Ivey et al., 2004), with some authors suggesting classifications ranging from ‘powerless spectators’ who lack capacity, skills and resources, through ‘coping actors’ who have the capacity to adapt but may not be doing so effectively, to ‘adaptive manager’ communities, who have high levels of both adaptive and governance capacity (Fabricus et al., 2007). The most effective methods of assisting communities to achieve adaptive manager status are not clear, although the capacity for social learning has received some attention (Ison, 2007). The ability of communities to take control of their own change management activities is important, as many social marketing/behavioural change interventions are predicated on the basis that communities are better able to understand their own needs and to develop, or co-create, appropriate solutions to challenges they face (McKenzie-Mohr, 2000). Co-creation has proven to foster innovation and the rapid dissemination of knowledge (Nambisan & Nambisan, 2009), and enhance the perceived quality and value of interventions within communities (Ouschan et al., 2006). Successful community-based social marketing interventions have been implemented in areas such as public health (Bryant et al., 2007) and recycling (Haldeman & Turner, 2009). The approach is not unproblematic, as existing systems, structures and norms present significant barriers to sustained behavioural change (Moloney et al., 2010). Additional challenges relate to competing knowledge and parochialism (Lane & McDonald, 2005).

Cognitive limits and functional literacy According to Tonn et al. (2006), most individuals only have the ability to visualize 15–20 years into the future, with 50 years seeming to be the longest conceptualization limit (O’Neill & Hulme, 2009), and scenarios projected beyond this being seen as largely hypothetical (Lorenzoni et al., 2007). Communication about what will happen in a hundred years or by the end of the century is unlikely to be effective. A major barrier to engagement with climate change information is that information may be inaccessible to those who are not experts in the field (Moser & Dilling, 2004). Studies of university students have identified significant misconceptions about climate change issues, causes and potential courses of action (Lombardi & Sinatra, 2010).

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The problem of understanding and engagement with climate change issues is also closely related to functional literacy. The Organisation for Economic Cooperation and Development (Nutbeam, 2008) defines functional literacy in relation to whether a person is able to understand and employ printed information in daily life, at home, at work and in their community. Varying definitions of literacy make cross-study comparisons difficult, however there appears to be agreement that some 20% of the population of most developed countries have severe literacy problems, and a further 20% have limited literacy (Adkins & Ozanne, 2005). Concerns that this problem raises are illustrated in the 2006 Australian Bureau of Statistics’ Adult Literacy and Life Skills Survey. The five-level assessment of literacy, for which Level 3 is regarded as the ‘minimum required for individuals to meet the complex demands of everyday life and work in the emerging knowledge-based economy’ (ABS, 2006), provides some alarming data (see Table 2-1). Thus, future communications need to be simplified for lay audiences. Table 2-1: Summary of functional literacy levels in Australians aged 15–74 years (2006) Domains measured Prose literacy

Document literacy

Numeracy Problem solving

Domain definition The ability to understand and use information from various kinds of narrative texts, including texts from newspapers, magazines and brochures. The knowledge and skills required to locate and use information contained in various formats, including job applications, payroll forms, transportation schedules, maps, tables and charts. The knowledge and skills required to effectively manage and respond to the mathematical demands of diverse situations. Goal-directed thinking and action in situations for which no routine solution is available.

% of respondents with scores falling within the lowest two quintile levels 46

47

53 70

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Conclusion On the basis of the secondary sources reviewed above, it is possible to conclude that in order to improve sustainability and climate change adaption interventions, it is necessary to research and gain deeper understanding of: (a) the content of messages being sent by climate change lobbyists and sceptics and those promoting an adaptation approach; (b) how these messages are accessed and synthesized; and (c) how the complexity of the messages being sent by sustainability and climate change adaptation advocates can be attenuated and simplified for publics and readerships who struggle with literacy. Research into these topics will better inform the process of recasting adaptation interventions.

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CHAPTER THREE IDENTIFYING KEY CRITERIA AS PREDICTORS OF SUCCESS IN SOCIAL MARKETING: ESTABLISHING AN EVALUATION TEMPLATE AND GRID (ETG) AUDREY ROBINSON-MAYNARD, JULIA MEATON AND RAY LOWRY

Introduction The concept of social marketing is a developing global discipline without a universally agreed definition. Its processes are therefore subject to the interpretations of the practitioners who implement intensive and extended programmes on a range of topics under the umbrella concept of social marketing. This kaleidoscope of applications has meant that few campaigns are the same, and they are shaped by the varied interpretations of the social marketing process and the diversity of target audiences. Despite these vagaries, social marketing has become a popular method for influencing behaviour, especially in target populations with poor lifestyles and poor health. However, this popularity has been fashion driven rather than evidence based and there is an urgent need to establish what elements of social marketing are most likely to promote behavioural change in a target audience. Several researchers and practitioners have identified benchmark criteria for the streamlining of social marketing exercises, including Andreasen (1995, 2002), French and Blair-Stevens (2005, 2007) and Lefebvre (2006). However, these criteria have not been fully analysed regarding their contribution to the success or failure of social marketing campaigns. This chapter reports on an attempt to identify benchmarks that will lead to greater success. This has resulted in an evaluation template of

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19 benchmark variables, four of which have been statistically proven to contribute to the success of social marketing interventions. This outcome is designed to help busy marketers, constrained by time and budgets, assess past social marketing campaigns and inform and shape future initiatives.

Benchmarks One of the first challenges of any study exploring social marketing campaigns is the issue of ascertaining whether a case study is an example of social marketing or not. Lefebvre (2006) proposes five questions that could identify genuine social marketing campaigns. These are: 1. Do the authors have an insight into their target audience? 2. Are they focusing on behaviour as their “product” (what are they encouraging a large number of people to adopt or sustain)? 3. Do they influence or try to alter the relative balance of incentives and costs for either maintaining the current behaviour or adopting a new one? 4. Do they attempt to increase access and opportunities for the audience to try new behaviours and then sustain them? 5. Are communication and other promotional techniques used to reach and engage the audience in ways that are relevant, attention-getting, tap into existing motivations and aspirations and have sufficient frequency to be remembered and acted on? (Lefebvre, 2006: 1).

These questions point to the importance of ascertaining formative information to achieve a better intervention ‘fit’ with the target audience and to support potential behavioural change through communication and resources. When Andreasen (1995) attempted to identify benchmarks, their rationale was linked to the following definition of social marketing: …the application of commercial marketing technology to the analysis, planning, execution and evaluation of programs designed to influence the voluntary behaviour of target audiences in order to improve their personal welfare and that of their society (Andreasen, 1995: 7).

This definition includes five key features that embrace the concept of social marketing: a. Transference of commercial marketing concepts to social marketing programmes;

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b. Segmentation and targeting with a good marketing mix and an evaluation procedure; c. Influencing voluntary behavioural outcomes; d. Exchange benefits for improved personal welfare and that of society and e. Background information of target audiences. Andreasen (2002) then presented six benchmarks (Table 3-1), arguing that social marketing intervention programmes should meet each of these benchmarks although not in equal measure, as each programme’s circumstances and personnel are unique. Table 3-1: Andreasen’s (2002) benchmarks, with explanations Benchmarks 1. Behavioural changes 2. Audience research

3. Segmentation and targeting 4. Exchanges 5. Marketing mix

6. Competition

Explanations Used to design and evaluate interventions. (a) Conduct formative research, understanding target audiences at the outset of interventions, (b) routinely pre-test intervention elements before implementation and (c) monitor interventions as they are rolled out. (a) Tailor messages to target audiences’ needs and levels of understanding and (b) ensure maximum efficiency and effectiveness in the use of scarce resources. Create attractive and motivational exchanges, which are central elements in influential strategies. Use all ‘4Ps’ of the traditional marketing mix to create attractive benefit packages, easy access, good communication and minimum costs. New behaviour attracts challenges that negate such changes and will require addressing.

Andreasen’s (2002) benchmarks were mirrored and expanded to eight by French and Blair-Stevens (2007: 38–113) as follows: 1. Customer orientation 2. Behaviour and behavioural goals 3. Theory based and informed

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4. 5. 6. 7. 8.

‘Insight’ driven ‘Exchange’ analysis ‘Competition’ analysis Segmentation and targeting Intervention and marketing mix

Lefebvre’s (2006) questions and Andreasen’s (2002) and French and Blair-Stevens’ (2007) benchmarks depict five common themes: customer insight, behavioural change, support, exchange (relationships) and segmentation and targeting. These are discussed below and link to the proposed 19 benchmarks: 1. Customer insight means knowing the target audience’s background, where they are ‘at’ and how best to work with them, taking into consideration their present lifestyles, hopes and aspirations before attempting to engage them in any social marketing intervention. The target audience is therefore kept at the centre of planning, designing and implementation (French & Blair-Stevens, 2007). This formative knowledge determines the relevant and effective marketing mix, so realistic, ‘do-able’ and sustainable targeted behavioural change can be achieved. It is unreasonable and unethical to ask target audiences to change their behaviour when they, for example, cannot afford or do not have access to the means to do so. 2. Behavioural change can be long, medium or short term. The ‘message’ needs to be attractive, accessible, achievable and clear to avoid confusion. Value for money is important as target audiences often demand minimum costs for maximum returns (Black & Blue, 2001; Hastings, 2007). 3. Support should be comprehensive, measurable and able to withstand scrutiny. Target audiences must believe that marketers are genuine to engender confidence and the development of good relationships. 4. Exchange is widely accepted as the core concept in marketing (Houston & Gassenheimer, 1987; Bagozzi, 1974). The social marketing exchange process looks beyond value for money, with each engaged person willingly making an exchange to achieve satisfaction. Levy and Zaltman (1975) define marketing as a ‘social

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system’ and conceptualize exchange as something in which interrelated people or groups join together to reach a shared goal. Beneficial exchanges are therefore key to success (Layard, 2005). 5. The term ‘segmentation and targeting’ means dividing target audiences into relevant groups to progress the social marketing intervention. This means that marketers do not apply the same theoretical framework in each intervention. Once benchmarks have been identified and tested, they can be used to influence target audiences’ behaviours and to promote or commission work in social marketing with regards to training, planning, developing, evaluating and researching aspects of social marketing (French & BlairStevens, 2007).

Developing an evaluation template and grid (ETG) Despite efforts to identify benchmarks and guidelines, very little systematic or quantitative analysis of their efficacy has been conducted. This chapter describes an attempt to identify benchmarks and then reports on the testing of these. Initial research involved the in-depth qualitative analysis of 12 global social marketing case studies. All but two were selected from peerreviewed journals and most complied with all of Andreasen’s (2002) benchmarks, which suggested that they had been conducted with some rigour. These case studies (see Table 3-2) deal with diverse problems of mixed target audiences and were all in the public domain. These 12 case studies were scrutinized against the literature on benchmarks and social marketing criteria. The major variables from the 12 cases, as used by their marketers, were appraised against three objectives: Objective (a): identify the variables evident in successful social marketing campaigns; Objective (b): evaluate relationship building with target audiences and its effect on advancing and sustaining exchange behaviours and Objective (c): identify what other variables are predictors of social marketing processes.

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Table 3-2: Twelve case study campaigns Topics/problems Case 1: Women’s iron fortification Case 2: HIV testing Case 3: Youth smoking Case 4: Environmental health Case 5: Mental health

Locations China

References Sun et al. (2007)

US US Canada

Futterman et al. (2001) Forster et al. (1998) McDowell (2004)

US

Case 6: Smoking in pregnancy Case 7: Male youth violence Case 8: Skin cancer care

UK

Kirkwood & Stamm (2006) Lowry et al. (2004)

Case 9: Infant health Case 10: HIV and domestic violence Case 11: Prison welfare Case 12: HIV/Aids prevention

Canada Tanzania

US New Zealand

UK Canada

Quinn et al. (2007) The Health Sponsorship Council (2008) Cotroneo (2001) Weiss et al. (2004) Stead et al. (2007) Lombardo & Leger (2007)

This qualitative investigation identified 19 potential benchmarks, which are discussed below. 1. Peer Reviewed Social marketing campaigns that have been written up in journals and other publications suggest that they have already passed through a quality control process that has adhered to set standards laid down by the researchers’ peers. Although this is included as a benchmark, this is obviously slightly different to the others as it is not about the actual method of conducting a campaign. However, its use as a benchmark lies in its evaluative application of past campaigns. 2. Formative Research Pre-gathering information about target audiences before designing a social marketing campaign is fundamental to its development and success (French & Blair-Stevens, 2007). Thus, the utilization of ‘formative research’ is of key importance.

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3. Pre-testing Linked to the collection of formative research data, pre-testing can provide important additional information to strengthen the delivery of a social marketing campaign. For example, pre-testing a planned campaign on a priority audience can clearly indicate any changes required to improve the campaign’s delivery. 4. Questionnaires/In-depth Interviews Gathering salient information through questionnaires and interviews can maximize positive outcomes. Campaign planning can be significantly aided by such information, if the appropriate groups are targeted and the data is efficaciously evaluated. 5. Piloting Piloting is always important for any research as it helps to deal with problems and can diminish flawed assumptions. 6. Segmentation and Targeting Interventions should be tailored to specific audience segments. Good segmentation and targeting facilitate a campaign’s ‘message’ acceptance. This means that time, money and energy will be efficiently utilized. 7. Further Segmentation and Targeting To be more successful, it is often necessary to use different strategies to deliver the same message. In doing so, the message will be more relevant and will cater for a sub-set’s needs, aspirations and motivations, while accounting for differences in language, levels of understanding and culture. 8. Upstream Targeting Upstream audiences are the creators of regulations, policies and laws, which have consequences when disregarded. Their involvement through partnership alliances can strengthen ‘messages’ of behavioural change. Mid-stream target audiences are the ‘power brokers’, facilitators, manufacturers and suppliers of merchandise needed to advocate compliance. These audiences must be targeted to work with marketers, in order to improve such aspects as the infrastructure and accessibility of resources required to improve outcomes: for example, the promotion and provision of HIV testing venues (Futterman et al., 2001).

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9. Relationship Building The quality of any relationship is difficult to quantify, but meaningful rapport and good interactions built up over periods of quality time engender trust and confidence (Weiss et al., 2004). 10. Clear Benefits Clear benefits ensure that the behavioural changes being encouraged by marketers have obvious beneficial gains that outweigh any costs or efforts incurred by the target audiences. New behaviours are more likely to be adopted when they are seen as beneficial and achievable (Lefebvre, 2006: 88–97). Target audiences are usually comfortable with their present behaviours, often supported by friends and families. The force of interpersonal social pressure can be a very powerful influence, both for and against campaigns (Andreasen, 2002: 103). Therefore, the benefits of change must appeal to target audiences and their influencers. Benefits must significantly outweigh costs and the target audiences’ confidence levels must be boosted by making them feel that they can and want to achieve behavioural change for their own good. Examples of such processes lie in some smoking cessation campaigns, such as Lowry et al. (2004) and Forster et al. (1998). 11. Measurable Benefits/Stand up to Scrutiny All benefits should prove to be beneficial, affordable in terms of time and effort, available and useful. They must be evidence based for target audiences to have confidence in the behavioural changes being encouraged. This means planned campaigns must execute their promises. 12. Sustainability Good support systems are more likely to sustain the growth and development of desired behavioural changes. The setting up of these systems should be part of a campaign’s design and planning and should be activated when the campaign is in progress. These support systems will help combat any internal and external competitions that might negate behavioural changes taking place. For example, convincing target audiences to eat healthily will not happen quickly. However, having relevant and effective support systems in place will serve to strengthen confidence and resolve. Smith (2002: 46) argues that ‘…people change not because they are smarter or forced into action, but because they get something they value in return’.

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13. Marketing Mix/Extra ‘Ps’ ‘Product, price, place and promotion’ are the traditional marketing 4Ps, and they are also fundamental to social marketing. As social marketing develops, new ideas emerge (Peattie & Peattie, 2003) and other Ps, such as policy, purse string, people and partnerships, evolve. All of these Ps could contribute to the implementation and delivery of social marketing campaigns. Campaigns need to identify the most effective mix of these elements for their target audiences in order to achieve the desired outcomes. Smith (2002: 48) states: programs exhibiting the greatest change have been those in which a product was developed to meet the needs of consumers and then… promoted consistent with marketing principles.

14. Multimedia Initiatives Multimedia can help to promote a ‘message’ to a wider audience. Raising awareness, heightening interest, informing and educating not just target audiences and their influencers but other stakeholders as well can help the promotion of social marketing. Such ‘prevention interventions’ engage the concept of social cognitive theory and the socio-contextual aspects of decision making. These key issues go beyond simple advertising to make the message clear. 15. Understanding the Concept of the Target Audience’s Environment ‘Good marketing starts by appraising the situation, defining the problem and assessing the competing forces’ (Hastings, 2007: 10). This knowledge will help marketers launch their interventions at the correct level, aid the identification of potential challenges and evidence the level of support required by the target audience. 16. Marketers’ Systematic Analysis of Own Results The process and results of the intervention need evaluating and recording. This is a learning experience for the marketer but also aids operational development. Sharing this information is beneficial to other marketers. Evaluation should be built into all stages of the intervention process. This may include statistical analysis or qualitative measures. Ongoing evaluation, although costly, minimizes damaging inefficiencies and takes advantage of the positive elements that can be prepared and factored into the intervention process or into any follow-up actions. French and BlairStevens (2007: 138) argue that good evaluation can boost good

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achievement and could directly inform further resource decisions for ongoing work, ensuring that results are not overlooked or abandoned. 17. Biases and Flaws The value of qualitative research is in its planning and design. It encompasses methods, management and control. Flick (2007) argues that there is potential bias in data collection that can confound the research results. One way of dealing with this is by having an open discussion with the planning team and identifying potential bias. Marketers’ biases can also arise through the way in which their interventions are applied, pretested and interpreted (Creswell & Clark, 2007). These biases can show up in the analysis of results when marketers find that their planning was flawed in some way. For example, this could occur if further segmentation of the target group would have been a positive step towards the desired outcome and addressing this would have improved the quality of the marketing intervention. 18. Incentives Incentives are encouragements for target audiences to be part of the intervention process. These can be tangible or intangible. Some social marketing campaigns use specific inducements as part of a campaign process. These are usually built into the campaign plan from the beginning rather than added on later. 19. Disincentives Sometimes successful campaigns include specific constraints or barriers if members of the target audiences do not wish to consider the ‘message’ being promoted. Disincentives could be in the form of monetary costs or other consequences. An example would be legislation to combat drink driving or the non-wearing of seatbelts. Such legislation has helped the respective campaigns to achieve better results.

Benchmarks and the 12 case studies The benchmarks are not a check-list but a guide to the planning of social marketing campaigns to be used intelligently and to ensure that potentially useful actions are not overlooked. The 19 proposed benchmarks could be helpful to busy marketers. Table 3-3 illustrates how these case studies have used these benchmarks and shows that, although there are widespread uses, none have used them all. This is an important

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Table 3-3: The ‘Grid’. Qualitative analysis of 12 case studies in relation to the 19 benchmarks. Y = Yes; N = No. (Cases as set out in Table 3-2) Case Study Numbers

Benchmark Criteria Peer Reviewed

1

2

3

4

5

6

7

8

9

10

11

12

Y

Y

Y

Y

Y

Y

Y

N

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

N

Y

N

Y

Y

Y

Y

Y

Y

Y

N

N

Y

Y

Y

N

N

N

Y

Y

N

Y

Y

Y

Y

Y

N

Y

N

N

N

N

N

N

N

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

N

Y

N

N

N

N

N

N

N

Y

N

Y

N

Y

Y

N

Y

Y

N

Y

N

Y

Y

Y

Y

Y

Y

Y

N

Y

Y

N

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

N

Y

Y

Y

Y

Y

Y

N

Y

Y

Y

N

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

N

Y

Y

Y

N

N

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Y

Formative Research Pre-testing Questionnaire/Indepth Interviews Piloting Segmentation and Targeting Further Segmentation Upstream Targeting Relationship Building Clear Benefits Measurable/Stand up to Scrutiny Sustainability Support Systems Marketing Mix/Extra ‘Ps’ Multimedia Initiative Understanding Concept of TA’s Problems Analysis of Own Results Biases/Flaws Incentives

Y

Y

Y

N

Y

Y

N

N

Y

N

Y

N

Y Y

N N

N N

Y Y

N N

N Y

N N

N Y

N N

N N

N N

Y N

Disincentives

N

N

Y

Y

N

N

Y

N

N

N

N

N

Scores

17

15

15

15

14

13

12

12

12

11

10

9

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issue that needs to be considered when evaluating any case study against the proposed 19 benchmarks. This initial qualitative analysis identified the potential benchmarks, but a wider study of their use in a greater number of campaigns was required. This quantitative approach was used to triangulate, or not, the results of the case study work and to allow stronger conclusions to be drawn. According to Sirkin (1995), data from larger samples is usually more reliable, has fewer sampling errors and offers more statistical information for analysis; it is considered to be more representative from a quantitative perspective. Therefore, a population sample size of 100 cases was identified to lend weight to the breadth and depth of this research study. A global mix of campaigns and target groups was selected in order to amass a global variety of processes and application strategies. The survey was undertaken using a data framework sheet designed to facilitate the accurate recording of the mechanics of the 100 social marketing campaigns against the 19 benchmark criteria and other descriptive variables. These descriptive variables included areas of location, target groups, the focus of the intervention, stakeholders, costs and the length of time each campaign lasted. Clearly ‘success’ was a key issue and thus the survey instrument included a variable that noted the success or otherwise of the campaigns.

Quantitative measurement of success ‘Success’ was categorized into successful, partially successful and not successful. Although this was a subjective measure, attempts were made to ensure accuracy by comparing each case study’s set goals with their final evaluation outcomes. For example, in case 5 (Kirkwood & Stamm, 2006), success was demonstrated by proven behavioural changes coupled with multiple national awards. In case 3 (Forster et al., 1998: 1193), their Intervention Group was compared with their Control Group and the ‘…difference was not statistically significant’; therefore, the campaign was not successful. Case 6 (Lowry et al., 2004: 1) reported that ‘…innovative intervention has been successful… it is only by diligent application and hard work by the participants that the success has been achieved.’ Overall, 60% of the 100 campaigns included in the study were found to be successful. Of the 12 cases featured, 66% were successful and 1% were not successful.

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Quantitative analysis The success of a campaign was used as the dependent variable against multiple independent variables (benchmarks) in a multivariate analytical process. This created ‘robust models’ to satisfy the quantitative and theoretical assumptions (Sweet & Grace-Martin, 2008). Therefore, cross tabulation and Pearson’s chi-square tests were conducted to show the relationships between the various categories of variables. The results show that the campaigns considered successful mainly used the benchmarks shown in Table 3-4. Table 3-4: Benchmarks mainly used by successful campaigns Benchmarks

Percentages of use by successful campaigns

Clear benefits

72

Segmentation and targeting

72

Measurable benefits

70

Marketing mix

70

Relationship building

70

Questionnaire and interviews

70

Sustainable support

69

Understanding concept

66

Formative research

65

Peer review

64

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Significant tests with chi-square outcomes The chi-square test determines if a relationship between variables is ‘statistically significant’ and is based on probabilistic reasoning (Field, 2005). The test was used to ascertain whether the proportion of benchmarks applied to successful outcomes of social marketing campaigns in the sample data was or will be similar to that in any other specified sample (Bryman & Cramer, 2001). The analysis used success of campaign, with its three categories, as the dependent variable against the 19 benchmarks as independent variables. The results show that four benchmarks are statistically significant. These are: understanding concept, sustainable support, clear benefits and piloting. Table 3-5 shows that they are significant to the 0.5 level. Table 3-5: Four benchmarks and their statistical significance to success Significant Benchmarks Piloting Clear Benefits Sustainable Support Understanding Concept

Levels of Significance (Pearson’s chi sq.) .043 .014 .014 .013

These four benchmarks resonate with some of the key themes that have emerged from the literature. For example, the importance of piloting in testing for biased or flawed assumptions before launching a programme and the theme of behavioural change and exchange is clearly represented by the benchmarks identifying clear benefits for the target audience and the necessity of understanding concepts. Gaining customer insight through these measures would seem to be a core predictor for success. Sustainable support, both during and after the intervention, is a crosscutting benchmark and demonstrates the need to fully engage, long term, with target audiences. Marketers who incorporate these benchmarks as part of their campaign are likely to have a greater chance of sustainable, successful outcomes than more short-term, superficial exercises.

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Conclusions The research findings are likely to enrich our knowledge base of what determines successful social marketing campaigns. This research highlights the use and value of an evaluation grid in the assessment and investigative processes dealing with the diversity of behaviours in social marketing campaigns. It suggests that the key benchmarks stated are good predictors of success within the complex field of social marketing. This research represents the first stage of the identification and testing of the evaluation template and grid (ETG). It is acknowledged that the analysis has been conducted on a limited number of case studies and further refinement will be achieved once it is more widely tested. However, this initial step is important as it clearly demonstrates that social marketing can benefit from the criteria of the ETG methodology. The research represents a significant step forward in understanding the essential components of successful social marketing campaigns. In a world of diverse cultures and constrained resources, it is challenging for social marketers to identify methods of changing people’s behaviours in a positive and sustained manner. The ETG could help to define a more efficient marketing mix in a climate of time and budgetary constraints while encouraging quality interactions between the marketer and the target audience. The research is underpinned by past works of marketers such as Andreasen (1995); Dann (2010); Donovan and Henley (2003); Hastings (2007); Kotler and Zaltman (1971) and Kotler et al. (2002), and it should therefore be considered as a valuable addition to the knowledge on the planning, implementation and evaluation of social marketing campaigns.

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Bibliography Andreasen, A. R. 1995, Marketing Social Change, San Francisco: JosseyBass —. 2002, “Marketing Social Marketing in the Social Change Marketplace”, Journal of Public Policy and Marketing 21 (1), 3 Bagozzi, R.P. 1974, “Marketing as an Organised Behavioral System of Exchange”, Journal of Marketing 38 (4), 77 Black, D. R. and C. L. Blue 2001, “Using Social Marketing to Develop and Test Tailored Health Messages”, American Journal of Health Behavior 25 (3), 260 Bryman, A. and D. Cramer 2001, Quantitative Data Analysis, London: Routledge Cotroneo, S. 2001, updated 2004, “Back to Sleep–Health Canada SIDS Social Marketing Campaign”, http://www.toolsofchange.com/English/CaseStudies/default.asp?ID=16 1 (accessed 8/11/2007) Creswell, J. W. and V.L. Plano Clark 2007, Designing and Conducting Mixed Methods Research, Thousand Oaks: Sage Publication Inc Dann, S. 2010, “Redefining Social Marketing with Contemporary Commercial Marketing Definitions”, Journal of Business Research 63 (2), 144 Donovan, R. J. and N. Henley 2003, Social Marketing Principles and Practice, Melbourne: IP Communications Field, A. 2005, Discovering Statistics Using SPSS 2nd ed., London: Sage Publications Flick, U. 2007, Designing Qualitative Research, Los Angeles: Sage French, J. and C. Blair–Stevens 2005, Social Marketing Pocket Guide 1st ed., London: National Consumer Council French, J. and C. Blair-Stevens 2007, Big Pocket Guide Social Marketing 2nd ed., London: National Consumer Council Forster, J. L., D. M. Murray, M. Wolfson, T. M. Blaine, A.C. Wagenaar, and D. J. Hennrikus 1998 “The Effectives of Community Policies to Reduce Youth Access to Tobacco”, American Journal of Public Health 88 (8), 1193 Futterman, D. C., L. Peralta, B. J. Rudy, S. Wolfson, S. Guttmacher, A. Smith Rogers, and Project Access Team 2001, “The ACCESS Project: Social Marketing to Promote HIV Testing to Adolescents, Methods and First Year Results from a Six City Campaign”, Journal of Adolescent Health 29 (3S), 19

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Hastings, G. 2007, Social Marketing: Why should the Devil have all the Best Tunes?, Oxford: Elsevier Ltd. Hennink, M., I. Hunter and A. Batley 2011, Qualitative Research Methods, London: Sage Publications Ltd. Houston, F.S. and J. B. Gassenheimer 1987, “Marketing and Exchange”, Journal of Marketing 51, 3 Kirkwood, A. and B. H. Stamm, 2006, “Challenging Stigma”, Professional Psychology: Research and Practice 37 (5), 472 Kotler, P.and G. Zaltman, 1971, “Social Marketing: An Approach to Planned Social Change”, Journal of Marketing 35, 3 Kotler, P., N. Roberto and N. Lee, 2002, Social Marketing: Improving the Quality of Life 2nd ed., London: Sage Publications Ltd. Layard, P.R.G. 2005, Happiness: Lessons from a New Science. In, Hastings, G. 2007, Social Marketing Why should the Devil have all the Best Tune? Oxford: Elsevier Lefebvre, R. C. 2006, “On Social Marketing and Social Change: When is it Social Marketing?” http://socialmarketing.blogs.com/r_craiig_lefebvres_social/2006/06/wh en_is_it_soci.html (accessed 01/02/2012) Levy, S. and G. Zaltman 1975, Marketing Society & Conflict Englewood Cliffs, NJ: Prentice-Hall Inc. Lombardo, A.P. and Y. A. Leger 2007, “Thinking about ‘Think Again’ in Canada: Assessing a Social Marketing HIV/Aids Prevention Campaign”, Journal of Health Communication 12, 377 Lowry, R.J., S. Hardy, C. Jordan, and G. Wayman 2004 “Using Social Marketing to Increase Recruitment of Pregnant Smokers to Smoking Cessation Services: A Success Story”, Public Health 136, 1 McDowell, J. 2004, “20/20 The Way to Clean Air”, http://www.toolsofchange.com/English/CaseStudies/ (accessed 09/06/2012) Peattie, S. and K. Peattie 2003, “Ready to Fly Solo? Reducing Social Marketing’s Dependence on Commercial Marketing Theory”, Marketing Theory, 3(3), 365 Quinn, P., B. A. Bell-Ellison, W. Loomis, and M. Tucci 2007, “Adolescent perceptions of violence”, Journal of the Royal Institute of Public Health 21, 357 Silverman, D. 2006, Interpreting Qualitative Data: Methods for Analysing Talk, Text and Interaction, London: Sage Publications Ltd. Sirkin, R.M. 1995, Statistics for the Social Sciences, California: Sage Publications Inc.

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Smith, W. A. 2002, “Social Marketing and its Potential Contribution to a Modern Synthesis of Social Change”. Social Marketing Quarterly 8. (2) Summer. Stake, R. E. 1995, The Art of Case Study Research, Thousand Oaks: Sage Publications Stead, M., L. McDermott and G. Hastings 2007, A Marketing Strategy to Reduce UK Prison Numbers, in Hastings, G. 2007, Why Should the Devil have all the Best Tunes?, Oxford: Butterfield-Heinemann Sun, Xinying, Yan Guo, Sisun Wang and Jing Sun 2007, “Social Marketing Improved the Consumption of Iron-fortified Soy Sauce among Women in China”, Journal of Nutrition Education and Behavior 39 (6), 302 Sweet, S. A. and K. Grace-Martin, 2008, Data Analysis with SPSS 3rd ed. Boston: Pearson Education, Inc. The Health Sponsorship Council 2008, “SunSmart Programme 2002 – 2004”, www.sunsmart.co.nz/ (accessed 08/06/2012) Weiss, E., S. Maman, H. Lary, J. Mbwambo, and A.McCauley, 2004 “Preventing HIV and Partner Violence”, Horizons Report, Social Science and Medicine 50 (4), 459.

CHAPTER FOUR SOCIAL MARKETING: IMMUNIZING AGAINST UNETHICAL PRACTICE STEPHEN S. HOLDEN AND DAMIAN COX

Introduction Do you think that social marketing is more ethical than commercial marketing? If you do, you are in good company, as straw polls we have taken at conferences show that virtually everyone (95% or more) thinks so. But what justifies this belief? Social marketers may be well meaning, and perhaps more so than commercial marketers, but is there anything about social marketing that makes it inherently ethical? We argue that social marketing is not inherently ethical and that there are unique ethical concerns that confront, or perhaps ought to confront, social marketers. As commercial and social marketers use the same marketing tools, social marketers cannot claim to be inherently more ethical than commercial marketers in terms of the ‘means’. We may well hope that social marketers subscribe to a high standard of ethics in their use of marketing tools, as has been urged by some (Kirby & Andreasen, 2001; Kotler & Andreasen, 2007; Murphy & Bloom, 1992), but there is certainly no assurance that they do so simply because they are social marketers. Where social and commercial marketers are held to differ is in terms of the ‘ends’ of the marketing effort, in the goals or objectives of each: social marketers aim at a social or common good. However, does this ensure that social marketers are ethical? We suggest not as what constitutes the social good is difficult to determine and often contested, as illustrated in the

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example of immunization and vaccinations 1 that we develop here. We chose this particular example because it has a long history as a social marketing target and has evoked much public debate highlighting the issues we wish to discuss. However, as we argue elsewhere (Holden & Cox, 2013), the issues raised are relevant to many domains of social marketing. The ultimate objective of this chapter is to reflect on what constitutes ethical behaviour in our field. We are not questioning the ethicality of social marketers but rather questioning the presumption of ethicality. Marketing for the social good may be praiseworthy in many instances, but this does not yet establish the ethical legitimacy of the relevant marketing practice. Our approach here, like that of Brenkert (2001, 2002), is philosophical rather than empirical. To some extent, this means we raise tough questions, and we do not provide answers! Nonetheless, we believe social marketing can benefit if there is a willingness to understand the unique ethical challenges faced and to address the questions raised.

Commercial vs. social marketing of vaccinations Typically, social marketers are distinguished from commercial marketers primarily by their motives (Andreasen, 1995; Andreasen, 2006; Dann, 2010; Donovan & Henley, 2010; Grier & Bryant, 2005; Kotler & Zaltman, 1971; Smith, 2000). Donovan and Henley (2010: 1) assert that the matter is straightforward: ‘If the well-being of the community is not the goal, then it isn’t social marketing’. We believe the situation is not quite that simple. Consider the following two scenarios as we explore what is excluded from social marketing: Scenario A: CSL is an Australian-based global marketer of vaccines (http://www.flu.com.au/) and Sanofi is a French-based global competitor (http://www.sanofipasteur.com/EN/value-of-vaccines.html). Each markets and promotes vaccines to consumers through websites (see examples given) and other media.

1

In line with common usage, we use the word vaccination to refer to a wide variety of pharmaceutical products that offer immunity to a wide variety of diseases. Immunization is the outcome of applying a vaccination.

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Scenario B: Immunise Australia (http://immunise.health.gov.au), the Public Health Agency of Canada (http://www.phac-aspc.gc.ca/im/indexeng.php) and the Center for Disease Control in the US (http://www.cdc.gov/vaccines/) all market and promote vaccines to consumers through websites and other media. Both the commercial marketers and the government health agencies are promoting vaccinations, so both are marketing a social good. The standard explanation given for why B is an example of social marketing and A is not is that the commercial marketer generates profits if their marketing effort is successful. The commercial marketers are promoting a social or public good, but there is also a self-serving motivation to generate a profit (Donovan & Henley, 2010; Gordon et al., 2006; Smith, 2000). Donovan (2011: 9) states: Where the primary, if not only motivation, is to enhance the public good, then it is social marketing. Where the primary motivation is to turn a profit, even where this contributes to the public good, it is not social marketing–simple.

We believe that this suffices for most practical purposes, but it may inadvertently suggest that the social marketer is motivated only by the social good. Just as we might question whether a commercial marketer who claims to serve customer needs above all else is being honest, so might we question a social marketer who claims to prioritize social good above all else. Social marketers may have ulterior and potentially self-serving motivations beyond advancing the social good. Social marketers operate with financial imperatives: they are obliged to set and meet budgets, to maximize the impact for the expenditure available and, ultimately, to show a positive return on investment (Lingane & Olsen, 2004). Obtaining funding within the competitive environment where they seek support requires evidence of results and good management skills (Andreasen, 2002). The individuals that make up social marketing organizations also have personal motivations, such as the satisfaction of doing a job well, recognition, status, promotion and job security – just like their commercial marketing counterparts.

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The public health agencies that are marketing vaccinations (Scenario B) may not have direct financial interests in the uptake of vaccination, but there are financial consequences that are likely to arise from the success or otherwise of their efforts. The marketer as an organization and the employees making up the organization have indirect financial (and, indeed, existential) interests in the success of their marketing efforts. Both social and commercial marketers, therefore, are guided by multiple goals. A commercial marketer can be readily distinguished from the social marketer by having a reportable profit, yet still maintain that advancing the social good is their sole or even primary objective. A case in point is the ISIS Group (http://www.isisgroup.org/): a corporate advisory business (ISIS Asia-Pacific) operates primarily to fund international development (ISIS Foundation). Similarly, a social marketer may have objectives and priorities aside from the social good. Knowledge of intentions and motivations relies in a large part upon self-reporting, but this in turn relies on self-knowledge and honesty. Can we trust what people say? This problem confronts those who would endeavour to treat non-vaccinators differently depending on their stated reason for non-vaccination (Asveld, 2008). The law similarly acknowledges the difficulties of intentions such that they are rarely admitted in courts of law as a basis for conviction – cases of pre-meditated murder / murderous intent being one of the few exceptions. The motivations and intentions underlying the actions of an organization can be varied – financial, political and personal – and may or may not be clearly stated.

Social marketing for and against vaccination Even if motivation for the social good is the primary motivation of a social marketer, how clear is this goal? To explore this problem, let us add a third scenario: Scenario C: Many public interest groups encourage people to ‘be informed’ about vaccination, to ask how necessary it is and to understand its limitations and possible side effects. These groups market and promote non-vaccination through websites and other media (e.g. avn.org.au, vaccines.procon.org and www.vaccines.me/). Scenarios B and C include two types of not-for-profit agency: one promoting vaccination (B) and the other promoting non-vaccination (C).

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Some might be inclined to dismiss the idea that so-called anti-vaccinators are social marketers, but this presupposes that vaccination is unequivocally in the social good. Who defines what is in the best interests of society? Do the anti-vaccinators have a good and legitimate role to play in answering this question? We argue that they do. As knowledge is never certain, and as marketers of vaccinations – commercial or social – may have other objectives aside from the social good, there appears to be value in anti-vaccination marketing. This is not to say that it is legitimate for anti-vaccinators to disseminate falsehoods knowingly: this ethical provision applies equally to all marketers, commercial and social. Social marketers are challenged, however, as ‘social good’ is vague, contested and difficult to define (Bayer et al., 2007; Polonsky & Grau, 2008). It is unclear, then, whether pro-vaccinators or anti-vaccinators can make an unequivocal case that they, and they alone, are furthering the social good. It therefore appears that the goals of social marketers, like the goals of public health, ‘are too often assumed or simply asserted, rather than cogently explained or justified’ (Gostin et al., 2007: 57). While most social marketers hold that social marketing should consider the ethics of their methods (means), there are a number that take the view that examining the ethicality of the social good is not the responsibility of social marketing (Donovan & Henley, 2010; Kirby & Andreasen, 2001; Lee & Kotler, 2011). However, if this is the case, then this makes social marketers little more than ‘hired guns’, as described by Andreasen on a social marketing list-server (Lee & Kotler, 2011). This fails to set a social marketer apart ethically from any other marketer. Indeed, the social marketer holding this view sounds little different from the tobacco industry lobbyist Nick Naylor in the film Thank You for Smoking, who justifies his professional practice with the statement: ‘I need to pay the mortgage.’ In an internal monologue, Naylor describes this as ‘The yuppie Nuremberg defence.’ We believe that social marketers are obliged to examine the bona fides of their claims to advance the social good, despite the difficulties of doing so; to not do so is to engage in ‘ethics avoidance’ (Cribb, 2010). To examine the social good is of critical importance as it results in the determination of objectives of social marketing programs affecting individuals who have had no part in determining those objectives.

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The ethicality of all social marketing should be subject, therefore, to critical scrutiny. Examining the ethicality of methods is important to both social and commercial marketing. Examining the ethicality of goals is especially important in the case of social marketing, where the social good is defined and marketed independently of, and possibly in violation of, individual wishes. In this vein, we trace the emergence and contribution of ‘for’ and ‘against’ positions in vaccination marketing.

The social good of immunization – for and against The notion that ‘prevention is better than the cure’, stated by Erasmus long before vaccination and social marketing were even conceived, underlies many forms of social marketing, such as primary prevention in public health (Carter et al., 2012). The principle motivates efforts to encourage people to vaccinate but also to wear seatbelts/helmets, engage in activity/exercise, breastfeed, eat healthily, get appropriate health checks, etc. Some social marketing is aimed at discouraging behaviours (e.g. consumption of alcohol, fast-food, cigarettes, drugs, etc.), but the general principle is the same: in these contexts, the promotional effort encourages foregoing immediate or short-term gains in place of some greater benefit in the longer run. The first great drive for immunization was against smallpox. This virulent disease could kill up to 20% of those infected and would leave many of the survivors permanently scarred, blind or both. However, some cultures, notably China, India and Africa, had found that immunity could be induced by inoculating uninfected persons with the crusts of smallpox sores. This practice was introduced to France by Boyer, to the UK by Lady Montagu (wife of the ambassador to Turkey) and to the US by Dr Zabdial Boylston in Boston in the early 18th century (White, 1993 / 1896). Inoculation with smallpox, also called variolation, led to the development of immunity – but there was a drawback. Up to 2% of those variolated might be expected to die. Medical and theological authorities in the UK, Europe and the US vigorously denounced variolation as poisoning, murder, blasphemy and more generally as being against the will of God (White, 1993 / 1896). Voltaire (2001 / 1909-14) famously ventured his own views, which neatly capture the conflict of those for and against:

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[Europeans consider] the English are fools and madmen. Fools, because they give their children the small-pox to prevent their catching it; and madmen, because they wantonly communicate a certain and dreadful distemper to their children, merely to prevent an uncertain evil. The English, on the other side, call the rest of the Europeans cowardly and unnatural. Cowardly, because they are afraid of putting their children to a little pain; unnatural, because they expose them to die one time or other of the small-pox.

The development of vaccination, where patients were inoculated with cowpox, offered immunity against smallpox at a much-reduced risk (Jenner, 1909–1914 / 1798). Nonetheless, strong opposition emerged again from both the medical profession and from the church. No sooner had Jenner published his ideas about vaccination than an Anti-Vaccination Society was established in Boston in 1798 (White, 1993 / 1896). Jenner’s idea was lambasted publically, which gave rise to the famous political cartoon featuring vaccinated patients having cows erupt from their bodies: Figure 4-1: James Gillray’s 1802 cartoon highlighting vaccination fears (http://en.wikipedia.org/wiki/File:The_cow_pock.jpg)

Despite the negative responses, the evidence that vaccination could prevent infection by smallpox with very small risk was overwhelming and the British government began an early social marketing campaign

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promoting vaccination. The Vaccination Act of 1840 banned the practice of variolation and promoted vaccination by offering it for free. The Compulsory Vaccination Act was introduced in 1853. The anti-vaccination movement continued. Offit, a paediatrician and pro-immunization advocate, stated in an interview that the anti-vaccinators ‘were great at mass marketing. It was a print-oriented society. They were great pamphleteers’ (Wallace, 2009). Today’s anti-vaccinators are equally marketing savvy and the opposition remains both medical and theological. While not necessarily well articulated, the anti-vaccinators offer an important contribution. They highlight the fact that whether vaccination is good for the community is disputed. For instance, the fact that different vaccinations are required in different jurisdictions indicates that not all agree on what is in the best interests of the community. The MMR (measles, mumps and rubella) vaccine has been banned in Japan since 1993 due to the side effects associated with the mumps component of the vaccine (Hope, 2001). While the most recent meta-analysis confirms these negative events (Demicheli et al., 2012), it would appear that most public health agencies consider these acceptable risks while the Japanese do not. Another important contribution of anti-vaccinators, which again is not always necessarily clearly articulated, is that universal social marketing efforts such as the promotion of mass vaccination can impinge on individual liberties, autonomy and self-determination.

Social good vs. individual rights Many social marketing ventures face the same challenge confronted in immunization: what is good for the community is not necessarily good for the individual, even though the individual is necessarily embedded within the community. The basic conflict is one of social good versus individual rights or, more simply, social marketing’s ‘interference in personal choices’ (Dawson & Verweij, 2010: 89). Social marketers are mostly interested in advancing what they understand to be the social good, and they are less inclined to accommodate individual choice or fully acknowledge the roles that liberty and autonomy play in many conceptions of the social good. This puts social marketers in a precarious position ethically. In effect, by their efforts, they are saying to their markets: ‘we have decided what is best for

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you – whether you like it or not.’ Of course, social marketing is a process that incorporates extensive public consultation (e.g. Andreasen, 2002), but even if that process is unbiased and fair – and that is difficult to establish, even if the process is transparent – the outcome will effectively operate against those with a contrary view. This requires unflagging scrutiny of the justice of marketing programs. Social good based on ‘a rough-and-ready utilitarian calculation is probably what the authorities have in mind when they decide to use preventive measures [such as vaccination] regardless of the risk they are imposing on a certain number of people’ (Häyry & Häyry, 1989, cited by Holland, 2007: 153). Pro-vaccinators (and social marketers in general) are therefore adopting a utilitarian argument that the social good is represented by the greatest good for the greatest number (Bentham, 1961 / 1789). The anti-vaccinators invoke a different ethical principle that is a relevant challenge to most social marketing: that the rights of choice of individuals ought not to be breached, even if for their own good. John Stuart Mill, in his essay On Liberty (Mill, 1991 / 1859: 30), states that ‘…the only purpose for which power can be rightfully exercised over any member of a civilized community, against his will, is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.’ The problem is that what is good for the individual does not necessarily align with what is good for the community. Individual preferences may be subjective but are nonetheless deemed important from an ethical point of view. It is noteworthy and ironic perhaps that commercial marketers are probably more sensitive to individual preferences than social marketers. Even if subjective issues are removed, the calculation of risk at a community level does not necessarily correspond to the risk experienced at the individual level. As more and more people are vaccinated, an unvaccinated individual’s risk of infection declines. Ultimately, when herd immunity is attained, the calculation for the individual can shift significantly to a point where the risks associated with vaccination, even if small, may come to outweigh the risk of contracting the disease. This then raises the free-rider problem. Specifically, herd immunity describes a positive externality whereby the benefits accrue to others beyond those who have ‘paid’ (i.e. been vaccinated). Interestingly, even social marketers who may tend to be utilitarian as regards the social good of vaccination

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may nonetheless agree that the free-rider problem represents an unjust distribution of the good. The ethical question now becomes a determinately non-utilitarian one: to what extent, and in what ways, can free-rider considerations trump claims to choose a course of action for oneself? Mill’s (1991 / 1859) harm principle can be invoked so that individual rights might be curtailed if non-vaccinators are judged to bring harm to others. Offit’s (2011) book entitled Deadly Choices: How the anti-vaccine movement threatens us all is one such statement of this notion. However, Offit’s hyperbole, combined with the related issue of the ethical obligation on an individual to vaccinate in order to protect others (Bayer et al., 2007; Diekema & Marcuse, 2007), leads us to the final issue: consideration of the appropriate level of influence that might be adopted by social marketers.

Means: influence and coercion At this final point, we give some brief consideration to the important issue of the means of social marketing. As noted earlier, the means of marketing are common to both commercial and social marketing and so form no basis for defending social marketing as being more ethical than commercial marketing. However, the lack of clarity around what constitutes the social good and how it might be legitimately advanced suggests that the degree of influence appropriate for marketers is an especially important consideration. Marketing in general is held in poor public regard, particularly because there is little assurance that a marketer is being open and honest (Barksdale et al., 1976; Murphy & Bloom, 1992; Murphy, 2010). Regrettably, social marketers are not exempt from misusing the tools of marketing. Anti-vaccinators have been fairly challenged for making dubious claims, such as promoting the link between autism and the MMR (measles, mumps and rubella) vaccine. Anti-smoking advocates have sometimes manipulated or even fabricated data, especially about the ill effects of second-hand smoke (Donovan & Henley, 2010; Hatton, 1994; Johnstone & Ulyatt, 1991). Other social marketers have demeaned and even damaged some members in society in promoting their causes (Donovan et al., 2008; Donovan et al., 2009). All such ethical violations remind us that a stated objective of the social good, even in the absence of a profit motive, does not immunize against unethical behaviour.

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Is coercion ethically permissible? Social marketing definitions are surprisingly variable about this matter. Many definitions explicitly limit social marketing influence to ‘voluntary behaviour’ (e.g. Andreasen, 1995; Dann, 2010; Grier & Bryant, 2005; Smith, 2000). Rothschild (1999, 2001) similarly excludes coercion from social marketing influence efforts, which he places between education and information on the one hand and law on the other. However, others argue that the exclusion of more coercive influence is somewhat artificial and that legislation and regulation are important social marketing tools (Donovan, 2011). Moreover, Donovan and Henley (2010) note that commercial marketers are often willing to push their influence and will wield monopoly power if available. Of course, no ends automatically justify the means, but if the ends are in doubt, then an extra degree of caution around the means seems appropriate. ‘Forcing people to get vaccinated is not like forcing people to drive on the right side of the road, because the risks and benefits of vaccination are contestable, the phenomenology of vaccination is complex, and features such as parental rights are influential’ (Holland, 2007: 159). Marketing in general aims to influence people. Influence invokes concerns about autonomy and self-determination. As influence moves from education towards regulation (Rothschild, 1999), these concerns seem to grow. If regulation is going to be used, then it would appear that there needs to be a great deal of confidence around the social good that is being offered, including whether it is justified even if in opposition to individual choices.

Conclusion We challenge the view that social marketing is in its nature more ethical than commercial marketing and suggest that social marketers are not entitled to claim any inherent ethical praiseworthiness relative to commercial marketers. We suggest that the following might be added to the list of ‘mythunderstandings’ offered by Donovan (2011): social marketing is not inherently ethically good. More specifically, we propose that differentiating commercial and social marketers in terms of their intentions is problematic as intentions reflect internal states that are not readily available to an external observer, and agents pursue multiple goals and possess a variety of intentions. Being commercial does not necessarily mean that profit is a primary objective of

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one’s activities; being socially oriented does not mean that self-serving motivations are not salient and sometimes even primary. Even if we accept that the social good is the primary objective of social marketers, the problem becomes one of what constitutes the social good. Social marketing purports to provide benefits to the individuals it serves, but consulting with those individuals is not assured and, even if conducted, may proceed even in denial of the stated interests of at least some of the individuals. Social marketing serves the community or society at large; individual preferences and wishes are subordinated to this objective. This is a striking contrast with ‘less ethical’ commercial marketing, in which individual interests are king and caveat emptor gives the individual the ultimate power of veto. A consideration of individual rights evokes the problem of how much influence is appropriate. Social marketers often shy away from any involuntary behavioural change, which perhaps reflects an understanding that promotion of the social good may be at odds with supporting autonomy and self-determination, which are generally considered to be important rights. Our chapter explores some of the unique ethical issues confronting social marketing in the context of vaccination, but these issues also apply to social marketing more broadly (e.g. Holden & Cox, 2013). We believe that many if not most social marketers are motivated to be good citizens and to help society. Nonetheless, we argue that they are obliged to examine the ethicality of their goals and to assess whether what they are doing is morally legitimate. In particular, we suggest that there are three questions that social marketers might ask to inform themselves of the ethicality of their practice: Is the social good good? How are individual rights accommodated? What degree of influence is ethically justifiable? There are unfortunately no ready answers to these questions; they must be explored on a case-by-case basis, and even then the questions may be difficult to answer. Social marketing has the power and the potential to benefit some individuals, but it also has the potential to limit or even harm others. We acknowledge that this chapter poses some tough questions for social marketing. The chapter is offered as a preventative measure, as a ‘shot in

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the arm’ encouraging consideration of the questions raised – even if they are difficult to answer. Our hope is to protect social marketers from hubris and to encourage vigilance against inadvertent engagement in unethical behaviour.

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PART II: SOCIAL MARKETING THEORIZING

CHAPTER FIVE FROM REDUCTIONISM TO HOLISM: HOW SOCIAL MARKETING CAPTURES THE BIGGER PICTURE THROUGH COLLABORATIVE SYSTEM INDICATORS PATRICIA MCHUGH AND CHRISTINE DOMEGAN

An introduction to the bigger picture and systems thinking Systems serendipitously envelop our every action and behaviour, whether in our homes, cars, workplaces, communities or societies. Economic and social behavioural systems interact with one another and shape what we did yesterday, what we do today and what we will end up doing tomorrow. The Story of Stuff by Annie Leonard is a powerful representation of how ‘we’ as both consumers and citizens become obsessed by stuff, with little thought for the systems that guide where the stuff comes from, or where it goes to, in the materials economy. As consumers, do we consider how a simple bottle of water goes from extraction to production to distribution to consumption to disposal and the effects and impacts that this simple plastic bottle has on our environment? In the eyes of the consumer, this system looks fine. However, in recognition of the multiple processes that create stuff and the millions of citizens pursuing infinite and self-serving consumption, the system is in fact in crisis because we cannot run a system of behavioural processes on a finite planet indefinitely (Leonard, 2008). Therefore, it is imperative that we understand the bigger picture and recognize that systems interact continuously with societies, cultures, economies and the environment.

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Wroe Alderson, the most influential marketing author on systems theory, understood the interaction between systems and society. Alderson (1957) analysed the behaviours of the system parts, concentrating on both the individual micro behaviours of a mechanical system and the collective co-ordination of both micro and macro group behaviours in an ecological system. Alderson (1957: 32) recognized that an ecological behavioural system upholds a peculiar bond in that the components are ‘sufficiently integrated to permit the system to operate as a whole, but the bond is loose enough to allow for the replacement or addition of components’. These loose interactions between a system and a society occur in two ways: through reductionism and through holism. Reductionism breaks a system down into micro pieces, understanding the individual actions and behaviours of the multiple components of a system, whereas holism analyses the behaviour of an entire system ‘without breaking it into pieces, so that the internal interactions are left intact, and the system is, in the well-known words, studied as a whole’ (Dixon & Wilkinson, 1989: 61). In the systems literature, Bartels and Jenkins (1977) and Nason (1988) have recognized an impinging divide between macro-level systems thinking and micro-level systems thinking, whereby the macro was perceived as superior to the micro and vice versa, respectively. The bigger picture from the Story of Stuff reveals that, regardless of whether a system is reductionistic or holistic, it bumps up against limits (Leonard, 2008). The greatest limit is the omission of people or citizens from a system. This is the gap in the systems literature: both reductionistic and holistic systems interact with citizens, and citizens interact with reductionistic and holistic systems. Social marketing, as a discipline, recognizes the importance of citizens in the bigger picture and seeks to understand the dynamic interplay between systems and citizens, as social marketing looks to create value for both individuals and society (Lefebvre, 2012). Social marketing emphasizes the convergence, collaboration and co-creation of shared ideas, values and experiences for both reductionistic and holistic systems. Social marketing advocates a total market approach to the analysis of group behaviour, as opposed to the either/or choice of reductionism versus holism. A total market approach to the analysis of group behaviour integrates three environmental levels: the micro individual level, the meso group or community level, and the macro societal level. Applied to obesity, total market approaches to change, for example, ‘challenge us to think about not just the child’s eating behaviour, but also about parents'

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cooking skills as well as school lunch policies, food advertising and production methods as well as government regulations’ (Hastings & Domegan, in press: 47). This chapter details how complex problem co-ordination processes in social marketing can deviate from reductionistic to holistic systems thinking. The chapter also considers that citizens lie at the heart of creating meaningful solutions to complex societal problems. Complex societal and policy problems, such as obesity, biodiversity, global marine management, climate change and child poverty, now require broader systems of active and empowered partnerships, alongside social marketing network formations at every level (from national to individual), ensuring collaborative systems integration for social marketing. Furthermore, the chapter considers how the use of collaborative system indicators in social marketing can influence and shape the intricate interplays between macro-, meso- and micro-level stakeholders in a total market approach to resolving complex societal problems.

Tackling complex societal problems – the reductionistic systems approach Complexity, by its dictionary definition, denotes a whole that is made up of many interconnected parts that are hard to understand or address (Oxford, 2013). In society, problems are becoming increasingly difficult to understand due to the complex nature of defining the problem and the associated complexities of the system structures, environments, behaviours, processes and exchanges. The complexity of a system is further exasperated by its interaction with citizens and their associated behaviours. Behaviours do not just happen by themselves; behaviours are shaped by the systems surrounding a citizen and the interaction of a citizen with their respective environments, cultures, communities and societies. Societal behavioural problems have become so complex that they have been dubbed ‘wicked problems’ (Rittel & Webber, 1973; Roberts, 2000, 2011). Wicked problems refer to those problems that are tricky and unique, and solutions to such problems are not true or false but better or worse, given there is no opportunity to learn by trial and error. Every attempt to resolve these particular problems counts significantly (Chapman et al., 2009).

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Traditionally, societal problems such as smoking have been resolved through reductionistic system approaches that represent short-term gains for a long-term problem. Reductionistic approaches represent a linear system of command and control governance styles whereby the system and citizens are separated by a hierarchy, as illustrated in Table 5-1. A reductionistic systems approach subsumes control and power at the top of the hierarchy, where macro-level stakeholders such as policy makers know best. In anti-smoking campaigns, the health authorities and doctors know best, as these experts say ‘smoking kills and is bad for you’ and to ‘stop smoking’ (Chapman, 2004; Hastings & Domegan, in press). However, knowing best approaches not only closes the door to learning but also closes off the possibility of understanding other perspectives, views and opinions (Chapman, 2004). A subordinated ‘knowing best’ approach also blocks reflective citizen engagement and the co-ordination of dyadic, triadic and complex networks of relational exchanges between a system and its citizens. Table 5-1: The reductionistic systems approach A Reductionistic Approach Command and Control Governance Style Hierarchical System Structure Macro versus Micro Communication Style Boundaries Well Delineated Boundaries between Levels Find a Solution Focus Integration of Values and Facts Separation of Values and Facts Value Added Value Creation Transfer is Linear (One-sided) Mode of Interaction Product Type of Output Instrumental Use Type of Knowledge Use Closed Feedback Loops Feedback Adapted from: Pulzl & Rametsteiner (2009)

Reductionism places special emphasis on the micro segments or parts of the system. According to Langlois (1983), reductionism is applicable to phenomena of organized simplicity. Simplicity is further invoked by macro-level stakeholders such as policy makers and regulators, who create oversimplified solutions to complex policy issues such as health and wellbeing, child poverty, tobacco control and global warming: for example, ‘don’t drink and drive’, ‘smoking kills’ and ‘think of the environment’. Oversimplified solutions become the optimal choice for government when insufficient time is given to the clarification and

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definition stage of a wicked problem. A reductionistic systems approach to wicked problems embraces linear communication styles, as upstream social actors in the hierarchical macro levels ‘market the desired behaviour to’ the subordinate downstream meso and micro levels (Lusch et al., 2007). These linear mechanisms of communication hold similar values to the goods-dominant logic of marketing (Lusch & Vargo, 2009), whereby the exchange processes of governments and policy makers are closed, rational and dyadically influenced (Chandler & Vargo, 2011). Closed exchange processes segregate stakeholders into three clear levels of context: macro, meso and micro environmental levels (Chandler & Vargo, 2011). Reductionistic system approaches to complex problem co-ordination often follow a hierarchical deconstruction strategy, whereby policy makers at upstream macro environmental levels confine the deliberation processes to a select group of stakeholders, inhibiting the flow and exchange of knowledge and information from multiple levels in society (Jaworski et al., 2000). These closed and confined exchanges exhibit a first-order relationship in that the stakeholders involved in the deliberation processes are functionally necessary to one another (Lewis & Erickson, 1969). Closed exchange processes in reductionism separate the system from the citizen and fail to understand the complexity of interactive relationships, resulting in a passive, isolated and unaware micro society.

Tackling complex societal problems – the holistic systems approach Holism or collectivism ‘insists that wholes possess emergent properties that cannot be derived from the properties of constituent parts. To the holist, the whole is greater than the sum of the parts’ (Langlois, 1983: 583). Holistic systems are comparable to total market approaches, whereby stakeholders from each level in society (whether from macro, meso or micro environments) are fully integrated throughout the societal process of change, as illustrated in Table 5-2. Holistic systems capture the bigger picture, through synthesis, focusing on the multiple structures, functions, processes and environments in which actors engage (Shaw & Jones, 2005; Hult & Ferrell, 1997). Thus, they acknowledge the dynamic interplay between systems and citizens. Holistic systems recognize that change is evolutionary and social issues do not remain constant: they evolve into uncertain and unpredictable behavioural patterns.

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Table 5-2: The holistic systems approach A Holistic Approach Adaptive to Change Governance Style Collaborative System Structure Macro and Micro Communication Style Boundaries Blurred Boundaries between Levels Make an Improvement Focus Integration of Values and Facts Complex Mixing of Value and Facts Co-creation Value Creation Transfer is Non-linear (Two-sided) Mode of Interaction Process Type of Output Reflexive Use Type of Knowledge Use Double / Triple Feedback Loops Feedback Adapted from: Pulzl & Rametsteiner (2009)

Holistic systems exhibit similar traits to those of open innovation, where there are two complementary kinds of openness. One is outside-in, where macro-level stakeholders make greater use of external ideas and knowledge, exhibiting the ‘not invented here’ syndrome (Chesbrough, 2011). The other kind of openness is inside-out, where upstream macro environmental stakeholders share their knowledge and expertise with those stakeholders who are external to their upstream networks (Chesbrough, 2011). Holism allows for outside-in and inside-out collaborations between multiple stakeholders in multiple levels of society in order to create and co-create value (Lee et al., 2012). This form of open innovation can be seen in the Netherlands with a glow-in-the-dark design solution to behavioural change. The ‘smart road’ system designed by Studio Roosegaarde will be implemented from mid-2013. The smart road uses an infrastructure that features glow-in-the-dark tarmac and illuminated weather indicators. The photo-luminizing powder will replace road markings as it charges in the daylight and gives up to ten hours of glow at night. Special paint is also being used to paint markers such as snowflakes across the road surfaces so that when temperatures fall to a certain point, these images will become visible to the driver, indicating that the road surface is slippery (Clark, 2012). This innovative technology, in conjunction with road traffic news, internal navigation systems and legislation, will lead to a more holistic system of road safety in the Netherlands, creating value for individual drivers, families and society. Co-creational relationships follow Lewis and Erickson’s (1969) second-order relationship, whereby the multi-level relationships are

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complementary to the social change framework but are not functionally dependent or reliant on one another. For example, Healthy Cities sees ‘health and change as the business of all sectors. It engages local governments in health development through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects. About 90 cities are members of the WHO European Healthy Cities Network, and 30 national Healthy Cities networks across the WHO European Region have a membership of more than 1400’ (Hastings and Domegan, in press: 185). Co-creational relationships in holistic systems strive to make collaborative improvements to the system over the long term. The cointegration of multiple stakeholder levels is seen as evolutionary, nonlinear and interactive, requiring intensive communication, collaboration and feedback between citizens from macro, meso and micro environmental levels (Todtling & Trippl, 2005). Holistic systems acknowledge that complex problems are difficult to solve as they incorporate multiple environments, multiple layers, multiple levels and multiple stakeholders. More specifically, the multi-causal nature of complex problems creates specific challenges to behavioural change as ‘causal processes involve more than linear chains of events; every element in a sequence has a possibility of affecting everything else in the sequence before and after it. Thus the effect of an initial change can be magnified as the change reverberates through the system’ (Diez-Roux, 2007: 571). This is again reflected in a simple behaviour such as buying a bottle of water. Before the behaviour, do we as consumers consider the processes behind the manufacturing of a plastic bottle? Or, more importantly, do we consider the disposal of a plastic bottle, where 80% end up in landfill or in incinerators where they are burned and release toxic pollutants while the remainder end up in recycling bins (Leonard, 2008)? These pre- and postbehavioural sequences create multiple layers and levels to the complex environmental problem of buying bottled water over tap water. Holistic approaches to behavioural and societal change are challenging, in that it is difficult to manage the process of tackling a wicked problem. Rittel and Webber (1973: 161) believe that ‘one has to develop an exhaustive inventory of all conceivable solutions ahead of time’, which involves selecting who the stakeholders are, how to bring the groups together, considering the possible outcomes and solutions, and the facilitation of exchanges and interactions between the diverse stakeholder groups. Therefore, the optimal solution to complex societal problems

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involves ‘whole systems in the room thinking’ (Hastings & Domegan, in press), which requires collaborative integration between reductionistic linear systems and dynamic holistic systems (Roberts, 2000), as illustrated in Figure 5-1. Figure 5-1: Collaborative systems integration

Adapted from: Pulzl & Rametsteiner (2009)

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Tackling complex societal problems – collaborative systems integration in social marketing Tackling wicked societal problems involves whole systems behavioural change, to be known as ‘collaborative systems integration’. Social marketing acknowledges that the exchanges that underpin complex societal problems do not occur in a vacuum. They incorporate multiple stakeholders at multiple levels of influence, such as at the individual, interpersonal, organizational, community, societal and public policy levels (McLeroy et al., 1988). Social marketing ‘encompasses all the processes and outcomes that influence and are associated with change among: individuals, organizations, social networks and social norms, communities, businesses, markets and public policy’ (Lefebvre, 2012: 120), thus acknowledging the interactions between citizens and systems. Social marketing is also successful at linking individual exchanges to societal outcomes through behavioural change, which brings shared values into action. However, social marketing interventions at both the operational and policy levels, like the systems literature, have been criticized for having an over-reliance on micro-level behavioural change strategies. Dholakia (1984) asserts that it is necessary for the domain of social marketing to examine and evaluate the macro-level effects of social marketing, as well as the micro-level processes of social marketing. Such an approach necessitates the careful co-integration of micro-level and macro-level behavioural change strategies. Social marketing therefore requires greater connectedness across system levels. Boundaries must be spanned and shared value networks co-created for experiential solutions ‘to facilitate not just behaviour change, but far-reaching social change’ (Hastings & Domegan, in press: 4). Co-created solutions to complex societal problems involve not just the implementation of authoritative and hierarchical strategies but also the use of collaborative strategies (Roberts, 2000). These strategies direct how power and communication are dispersed among system stakeholders. Authoritative and hierarchical strategies in a reductionistic system approach display closed communication styles where knowledge, skills and resources move from the macro environmental level down to the meso and micro levels. Collaborative strategies embrace holistic systems of problem solving, integrating the macro, meso and micro environmental levels simultaneously.

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Social marketing takes the stance that tackling complex societal problems requires a systems approach with multi-level and multidirectional co-ordination processes. Complex societal problems cannot be tackled unless boundaries are crossed and system networks are created (Roberts, 2011). The collaborative systems required to tackle societal change necessitate ‘emancipation from the shackles of the dyad’ and demand ‘a focus on the broader context of a network of relationships between complementary and competing actors’ (Storbacka & Nenonen, 2011: 242). Interactive communication processes between groups of individuals need to move beyond simplistic transactions towards more meaningful exchanges of both tangible and intangible resources in order to co-create solutions or re-solutions to wicked societal problems. The process of whole systems behavioural change is viewed as socially complex due to multi-causalities, conflicts, constraints and unforeseen consequences (Australian Public Service Commission, 2007; Kennedy & Parsons, 2012). Governments and policy makers at the macro environmental level now need to move beyond isolated and dyadic relationships towards the formation of open, triadic and complex network exchange systems (Juttner & Wehrli, 1994: Layton, 2007). Network exchange systems accentuate the interconnected and iterative relationships between individuals and groups of individuals in society, strengthening the ways in which these relationships facilitate the co-created exchange of knowledge and resources. Meaningful solutions to complex societal problems require a balance between reductionism and holism, which collaborative systems integration in social marketing provides. Collaborative systems integration is a bigpicture model concerned with the co-creation of macro-micro, micromacro and interactive behavioural solutions to complex societal and policy issues. The dominant mode of response is non-linear (Chapman, 2004), requiring action within and between every level of the system, which encourages citizens to become effective agents of change in co-defining, co-contextualizing, co-sensing and co-creating meaningful solutions to such issues. Collaborative systems integration frameworks move beyond closed and open models of innovation to the facilitation of co-innovation, where emphasis is placed on shared value networks through convergence, collaboration and co-creation (Lee et al., 2012). Co-innovation is structurally shaped by the formation of constructive relationships between diverse stakeholders and is also shaped by functional modification relationships, where the roles and functions of existing collaborative

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partners are modified depending on the societal and public policy issues under consideration (Jaworski et al., 2000). Collaborative systems integration, like total market approaches to change, transcend traditional push/pull strategies of linear communications and exchanges in problem co-ordination. Collaborative systems integration emphasizes the richness of interconnections between systems and citizens, and involves the ability to co-create experiential solutions to complex problems. As an example, the Health Promotion Board in Singapore is implementing a collaborative strategic plan for tobacco control that co-integrates a reductionistic anti-smoking campaign and a holistic pro-quitting campaign. Tough top-down reductionistic approaches brought smoking rates in Singapore down from 18.3% to 14.3% between 1992 and 2010 (Health Promotion Board, 2012). Singapore is now aiming to reduce smoking prevalence to below 10% by 2020 through the empowerment of citizens and the mobilization of communities. Facebook and mobile apps are being used to de-normalize smoking and to promote smoke-free living in a holistic ground-up national social movement (Health Promotion Board, 2012). The bottom-up social movement complements the reductionistic top-down anti-smoking campaign, creating a collaborative systems approach to tobacco control. Collaborative systems integration has similarities to the servicedominant logic in marketing, as the focus shifts from optimization to learning in dynamic environments (Vargo & Lusch, 2010). Furthermore, co-creational processes inspire citizens to co-learn and co-adapt through double and triple feedback loops. Reciprocal learning and the incorporation of adaptive feedback loops between upstream, midstream and downstream levels facilitate the empowerment of mutuality, resulting in a win-win-win situation for the macro, meso and micro environmental levels in collaborative systems integration. However, the assessment of multi-linear and multidimensional exchange processes in social marketing systems is extremely difficult to undertake.

Collaborative system indicators for social marketing Collaborative system indicators allow social marketers to focus on ‘what is being co-ordinated; the system parts and their unique attributes and how coordination is occurring; the mechanisms that forge the integration of system parts and sustain them over time as a coherent whole’ (Roberts, 2011: 677). Collaborative system indicators for social

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marketing examine the interrelationships and interconnections between the elements, processes and outcomes in a system (Vargo & Lusch, 2010). More specifically, collaborative system indicators for social marketing examine the elements that stipulate and shape the intricate interplays between systems, processes and citizens. Collaborative system indicators for social marketing integrate the valuable contributions from citizen groups who hail from divergent and sometimes conflicting views, backgrounds, orientations, organizations, institutions and sectors in society. Collaborative system indicators fall into three broad categories in social marketing: knowledge, networks and relationships, as displayed in Figure 5-2. Figure 5-2: Collaborative system indicators in social marketing

Collaborative System Indicators

Knowledge

Networks

Relationships

Transfer Exchange Generation

Involvement Connections Position

Trust Commitment Learning Reciprocity

The assessment of total market knowledge in a system measures knowledge transfer, exchange and generation. Knowledge transfer identifies the linear flow of ideas and information from knowledge producers to knowledge users, such as the one-way communication of information from policy makers to citizens. Knowledge exchange explores the shared learning and communication patterns that emanate from webs of interactions. In a collaborative system, citizens from multiple levels cointegrate, co-sense and co-contextualize their individual skillsets, ideas and intellectual capabilities, ensuring the empowerment of mutual interests rather than focusing on individual silos of knowledge from one sector alone, a trait which is attributable to hierarchical reductionistic systems

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(Dodgson & Hinze, 2000). Knowledge generation is a process that measures the ability of an organization or institution to create and share tacit or explicit ideas, insights, knowledge and expertise. The collaborative co-configuration of knowledge changes the roles of resource integrators from being isolated, passive and unaware to being strategically connected, active and informed, promoting an all-inclusive approach to effective social change (Australian Public Service Commission, 2007; Prahalad & Venkat, 2004). Inclusivity highlights the importance of relational indicators, which involve exploring the feedback loops, reciprocal exchanges and balanced partnerships between stakeholders in a system. More specifically, trust and commitment between stakeholders ensure each party contributes equally to the exchange process, which over time develops into an ongoing relationship. Learning and reciprocity assess how stakeholders retain the information they have acquired, exchanged and interpreted and their dedication to the ongoing exchange of tangible and intangible resources with their network partners. Networks assess the connections and linkages between resource integrators as well as analyse the composition of the network – the identities, status, resources and access (Gulati et al., 2000). Network position determines the centrality of stakeholders in the integrative system and determines if an organization, institution or group of stakeholders commands a central position in their network of if they assume the role of a contributor or receiver of network knowledge. Network position also determines if a group holds an outlier position in the system of networks. Collaborative system indicators provide a forum in which total markets can be deconstructed and understood from multiple levels and multiple perspectives. Collaborative system indicators for social marketing capture the properties of the individual components of a system as well as create a big-picture model of the interactions, connections and linkages between stakeholders at multiple levels in society. The examination and exploration of such indicators can assist social marketers in bridging the gap between individual-based and population-based societal change, resulting in a better understanding of total market approaches while also providing a platform for devising more effective solutions and resolutions to complex and wicked societal issues, such as obesity, biodiversity, tobacco control, global marine management and child poverty.

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Conclusion This chapter details how complex problem co-ordination processes in social marketing can deviate from reductionistic to holistic systems thinking. The chapter also considers that citizens lie at the heart of creating meaningful solutions to complex societal issues. Furthermore, the chapter details how complex societal and policy issues now require broader systems thinking and the management of active and empowered partnerships, alongside social marketing network formations at every level (from national to individual), ensuring collaborative systems integration for social marketing. The chapter also details how the use of collaborative system indicators for social marketing can influence and shape the intricate interplays between macro-, meso- and micro-level stakeholders in a total market approach to resolving complex societal problems.

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CHAPTER SIX DECISION FRAMING AND THE ROLE OF COMMITMENT IN SOCIAL CHOICE: IMPLICATIONS FOR SOCIAL MARKETING AND COMMUNICATIONS KATHERINE C. LAFRENIERE AND SAMEER DESHPANDE

Introduction An important issue that non-profit and public policy managers face is how to change the behaviour of a target audience to benefit society as well as the target audience. Extensive research has been conducted to identify the factors underlying successful and failed behavioural change attempts (e.g. Forbus & Snyder, 2013). A central theory is that many campaigns promoting a desired behaviour fail because they rely heavily on education and law but neglect social marketing (McKenzie-Mohr, 2011; Rothschild, 1999; Weinreich, 2010). Thus, for managers to be successful in promoting a desired behaviour, it is important that they understand the appropriate application of marketing, education and law. Rothschild’s (1999) conceptual framework for the management of public health and social issue behaviours offers significant contributions to that understanding. Rothschild’s (1999) framework determines the circumstances in which education, marketing and law are appropriately applied, based on the target audience’s degree of motivation, opportunity and ability (hereafter referred to as MOA). The central focus of this chapter is to incorporate these meta factors of social change into the formation of the reference point in order to provide an enhanced understanding of the decisionframing process for public health and social issue behaviours. Empirical research over the last 25 years has shown that reference points in

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Kahneman and Tversky’s (1979) prospect theory are reliable predictors of choice in a variety of contexts, even in situations involving risk (Baucells et al., 2011). Reference points have also been empirically tested as predictors of particular social choices (e.g. McFerran et al., 2010). We present a social behaviour influence (SBI) model that incorporates factors from traditional social choice models into the formation of the reference point in order to provide an enhanced understanding of the appropriateness of behavioural change strategies. In formulating the model and its applications, we have integrated Puto’s (1987) discussion of how reference points are formed with Rothschild’s (1999) MOA framework for the management of public health and social issue behaviours. Therefore, this chapter contributes to the decision-making literature by offering an alternative model for social behaviours at the individual level that moves beyond current cost-versus-benefits models (e.g. the theory of planned behaviour). This knowledge of how an individual decides whether or not to enact desired social issue behaviours will help social marketers achieve elusive behavioural change objectives. This chapter is organized as follows. In the next section, to provide a background, we review the literature on the formation of reference points and integrate it with social issue behaviours. Next, building on this integrated framework, we argue that a successful behavioural strategy depends not only on MOA but also on commitment to the initial reference point and the power of the social network. Managers can ensure that the behaviour strategy correctly modifies or matches the reference point of the decision maker either directly or indirectly through upstream, midstream or downstream behaviour strategies or a combination thereof. The chapter concludes by considering the implications for future research in the social marketing and communications fields.

The formation of reference points Kahneman and Tversky (1979) developed prospect theory to describe decision making under risk, and it accounts for context effects by means of the decision frame: ‘The frame that a decision maker adopts is controlled partly by the formulation of the problem and partly by the norms, habits and personal characteristics of the decision maker’ (Tversky & Kahneman, 1981: 453). As a consequence, the attractiveness of decision alternatives varies with the nature of the decision frame. The rationale for this phenomenon is based on the argument that people do not always make

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rational decisions based on absolute values. Instead, people make decisions based on how the problem is framed. More specifically, alternatives are selected or rejected based on their perceived positions relative to the reference point. The reference point refers to the asset position that one is expected to attain in life. The term asset includes not only monetary value but also practical aspects of everyday life, such as lifestyle preferences (Kühberger, 1998). It is based on past experience and acts as a benchmark in the evaluation of current choices (Tarnanidis et al., 2010). A negative decision frame occurs when a set of alternatives are below the reference point and are perceived as possible losses. A positive decision frame occurs when a set of alternatives are above the reference point and are perceived as possible gains. People who perceive options to be below their reference point seek more risks to avoid losses, while those who perceive their options to be below their reference point avoid risks to ensure gains (Kahneman & Tversky, 1979). Puto (1987) expands prospect theory to include a conceptual model of the decision-framing process for buying. This framework proposes the factors (rooted in perceptions and judgements) that change the position of the reference point. The model conceptualizes that people ‘approach a purchase with a set of expectations about the performance of the item being purchased and a set of specific buying objectives’ (Puto, 1987: 303). The reference point is often a weighted average of past information (Baucells et al., 2011). This information serves as the initial reference point. Puto (1987: 303) posits that this ‘initial reference point then is subject to a series of iterations as additional information becomes available until, immediately prior to making a decision, it becomes the final reference point.’ The type of information affecting the final reference point depends on the previous reference point and the previous piece of information (Baucells et al., 2011). Puto’s (1987) framework incorporates and tests factors commonly used in traditional organizational adoption process models and confirms Kahneman and Tversky’s (1979) notion that the reference point has the ultimate influence on the selection of an alternative. However, Puto’s (1987) model was tested in the limited context of the industrial buyer and excluded the existence of other factors that may influence the decisionframing process in other contexts. Other studies on the formation of the reference point have considered possible factors in other contexts, such as

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marketing (e.g. Lim, 2010), negotiations (e.g. Novemsky & Schweitzer, 2004), employee satisfaction (e.g. Abeler et al., 2011) and finance (e.g. Barberis & Xiong, 2009; Baucells et al., 2011). We advance the understanding of reference point formation by using MOA theory to conceptualize the model in the social issue behaviour context. Marketers use two strategies to influence decisions. The first approach is to influence the formation of the reference point. For example, commercial retailers may set up the reference point to influence purchase quantity decisions (e.g. ‘limit of 12 per person’) (Wansink et al., 1998). However, if the audience is strongly committed to its reference point, then the second approach is to change the perceived characteristics of the desired alternative in a manner consistent with the decision frame (Qualls & Puto, 1989). In this instance, marketers can target the variables present in the environment that cause an unhealthy condition (Wymer, 2011). For example, childhood obesity may be targeted by changing the food industry’s product offerings to include healthier ingredients (Wymer, 2011). These strategies must be kept in mind throughout the following section in order to understand how marketers can use reference points to influence social issue decisions.

Factors affecting social issue behaviours Unlike Puto’s (1987) decision-framing process model, Rothschild’s (1999) conceptual framework for the management of social issue behaviours considers the contexts of social issues. It describes how the factors inherent in MacInnis et al.’s (1991) MOA theory affect social decisions. Information processing and behaviours are influenced by consumers’ levels of motivation (their desire to carry out the new behaviour), opportunity (how well their environment facilitates the new behaviour) and ability (the skills or proficiencies they perceive they have for carrying out the new behaviour) (Brug, 2008; Hung et al., 2011; Thorton et al., 2012). Although motivation, opportunity and ability are present prior to a marketing campaign, their levels can be enhanced by ad design strategies (MacInnis et al., 1991). Thus, consumers’ levels of MOA moderate the relationship between ad design strategies and communication outcomes (MacInnis et al., 1991). Marketers can improve communication outcomes by (a) matching ad design strategies to consumers’ existing MOA levels or

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(b) enhancing consumers’ MOA levels so that they can process information from an advertisement (MacInnis et al., 1991). Rothschild (1999) expands MOA theory by incorporating it into the public health and social issue context. When one or more components of the set of MOA are lacking, the decision maker is resistant or unable to act in a manner that solves the social issue (Rothschild, 1999; Westley et al., 2010). However, the strategies and tactics inherent in education, marketing and law can be developed to match existing levels of MOA or to enhance the probability of achieving future desired levels of MOA. Empirical evidence suggests that the combination of MOA components that are present determines which behavioural strategy tool may be superior at achieving the manager’s goals of obtaining appropriate behaviour from decision makers (see Figure 1 in Rothschild, 1999: 31) (Binney et al., 2006; Binney et al., 2003). Thus, public health and social issue behaviours can be influenced by the target’s current level of MOA and by the manager’s use of behaviour strategies (Rothschild, 1999). In the social issue context, ability refers to the target’s skills or proficiencies in carrying out the desired behaviour. Higher expectancies of personal achievement are associated with greater ability. However, dominant competitors can impede the ability of the decision maker (Rothschild, 1999). For example, consider the case in which perceived peer pressure to binge drink is so influential that students need some outside force to prohibit them from drinking. Ability can be enhanced when the target is forced to do the right thing (Rothschild, 1999). In this situation, decision makers must comprehend that the prospective alternative solves their problem of avoiding risky drinking and yet maintaining peer networks. Thus, Rothschild (1999) posits that the ability to perform the desired behaviour can be enhanced through education. Marketing may assist the education campaign by reinforcing a newly developed skill. However, the use of law may inspire resistance in a target that does not have the ability to make appropriate choices. There is a lack of opportunity when the target wants to act but is unable to do so because no environmental mechanisms are available (Rothschild, 1999). Environmental mechanisms include physical infrastructures, technical facilities, the availability of products and product characteristics (Steg & Vlek, 2009). For example, alternative forms of recreation may compete with binge drinking. Decision makers must perceive the environmental mechanisms that are available and assess their

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appropriateness for solving the social issue. Since marketing can lead to the introduction of environmental mechanisms (e.g. conveniently available flu shot booths) to compete with the current behaviour, it has the ability to enhance opportunity. Education may be used to create awareness for existing opportunities. Law may indirectly create opportunity by mandate (Rothschild, 1999). For example, banning the use of dangerous meat additives may lead to universal usage of a healthier alternative. Motivation refers to goal-directed arousal. Decision makers must recognize that their self-interests will be served by performing the desired behaviour in order to perform it (Rothschild, 1999). There is no natural motivation to comply with many socially useful behaviours because decision makers may not perceive that their self-interests have been considered (Rothschild, 1999). For example, people may refuse to vote because they believe that their votes will not matter. Education may increase motivation to act voluntarily (Steg & Vlek, 2009) by discussing how the decision maker’s self-interest will be served. However, the force of law can be used to elicit a desired behaviour.

The social behaviour influence (SBI) model Both Puto (1987) and Rothschild (1999) propose that decision makers approach a decision with pre-existing perceptions based on past and present information and experience. The initial reference point is posited to be a function of that information and experience (Puto, 1987; Baucells et al., 2011). Puto (1987) conceptualizes this information as buying objectives and expectations. In the SBI model (Figure 6-1), we posit that the initial reference point is a reflection of MOA. For example, individuals deciding whether or not to recycle at a drop-off depot may perceive low opportunity because they do not have the resources, such as transportation, to visit the drop-off depot (Saphores et al., 2012). Thus, low levels of MOA may result in the perception that options are below the initial reference point. The initial reference point becomes the final reference point unless environmental factors present in the decision maker’s environment at the time of the decision exert sufficient influence to shift it to a new position (Puto, 1987). When the decision maker’s environment influences the position of the reference point, it also influences the existing levels of MOA into new positions. However, the decision maker’s environment may influence the initial reference point and MOA only if the decision

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maker is not strongly committed to its position (Puto, 1987). Puto (1987: 304) indicates that ‘the stronger the decision maker’s commitment to the initial reference point, the less likely it is to change’. Figure 6-1: The social behaviour influence (SBI) model Motivation, Opportunity and Ability (MOA)

MOA/MOAΌ

Initial Reference Point

Final Reference Point

Social Network

Behaviour Strategy

Choice

Puto (1987) and Rothschild (1999) also propose that a decision may be influenced by additional information that becomes available before a choice is made. In the SBI model, behaviour strategies (whether downstream, midstream or upstream) and/or social networks modify a decision maker’s reference point and ultimately increase the attractiveness of the desired behaviour. Rothschild’s (1999) three downstream behaviour strategies used to impose society’s interests on social decisions are education, marketing and law. A manager’s use of the strategies and tactics inherent in education, marketing and law can be developed to match existing levels of MOA or change MOA into future desired levels. It must be noted that the combination of MOA components that are present determines which behaviour strategy tool or tools (education, marketing or law) might best achieve the manager’s goal of obtaining the desired behaviour from a variety of decision makers (Rothschild, 1999). Therefore, the most appropriate behaviour strategy tool must be selected in order to influence the final reference point (see Rothschild, 1999 for a complete review of this selection process). Researchers in multiple fields have argued that additional information may also come from the decision maker’s social network (e.g. Frambach

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& Schillewaert, 2002; Maignan & Ferrell, 2004; Waarts et al., 2002). In the social issue context, research has shown that reference points are sensitive to the behaviour of others (midstream). For example, other people can affect the reference point that consumers use in deciding how much food to consume (McFerran et al., 2010). Members of the decision maker’s social network may include their peers and other related stakeholders, such as environmentalists, policymakers and community members. The social network provides additional information to the decision maker through its members’ interactions. In the SBI model, the final reference point is influenced by the initial reference point, the behaviour strategy and the social network (see Figure 6-1). When prospective decisions are compared to the final reference point, they will be framed as losses or gains depending on the position of the decision frame (Kahneman & Tversky, 1979). A negative decision frame is comparable to a situation in which one or more components of the set of MOA are lacking. Consider, for example, a decision maker who decides to go fishing with friends even though she does not have a fishing licence. Although the alternatives (buying a licence or not going fishing) are less risky, the decision maker may not try to avoid the losses associated with risk taking because, if she did, she might lose the opportunity to go fishing with her friends. That is, since her alternatives are negatively framed, her choice is more risk seeking. In terms of MOA, opportunity is lacking because the decision maker does not perceive that the environmental mechanisms (e.g. a fishing licence) are available to allow her to make a socially responsible decision. Likewise, a positive decision frame corresponds with high levels of MOA. When levels of MOA are high, decision makers are prone to choosing the desired behaviour, either because they can easily discern that their self-interests will be served or because campaign managers can easily convey this point (Rothschild, 1999). It is reasonable to assume that, in either scenario, the decision makers are comfortable with their decision environment and consequently perceive their alternatives through a positive decision frame. The relationship between the final reference point and choice is well established in prospect theory (Puto, 1987). As mentioned above, Kahneman and Tversky (1979) posit that choices among gains will tend to be risk averse and choices among losses will tend to be risk taking. If none of the decision alternatives are acceptable, the decision maker can either

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seek more alternatives or modify his or her reference point (Qualls & Puto, 1989).

Applications of the SBI model Combining Puto’s (1987) and Rothschild’s (1999) frameworks creates opportunities to target the decision maker better. The SBI model reveals situations where downstream, midstream and upstream behaviour strategies are most successful in effecting behavioural change. Situations occur in which individuals are strongly committed to the initial reference point and will not change their behaviour, regardless of environmental factors (Qualls & Puto, 1989). The following propositions reflect four different situations that may occur based on commitment to the initial reference point and offer tailored solutions (see Table 6-1). Table 6-1: Summary of possible situations in the SBI model Situation 1

Commitment Strong

2

Weak

3

Weak

4

Weak

Behaviour Strategy No Influence Downstream/Upstream Strategy Influence Downstream Strategy No Influence Midstream Strategy Influence Downstream/Midstream Strategy

Social Network No Influence No Influence Influence Influence

The first situation involves decision makers who are strongly committed to the initial reference point and to their existing levels of MOA. For example, consider an individual addicted to heroin. This person may have a strong commitment to his initial reference point and therefore will be less likely to change his reference point and consequent choice, regardless of imposing factors in his environment. Campaign managers may not be able to change such behaviours, but they can at least reduce any harm to the public that may result from that behaviour. Thus, when an individual is highly committed to the initial reference point, the manager should not target the high-commitment behaviour but instead focus on a low-commitment behaviour that at least reduces the consequences of the high-commitment behaviour.

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Some real-life campaigns have already employed these recommendations. For example, needle exchange programmes (NEPs) provide the users of injection drugs with clean needles and other supplies to prevent or reduce the harm of the risky behaviour (Kaiser Foundation, 2003). Rather than focusing primarily on drug use, NEPs have increased the amount of injection equipment appropriately discarded, reduced blood-borne disease transmissions and improved access to health and other welfare services (Kaiser Foundation, 2003). Given the lack of research on the effect of commitment, it would be interesting to ascertain the role of commitment in behavioural change campaigns that have failed. Alternatively, campaign managers may use an upstream strategy to tackle a social issue involving high commitment by changing the perceived characteristics of the desired alternative (Qualls & Puto, 1989). In this instance, managers can target the variables present in the environment that cause an unhealthy condition (Wymer, 2011). For example, research indicates that the food industry’s product offerings and marketing activities are major contributors to childhood obesity (Kessler, 2009; Wymer, 2010). Obesity may be targeted by changing food products to include healthier ingredients (Wymer, 2011). An upstream strategy attempting to change the public policies, regulations or laws that deal with a social issue may require lobbying and activism (Wymer, 2010). Based on these considerations, the following application is proposed: PΌ: The MOA levels of decision makers who are strongly committed to the initial reference point are unlikely to be influenced by any behaviour strategy or social network. Downstream or upstream behaviour strategies should be called on to reduce the consequences of the risky behaviour.

The three remaining situations involve decision makers who are weakly committed to the initial reference point and have low existing levels of MOA. When there is low commitment, downstream and midstream strategies can target an individual’s reference point and ultimately increase the attractiveness of the desired behaviour. For example, persuasion may be aimed at strengthening the decision maker’s commitment to act in a socially desirable behaviour (Steg & Vlek, 2009). In the second situation, the appropriate downstream behaviour strategy (education, marketing or law) may influence the final reference point more than the social network does. For example, a behaviour strategy may have a stronger impact on MOA than a social network does when a desired behaviour is not openly discussed among peers (e.g. when to see a dentist)

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or when decision makers perform the current behaviour even though it is frowned upon by their peers (e.g. not washing your hands after a trip to the bathroom). Campaign managers must analyse the MOA of the target market and consequently decide on a downstream behaviour strategy. Therefore, the following application is proposed: P΍: The MOA levels of decision makers who are weakly committed to the initial reference point may be more influenced by a behaviour strategy than by a social network. In such a case, the appropriate downstream behaviour strategy should be called on to modify existing levels of MOA.

In the third situation, the social network may influence the final reference point more than the appropriate behaviour strategy does. For example, colleagues who regularly go out for lunch together at unhealthy restaurants may be influenced more by each other than by a downstream behaviour strategy. Downstream behaviour strategies may have a slight impact, but a larger impact results from midstream behaviour strategies targeting the social network. Therefore, the following application is proposed: PΎ: The MOA levels of decision makers who are weakly committed to the initial reference point may be more influenced by a social network than by a downstream behaviour strategy. In such a case, the appropriate midstream behaviour strategy should be called on to target the social network rather than the decision maker.

Finally, in the fourth situation, both the appropriate behaviour strategy and the social network may influence the final reference point. For example, individuals who drive under the influence of alcohol may be influenced by the appropriate downstream behaviour strategy, by the social network or by both. The appropriate downstream and midstream behaviour strategy must be called on to modify the existing levels of MOA of both the decision makers and their social networks. Therefore, the following application is proposed: PΏ: The MOA levels of decision makers who are weakly committed to the initial reference point may be influenced by their social network, by an appropriate behaviour strategy or by both. In such a case, the appropriate midstream or downstream behaviour strategy should be called on to modify the decision makers’ and/or the social networks’ existing levels of MOA.

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Discussion and future research This chapter proposes a social behaviour influence (SBI) model by incorporating traditional social choice models into Puto’s (1987) theory of the formation of reference points to provide an enhanced understanding of the individual decision-making process for social problems. We posit that the combined model is more effective at targeting behaviour than either model alone and offers an alternative that moves beyond current costversus-benefits models. The SBI model suggests how commitment to the reference point may affect behaviour in four distinct outcomes and consequently proposes a behaviour strategy directed at a downstream, midstream or upstream audience. The purpose of this chapter is not to make broad generalizations about the decision-making process but rather to provide an enhanced understanding of the individual decision-making process for social issues. Nonetheless, to expand this understanding further, researchers should use broader samples by including decision makers from a larger variety of contexts and in the setting of a greater number of social problems. For example, members of a collectivist culture may be more committed to reference points formed by their social network than members of an individualistic culture are. The SBI model may explain some contexts more than others. Greater variance among decision makers in different contexts will provide more information regarding the decision-making process for social issues under varying conditions. In addition, the theoretical nature of the model means it provides an explanation of the decision-making process for social issues based only on what the literature says ought to be present and how the decision-making process is based on our experience. Future studies should employ a longitudinal design that follows decision makers throughout the decisionmaking process (i.e. before, during and after exposure to an appropriate behaviour strategy). This design would provide a more comprehensive understanding of the decision-making process for social choices over time. Overall, this chapter considers the decision-framing process for public health and social issue behaviours. Our purpose here is to provide an enhanced understanding of the decision-framing process for social problems by incorporating factors from traditional social choice models into this process. By understanding that a successful behaviour strategy depends not only on MOA but also on commitment to the initial reference

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point and on the power of the social network, campaign managers can ensure that the behaviour strategy they choose correctly modifies or matches the reference point of the decision maker, either directly or indirectly through the social network.

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CHAPTER SEVEN A SERVICES APPROACH TO SOCIAL MARKETING PROGRAMS REBEKAH RUSSELL-BENNETT, JOSEPHINE PREVITE, DANIELLE GALLEGOS, CHARMINE E.J. HधRTEL, GEOFF SMITH AND ROBYN HAMILTON

Introduction A core principle of social marketing is the use of a marketing mix (French & Blair-Stevens, 2006). Regardless of whether this is defined as the four Ps (Lee & Kotler, 2012), a value exchange matrix (French, 2011), a metaphorical social marketing mix (Peattie & Peattie, 2003) or any combination of the above (Wood, 2012), there needs to be a ‘product’ being offered. Many organizations that deliver social marketing programmes, such as government departments, structurally separate the service design and delivery from the control of marketing staff, thus reducing their role to focus on the promotional element rather than the entire marketing mix. The effect of this separation of the marketing functions could be one reason why the ‘one P’ approach to social marketing still persists in both practice and research and why there is a gap in the social marketing literature about the role of the service mix in achieving behavioural change. Given that many social marketing programmes, particularly those by government organizations, involve a service rather than a good (e.g. health screenings, water usage monitoring, installation service of baby seats in cars and fitness programmes) (Zainuddin et al., 2011), it is timely to investigate how service theory can and should be used in the field of social marketing. The purpose of this chapter is to demonstrate how service

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theories are being used to inform social marketing behavioural change strategies and to highlight the need for the integration of service delivery with the rest of the service mix. In this chapter, we draw on three collaborative projects between social marketing scholars and practitioners in Australia: Gen Y donor experiences (with the Australian Red Cross Blood Service), benchmarking internal social marketing (with BreastScreen Queensland) and MumBubConnect (MBC) (with the Australian Breastfeeding Association). The first case discusses consumer insights about donor emotional responses and servicescape preferences and the managerial implications of implementing the research. The second case discusses employee insights about who in the organization should be responsible for social marketing and the managerial implications of improving the service process. The third case discusses a social marketing SMS intervention and outlines the managerial implications for integrating a virtual service.

What is service? Lovelock and Wright (2001: 5) define service as ‘an act or performance that creates benefits for customers by bringing about a desired change in–or on behalf of–the recipient’. This definition has a clear relationship with the purpose of social marketing in bringing about changes in behaviour for the benefit of people and society. Services marketing as a sub-discipline of marketing emerged as a clear area of scholarship in the mid-1970s: the key research imperative was to establish the differences between goods and services marketing (Fisk et al., 1993). From this ‘crawling out stage’, services marketing flourished and moved through the ‘scurrying about’ stage in the 1980s to the ‘walking erect’ phase in the 1990s. Since the development of the internet and social media, services marketing has moved through three more phases, labelled ‘making tools’ (e.g. measurement scales and data analysis techniques), ‘creating language’ (e.g. service-dominant logic) and a proposed future stage about ‘building community’ (e.g. a multidisciplinary approach) (Fisk et al., 2013). We contend that it is this final stage where service and social marketing intersect through the integration of disciplines such as preventative health, environmental psychology and marketing. This is a significant paradigm shift for the many government departments and NGOs that seek to implement social marketing. This chapter outlines three health organizations’ efforts in making the move to service thinking.

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The nature of service When commencing on a service thinking path, a useful place to start is understanding the type of service involved, as this contextualizes the nature of organizational and consumer responses. There are many classifications of services (see Fisk et al., 2013); however, the most pervasive and influential is Lovelock’s (1983) service matrix, which distinguishes services on the basis of the nature of the service act. In the matrix there are two types of processing services: people processing and possession processing. Within both of these types there can be tangible and intangible actions, resulting in a matrix containing four types of services. We apply Lovelock’s (1983) matrix to social marketing to show four types of social marketing services (see Figure 7-1). In this chapter, we use three health services (which could be classified as people-processing services) to illustrate service thinking. Figure 7-1: Classification of social marketing services

People Services aimed at people’s bodies Tangible actions

Intangible actions

Source: Lovelock (1983)

Possessions Services aimed at goods and physical possessions

EXAMPLES: Cancer screening services Blood donation collections Breastfeeding demonstrations Baby seat fittings

EXAMPLES Energy/light bulb checks Motor vehicle safety services Glucose meters

Services aimed at people’s minds

Services aimed at intangible assets

EXAMPLES: Helplines Ante-natal classes

EXAMPLES Financial literacy education Legal advice

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Lovelock’s (1983) service classification distinction between services aimed at the body and mind versus those aimed at possessions is an important basis for developing a social marketing campaign or programme. The key message from Lovelock (1983) is that the nature of the service changes the types of service strategy that can be effective. Campaigns that target people’s bodies, with a call to action for exercise, nutrition or medical screenings, require different resources and skills from both individuals and service providers compared to the resources and skills needed for a service aimed at the same individual’s possessions, for example home electricity. For social marketers, this means that a tailored service offering is necessary rather than a generic one-size-fits-all approach. So, when ‘borrowing’ ideas from other social marketing service campaigns, care should be taken to look for services of the same service type.

Creating value The creation of benefits has been explored and discussed extensively by marketers over the past few decades, albeit typically from an economic perspective (Lovelock & Gummesson, 2004). More recently, scholars have moved from a goods-dominant (G-D) logic, which framed marketing exchange in economic terms and placed the organization as delivering value to the marketplace, to a service-dominant (S-D) logic where value is described as co-created by all actors (Vargo & Lusch, 2004). S-D logic has reframed marketing scholars’ approaches to understanding the exchange and creation of benefits as a shared process involving individuals and organizations brought together into networks and societies (Vargo & Lusch, 2004). The concept of S-D logic has not gone unnoticed by social marketers, with Lefebvre (2012) observing the shift from a producer perspective to the customer. Indeed, one of the originators of S-D logic, Robert Lusch, was a keynote speaker at the World Social Marketing Conference in 2013. In social marketing, therefore, the co-creation of value is done through facilitating, supporting and involving customers, rather than through punishing, coercing or driving. S-D logic contains ten foundational premises, which since 2004 have been refined through scholarly feedback and debate (Vargo & Lusch, 2008). These ten foundational premises of services can be translated to illustrate the usefulness of service thinking for social marketers (see Table 7-1).

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Table 7-1: Application of S-D logic’s foundational premises to social marketing Foundational Premise FP1: Service is the fundamental basis of exchange.

FP2: Indirect exchange masks the fundamental basis of exchange.

FP3: Goods are a distribution mechanism for service provision.

FP4: Operant resources are the fundamental source of competitive advantage.

FP5: All economies are service economies. FP6: The customer is always a cocreator of value.

Explanation

Social Marketing Implications

Customers and organizations exchange skills and knowledge with each other (service-forservice exchange). The exchange of service involves multiple actors – marketers, institutions and organizations – who collaborate in offering marketplace solutions. Goods gain their value when used through the service they provide.

Both organizations and customers can contribute equally: neither party is dominant. This requires a less policy-focused and more customer-focused emphasis.

Knowledge within the organization drives competitive advantage. Knowledge resources are dynamic, subjective and situational. Service rather than services is the basis of all economies. Value can never be created without the involvement of the customer.

Social marketing exchanges are either ‘complex’ and/or ‘generalized’ in that they typically involve three or more actors in mutually beneficial relationships in creating social and health solutions for society. Typically, social marketing programmes do not directly involve goods; however, there are exceptions, such as condom supply. When goods are used, the service they provide relates to the ‘behaviour’ idea, for example safe sex. Governmental and NGO social marketers need to ensure that their knowledge is current and dynamic to support and facilitate the desired behavioural change.

All governments and NGOs engage in service to improve the wellbeing of society. Social marketers need to view the customer as an active participant rather than a passive recipient of their social marketing interventions.

116 FP7: The enterprise cannot deliver value, but only offer value propositions.

Chapter Seven Organizations cannot control the delivery of value to the marketplace. Value is interactive and not independent of the customer. Relationships are important and customer centric.

FP8: A servicecentred view is inherently customer oriented and relational. FP9: All social and All actors participate economic actors are in a network to resource integrators. create value FP10: Value is Value is subjective, always uniquely dynamic, and experiential and phenomenologically imbued with determined by the meaning. beneficiary. Adapted from: Vargo & Lusch (2008)

Governments and NGOs cannot control customers’ value perceptions and therefore need to collaborate with the customer.

Governmental and NGO social marketers need to bring a relationship view to their social marketing programmes to achieve sustainable behaviours. Social marketers need to bring a systems view to designing solutions for social problems. Social marketers need to ensure their services are based on customer insight and must facilitate the adaptation and personalization of the service.

The co-created service mix The development of S-D logic offers an alternative way of viewing the elements of the 4P marketing mix through the development of the S-D marketing model (Vargo et al., 2007). This model reframes the 4Ps with a focus on collaboration with customers and partners to compete through service (Vargo et al., 2007). Specifically, the product is reframed as a ‘service offering’, the price becomes a ‘value proposition’, the place is ‘value networks and processes’ and promotion becomes ‘conversation and dialogue’. The service marketing mix extended the four elements of the marketing mix to seven elements, which have subsequently been used to design and develop services strategies for the past 30 years (Booms & Bitner, 1991). We therefore add these three service elements (processes, people and physical evidence), as well as the social marketing element of ‘partners’, into the S-D logic marketing model to create the social marketing service mix (see Figure 7-2). We reframe processes as ‘value networks and processes’, people as both ‘service offering’ and ‘conversation and dialogue’, physical evidence as ‘value proposition’ and

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partners as part of the central c collab boration. Thiss use of the five core elements off the S-D loogic marketin ng model (coo-creating thee service offering, vallue propositioon, network/prrocesses, convversation/diallogue and collaborating with custom mers/partners) will be highliighted in the following f five cases. Figure 7-2: The social markeeting service mix

Adapted from m: Lusch et al. (2007) (

IInsight intoo the mediccalized servvicescape of blood donation d This firsst case involvees the non-pro ofit organizatiion the Austraalian Red Cross Blood Service, which w seeks to t change thee social behaaviour of donating bloood. The corre elements of the social m marketing serrvice mix highlighted in this case arre the service offering and tthe value prop position. Blood doonation is an altruistic sociial product thaat has the paraadox of a highly mediicalized serviccescape with customers wh who are not paatients. A key barrier (social pricee) for these customers c in engaging in donation behaviour iss therefore thee psychologiccal discomfortt of being in a medical environmentt (with the asssociated fear, anxiety and ppotential physical pain) for no direcct personal gaain. This conttrasts with thee usual outco omes of a medical envvironment, whhere sick patieents are treatedd. As a key su upplier to the Australian health servvice sector, th he Blood Servvice plays a major m role in the wellbbeing of Austrralians. The provision p of a safe, secure and cost-

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effective supply of blood and blood products is the key mission of the Blood Service. Underpinning this aim is undertaking leading edge research to improve service delivery. Therefore, blood donation presents a unique challenge for social marketing. The Blood Service aims to influence people to engage voluntarily in behaviour (giving of themselves) to benefit others, without tangible reward. Creating a value proposition that overcomes key barriers is critical for ensuring a sustainable blood supply. In positioning the Blood Service within Lovelock’s service matrix (1983), we classify blood donation as a ‘people-processing service’ with tangible actions (aimed at the body). The adoption of service thinking as part of the overall social marketing approach within the Blood Service was used to identify key barriers for donors as an input to adapting the service offering and value proposition. The results of the initial consumer insight phase are re-reported in this case. Only around one in 30 of the eligible population in Australia donates blood; however, one in three people will require blood or blood products in their lifetime (Australian Red Cross Blood Service, 2013). As the population ages, the demand for products is likely to increase, creating serious implications for the sustainability of the blood supply. Allied to this demand increase is the fact that donors aged between 40 and 49 years make more donations than any other group. This age range must be replaced as they get older and stop donating and may indeed begin to be recipients themselves. The younger age group of 18–29 years presents a unique challenge, as Blood Service statistics show that while this age group is the most likely to become first-time donors, they are the least loyal group within the donor pool, with approximately 60% not returning to re-donate (Australian Red Cross Blood Service, 2009). The Blood Service is therefore currently examining donor retention (loyalty), as retention is more cost effective than acquisition of new donors. Therefore, service marketing theory may offer some strategies.

The important role of service quality and emotions A key aspect of a service offering is service quality. Service quality creates satisfaction, which in turn creates loyalty (manifested as repeat behaviour). For high-credence services (those difficult to evaluate after the service has been consumed), quality depends highly on environmental cues (e.g. does the place look shabby or clean?). Research on service quality can be separated into two streams of thought: American and Nordic (Brady & Cronin Jr., 2001). The American approach views service

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quality as the gap between expectation and experience. The Nordic approach compares performance perceptions. Brady and Cronin Jr. (2001) combined the two approaches, focusing on perceived experience. More recently, Dagger et al. (2007) applied their framework to a health care setting. The four dimensions they identified are interpersonal (relationships), technical (e.g. getting a needle in the donor’s vein the first time), environmental (comfortable and clean) and administration (e.g. scheduling and paperwork) quality. Overall service quality is defined as scoring highly on all dimensions. Perceptions of service quality are affected by past experience, beliefs, attributions and emotional responses (Härtel et al., 1999; Härtel et al., 1998; Leo et al., 2005). The latter has become of increasing interest to scholars as the study of emotions in organizational settings continues to grow (Russell-Bennett et al., 2011). Previous researchers have identified emotions as key internal drivers of loyalty for both blood donors and non-donors (e.g. Masser et al., 2009). The focus of research in the area of blood services, however, has been on negative emotions, such as anticipated regret and anxiety (e.g. Masser et al., 2008, 2009), with little emphasis on the full range of emotions and in particular emotional ambivalence (mixed emotions). Emotional ambivalence refers to simultaneous experiences of positive and negative emotions (Russell & Carroll, 1999). Blood donation is a service situation likely to evoke emotional ambivalence (e.g. anxiety associated with needles and pride in being able to help others) as it signals a motivational conflict. In the case of blood donation, if an individual is able to resolve the conflict and overcome the negative emotions, they are likely to donate. If not, they are likely to avoid donation.

A qualitative study of Gen Y donor experiences We conducted qualitative research to explore why members of the 18– 29 group donate once and then leave, in large numbers. This project explored the expectations and affective appraisals of new Gen Y blood donors towards the blood donation experience at three stages of the donor process: pre-donation, donation and post-donation. Responses from 68 young Australians in Brisbane and Melbourne were gained from 12 focus groups. The groups included Australians who were current experienced donors, novice donors, lapsed donors and non-donors (Russell-Bennett et al., 2012).

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This formative research suggested improvements were needed for the service offering and the value proposition in the social marketing service mix. For example, the Gen Y sample were not comfortable with the ‘medicalized’ service environment of blood donation and felt that the process was more centred around the needs of the Blood Service than around their needs. This included the physical layout and design of the blood donor vans and centres (seen as ‘clinical’ and ‘scary’) (see Figure 73), the requirement for bookings, the preparation required (not viewed as convenient) and the screening process (which was seen as inconsistent with blood service processes in other countries and outdated). Figure 7-3: The medicalized servicescape of blood donation

Source: Provided by the Australian Red Cross Blood Service

The lack of convenience and post-donation recognition was also highlighted. Some donors indicated that while they wanted to ‘do the right thing’, they also wanted to receive something out of the act. Many gave examples of wanting rewards and pampering (e.g. ordering refreshments from a menu or receiving a foot massage) and tangible signs of being a donor (e.g. a logo on Facebook or a badge). The colour red in the Blood Service brand and service environment was a source of fear and discomfort for many of the inexperienced and non-donors, who disliked the ‘tidal wave of blood’ on the exteriors of the mobile vans (see Figure 74).

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Figure 7-4: Branded mobile donor van

Source: Provided by the Australian Red Cross Blood Service

The managerial implications of service thinking While the research contains many clear and obvious options for changing the service offering and value proposition to be more attractive to Gen Y donors, the challenge lies with the implementation of the service. (a) The Blood Service is a risk-averse and conservative organization that is highly focused on medical standards, some of which are inconsistent with the stated needs of younger donors. While the idea of drop-in, spontaneous donations rather than appointments is more convenient, this creates the challenge of managing the supply and aligning that with forecast demands, as well as being able to respond to needs for specific blood types. Likewise, the use of social media recognition strategies and giving up control is difficult for a conservative organization. (b) Assisting donors in managing their emotional ambivalence at the point

of donation by increasing the friendliness of the servicescape through redesign and different furniture may compromise the rigorous medical standards that are the hallmark of the Blood Service. The introduction of more pampering of donors may create an impression of a nonclinical environment, thus reducing donor perceptions of safety.

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(c) Finally, there are substantial cost implications to implementing servicescape changes across the Blood Service collection sites. Increasing the cost of each collection by only a few dollars each could potentially affect the Blood Service’s capability to supply costeffective products where they are needed in the Australian community. Thus, while service thinking is an important part of supporting donor behaviour, particularly in the younger age group, the managerial and resource constraints need to be considered.

Benchmarking internal social marketing The second case involves the organization BreastScreen Queensland (BSQ), which is a government-based, preventative health service that provides free breast cancer screening services to eligible women via mammography technology. 1 The core elements of the social marketing service mix highlighted in this case are the networks/processes and the conversation/dialogue. Using social marketing and health promotion activities, the Queensland government mobilizes ‘well women’ to enter the health service system every two years for the purpose of protecting their health through early detection breast screening services. Applying Lovelock’s (1983) services process perspective, we position BSQ as a ‘people-processing’ service, as women need to physically enter the service system and they perform integral parts of the service process. Commencing from the moment they respond to a reminder to make an appointment for their breast screen through to attending a BSQ service centre and giving themselves over to the control of health service experts during a mammogram, the women bring important skills and resources to this health service setting (see Zainuddin et al., 2011 for a full detailed discussion on women’s roles). In exchange for these services, BSQ gives well women ‘behavioural opportunities’ to perform preventative health behaviours through engagement with a health service system (Kirscht 1983: 282), which benefits the individual’s health outcomes and society through the cost savings associated with early detection and reduced health interventions and medical costs. Adopting service thinking in organizations where the service elements are split across different occupational classifications 1

BreastScreen Queensland.2012. About Us. http://www.health.qld.gov.au/breastscreen/about-us.asp Accessed 1st June 2012.

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requires an initial benchmark of internal marketing orientation levels. This case reports the results of a quantitative survey and the managerial implications of using these results.

Social marketing skills, knowledge and dispositions within BSQ In 2007 BSQ launched its first social marketing campaign2 aimed at achieving a 30% increase in women’s programme participation by addressing the barriers (social price) to regular screening and by dispelling myths about breast cancer (Tornabene, 2010). This campaign was successful in improving women’s attendance at breast screening centres. However, across the 12 service centres in Queensland, there continued to be inconsistent demand and some services remained under the desired target for screenings. One approach adopted by BSQ to address this service challenge was to align internal marketing efforts with the external social marketing message disseminated through ‘The Facts’ mass media social marketing campaign that delivered the call to action: ‘Don’t make excuses. Make an appointment’ (Previte & Russell-Bennett, 2013). To achieve this alignment, BSQ partnered with university researchers to conduct a collaborative research project that aimed to benchmark internal marketing orientation (IMO) to be followed by up-skilling employees with social marketing knowledge and measuring staff attitudes and behaviours towards marketing-like activities. Developing an ‘internal social marketing’ focus within BSQ commenced with spreading the idea among service workers that, to encourage sustainable breast screening behaviours among the target audience of women, employees at all service touch-points needed to consider themselves important influences in encouraging and supporting women to attend a regular breast screen. Furthermore, to stop women ‘making excuses’, BSQ staff also needed to focus on building customer satisfaction by creating positive service interactions and providing women with a service setting that was both reassuring and comfortable. This ‘service encounter perspective’, which suggests that any service encounter has the potential to have an impact on consumer behaviour (Shostack, 1985), was an underdeveloped perspective in BSQ. More challengingly, this was also 2 In Queensland, the participation rate for the target age group in the period 20062007 was 56.4% (BSQ 2009), which is below the state and national target participation rate. BreastScreen Queensland. 2009. About breast cancer. http://www.breastscreen.qld.gov.au/breastscreen/breastcancer/default.asp Accessed: 2nd March, 2010.

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a contentious perspective in some service centres, as it was perceived to be re-directing focus and funding away from clinical health interests (Previte & Russell-Bennett, 2013). A further challenge in developing an internal social marketing perspective within BSQ services was that many of the service workers viewed their roles and responsibilities as not involving social marketing activities; they considered social marketing to be separate from their duties. This view was influenced strongly by the belief that social marketing was the domain of trained professionals, such as health promotion officers (Previte & Russell-Bennett, 2013). The lack of integration between health and marketing skills was identified following the qualitative analysis of the interviews and focus groups conducted with the service managers and employees (N=60), which showed that the service mix was functionally separated. This lack of integration influenced how the health service employees approached and supported social marketing activities within BSQ. Future internal social marketing activities are required to support communication and dialogue to ensure that the social marketing service mix is leveraged to assist value creation. As a result of the functional separation of the social marketing functions, important resources (e.g. particular skills and knowledge about women’s service experiences) were not easily shared across service boundaries and interaction points with clients. Essentially, service resources were segregated by professional boundaries. For example, clinical health services were the domain of professional staff such as trained radiographers and doctors; services marketing was the domain of service managers and involved the management of administration roles (i.e. receptionists, database managers and appointment service staff) and servicescape attributes; and health promotion was the established approach to promoting and educating women about breast cancer risks and was considered a shared responsibility between the localized health promotion officers embedded within each service centre and the senior health promotion officers positioned with the government’s health department, who interface with policy decision makers. Social marketing was the ‘latest’ approach introduced to BSQ staff and was designed and implemented by the government decision makers to increase demand for BSQ screening services across 12 service centres. While social marketers have many tools and techniques that they use to understand and influence external customers (target audiences), the tools used to influence and manage internal customers (employees) are less well

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developed. Internal marketing is a well-established approach in addressing the role of the employees in commercial organizations (Lings & Greenley, 2005). We know little about where and how to modify this model with social marketing thinking so that it can be used to promote social marketing practices to health service employees.

What is internal social marketing (ISM)? The underlying premise of internal social marketing (ISM) is that to satisfy external customers, it is desirable (and, in most circumstances, necessary) to have satisfied internal customers: namely employees. The internal customer concept is well established in marketing thinking and was originally proposed over 30 years ago as a solution to the problem of delivering a consistently high-quality service (Berry et al., 1976). The contribution of ISM thinking is that it has more to offer than purely improving the HR function within social marketing services. It also calls for designing initiatives that aim to motivate employees towards serviceminded performance and customer-oriented performance through developing active marketing-like tactics (Gronroos, 1990). We adapt Rafiq and Ahmed’s (2000: 456) internal marketing definition for the purposes of internal social marketing, defining it as: A planned effort using a marketing-like approach to overcome health care worker’s resistance, to change and to align, motivate, and integrate employees towards the effective implementation of social marketing programs, interventions and health care service policy in order to deliver customer satisfaction through the process of creating motivated and customer-orientated employees focused on achieving sustainable client behaviours.

Benchmarking internal social marketing A benchmark survey was designed to measure BSQ staff members’ perceptions and feedback on the influence of marketing-like activities in achieving the goals of the BSQ programme. The survey was completed by 141 staff members across all service touch-points (i.e. managers, administration staff, radiographers, health promotion officers, etc.). The survey instrument asked a number of questions about the role of social marketing in BSQ and modified items from Lings and Greenley’s (2005) internal marketing orientation (IMO) scale, using a five-point Likert scale (where 1 = low and 5 = high). The purpose of using these IMO items was to delve further into understanding how communication and information

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dissemination about social marketing practices among BSQ staff members influenced their attitudes and feelings towards social marketing practices. The survey results revealed interesting insights into BSQ staff members’ current thinking and indicated important areas that need to be addressed to facilitate staff engagement with marketing-like activities. Information dissemination about social marketing programmes and service offerings required improvement. Staff members’ survey responses indicated that they received insufficient information about clients’ needs and wants, and they were not given sufficient information about changes/updates in service offerings (2.54/5). Formal information generation between BSQ decision makers and staff members was also relatively low. In face-to-face settings, sharing between BSQ decision makers and staff was low, with staff members indicating lower levels of value being exchanged between organizational rewards and their work efforts (2.63/5). This was also evident in staff members’ assessment of written communication and information generated around social marketing activities (2.12/5). Staff members also indicated that BSQ decision makers lacked responsiveness to their employee needs, indicating that they were not provided with sufficient incentives and training to encourage them to engage more in social marketing activities (2.64/5). More positively, the staff survey responses indicated that informal information generation about social marketing activities and job roles was satisfactory (compared to the other IMO factors) (3.31/5). These IMO results indicate that there is a need for improved communication dissemination, both informal and formal. Drawing from the social marketing service mix, these challenges can be addressed via collaboration to enhance the networks and processes within BSQ.

Managerial considerations for implementing ISM programs in health service contexts Researchers in the past have stated that health services too frequently rely upon the technical and clinical attributes of the service to convince health clients to continue using these services (Berry & Bendapudi, 2007; Dagger et al., 2007). In attending to this critique, an ISM programme can be implemented to design employee-focused activities that involve building the social marketing skills, knowledge and disposition of health service workers so that the workers aim to improve each service interaction with their clients. In extending the ISM service perspective to

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BSQ’s social marketing programme, the following three key building blocks are suggested to improve the preventative health process: (a) Develop a view of health care employees as an internal customer and institute programmes that explicate the rewards and incentives given to good service workers; (b) Where the social marketing functions are structurally separated, develop strategies to promote the idea that each health service role is critical to creating a ‘whole-of-service’ approach, which will achieve integration and sustainable behavioural change among both internal and external customers; and (c) Decision makers need to implement training programmes that satisfy all internal customers so that they are prepared and skilled in serving external customer needs. The key social marketing outcome from focusing on service quality and customer satisfaction is achieving sustainable behavioural change in the continued use of the health services provided by the government.

An ISM service intervention The third and final case is the Australian Breastfeeding Association (ABA): a non-profit organization that promotes the importance of breastfeeding and supports breastfeeding mothers. The core elements of the social marketing service mix highlighted in this case are the service offering, the value proposition and the dialogue/communication. ABA provides a range of services, one of which is its peer support service. This takes the form of face-to-face meetings as well as a 24 hours a day, 7 days a week, toll-free Breastfeeding Helpline that receives over 7,000 calls per month. ABA acknowledges that this represents a small percentage of breastfeeding mothers, usually from a homogenous demographic, and relies on mothers identifying that there is an issue and initiating a call. Prior research indicates that face-to-face support is more effective than telephone contact (Hall Moran et al., 2007; Britton et al., 2009). Combinations of lay and professional support have also been found to be more effective in improving breastfeeding behaviours than either type of support on its own (Britton et al., 2009).

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In Australia, most women initiate breastfeeding (96%). However, by four months only 40% are exclusively breastfeeding (BF) and at six months only one in five infants receive any breast milk (Australian Institute of Health and Welfare, 2011). Increasing breastfeeding rates has proved to be resistant to change, with the majority of strategies to date relying on education and mass media campaigns (Kukla, 2006; Knaak, 2010). Increasingly, it is evident that women know that BF is the better choice for their infants, but they feel less equipped and confident to continue breastfeeding due to a range of factors, including lack of personal support (Meedya et al., 2010; Andrew & Harvey, 2011). Women are increasingly looking for a variety of supports that meet their individual needs, from accessing web-based information and peer support through to personalized health professional access (Russell-Bennett et al., 2012). With breastfeeding posited as a simple, ‘natural’ and doable behaviour, women need to be able to feel that they can safely identify that they are experiencing challenges and to feel empowered to solve problems. Developing this self-efficacy is routinely acknowledged as key to continued breastfeeding (Blyth et al., 2002; Dennis, 2006). Thus, ABA embarked on service thinking by trialling a new social product: a virtual counselling service delivered using SMS. The results of a pilot study are reported in this case along with the managerial considerations related to offering a new type of service.

MumBubConnect (MBC): a two-way branded SMS service These issues led to the development of MBC: an innovative, branded, two-way text messaging service combined with a website and a Facebook page (see Figure 7-6) that used the theoretical frameworks of self-efficacy (Bandura, 1977) and social-support-seeking behaviour (Vitaliano et al., 1985) to improve breastfeeding duration. The service offering was cocreated with mothers, who guided the timing, messages and responses that were used in the intervention. This represents the service offering element of the social marketing service mix. In positioning MBC within Lovelock’s (1983) service matrix, we classified breastfeeding advice and support as a ‘people-processing service’ that has both intangible (aimed at the mind) and tangible actions (aimed at the body). Social behaviours such as breastfeeding are difficult to classify into a single category using the Lovelock (1983) matrix, as this behaviour affects both the body and the mind of the woman. Given that the

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barriers to sustained breastfeeding behaviour are typically psychological, social and emotional (Parkinson et al., 2012), we classified the MBC service as involving intangible actions aimed at the mind. The MBC service sent women a single text message a week for eight weeks, asking them how their breastfeeding was proceeding. It then asked for a standard response, to which they received an automated reply. A response indicating some level of distress prompted a trained breastfeeding counsellor to make an outbound call. The text message responses were about normalizing common issues and problems, providing active solutions and affirming positive behaviour. Text messaging (SMS) using mobile phones has been used effectively in health for behaviours such as increasing adherence to treatment programmes and is being increasingly used in preventative health (Fjeldsoe et al., 2009). Use of mobile phones as a service delivery channel is one of the few technological options with high coverage and pervasiveness across socioeconomic factors, age and gender, therefore making it a viable option for broad public health programmes (Tanguay & Heywood, 2007; Holman, 2009). Specifically, text messaging offers the benefits of immediacy, privacy, accessibility, convenience and personalization (Fogg & Eckles, 2007). Underpinning the programme were a number of theoretical approaches, the main one being coping theory. Changes to coping strategies increase or facilitate self-efficacy, which will in turn increase breastfeeding duration. Research has shown that when people feel responsible and self-accountable, they are more motivated to act and change behaviour compared to when they feel less accountable (Passyn & Sujan, 2006). The service was designed to create a value proposition that overcame the known barriers that mothers experience. Results from 120 women from diverse social backgrounds and geographical locations indicated a significant improvement in self-efficacy (p=0.005) and perceived social support (p