Communications are Not Enough

When people want to bring about health change on a broad scale, most think about communications campaigns.  While these can be very effective, don’t forget about the P in the social marketing mix that stands for policy.  Governmental or organizational policies can create an environment that supports individual behavior change or that does not even require the individuals themselves to be the ones that do the changing.

A study by the American Heart Association found this to be the case:

A Colorado city ban on smoking at workplaces and in public buildings may have sparked a steep decline in heart attacks, researchers reported on Monday.

In the 18 months after a no-smoking ordinance took effect in Pueblo in 2003, hospital admissions for heart attacks for city residents dropped 27 percent, according to the study led by Dr. Carl Bartecchi, a clinical professor of medicine at the University of Colorado School of Medicine in Denver.

“Heart attack hospitalizations did not change significantly for residents of surrounding Pueblo County or in the comparison city of Colorado Springs, neither of which have non-smoking ordinances,” said the American Heart Association, which published the study in its journal Circulation.

The association said this was further evidence of the damage wrought by secondhand smoke.

This policy led to 108 fewer heart attacks in Pueblo in an 18-month period, likely as a result of a decrease in the effect of secondhand smoke as a triggering factor for heart attacks, according to the AHA.

This result actually ties in nicely with part of Craig Lefebvre’s recent post on critiques of social marketing, where he says:

Bottom line: Your theoretical or philosophical model for how behavior comes to be, is maintained and can be most effectively modified or changed determines how you use the principles and tools that social marketing provides.  This was always the central point of people like Larry Wallack and other proponents of a social determinants point-of-view who criticized social marketing for ‘blaming the victim.’  Individual theories of behavior change will lead you down that path, whether you utilize a social marketing approach or some other model. The rise of social ecological models, policy interventions and environmental change approaches to public health are all attempts to reorient how ‘we’ view the world and interact with it in our professional capacities. In the way I think about social marketing, it provides a systematic and strategic way to think about issues of being audience-centric, aware of and responsive to larger trends and competition in the environment, using research to guide and inform program development, and applying the 4Ps. The more theoretical models we have in our toolboxes to bring to the task, the more successful, I believe, we will be.

Before you invest lots of money in a media campaign or other communications (i.e., Craig’s 4 Ps of communication – posters, pamphlets, PSAs and publicity events), think about how you can change the environment rather than just how you can change behavior.

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