AMCHP 2005 ANNUAL CONFERENCE
DELIVERING RESULTS, IMPROVING PREGNANCY & BIRTH
February 19-23, 2005
STEPHANIE BEAUDETTE: Well, again, thank you for everybody coming this morning and I’ll just introduce myself again a little bit and give you my background and then I’m going to start going through the slides a little bit quickly so we can kind of make up on the time that we’ve lost a little bit. I’m Stephanie Beaudette, I’m a registered dietician with the Women’s Health Section of the Colorado Department of Public Health and Environment and this campaign is my entire job. So I am--I’m very closely tied to this, very passionate about this issue and we’re very happy to have Kelly and Alison with us to kind of ground us a little bit more in the social marketing aspect. Because as--as you know, our campaign is is a social marketing campaign; however Jodi and I don’t claim to be experts. We’re certainly learning from a lot of our lessons throughout this campaign and hoping that others can maybe not make the same mistakes that we’ve made going forward, i.e. Wyoming. So with that we’ll just get going here.
So I’m going to talk today a little bit about the research behind the campaign and kind of why we’re doing this and how we got to where we’re at today with the campaign. Then we’re going to turn it over to Kelly and Alison. They’re going to give you some of the fundamentals and principles of social marketing. Jodi’s going to highlight focus groups, not really so much how to do them but why and--and what we’ve learned through our focus group testing and then where we’re at with the campaign--the process. And our goal with this presentation was to try to give you an idea of the big picture on a macro level, how to do this on a statewide initiative all the way down to if you’re just going back to a clinic setting, how you would do the day-to-day incorporation of this or another campaign. In Colorado and statewide about 25 percent of women do not gain enough weight in pregnancy.
I think the obesity epidemic as it is today tends to get a lot of the focus in society and this is an area that’s overlooked. But what we found in Colorado and this is true throughout the literature in many areas is the one in four women in Colorado do not gain enough weight during pregnancy. And as I’ll talk later you’ll find out that this is our biggest contributor to the low birth weight problem in Colorado for singleton pregnancies. So it is a big issue. In Colorado more women do not gain adequately than those-do not gain adequately and have low birth weight babies than compared to moms who smoke. So how do we know that this is a a problem? And if you’re from a high altitude state which it doesn’t seem like many of you are except for Wyoming —
JODI DRISKO: Maybe Idaho .
STEPHANIE BEAUDETTE: Altitude is a factor, however I’m going to talk a little bit--it’s not a modifiable factor. In Colorado it’s not reasonable for us to tell all of our pregnant women to move to Kansas to deliver or--or to have other prenatal care in Kansas . So I’m going to just talk quickly about the altitude. Colorado does have a very high low birth weight rate. We were nine percent in 2003 and as you know the Healthy People 2010 Goal is five percent or less. So we’ve got a long way to go and according to numbers we would need to have less than 3,400 births per year be low birth weight to kind of get to that and as you can see we’re almost double that. So in 1999 the health department did some analyses. They took birth certificate data from ’95 to ’97, analyzed a myriad of factors on the birth certificates and queried this and found several factors contributing to the low birth weight problem. And this is summarized in the Tipping the Scales Report.
There’s a hyperlink in the presentation the web address is on there and we have a website for the campaign at the end where you can readily access this report in full detail. And what we found is that the medical factors may play a less important role in our low birth weight problem, at least in Colorado, than some of the behavioral factors and--and you may see this as well with maybe some other programs that you’re familiar with for prenatal care. How much lifestyle factors do have a contributing effect on this. So we talk about the altitude and there’s just a little comic here. As you go higher in elevation, you have less oxygen and so less oxygen for the mom is less oxygen for the fetus and therefore you have a smaller baby as a result. So this cartoon sketch is an oxygen tanker truck going up to the top of the mountain, taking oxygen to all the pregnant women up at the top.
In Colorado one of our problems that we’ve encountered through our focus groups and through rolling out this campaign is that altitude is the perennial excuse for our low birth weight problem. There’s a lot of research in this area. It’s a well-documented association. We’re not going to debate that. On average you see about one ounce of birth weight loss for 1,000 feet that you go up. Denver is 5,280 a lot of our births-I for example, live at about 6,500 feet, the mountain resorts areas are 8-9,000 so we do see some lower birth weight babies as you get up higher. But it’s not as much of a contributing factor as we once thought. And there’s some GIS studies going on right now. I’m not sure when they’ll be completed, but they’re they’re evaluating this further. I’ve been told from some of our demographers and researchers that if you basically take Colorado , flatten it to sea level, and compare us to other states for our low birth weight rates we would still only rank about in the middle of all the 50 states. So altitude isn’t the biggest factor. So what are our biggest factors?
Obviously multiple births. I think nationwide we’re seeing an increase in twins and triplets, largely due in part to the assisted reproductive technology. This isn’t something that we’re going to tackle within the State Health Department, nor is it appropriate for us to tackle, so we focused on factors contributing to the low birth weight problem among singleton pregnancies. And we found that inadequate maternal weight gain is our number one contributing factor. Smoking is a close second, which is I think what most providers and other healthcare professionals would assume would be the first contributing factor. Granted the risk with smoking and the fetus is a lot greater but it is--it is a factor to consider. Altitude ranked number 16 on our 18 factors that we found to be contributing to the low birth weight problem. This is a little--statistics about the number of births. One in eight low birth weight babies can be attributed to inadequate weight gain, again close second was smoking, again that’s about one in eight, combined a lot of smokers obviously are not gaining enough weight as well.
They’re not having a nutrient-dense diet and taking care of themselves. When you combine those two three that contributes to one in three low birth weight babies in Colorado . And these are not unique for Colorado . There’s a lot of PRAM states who also look at inadequate weight gain and CDC data that also support inadequate weight gain being a contributing factor to low birth weight. It says here that women with inadequate weight gain increase their risk of having a low birth weight baby by greater than 50 percent. Some of our analyses to be specific was about 65 percent. So that, in my opinion, is pretty significant. When I start talking a little bit about the weight gain recommendations, my biggest concern providers are obviously talking about the excessive weight gain or the mom’s overweight or obese to begin with and what does this mean as far as the baby? The data’s out there that shows if women gain within the IOM guidelines, which I’m just going to go over quickly, that their postpartum weight retention is in the range of about 2.2 pounds. And women who gain inadequately, their postpartum weight retention about 12 months out is 2.1 pounds. So a tenth of a pound difference yet you’ve got 65 percent greater chance of having a low birth weight baby.
So the Institute of Medicine ’s 1990 weight gain recommendations, which it seems like they’re brand-new even though they’ve been out for 15 years. Many providers are not familiar with these. The booklets that I have left on your desk are just a practioner’s guide and summary that you can use for some counseling points and assessment. There is a web address on here from the National Academy Press where you can go and you can read the full text version of the “Nutrition During Pregnancy Weight Gain” book from the IOM. So as you can see, the weight gain recommendations have greatly been liberalized throughout the decades. In the ‘60s it was not uncommon for providers to have women restrict their weight gain to about 15 to 20 pounds. They did start seeing some correlations between the low birth weight rate and this restrictive weight patterns, and so they’ve liberalized to body mass index-specific guidelines, which is appropriate.
Not every woman comes into pregnancy at the same size and therefore not every woman should gain the same amount of weight. However, providers are still typically recommending the 20 to 25 pounds across the board for most women. And more concerning is for overweight and obese women they’re just telling them just don’t lose weight during their pregnancy. So someone with a low BMI or is underweight prior to pregnancy, they should gain a little bit more, 28 to 40 pounds, whereas someone who is obese, they’re still recommending 15 pounds of weight gain. This basically is the products of conception. It’s all of the weight gain that occurs during pregnancy short the maternal fat and protein reserves to help the pregnancy just in case there’s a caloric deficit and also to help support lactation postpartum.
So we still want to advocate for these obese women to be gaining some weight. I personally don’t think that if they’re not consuming enough calories to gain weight then they’re in a caloric and energy deficit state what kind of healthful environment is that for the fetus? We don’t want a ketogenic state so to speak for that baby to thrive in. Rate of weight gain, again slow steady gains throughout the pregnancy. We don’t want to see no weight gain through the first part of the pregnancy and a lot of gains at the end. That’s not healthful either. Any questions at this point in time just about the the weight gain recommendations and we’re going to turn it over to the social marketing presentation. Okay thanks.
KELLY CAREY: Good morning again, my name is Kelly and as we mentioned earlier we’ve all had a lot of coffee so I have a tendency to speak a little fast so please don’t hesitate if I’m speaking too fast to let me know and I’ll--I’ll slow down for all of you. What we’re going to do for probably the next 35-40 minutes is really talk about the fundamentals of social marketing. And to begin that, what I really wanted to do is sort of put the question to all of you. You’ve probably heard the term social marketing bandied about, maybe you’ve used it yourself, maybe you’ve been involved in a social marketing campaign, so I just really wanted to ask you what’s--what’s your definition of social marketing if any of you have had experience or just if you’ve used the terms and what do you think social marketing is? Anybody? Jane, Milo ?
UNIDENTIFIED SPEAKER: Probably I’ll put a stab at it and I know that I’ve been given a definition but because I have poor memory but it’s using--using media to influence behavior.
KELLY CAREY: Influence behavior? Anybody else? Any other thoughts?
UNIDENTIFIED SPEAKER: I think of it as in relating to healthcare--specific to healthcare.
KELLY CAREY: Related--there is definitely a healthcare component. There’s also other issues that are social issues, too, that fall into that too. Anybody else? Because you also hear sometimes cause-related marketing, which you know, is sometimes where a product is associated with a cause and you purchase that product and then money goes to a cause. I wanted to make that distinction. That’s different than social marketing. Sometimes you’ll also hear non-profit marketing, which is a type of outreach that universities do, museums do, hospitals do to raise awareness about their particular programs and the money and stuff that they may need to glean. Those are also different than social marketing. So let’s--let’s put a definition up here of social marketing. So you’ve got social marketing seeks to influence social behaviors, not to the benefit of the marketer but to benefit the target audience and the general society. Again, that speaks to what Jane pointed out about you want to really raise awareness, influence the social behaviors and effect change. And it does obviously to your point, Deborah, have a really good place in the world of healthcare.
So regular versus social marketing and the reason we want to talk about this is because what has happened is over the last maybe 10-15 years, social marketing has really taken traditional business marketing principles and applied it to social issues in order to effect change. So we’re going to talk about the four P’s of marketing in a minute. But what you want is you want to look at what are the needs and wants of your consumer and then--and in terms of social issues that’s what you’re looking for. Like, what are those needs that your particular issue has in healthcare and maternal child health? What are the needs and wants of those consumers versus traditional marketing is usually about a product or a service and getting people to certainly buy that product or service. The general principles of marketing--we talk about four principles of marketing. And I don’t know if any of you have, you know, marketing backgrounds but it’s product, price, place and promotion. But what I have up here are definitions of how that is applied to social marketing.
So when you think about your traditional product, if you’re talking about, you know, a shampoo or a stroller, that’s your product. What we’re talking about is the behavior, the beliefs, the information, the services that we want people, we have an issue that we want to talk about. In this case it’s appropriate birth weight. I mean, that is your product, that is your issue that you’re trying to get out there. In traditional marketing your price is how much is it going to cost your consumer to buy your product? But for the work of social marketing it’s really what is the price on society if this issue is not dealt with? If--if children are born at a lower birth weight what happens then in terms of healthcare costs and other risks to society by having low birth weight babies? That’s the type of price we’re talking about. In terms of place, if it’s a product you’re talking about you’re talking about where--where are you going to buy that product? Where’s it going to be distributed?
In your grocery store, in your department store. For the work that we’re talking about, social marketing, you’re still distributing it but you’re also talking about where are people going to get those services and access that information and that need to address that social issue. And then promotion is probably one of the--the places where it crosses over the most with traditional marketing, which is how are you going to communicate what it is that you’re talking about through the different communication channels, which can be everything from media as you mentioned, Jane, to paid advertising to grassroots organizing. There’s all kinds of ways that you can reach out to communicate your social issue. And we’ll talk a little bit more specifically with some examples in a couple of minutes. In addition to the traditional four P’s of marketing, with social marketing we like to say that there’s an additional four: publics, partnership, policy and purse strings. And to talk a little bit about this, when we say publics, you’re in a social issue and you’re not in it by yourself.
There are obviously other organizations and both the government and what not that are concerned about your issue. So you are in an arena with healthcare issues in particular that it isn’t just your organization that’s dealing with them, so you’re going to be working collaboratively. And that leads to partnership. When you’re doing the work that you’re doing on social issues, you have many, many opportunities to partner with other organizations, businesses, any kind of group that is interested in your issue to further reach your overall objectives of your social marketing campaign. Then you’ve got the policy piece. And a lot of what we do in social marketing really does have ramifications on policy. And policy can affect, as you know, regulations, legislation, all of that. It really has some serious policy implications that can--for example, if you’re working on anti-tobacco work, can end up with restrictions so that smoking is no longer allowed in restaurants or public places and things like that. That’s all policy change that comes out of social marketing.
And then as we all know, because you work in government or non-profit, there’s the purse strings, like how are we going to fund all of this stuff? Because that I think is for all of us. Always a challenge is making sure that we have the resources to do the work that we want to do. So when we think about social marketing from GMMB, which is the firm that we work for, this is sort of our definition of how we look at it, sort of our philosophy, which is it is about changing attitudes and behaviors through targeted communications campaigns. And that’s really what we try to do. We try to build what we refer to as an integrated communication campaign that really raises awareness and then at the same time uses all kinds of different traditional marketing channels to reach our target audiences and ultimately get them to effect change. And to do this, first and foremost you’ve got to raise awareness. I mean, a lot of people as we all live in the worlds that we work in and so we think we live and breathe everyday in maternal child health issues for example or Alison and I do a lot on the uninsured issue and so we’re very familiar. But when you step outside of that you realize that there’s an awful lot of people who really have no idea.
So first and foremost we have to raise awareness and make sure that not only is their awareness raised but we’re really capturing their interest so that they can help us become a collaborator in our issue to expand the awareness and hopefully get people engaged in this issue. And then we need to change the attitudes and--and the conditions in the environment that exist. I mean, people have to be more receptive to the information that we’re putting out there about healthcare issues or other issues. And then the environment has to change so that things can be done to address those healthcare issues. Ultimately, the message that we have to get out there also has to motivate people to make change. They have to see themselves. It has to be realistic and they have to say, “Okay, you know what? This is--they’re talking to me and I understand. I am listening and what I’m going to do is I’m going to call that number.
I’m going to talk to my healthcare provider. I’m going to find out information.” You’ve got to be motivated to make change, and that’s part of the empowering people to act. You know, a lot of times when we put out messages they really do have to be messages that are realistic, that people can--can really--can see themselves and that the type of change we’re asking for is change that people can do. That they understand that if they take this one step that that’s the first step and they feel empowered by that and then can take whatever additional steps are necessary. And the other thing that is very important when you’re thinking about social marketing is we always call it prevent backsliding, but really what that means is let’s say we have a successful campaign and we see some some really terrific results when we’re evaluating our campaign. That’s one effort but it never really ends. Like, we have to remember that success is sort of momentary when we reach one goal, but the type of issues that we all work on with social issues and healthcare issues, they’re--they’re going to be there. So we have to always consistently be, you know, on the lookout, on guard, continuing to think of ways that we can continue to keep these issues front and center in the public’s mind so that we can continue to make change. In terms of components of social marketing I’m going to turn it over to my colleague Alison. She’s going to talk through some very specific examples and then we’ll tag team again and keep moving.
ALISON VOLZ: Thanks. We’ll go back and forth. You can see enough faces to keep it interesting this morning.
KELLY CAREY: We hope it’s interesting back and forth.
ALISON VOLZ: Right, we hope. Good morning again. So our goal here is to try to provide a framework for social marketing in its entirety so that when Jodi and Stephanie are talking a little bit you can apply the formula that we have here to what they’re doing. And this is--this is a unique opportunity. Kelly and I do many social marketing workshops and we always feel like we’re just talking in generalities. So this is really an opportunity to take these components that we’re talking about and apply it to what Stephanie and Jodi have done so well. So if you leave with nothing else from what Kelly and I are discussing today, try to keep these components in mind. Research. My middle name is going to be research today and I have a feeling that Stephanie and Jodi would agree. It is the absolute cornerstone of social marketing. It’s surprisingly not your message, not your target audience and not your goals. The research really can define everything else that you’re doing. I’ll talk a little bit more about that in a minute. We need to identify our target audience.
Not only our--our primary audiences but our secondary and our tertiary audiences as well. Message development and testing sometimes se--seems easy but there can be some obstacles along the way I want to talk with you about. Earn media, paid media. And just to be sure everyone’s clear there, earned media is when we’re talking to reporters and trying to get them to write up an article or a broadcast story about us. As opposed to paid media, which is more advertising and PSAs. Grassroots, coalition building, partnerships with organizations, partnerships with corporations and evaluation and tracking, just so we can be sure that we’ve done it all right. So back to research. I’ll say research a lot. This is just a quick diagram to explain that research is part of every stage of the campaign. You have your benchmark research in the beginning so that you know everything you need to know about the goals of your campaign through the data of how things are today. It’s going to help you develop your messages. It will help you indeed define your audiences. You’ll be able to analyze how effective you are and then it will help you evaluate and adjust, and that’s an important thing to keep in mind because you will have to adjust along the way.
I do want to mention a couple of different types of research because this sometimes seems a little--a little confusing because we use research for both of these. Issue data, of course that’s the issue we’re working on and we can--we can create that data in a few ways: public opinion surveys, state by state comparisons, partnership with a university or research institute around the issue itself. What we’re looking for here is compelling data that justifies our campaign, is newsworthy for a social marketing campaign and can be evaluated again toward the end and then probably again and again, on and on. Different from our campaign data, and that’s more to talk about how effective we’re being and whether or not we need to adjust our process along the way. And we can do that through focus groups, public opinion surveys and, of course, pre and post testing. Couple of notes about this. Focus groups, we’ve just learned in our experience that it is incredibly important to do them, it’s incredibly important to find the right people to do them. You really do want to look for an organization that can do your public opinion surveys and your focus groups that has some experience in maternal and child health issues. Because all of the research that they have done in the past on those issues they’ll be able to use and apply to your focus groups, and it just gives you a wealth of data to work with.
In addition, look for good recruiters, because a focus group organization is only as good as the people that are sitting around that room. And it’s important that it be a balanced group, that it really compose your primary and secondary audiences. State by state comparisons is worth considering partnering with an organization like yourselves in another state in your region particularly. It seems to be very newsworthy; reporters pick it up a lot. And partnering with a university or research institute if you’re in the position where you don’t feel that your organization is--either has a very wide reputation or perhaps not very credible, maybe you haven’t been doing research for a long time. Partnering with a state university or other research institute can help build that credibility really quickly. Identifying your target audience. I mentioned this just a little bit earlier and we’ve listed some questions here to be thinking about. Of course the primary audience, and that’s whose behavior are we trying to change?
Our secondary audience, and that’s what other audiences are going to influence our primary audience? Maybe we can’t reach our primary audience directly. Maybe they can’t hear it directly from us and we need to engage some other people in the process. And tertiary audiences. This is what Kelly was alluding to earlier, building an environment where change can happen. So we want to build communities that understand that change is important and that there’s a need for it. That helps both our primary and secondary audiences follow through. And we want you to prioritize the core audiences. I think that there’s always the assumption that we should start with our primary audiences, and often that’s not the case. We recommend that you start with the audience that’s the easiest to change first, because that creates a wave of change.
Message development. At GMMB when we’re talking with not-for-profit organizations and they’re trying to figure out how to create a concise message around their issue, we often say if we don’t get it then they’re not going to get it. We’re not that much smarter than the rest of them in understanding any basic social issue. So it’s important that things are as simple as possible but also are accurate. You can almost oversimplify something and then it doesn’t really generate change because it’s inaccurate. So we always say, try to--try to think of it kind of the lowest common denominator. Having said that, it’s incredibly difficult, I would use the word impossible but I won’t, to create a message that you haven’t tested and isn’t research-based and expect it to work. I would love to say that that’s the case and in my earlier days I believed that to be the case, but my experience has told me now that it just simply doesn’t work that way. We’re so involved in our own issues that even the way we talk about it, even though it sounds simple to us, really might not to other people.
And being able to put ourselves in other people’s shoes, as much as we all try to do that as people, it’s difficult to do in message development. So it needs to be research-based. It must be tested. And it must be tested with all of your different audiences: your primary, your secondary and your tertiary audiences. It’s also important that once that message is developed and it’s tested that you stick with it. It’s easy I think in the middle of a campaign and when you haven’t seen any early successes to get a little nervous and back off and say, “Maybe we should tweak here; maybe we should tweak there.” But try as best as you can to stick with it and the research helps back that up. So then when you’re talking with your other stakeholders and they say, “Gee, Alison, this really isn’t working yet. I think we need to switch gears.” You can say, “It’s researched. It’s tested. And we need to give it the time to follow through.” And also keep in mind how your messaging can affect the positioning of your organization. Think about a little bit what is the reputation of your organization? What do you want other people in the community to think of your organization? And will this campaign that may be the most visible thing you’ve done in recent years change that positioning at all and is that okay? Earned media we mentioned a little bit earlier.
I just want to make a couple of quick notes about this. I think most of you have had some experience reaching out to the media before. Media events, media events are a great alternative to a press conference. I would consider something like--Kelly and I work, as she mentioned, in the issue of the uninsured; we do health fairs across the country. If we do a press conference with a couple of high-profile speakers and we do a health fair with a press conference at the health fair, we get a lot more coverage at the health fair. Because not only do we have our data to release and the right people delivering the message, but we have this really great visual. And a visual goes a long way of course particularly with TV but with print as well. So consider media events as opposed to just those formal press conferences. Release compelling data. Any data-driven press event will be a whole lot better than announcing kicking off your campaign for example, here’s what we’re going to do. Even if it’s just a little bit of data, it does go a long way. It’s not always as expensive as you might think. It can be something as easy as a small public opinion survey that samples a certain amount of people in your state just to talk about perceptions and attitudes.
Pitching stories. Just keep in mind that beyond just pitching the big reporters in your community, to be looking for other opportunities like editorial opportunities and op eds and also media partnerships. And here I’m not necessarily talking about a media partnership around an event like you would do maybe with a TV station or a radio station. I’m talking about more of a content-based media partnership that you might do with your local newspaper or even something as goofy as the comic strips. This is something we did with Rex Morgan just a couple of years ago on the issue of the uninsured. It was a--a consumer-oriented campaign and we just decided we were going to go for every single thing in the papers. So not only did we go for the political reporters but we went for the healthcare reporters, we went to Dear Abby and we said, “Hey, why not? Why not do the comic strips, one step away from the horoscopes.” Kelly’s going to walk you through some paid advertising and the other components.
KELLY CAREY: Okay so we’ve talked about earned media which we’ve also referred to as free media and now we want to talk for a minute about paid media recognizing that, you know, not all campaigns have paid media. It is not absolutely essential but if you have an opportunity to have paid media it can be a really great thing, especially if it’s incredibly targeted to reach your audience. I mean a lot of people watch TV, listen to the radio, that type of stuff, so if you can do that that’s great. In terms of types of paid media you have, as I mentioned, TV, radio, print, internet, which is very popular now, and then outdoor. When we say outdoor that’s, you know, billboards or you know, bus shelters when you’re there or you know, on the back of buses, that type of stuff, in metro, subway systems that would be--constitute outdoor media. We put public service announcements up here and I think from the non-profit government world we’re probably more familiar with public service announcements, and I think we think of those as being free but they’re under paid because we usually pay to have them produced. So I--I just want to make sure that people understand that is money that’s going out to have your public service announcement produced. And again going back on the, if it’s done, research tested, I mean there is resources involved in doing that.
The other thing is placement in partner publications. This is really--when you think about trying to get your message out, really always look at whoever you’re partnering with, be it organizations, corporations. Look at their communications channels. They may produce--they may produce newsletters, they may have online, you know, websites, things that your particular target audience may have access to that could be a really great channel to deliver your message. Sometimes you might need to pay for those, sometimes hopefully as we like to say they would do it for free if they’re a partner, but just to put that up there as well. We also mentioned what we call co-branded efforts. And those are opportunities, for instance, let’s say you have a corporate partnership and with a local grocery store and this is something that you know, that we’ve done with Covering Kids and Families work. You have a partnership and say they regularly take out, you know, full page ad in your newspaper.
And maybe with one of the ads that they take out you can actually get your message, your healthcare message out there. Maybe they’re advertising something in the pharmacy department and you have an opportunity to get your maternal child healthcare message out there. That would be really a co-branded effort. Could sometimes involve paying for that or it could involve them just actually offering to donate that space to you. But again those co-branded efforts also can be incredibly valuable, so I wanted to make sure everybody’s aware of that. Covering Kids and Families. We mentioned that earlier is the campaign that we do and what we wanted to show you is just a really quick print ad to just show you how we’ve talked about that. This is our, “You work hard to take care of your kids. Now there’s help”. This is just a print poster that we made available to all of the Covering Kids and Families coalitions across the country and did it in such a way this is--the messages are tested messages.
It was really--when we worked with families we found out that a lot of families whose children were eligible for SCHIP and Medicaid just didn’t know that they were eligible. But the messages that resonated with them was, look, you--you--you want to be a good parent so, you know, you work hard to take care of your kids and now there’s help. That was really a message that when we tested it parents really understood and they said, you know, yes, if I get my child connected to healthcare coverage I’m--I’m feeling like a good parent. And that was a really important message for them to glean. And then also in terms of when you’re putting together whether it’s certainly a TV, radio spot, print advertising, you want to make sure that all your core messages are there. So you’ve got your primary message but for instance what is your call to action? You’ve got your, you know, 877-KIDS-NOW was a number that we wanted people to call. We made sure people recognized that it was toll free. You know, it’s introducing key things about in this case healthcare coverage your child could be covered for. You’ve got doctor visits, hospitalization, immunizations.
It’s really making sure that your target audience understands what it is you’re talking about, and if you can without overwhelming them give them some sort of key sense of what it is they’ll be getting, that actually goes a long way. The other campaign I wanted to use as an example is our “First Five California”. And this is actually comes out of Proposition 10, which really deals with--it’s anti-tobacco work. It’s a 50 percent tax that was put onto cigarettes and that money that was gleaned from that tax was--has been used by the state of California on early childhood development. And so with this campaign, part of what was done is a very significant, robust research regime, like, 40 focus groups, over 2,000 interviews, in an effort to reach out to ethnic and immigrant populations and really understand what they understood about early childhood development and how they could be involved in shaping their child, whether it’s their grandchild or their actual child’s early development. And really get them to understand that talking, reading, spending time with a child at a very young age is incredibly valuable and incredibly important to their early childhood development. So what I want to show you is a TV spot that was--that was created for this campaign. It’s called “Codger” and it’s a--well, it’ll speak for itself. Very cute. Do I need to hit it again?
UNIDENTIFIED SPEAKER: You know, back in my day, we didn’t have great food like this, we had to eat tree bark. Oh yeah, we really did. And back in my day we didn’t have great toys like this, we had to stack rocks, yeah.
UNIDENTIFIED SPEAKER: Studies show that the way you spend time with a child can make a huge difference in their life. The way you talk or even just play with them can make them grow up happier, more self-confident and better prepared for school. So even if you spend just a few hours a week with them, you can affect their lives for years to come.
UNIDENTIFIED SPEAKER: Back in my day—
UNIDENTIFIED SPEAKER: Bye Grandpa.
UNIDENTIFIED SPEAKER: Come to think of it, this is my day.
UNIDENTIFIED SPEAKER: Day.
UNIDENTIFIED SPEAKER: Yes.
UNIDENTIFIED SPEAKER: To learn more about how to have your child make the most of the first five years call for a free kit for new parents from First Five California at 1‑800‑KIDS-025.
KELLY CAREY: With that particular spot, as you can see, it was really talking about reaching out, getting that message across about the importance of communicating. And what the research showed is that our targeted audiences were very receptive if we made it real. That’s a very real situation you have, a grandfather with a granddaughter talking and having fun, and that was something that people could really relate to and understand and it got the message across. And then as you noticed at the end it talks about call eight--eight--the 800 line to get more information, so you still have that--what is that action step that you want your target audience to get.
Just wanted to share that with you. In terms of some of the other components of a social marketing campaign, the grassroots piece is incredibly important. That’s all the organizational partnerships, the corporate partnerships that you can build, sometimes it’s partnering with the government organizations and agencies, and some of you are with government organizations and agencies and officials and even celebrities could be local folks that are supportive of your issues. All of these people can become messengers for your message and can be incredibly powerful. And what we like to say, amplify the message that you’re trying to get out into the general public and certainly to reach your target audience.
Partnerships. We’ll take a minute to talk about this very specifically because they--I think this is an area that can be explored a lot more and I--I found that coming from the non-profit world, it was sort of a revelation that there are partnerships that you can--you can make. Not just with organizations but certainly with the business community, which is something that we’ve been able to do a lot with Covering Kids and Families and some of the other organizations that we’ve been working with. Partnerships really do lend credibility. You have a reputation with your organization, which is very good. The more people that are associated with you that are recognizable in your community, that just increases that reputation and credibility and it’s nice and, you know, when people can say, “Oh, well, there’s, you know, the Maternal Child and Health Organization and wow, they’re working with--” whatever other entity in your community. It just lends some additional weight to the type of work you’re doing. It also will help you increase your outreach abilities.
All these partners do have communication channels. They have opportunities that you can use to raise the awareness of your issue and to reach out to your target audience and again get those core message--messages out there. And as Alison mentioned earlier, there’s a whole positioning that can be done both for your organization and your issue, and positioning when, you know, other organizations see certain organizations working with you they may be more inclined. When the business community might see a business leader step out and speak on your issue, other businesses may say, Hey, you know, that’s really a big issue I--I need to get involved in that. You know, I noticed that the CEO of whatever company it is involved so I’m going to pay attention here. And certainly policymakers and folks it’s important. They’re the ones who are really going to help on that policy front and so they need to know that you’re out there and things are really, really important and they need to pay attention. In terms of a couple of examples, these are a few partnerships that we’ve developed for Covering Kids and Families.
One with H & R Block, one with CVS and one with Giant Food, which is a regional grocery store chain here. The reason why I want to point them out is because they’re a really great way to raise the visibility of your--your issue, but I also wanted to tell you that there’s no money that changes hands, which coming from a non-profit world was really important to me. These are what I like to call free partnerships in that we worked with H & R Block and during tax time when people are filling out their taxes because they have an ability to obviously know what your income is, anybody who was income eligible potentially for SCHIP and Medicaid and had kids in the house, they were given a special message saying that, you know, if your child is uninsured you may be eligible for low cost or free healthcare coverage. Call 877-KIDS-NOW. Again, very targeted to the target audience we’re trying to reach with this important information to let them know their kids might be eligible for healthcare coverage.
With CVS during our back to school time, when parents went to fill up prescriptions during the back to school September, October timeframe, they would--when they received prescriptions, they would also receive a healthcare coverage message. So you get your prescription and attached to that is this low cost and free healthcare coverage is available, find out if your child is eligible. and again promoting that 877‑KIDS‑NOW number. Same with the milk cartons, figuring you’re reaching people as they go about their day-to-day lives. They’re hearing about it in the pharmacy, they’re picking up a little quart of milk and they’re getting the grocery bags with the same message. Again, you’re trying to reach people in many, many different fashions and I point these out because what you all have, especially with maternal child health, I mean children’s issues, women’s issues, I mean, these are really important and--and actually very, very attractive to the business community because let’s face it, moms in particular are decision makers, shoppers, consumers.
And you all have a really, really great I think, opportunity to build some terrific partnerships because this is an audience that the business community in particular is very, very interested in talking to. The other piece that is incredibly important is the whole idea of evaluation and tracking, and we can’t stress this enough. Regardless of how you do your evaluation, and certainly there’s different ways, you need to do the evaluation. You need to know that you’re succeeding at what you’re doing and you also need to do it because you want to talk about it. Success is a great thing. People want to jump onboard with successful campaigns. So if you have ways to measure your success, then you can go out and sell that success to other partners, to other businesses, perhaps get more funding, whatever it is, you can really sell that success. You also need it, as Alison mentioned earlier, because when you’re going through the process of a social marketing campaign you do want to make sure that you are meeting your objectives, that you are reaching your target audiences, and that if something changes and it could be your environment changes, that you’re changing with that, so that you have an opportunity to shift your message if that’s necessary or change an element of your campaign and figure out what is working and what’s not and make those appropriate changes that you want to do.
So you always want to make sure that you do some form of evaluation. We listed a couple of things here, both quantitative and qualitative. You certainly can do surveys, you can track the media, is your message, the way that you want it that consistent message, for example, getting into the media in the right places? Are you seeing that happening? Qualitatively, if you’ve done some benchmark surveys, you know, or if you’ve done focus groups and what is happening? Are people actually seeing, you know, the messages that you’ve got and are they actually responding? And have they seen your messages out in public and has it caused them to take action, whatever that action may be, call a number, visit a website, make an appointment with their doctor. And really trying to find out. And I think that Jodi and Stephanie will talk very specifically about some of the measurements that they’re doing with their campaign but you always want to have this particular piece. We also put feedback forms up here too, it really--it is important for all of us to think about it and do the type of evaluation that works for us, recognizing that it can be an expensive component but we can’t stress enough, just like the research piece, that it is incredibly, incredibly important to do. So I’m going to pass this back to Alison and then we’re going to be wrapping up and just wanted to--I’ll say thanks on my end and have Alison wrap it up on ours, thank you, ma’am.
ALISON VOLZ: So what we’ve really tried to do is tee this up to get into the details with Stephanie and with Jodi. So we just want to go through the top 10 lessons learned. A small attempt to be David Letterman, but it’s really not that funny. First one, real lasting change takes time, years, decades. This is a long-term process, so it’s important that all of your stakeholders are engaged and committed to the long term. Two, change is incremental and success is not permanent. It’s the sad part about having a successful campaign is that you have to keep at it anyway. Three, a multi-prong strategy is needed. That’s exactly why Kelly and I went through those various components to explain that--most of those if not all of those we prefer are necessary in a social marketing campaign. Four, it takes--it takes collaboration, and partnerships are surprisingly effective. I think we’d like to think a lot about partnerships like corporate funding-based partnerships, but please don’t forget about all of the other organizations that are doing parallel work to yours and the necessity to be talking amongst each other.
Five, you don’t have to change everyone. Stay focused on your target audience. This is a difficult one to let go, because you start to notice as you get engaged in the campaign all of the people that aren’t listening. And it’s important to remember who’s important. Six, research is essential. I’m sorry I have to say it again, change does not occur because it’s right. Please consider as you begin a social marketing campaign first what kind of research you would want to do and how you can find a way to fund it. Seven, flexibility and a willingness to adapt to the campaign is necessary to stay on track. Eight, advertising works, PSAs work sometimes. That “Codger” ad for example, we are proud of it. It’s a great PSA. But we can’t control when its run, could be 3:00 in the morning, it could be when no one’s looking. Paid advertising is critical. And if you don’t have an advertising budget, which most of us don’t usually for things like this, do consider media partnerships for that exact reason so that you can talk with them and negotiate with them about when the ads may run.
Nine, evaluation and tracking are paramount. Kelly hit that. And ten, again, it takes time. We encourage your patience here and to talk with your colleagues about what the long-term goal is. Five years is always a good place to start. You won’t see those changes in six months. It’s just too hard. So questions to consider when you begin a social marketing campaign. Things to keep in mind. What is the goal? Is there a need? Who are the target audiences and is anyone doing this already? So a couple of challenges here.
Determining the goal and determining the need. The critical part here is that everybody actually agrees on what that goal is and what that need is. Some--sometimes it can be very slight but can make a complete difference in the messaging of your campaign. Internal questions to talk about with your colleagues. Are all of the necessary stakeholders internally committed to the project? Kelly and I really encourage an honest heart to heart discussion with your colleagues when you consider an endeavor like this. Because it will take time--it will take time, it will take resources and it will take everyone’s attention at some point or another. Are the resources available to maintain the effort? And by that I’m not only talking about money but I’m also talking about staff time, being sure that you have somebody to actually make it happen and it’s not a small part of somebody’s already overworked job. And how does this affect the organization’s position among its networks and in the communities?
Corporate partnerships are a good example of that. I think we all like the sound of it. You can be associated with a really recognizable brand. But there are a lot of reasons not to do corporate partnerships and not to do organizational partnerships if it’s going to affect your mission, your reputation or your goals. So it’s always worth it to have an honest conversation with all the stakeholders internally so that everybody can really just air out what they think is the need for this and--and why they would want to move forward. So hopefully we’ve just teed up a little bit the details that Stephanie and Jodi are going to go through. I’m sorry that we did not bring a presentation of this today but if you would like one I’m happy to share our email addresses with you quickly. I am Alison.Volz@GMMB.com and Kelly’s if you’d like it is Kelly.Carey@GMMB.com.