Evidence Review: Social Marketing for the Prevention and Control of Communicable Disease

Abstract

Background: Social marketing is the application of marketing theories and techniques to the planning, implementation, and evaluation of programmes and interventions to influence pro-social voluntary behaviour change in order to improve personal welfare, and the welfare of society. Objectives: To provide an evidence-based summary of social marketing for the prevention and control of communicable disease, with particular reference to the European context. Methods: A review of reviews was conducted to examine the international evidence base. An extensive search of databases was carried out to identify relevant English language systematic reviews published from 2000 to 2011. Inclusion criteria were that reviews were systematic, the substantive focus was social marketing, and at least a quarter of included studies related to the prevention and control of communicable diseases. Thematic analysis was used to identify intervention input and output variables and examine their association with measured change in behaviour or behaviour determinants. All individual studies included in the systematic reviews that reported on European interventions for the prevention and control of communicable disease were identified, analysed and described in more detail to provide insight on European-specific good practice. Findings: Five international systematic reviews and three individual European social marketing interventions were identified for inclusion. A narrative summary of learning from the systematic reviews and individual social marketing interventions described and discussed: conceptual clarity; consumer orientation; context; social marketing mix (product, price, place, promotion); strategic and long-term planning (policy, partnerships); implementation; knowledge and attitudes; behaviour change; social environment change; and changes in health status. Conclusions: The international evidence base indicates that social marketing can be an effective approach to behaviour change for the prevention and control of communicable disease. The European evidence is limited, but promising, with social marketing principles having been successfully applied in hand hygiene and sexual health interventions. There appears to be a lack of conceptual clarity on what constitutes social marketing, its purpose and scope. Improved understanding and practice through training and efforts to promote shared learning would enhance its utility and effectiveness. Promotion appears to be the best recognised and/or most commonly employed component of the social marketing mix and there is limited recognition of other social marketing techniques and strategies, such as competitive analysis to identify and modify barriers, the role of segmentation to reach priority targets such as disadvantaged groups, and policy in support of social marketing. Insights for policy and practice: The evidence indicates that audience-informed intervention design and development, partnership-based interventions, and sharing of lessons learnt from previous practice can enhance effectiveness of social marketing for communicable disease prevention and control. Conducting formative research as standard practice improves design and development of interventions and programmes. More emphasis in intervention, design, evaluation on contextual factors, and on all components of the marketing mix (not just promotion) will contribute to future development of policy and practice. More rigorous and extensive process and impact evaluations and detailed reporting of implementation could also make a useful contribution to the future development of policy and practice. It is recommended that greater priority is given to resourcing long-term interventions and programmes, and less on short-term and brief interventions.