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Tim Mask and I have both been thinking a lot about public health marketing this week. It’s a strange business. Public health campaigns are typically well researched and evidence-based. Public health marketing professionals typically come from a more academic background than, say, your typical product manager. They also¬†often work for government institutions. So, especially these days, there’s a lot of pressure to show cost-effectiveness.

Despite all of these factors, public health campaigns are often, well, not good. If you ask somebody from my generation about the best public health campaign of all time, there’s a good chance they’ll mention the “This is your brain on drugs” commercial for the Partnership for a Drug-Free America. That commercial ran more than 20 years ago!

So what “discoveries” have we made about creating public health campaigns that really and truly get results. Here are three excerpts from Tim’s blog post, Don’t Listen to What People Say And the Other Two Top Things I’ve Learned After a Decade of Public Health Marketing.

1. Don’t listen to what people say.¬†

….don’t place overdue emphasis on a research “finding” (particularly if it’s qualitative) if what you know about human psychology and your gut is telling you something different. By its very nature, public health marketing is typically concerned with focusing the target audience’s attention on a topic that is not already top-of-mind (it’s often unpleasant), and consequently convincing the audience to act in a manner which may be against natural instincts.

I think he has a good point here. Of course, you have to use any research that’s out there to guide your campaign. But too often, the research that we have is inconclusive when you get down to campaign specifics. Focus groups, especially, can be problematic because what people say in a focus group often correlates poorly with what they would actually do in the real world. If we were to believe focus groups, there would be no advertising at all because all focus group participants believe they are immune to advertising. Likewise, how well a focus group “likes” a particular message or approach matters very little because people often behave irrationally in the real world. Case in point: vaccine deniers. If you want to believe that vaccines are unproven and risky, fact-based appeals aren’t likely to change your mind.


Could Louis Pasteur have developed a compelling 30-second spot? Doubtful.

2. Shock value is short lived. 

You ask a group of people what kind of imagery should be depicted to prevent smoking and you will inevitably get a chorus of “show black lungs.”… Who wants black lungs? That’s gross and scary and shocking. Problem is we showed black lungs for about a quarter of a century before smoking rates among youth peaked in the late 1990’s.¬†Showing the worst pair of decayed, cancerous lungs is equivalent to basing your research results on the biggest anomalous outlier in a sample. We all know people who smoke and don’t die a youthful, hacking death.

The idea of shocking people into behavior change is certainly appealing and it has an intuitive logic. The problem is, people have a host of defenses lined up to help them rationalize the cognitive dissonance triggered by shock tactics. Sure, that happens to some people but it won’t happen to me. If I take lots of vitamins, I’ll be safe. How bad can cigarettes really be ‚Äì they’re legal aren’t they?¬†Those public health nuts are lying again. Shock does sometimes work, but people eventually¬†find a way around it.¬†

3. Realize that things DO change and we have to change with them.

¬†Ten years ago it was cool when Brad Pitt smoked onscreen. Now its more associated with fallen celebrities like Lindsay Lohan. The problem for counter marketing is that our efforts were largely successful‚Äîcounter marketing messages are now highly credible, but smoking itself is much less relevant. This means it has fallen “off the radar” in the public consciousnesses. We’ve had to shift our strategy to keep the issue relevant among a smaller but still sizable group of at-risk target audiences.

The message here is that you can’t apply yesterdays solutions to today’s problems. Things change. Here’s an example: We recently worked with a research partner to study attitudes about smoking among Mississippi youth. Surprisingly, at least to us, we discovered that when you say “smoking” to many kids, they think you’re talking about smoking marijuana ‚Äì not tobacco. As tobacco use has become less acceptable, marijuana has taken its place. You see this a lot in substance abuse trends. Demonize one drug and another pops up. It’s like a big game of Whack-a-Mole, only the stakes are very high.

Now here are the three things that I’ve learned about public health marketing:

1. You have to “mix up” your messages.

The conventional wisdom in advertising used to be to choose one message and stick with it forever. I’m dating myself here, but I’m sure some of you remember the “ring around the collar” commercials for Wisk laundry detergent. These was also the commercials with Mr. Whipple, the grocer, who admonished his customers for squeezing the irresistibly soft rolls of Charmin bathroom tissue. Those commercial were repeated endlessly and drilled into our nation’s collective memory. But remember there were only three TV networks back then. It was a lot easier to reach a huge audience cost-effectively, and there were fewer entertainment options that would allow you to escape from those dull, repetitive commercials. Today, marketers have to work a lot harder to attract the attention of viewers. In public health, especially for long-running campaigns, we’ve found a variety of message approaches can be very effective because you can tailor your messaging to fit the mindsets of various audience members. And you can create a stronger, deeper connection to the overarching message. Instead of leaving kids with the simple takeaway “tobacco is bad for you,” we want them to know 20 reasons why tobacco is bad for you.

¬†2. You can’t bore people into changing their behavior.¬†

The legendary adman, David Ogilvy, once offered this brilliant insight into effective advertising: “You can’t bore people into buying your product. You can only interest them into buying your product.” There’s a reason David Ogilvy was wealthy enough to own a French castle. He was a very smart marketer. His advice holds true for public health marketing, as well. All too often, evidence-driven campaigns rely on evidence only, not creativity, and are bland an uninteresting as a result. Often this result stems from an attempt to apply the scientific method to advertising. If a campaign is going to be analyzed scientifically, its message should be simple and straight-forward.¬†You have to eliminate all unnecessary variables. Unfortunately, those variables and nuances are exactly what makes advertising interesting, motivating and, frankly, tolerable. The results of mass communication are notoriously difficult to predict. What works in one place and time may not work in another situation. Always remember that the most carefully crafted public health marketing strategy will fail if it’s merely “background noise” in the lives of its intended audience.

3. The most important research happens after the campaign runs. 

I don’t want to sound like I’m opposed to market research. I’m not at all. In fact, many of our best campaigns were guided by insights gleaned from market research. That said, I firmly believe that post-campaign qualitative research is the type of research that’s most critical, especially when you can measure actual behavior ‚Äì not just opinions and attitudes. Pre-campaign research is great for gathering insights and disaster checking creative. But real qualitative data is where the rubber meets the road. What did people do after they saw your messages? Did they go to a website to learn more? Did they visit their doctor for the suggested tests? Did they change an attitude or belief, as measured by both pre- and post-campaign testing? If something along this lines didn’t happen, then it’s time to learn, adapt and try something new.

When you think about public health marketing is one of the trickiest forms of marketing out there. It’s not all that hard to get someone to try a new brand of potato chips. But encouraging someone who’s smoked for 30 years to enroll in a tobacco cessation program? Or putting the brakes on a teenagers raging hormones long enough to encourage them to abstain from sex (or, at the very least, protect themselves against STDs and unplanned pregnancies )? It ain’t easy, but we’re trying.

Any public health marketers out there? What discoveries have you made? Add your thoughts in the comment section. We would love to hear them.