Chapter 45. Social Marketing | Community Tool Box

• What is social marketing?

• Who can do social marketing?

• Why is social marketing important?

• Basic principles of marketing: The "4 Ps"

• Stages of a successful social marketing effort

Community groups use many strategies to address health, social, environmental, and community priorities. A group working to reduce child food insecurity, for example, might advocate for school meal access, strengthen enrollment in nutrition programs, support family economic security, work with food providers, and communicate with policymakers and community members.

Some of these efforts involve influencing individual behavior, but community change rarely depends on individual choices alone. Behaviors are shaped by relationships, organizations, policies, access to resources, physical environments, economic conditions, culture, trust, and other social and structural factors.

Social marketing can be one part of a broader community-change strategy. It uses marketing concepts together with research, behavioral and social science, community insight, communication, partnerships, and other approaches to influence behaviors that benefit individuals and communities.

This section introduces social marketing, explains why it may be useful, discusses the traditional "4 Ps" of marketing, and outlines major stages in developing an ethical and effective social marketing effort.

What is social marketing?

Social marketing applies marketing concepts and other evidence-informed approaches to influence behaviors that benefit individuals and communities and contribute to the greater social good.

Social marketing is not simply advertising, public education, or persuading people to do what an organization thinks is best. Effective social marketing begins by understanding people’s experiences, goals, motivations, barriers, environments, and competing priorities. It also considers what organizations, institutions, policymakers, businesses, and other actors may need to do differently to make beneficial behaviors realistic and accessible.

Ethical practice is essential. Social marketing should respect autonomy, privacy, dignity, cultural differences, informed choice, and the perspectives of the people affected by an intervention. It should avoid stigma, manipulation, stereotyping, coercion, and blaming individuals for conditions that are strongly shaped by social or structural barriers.

What is the difference between social marketing and commercial marketing?

Commercial marketing generally seeks to create value for customers while advancing an organization's commercial objectives. Social marketing adapts some of the same concepts to influence behaviors in ways intended to benefit individuals, communities, or society.

That distinction creates additional ethical responsibilities. The people whose behavior is being discussed should not simply be treated as targets or consumers to be persuaded. Their priorities, knowledge, experiences, and concerns should inform the strategy.

What is involved in social marketing?

A social marketing effort will often include the following activities:

• Define the behavior or decision you hope to influence. Be specific. For example, rather than saying "improve prenatal health," you might focus on increasing timely access to prenatal care, supporting use of recommended preventive services, or reducing barriers that keep people from obtaining care.
• Understand who is involved and affected. Identify the people whose behaviors or decisions are directly relevant, as well as partners, service providers, policymakers, organizations, family members, or others who influence the conditions surrounding those behaviors.
• Conduct formative research. Do not assume you already know why people behave as they do. Interviews, surveys, focus groups, listening sessions, observation, existing data, community-engaged research, and other methods can help identify motivations, priorities, benefits people value, barriers, trusted sources, competing behaviors, and environmental conditions.
• Identify meaningful audience segments when useful. People within a broad population may differ in their experiences, readiness, barriers, motivations, access to resources, trusted messengers, or preferred communication channels. Segmentation can help tailor strategies, but it should be based on relevant evidence rather than stereotypes or demographic categories used without a clear reason.
• Understand barriers and enabling conditions. Ask what makes the desired behavior easier or harder. Barriers may include cost, transportation, clinic hours, childcare, discrimination, language access, disability access, mistrust, policies, workplace requirements, social norms, limited information, or competing responsibilities.
• Address barriers rather than relying only on messages. If people cannot reasonably act on the message, communication alone is unlikely to succeed. Solutions might include changing service hours, improving transportation, reducing cost, making services physically and digitally accessible, providing interpretation, changing organizational policies, improving staff communication, or bringing services closer to the people who need them.
• Identify the benefits people value. The benefit promoted by a campaign may not be the one professionals initially assume is most important. Research can help determine what matters to people and what would make a behavior worthwhile from their perspective.
• Consider competing behaviors and influences. The desired behavior may compete with convenience, cost, habits, social norms, misinformation, distrust, commercial marketing, time demands, or alternative choices. Understanding those competing influences is important when developing the strategy.
• Develop and pretest strategies. Test messages, materials, service changes, incentives, outreach methods, and other elements with people from the intended audiences before implementing them broadly. Use what you learn to revise the approach.
• Use communication as part of a larger strategy. Let people know what opportunities, services, or supports are available and communicate benefits in ways that are relevant, accessible, accurate, and respectful.
• Evaluate implementation and results. Assess not only whether behavior changed, but also who was reached, who was not reached, whether barriers were actually reduced, whether benefits and burdens were distributed equitably, and whether any unintended consequences occurred.

Social marketing and advertising

Advertising and communication may be important parts of social marketing, but they are not the same thing as social marketing.

Imagine an anti-litter campaign that uses a memorable slogan but does nothing about the lack of trash and recycling containers in heavily used public spaces. The campaign may increase awareness, but it has not addressed an important barrier to the behavior it is promoting.

Similarly, a campaign encouraging people to attend preventive health appointments will be limited if appointments are unaffordable, transportation is unavailable, services are not accessible to people with disabilities, clinic hours conflict with work schedules, or people have experienced disrespect or discrimination when seeking care.

Social marketing considers both communication and the conditions that make the desired behavior possible.

Promotion alone is therefore not social marketing. A comprehensive effort combines audience insight, exchange, barrier reduction, service or environmental changes, appropriate communication, partnerships, and evaluation.

Who can do social marketing?

Social marketing requires planning, research, and skill, but its principles can be learned and adapted for organizations of different sizes.

Large public agencies and national organizations may have dedicated researchers, communication professionals, behavioral scientists, designers, and marketing specialists. Smaller community organizations may use the same principles on a more modest scale through partnerships, existing community data, listening sessions, pilot projects, and direct engagement with the people they hope to reach.

The most important requirement is not a large advertising budget. It is a willingness to understand the issue from the perspectives of the people involved, define the desired behavior clearly, address meaningful barriers, use evidence appropriately, and revise the approach as new information emerges.

Partnerships can strengthen the work. Depending on the project, social marketing efforts may involve community members, people with lived experience, health and human service organizations, schools, businesses, government agencies, communication specialists, researchers, designers, community health workers, advocates, and other partners.

Why is social marketing important?

Community organizations sometimes develop programs or messages based primarily on what professionals believe people need. Social marketing provides a more systematic way to understand the people involved and design strategies around their actual experiences, motivations, environments, and barriers.

Social marketing can help you:

• Define specific behaviors or decisions that matter to the community goal
• Understand the people and groups involved rather than assuming they are all alike
• Identify barriers and enabling conditions that influence behavior
• Understand what benefits people value
• Recognize competing behaviors, messages, incentives, and environmental influences
• Tailor strategies and communication to different audience segments when appropriate
• Combine communication with service, environmental, policy, organizational, or other changes
• Test ideas before investing heavily in them
• Evaluate whether the approach is effective, equitable, and sustainable

Social marketing is not appropriate for every community challenge. Problems caused primarily by policies, discrimination, unsafe environments, inadequate services, poverty, or other structural conditions cannot be solved simply by persuading individuals to behave differently.

In those situations, social marketing may still contribute by influencing the behaviors of organizational leaders, service providers, employers, policymakers, businesses, or other people with the ability to change those conditions. It can also be combined with policy, systems, environmental, community-organizing, advocacy, and service-delivery strategies.

Basic principles of marketing: The "4 Ps"

One traditional marketing framework is known as the 4 Ps: product, price, place, and promotion. The framework can help organize a social marketing strategy, but it should not be treated as a complete description of modern social marketing.

Effective social marketing also draws on concepts such as audience insight, behavioral goals, exchange, competition, segmentation, theory, partnerships, ethics, and a mix of methods.

Product

The product is the behavior, practice, service, opportunity, or benefit being offered.

In social marketing, the product is not simply what an organization wants people to do. Consider what people believe they receive in return.

For example, an initiative promoting use of a community walking trail is not only promoting physical activity. People may value social connection, stress relief, transportation, time outdoors, safety, or enjoyable recreation. Understanding those benefits can shape how the initiative is designed and communicated.

Price

Price includes what people believe they must give up, risk, or overcome to adopt a behavior.

Price may involve:

• Money
• Time
• Effort
• Transportation
• Inconvenience
• Social consequences
• Stigma
• Loss of privacy
• Physical discomfort
• Uncertainty
• Emotional or psychological burden
• Giving up something people currently value

Social marketing seeks to reduce unnecessary costs and increase meaningful benefits.

For example, if an organization wants more people to participate in a health program, reducing the "price" might involve offering evening or weekend appointments, transportation support, childcare or dependent-care assistance, language access, accessible facilities, telehealth options, or simpler enrollment.

Place

Place refers to where and how people can perform the behavior, obtain the product or service, access information, or receive support.

Ask whether the opportunity is available where and when people need it.

For example, an adolescent sexual and reproductive health initiative might consider whether young people can obtain accurate information, confidential counseling, and contraception in settings that are affordable, accessible, culturally responsive, and realistically available around school, work, transportation, family responsibilities, and privacy concerns.

"Place" may include physical locations as well as websites, apps, telehealth, mobile services, schools, community organizations, workplaces, homes, and trusted community settings.

Promotion

Promotion refers to the ways people learn about and engage with the opportunity, behavior, service, or benefit.

Promotion may include:

• Interpersonal communication
• Community outreach
• Social media
• Websites and digital communication
• Text messaging
• Print materials
• News and community media
• Events
• Peer communication
• Trusted messengers
• Health care, education, faith and spiritual, workplace, and community networks

Choose channels based on research about how the intended audience actually receives and uses information. More communication is not automatically better. Messages should be accurate, accessible, relevant, and delivered through sources people trust.

Beyond the 4 Ps: exchange, competition, and methods mix

Three additional concepts are especially useful in social marketing.

Exchange asks what people believe they gain and give up by adopting a behavior. A strategy is more likely to be meaningful when the perceived benefits outweigh the perceived costs from the audience's perspective.

Competition refers to anything competing with the desired behavior. Competition may come from another behavior, limited time, social expectations, commercial marketing, distrust, convenience, cost, misinformation, or existing habits.

Methods mix means using more than communication alone. An effective effort may combine communication with service improvements, environmental changes, partnerships, incentives, policy changes, community organizing, training, or other strategies.

Stages of a successful social marketing effort

People do not all begin with the same knowledge, experiences, motivations, opportunities, or readiness to act. Behavior also does not always change through one predictable sequence.

Instead of assuming that everyone should move through the same linear stages, understand the different circumstances people are in and provide support that is relevant to those circumstances.

A social marketing effort may involve:

• Understanding the context. Define the issue, behavior, community conditions, and people involved.
• Conducting formative research. Learn about motivations, barriers, benefits, competing behaviors, trust, access, and community perspectives.
• Setting clear behavioral goals. Identify specific, realistic, measurable behaviors or decisions the strategy seeks to influence.
• Segmenting audiences when useful. Determine whether different groups need different strategies because their circumstances, motivations, barriers, or communication preferences differ.
• Developing an exchange people value. Strengthen the benefits associated with the behavior and reduce unnecessary costs or burdens.
• Addressing structural and environmental barriers. Change services, access, policies, systems, or environments where those conditions make the desired behavior difficult.
• Developing and pretesting the strategy. Test messages, services, materials, channels, and other components with intended audiences and partners.
• Implementing a coordinated mix of approaches. Combine communication with other interventions needed to make the behavior realistic and worthwhile.
• Supporting people's ability and opportunity to act. Provide the information, resources, services, relationships, and conditions necessary to carry out the behavior.
• Reinforcing and sustaining beneficial behavior. Consider what ongoing environmental, social, organizational, or policy supports are needed for change to last.
• Evaluating and adapting. Assess implementation, behavior, reach, equity, unintended consequences, and sustainability, and revise the effort based on what is learned.

Evaluation should consider more than whether the overall behavior rate changed. Ask who benefited, who encountered barriers, whether some groups experienced unintended burdens, whether people felt respected, and whether the effort changed the conditions that influence behavior.

In Summary

Social marketing uses marketing concepts together with research, theory, community and audience insight, partnerships, communication, and other approaches to influence behaviors that benefit individuals and communities.

Effective social marketing does not simply tell people what they should do. It seeks to understand why people behave as they do, what benefits they value, what barriers they encounter, what other choices compete for their attention, and what environmental or structural changes may make beneficial behaviors more realistic.

The traditional 4 Ps - product, price, place, and promotion - remain useful planning concepts, but they work best alongside behavioral goals, audience insight, exchange, competition, segmentation, ethics, partnerships, and a thoughtful mix of interventions.

Above all, social marketing should be ethical, evidence-informed, respectful, equitable, and responsive to the people and communities affected by the work. Behavior change can be part of community improvement, but it should not be used to place responsibility on individuals for barriers that organizations, institutions, policies, or social conditions also need to address.

Example 1: The National High Blood Pressure Education Program

The National High Blood Pressure Education Program (NHBPEP) is, I believe, the longest-running behavior-change program to use social marketing concepts, processes, and tools in the United States. It is certainly one of the most successful.

The NHBPEP was established in 1972 by the National Heart, Lung, and Blood Institute (NHLBI) after a series of epidemiological, clinical, and actuarial studies made clear that high blood pressure was a major risk factor for stroke and heart disease. The program's objective was to increase awareness of the linkage between these two conditions and to influence those with high blood pressure to obtain treatment for their problem.

When the NHBPEP began, twenty-three million American citizens were estimated to be hypertensive (National Heart, Lung, and Blood Institute, 1992) according to a relatively strict definition. In subsequent years, the definition of high blood pressure changed to include about sixty million people with blood pressure over 140 /90 or taking hypertensive medication. The program evolved over time as the audience changed. Initially, only 29 percent of the public knew of the link between high blood pressure and stroke and only 24 percent knew that high blood pressure causes heart disease (National Heart, Lung, and Blood Institute, 1973). Only about one-half of all hypertensives were aware of their problem. Thus, the behavioral focus in the early stages of the social marketing project was to get people to get their blood pressure checked. The principal approach to achieving this end was educating people about the link between high blood pressure and disease and getting them to their doctors for a checkup.

Ten years later, 59 percent of the population knew the relationship between high blood pressure and stroke and 71 percent knew it caused heart disease. Ninety-two percent knew that it cannot be cured and that a hypertensive person must always stay on a treatment program (National Heart, Lung, and Blood Institute, 1986). Even further progress was made by 1985, when 91 percent knew of the link to heart disease and 77 percent knew the link to stroke (Roccella, Bowler, Ames, and Horan, 1986).

By 1985, the NHBPEP had brought much of the target market into what I shall later call the Contemplation Stage, that is, aware of the problem and actively thinking about doing something about it. According to a 1985 National Health Interview Survey, about one-half of the population with hypertension had moved beyond the contemplation stage to plan and take action to control their blood pressure. However, almost one-half had not taken action. The project therefore shifted its focus in 1985 to "aware hypertensives" and securing greater levels of compliance (such as taking efforts to control the problem) from this group. This change in strategy was effective in raising compliance to 73 percent by 1988-1991 (National Heart, Lung, and Blood Institute, 1992).

Other behavior changes have also been manifested. Over 95 percent of hypertensives report cutting salt and sodium in their diets, 89% diet to lose weight, and 86 percent exercise (Roccella, Bowler, Ames, and Horan, 1986). However, research has shown that aware hypertensives have trouble staying with their new behaviors and that there remain variations in awareness and compliance across racial and gender groupings. Thus, in recent years, the NHBPEP has emphasized the Maintenance Stage of the behavior -change process and has continued to develop segmented programs for men and women, for Blacks and Hispanics, for young, middle-aged, and elderly people, and for people in high-incidence sections of the country. Plans for the decade of the 1990s involve closer targeting of Black males over age forty-five (a group where prevalence rates are high and treatment of compliance is low), and of hypertensives in the Stroke Belt (the part of the Southeastern United States where incidence of strokes among hypertensives is ten percent higher than in any other part of the country).

The program began with--and continues to use--a number of important social marketing principles:

• It focuses on behavior. The concern is not with educating and communicating information, but with getting hypertensives to undertake and stay with treatment programs.
• It works through intermediaries. It recognizes that the problem is too large for one organization to tackle and that many other health care institutions have an important stake in reducing the incidence of high blood pressure. NHLBI coordinates high blood pressure programs through forty-one partner organizations.
• It insists on a unified communication approach. Working in cooperation with Porte/Novell, a Washington, D.C. social marketing consultant, NHBPEP regularly develops carefully articulated communications objectives and strategies, defines target audiences, and establishes roles for intermediary groups. All messages are designed to reinforce one another.
• It starts by understanding the customers. The development of strategy begins with target audience members and their perceptions.
• It adapts to changes in the audience. Program strategy follows the target audience as it evolves through various stages of the behavior change process.
• It avoids mass marketing. Careful attention was paid to developing differentiated strategies for different market segments.
• Its message strategies have focused on consequences, both positive and negative, to the hypertensive person. These consequences include those of going through the treatment regimen (the behavior process) and also those of being successful in controlling blood pressure (the behavioral outcomes).
• Its message strategies have also focused on social influence.
• It emphasized the Place component of the mix. By making it easy to check blood pressure in homes and shopping malls, the program tore down barriers to implementing behaviors audiences knew were important.

From Alan R. Andreasen's Marketing Social Change. Used with permission.

___You understand that social marketing is the application of commercial marketing techniques to social problems.

___You understand that the difference between commercial and social marketing is commercial marketing tries to change people's behavior for the benefit of the marketer, while social marketing tries to change people's behavior for the benefit of the individual, or of society as a whole.

___You have identified the behaviors you want to change.

___You have identified your audience.

___You have identified the barriers to change.

___You have reduced the barriers to change.

___You have pretested your ideas.

___You have publicized both the benefits of change, and also your efforts to make change easier.

___You have assessed your results.

___You understand that advertising is only one part of social marketing.

___You understand that social marketing is scalable and learnable.

___You understand that social marketing is important because:

• It helps you reach the target audiences you want to reach.
• It helps you customize your message to those targeted audiences; and by doing so,
• It helps you create greater and longer-lasting behavior change in those audiences.
• It works.

___You know that the "4Ps" of marketing are product, price, place, and promotion.

___You know the "stages of change" in a successful effort:

1. Create awareness and interest
2. Change attitudes and conditions
3. Motivate people to want to change their behavior
4. Empower people to act
5. Prevent backsliding

• Why should you use a social marketing approach?

• When should you run a social marketing campaign?

• How do you manage a social marketing campaign?

Marketing campaigns can look simple from the outside. A short advertisement, social media post, poster, or slogan may be the most visible part, but effective campaigns usually involve substantial research, planning, testing, implementation, coordination, and evaluation.

Social marketing uses marketing concepts together with behavioral and social science, community and audience insight, partnerships, communication, and other approaches to influence behaviors that benefit individuals and communities.

A social marketing effort might support safer transportation, increase use of preventive health services, reduce behaviors that contribute to environmental harm, strengthen participation in community programs, prevent gender-based violence, or address other health and community priorities.

Social marketing is more than producing posters or advertisements. It asks organizations to understand people's experiences and motivations, identify structural and practical barriers, consider competing influences, design services and environments that make beneficial behaviors easier, communicate through trusted channels, and evaluate whether the approach is effective and equitable.

This section explains when a social marketing approach may be useful and provides a framework for managing an effort from initial planning through implementation, evaluation, and adaptation.

Why should you use a social marketing approach?

Social marketing can be useful when a community goal depends in part on specific behaviors or decisions and when understanding the people involved can help improve the strategy.

Potential advantages include:

• It helps you understand the people whose behaviors, decisions, or experiences are relevant. Instead of assuming that everyone responds to the same barriers, benefits, messages, or services, social marketing uses research and engagement to understand meaningful differences.
• It focuses on behavior rather than awareness alone. Increasing knowledge may be useful, but knowledge does not automatically lead to action. Social marketing asks what specific behavior is important and what conditions make that behavior easier or harder.
• It helps identify practical and structural barriers. An intervention may need to change services, access, cost, transportation, hours, policies, physical environments, or organizational practices rather than simply provide more information.
• It helps identify benefits people actually value. The benefit professionals consider most important may not be the benefit that motivates the intended audience.
• It supports tailoring when a one-size-fits-all approach is unlikely to work. Different audience segments may need different services, supports, communication channels, or strategies.
• It encourages testing before large-scale implementation. Formative research and pretesting can reveal unclear, ineffective, inaccessible, or stigmatizing ideas before substantial resources are invested.
• It encourages the use of multiple approaches. Communication can be combined with changes in services, environments, policies, partnerships, incentives, or other supports.
• It creates a framework for learning and adaptation. Evaluation can show whether the effort reached intended audiences, changed relevant behaviors or conditions, and produced equitable benefits.

Social marketing is not automatically the right solution for every issue. When a problem is primarily caused by policy, discrimination, poverty, unsafe environments, inadequate services, lack of transportation, unaffordable care, or other structural conditions, asking individuals to change their behavior may be insufficient or inappropriate.

In those situations, social marketing may instead focus on the behaviors of employers, service providers, organizations, businesses, policymakers, or other people with the ability to change those conditions, or it may be combined with policy, systems, environmental, advocacy, organizing, and service strategies.

When should you run a social marketing campaign?

A social marketing approach may be appropriate when you have identified a meaningful behavioral component of a community or public-health priority and have enough capacity to research, design, implement, and evaluate an intervention responsibly.

Consider using social marketing when:

• A specific behavior or set of behaviors is important to the outcome you are seeking. Be clear about what people, organizations, or institutions would actually need to do differently.
• You need to understand why people are or are not engaging in a behavior. Social marketing is especially useful when motivations, barriers, perceived benefits, competing behaviors, trust, or access are not well understood.
• Different audiences may require different approaches. Relevant differences may involve behaviors, experiences, motivations, readiness, access, language, trust, geography, social context, or other factors.
• Communication alone is unlikely to be sufficient. You are prepared to consider changes in services, systems, environments, incentives, or policies in addition to messages.
• The effort is important enough to justify research and testing. Formative research, co-design, pretesting, implementation, and evaluation all require time and resources.
• You have the capacity to sustain the effort long enough to learn from it. Some campaigns may be short, while others may require ongoing implementation. The appropriate duration depends on the behavior, context, goals, and intervention.

Social marketing does not have to be expensive, but it does require adequate capacity. Avoid assuming that limited funding can always be overcome by asking staff, volunteers, or community members to contribute large amounts of unpaid labor.

Smaller organizations can scale the approach by narrowing the behavioral goal, partnering with other organizations, using existing evidence, conducting focused listening sessions or interviews, testing with a small number of people, and concentrating resources on the most important barriers and opportunities.

How do you manage a social marketing campaign?

A social marketing effort can be organized into four broad areas:

• Define and understand the issue, behavioral goal, context, audiences, barriers, benefits, competing influences, and community perspectives
• Develop the strategy by identifying possible approaches, selecting an appropriate mix of methods, designing services and communication, and pretesting
• Implement and evaluate the strategy
• Adapt, sustain, scale, or conclude the effort based on results and changing conditions

Define and understand the issue

Begin by developing a shared understanding of the health or community priority you are addressing.

Avoid defining the issue so narrowly that the proposed solution is built into the definition.

For example:

• Instead of "We need better teacher training so students will stay in school," you might begin with "Some students are leaving school before completion, and we need to understand the academic, social, economic, institutional, and other factors contributing to that outcome."
• Instead of "We need more shelters," you might begin with "People in our community are experiencing intimate partner violence, and survivors face barriers to safety, housing, services, economic security, and support."

Defining the issue broadly allows the group to investigate multiple causes and possible strategies rather than assuming that one solution is correct from the beginning.

Define your behavioral and community goals

Broad goals describe the change you ultimately hope to support. Behavioral objectives identify specific actions that are expected to contribute to that goal.

For example, a broad goal might be to reduce suicide deaths and attempts and strengthen community prevention and support. Specific objectives might address timely help-seeking, safe storage of lethal means, referral practices among service providers, follow-up after a crisis, or organizational adoption of recommended prevention practices.

Objectives should be specific enough to evaluate, realistic given the available resources and context, and meaningful to the people and communities affected.

Identify the people and organizations involved

Ask whose behaviors or decisions directly influence the outcome and who is affected by the proposed intervention.

These groups may include:

• People engaging in or considering the behavior
• Family members, peers, caregivers, or other influential people
• Health or human service providers
• Community organizations
• Employers or businesses
• Educators
• Public officials or policymakers
• Other institutions with control over relevant services, environments, or resources

Social marketing should not automatically focus on the people experiencing the greatest burden of a problem. Sometimes the most important behavior to change belongs to an organization, service provider, institution, or decision-maker with greater control over the conditions producing that burden.

Segment audiences when it improves the strategy

Segmentation means identifying groups whose circumstances are sufficiently different that they may benefit from different approaches.

Demographic information can sometimes be relevant, but avoid assuming that people should be segmented simply because they differ in age, race, ethnicity, gender, income, disability, or another demographic characteristic.

Useful segmentation may instead consider:

• Current behavior
• Motivations and perceived benefits
• Barriers and access to resources
• Readiness or intention to act
• Trust in institutions or messengers
• Knowledge or experience
• Geographic context
• Communication and language preferences
• Social norms and influential relationships
• Service-use patterns
• Competing priorities or behaviors
• Structural conditions affecting the ability to act

Use demographic characteristics when they are genuinely relevant to the issue or when data show inequities that need to be addressed. Do not assume that people who share a demographic characteristic have the same experiences, motivations, or needs.

Questions that may help identify useful audience segments include:

• Which groups experience meaningfully different barriers or enabling conditions?
• Which groups perceive different benefits or costs?
• Do people differ in their current behavior or readiness to act?
• Do different groups rely on different services, settings, communication channels, or trusted messengers?
• Are some groups experiencing inequitable access to resources or services?
• Would different interventions actually be needed for these groups, or would segmentation simply label people without improving the strategy?

Understand intended audiences and community context

Once relevant audiences have been identified, learn about their experiences rather than relying on assumptions.

Existing information may include Census and American Community Survey data, public-health data, community assessments, program records, peer-reviewed research, administrative data, and other appropriate sources.

Use individual-level or confidential information only when you have legal authority, an appropriate purpose, and suitable privacy and data-protection procedures. The fact that information exists in school, clinical, governmental, or organizational records does not automatically mean it should be used for marketing or outreach.

Quantitative data can tell you part of the story. Formative research can help explain why patterns exist and what people themselves consider important.

Ask about:

• Experiences with the issue
• Motivations and goals
• Perceived benefits
• Practical and structural barriers
• Social influences
• Competing behaviors and priorities
• Trusted sources and messengers
• Preferred services and supports
• Concerns about privacy, stigma, discrimination, or safety
• Communication preferences

CDC communication guidance similarly recommends conducting audience research rather than guessing or assuming what people need and building time for pretesting with intended audiences.

Understand barriers, costs, benefits, and competition

A program may be free and still carry substantial costs for participants.

For example, an adult literacy program may not charge tuition, but people interested in the program may still encounter:

• Transportation costs
• Unsafe travel conditions
• Scheduling conflicts with work or caregiving
• Childcare or dependent-care needs
• Disability-access barriers
• Language-access barriers
• Concerns about disclosing literacy needs
• Previous negative experiences with educational institutions

If these barriers are significant, more advertising will not solve the problem. The organization may need to change where, when, or how the service is provided.

Also identify what people value. Benefits might include convenience, independence, social connection, safety, belonging, financial savings, improved health, privacy, confidence, or another outcome.

Finally, consider competition. Competition does not necessarily mean another organization. It may be another behavior, a competing demand on time, convenience, cost, habits, social expectations, misinformation, commercial marketing, or a service that better meets people's immediate needs.

Gather information ethically

Formative research methods may include:

• Interviews. Individual conversations can provide detailed information about experiences, motivations, barriers, and ideas.
• Focus groups or listening sessions. Facilitated group discussion can reveal shared and differing experiences and generate ideas.
• Surveys. Surveys may be conducted online, by phone, through text, by mail, in person, or through another accessible format appropriate to the audience.
• Community-engaged research or co-design. Community members can participate directly in identifying questions, interpreting findings, and developing strategies.
• Observation. Observation can sometimes provide useful insight into settings or behaviors, but it should be conducted only when ethical, lawful, appropriate, and respectful of privacy. Avoid collecting identifiable or sensitive information unnecessarily.
• Program and service-use data. Existing organizational data may help identify patterns when their use is appropriate and consistent with privacy and data-governance requirements.
• Participant feedback. Satisfaction surveys, interviews, advisory groups, and other methods can help improve services people already use.

Consider informed consent, privacy, confidentiality, accessibility, language access, appropriate compensation, data security, and the potential burden on participants when conducting research.

Develop possible strategies

Once you understand the behavioral goal, context, audiences, barriers, benefits, and competition, generate possible strategies.

Think beyond communication. A social marketing strategy might involve:

• Improving a service
• Changing hours or locations
• Reducing cost
• Providing transportation or childcare support
• Changing an organizational policy
• Improving accessibility
• Working with trusted community partners
• Training service providers
• Redesigning a physical or digital environment
• Providing appropriate incentives or supports
• Changing communication
• Combining several approaches

Current social-marketing benchmark criteria similarly emphasize a methods mix rather than relying on awareness or communication alone.

Prioritize strategies and audiences equitably

Organizations rarely have enough resources to do everything at once. Decide where resources can make the greatest meaningful contribution while considering both effectiveness and equity.

Do not automatically prioritize the audience that is easiest or least expensive to influence. Doing so may increase overall results while widening inequities if people facing the greatest barriers receive the least support.

Consider:

• Where the burden of the issue is greatest
• Where inequities exist
• Which barriers can realistically be changed
• Which groups have historically had less access to services or resources
• What community members identify as priorities
• Whether changing the behavior of institutions or decision-makers might have broader impact than focusing only on individuals
• What resources and partnerships are required

Social influence can also matter. Behaviors sometimes spread through peer networks, families, organizations, or communities. Use formative research to understand these relationships rather than assuming that one group will automatically influence another.

Choose specific strategies and measurable objectives

Evaluate potential strategies by asking:

• Does the strategy offer benefits people value?
• Does it reduce meaningful financial, practical, social, emotional, or structural costs?
• Does it improve people's opportunity and ability to carry out the behavior?
• Does it address important competing behaviors or influences?
• Does it address relevant organizational or structural barriers?
• Is it feasible and sustainable?
• Is it equitable?
• Is it ethical?
• Is there a realistic way to measure implementation and results?

Design communication for intended audiences

Communication should be based on audience research rather than stereotypes about how particular groups talk, what they believe, or which authorities they trust.

Consider:

• Preferred language
• Literacy and health-literacy needs
• Disability access
• Cultural relevance
• Trusted messengers
• Privacy and stigma
• Tone
• Information needs
• Communication channels
• Whether people were involved in developing the message

If an audience prefers a language other than English, provide linguistically appropriate communication and interpretation when needed rather than simply translating material without considering cultural context and usability.

Avoid trying to imitate presumed slang or communication styles merely because the intended audience is young or belongs to a particular cultural group. Co-design and pretesting can help ensure that language feels natural and respectful.

Consider sequenced communication and support

Some interventions may use a sequence of communication and services over time. For example, an initiative might first increase awareness of an available health service, then provide information about how to access it, followed by reminders or ongoing support.

The sequence should be based on behavioral theory and formative research rather than assuming that everyone moves through one fixed continuum in the same way.

Use enough communication to maintain awareness and support action, but do not assume that simply repeating a message more often will make it effective. Repetition of an irrelevant, inaccessible, or stigmatizing message can reduce trust.

Select communication channels

Choose channels based on where and how intended audiences actually obtain information.

Possibilities may include:

• Community organizations
• Trusted interpersonal networks
• Health care settings
• Schools and educational institutions
• Workplaces
• Faith and spiritual communities
• Websites
• Social media
• Text messaging
• Email
• Print materials
• Radio, television, podcasts, and other media
• Community events
• Peer educators or community health workers

Select channels according to accessibility, trust, reach, cost, privacy, and how well they fit the behavioral objective. CDC similarly recommends choosing formats and distribution channels based on how intended audiences actually receive and use information.

Pretest messages, services, and strategies

Pretesting should occur before full implementation whenever practical.

Do not test only whether people "like" a message. Ask:

• Is it understandable?
• Does it communicate what was intended?
• Is anything confusing, stigmatizing, offensive, or exclusionary?
• Is the proposed behavior realistic?
• Are the benefits meaningful?
• Have important barriers been overlooked?
• Are services or supports actually accessible?
• Is the call to action clear?

Revise based on feedback and test again when substantial changes are made.

Implement the strategy

Implementation often reveals conditions that were not visible during planning. Track activities closely enough to know whether the intervention is being delivered as intended and whether people can actually access it.

Maintain communication with community partners and intended audiences throughout implementation rather than waiting until the end to ask whether the approach worked.

Evaluate your work

Evaluation should begin during planning rather than after the campaign has already been implemented.

Consider measures related to:

• Implementation
• Reach
• Awareness and understanding
• Service access
• Relevant behaviors
• Environmental, organizational, or policy changes
• Audience experience
• Equity
• Unintended consequences
• Cost and resource use
• Sustainability

Whenever possible, establish baseline information so changes can be assessed over time.

If the strategy is not working as expected, investigate why before simply increasing communication. The problem may involve the message, but it may also involve cost, access, trust, services, policies, timing, competition, or another condition.

Continue seeking feedback from people affected by the intervention and make reasonable changes during implementation.

Recognize progress and learning

Community and public-health change can take time. Recognize meaningful progress, contributions, partnerships, and learning along the way.

Avoid treating success only as the achievement of a final behavioral target. Improvements in access, trust, organizational practice, community participation, service quality, or equity may also represent important progress.

Adapt, sustain, scale, or conclude the effort

A social marketing campaign does not necessarily need to continue indefinitely.

At regular intervals, ask:

• Is the behavioral goal still important?
• Have community conditions changed?
• Is the strategy still effective?
• Are some audiences benefiting more than others?
• Have new barriers or unintended consequences appeared?
• Should the strategy be expanded, adapted, integrated into routine services, or reduced?
• Is continued communication necessary, or can resources now be directed elsewhere?
• Has the original goal been achieved or changed enough that the campaign should end?

Some behavioral goals may require ongoing support. Others may be achieved through a time-limited campaign, institutionalized within regular services, or replaced by a different strategy as conditions change.

Sustainability means maintaining the conditions necessary for beneficial behavior and community well-being, not repeating the same campaign forever.

In Summary

Managing a social marketing effort requires more than creating persuasive messages. Effective social marketing begins with a clearly defined behavioral goal and a strong understanding of the people, organizations, systems, and conditions connected to that behavior.

Formative research can help identify motivations, barriers, benefits, competing behaviors, access issues, trusted messengers, and meaningful audience segments. Current social-marketing practice emphasizes behavior, audience orientation, theory, insight, exchange, competition, segmentation, and a mix of methods rather than communication alone.

Strategies should then combine the communication, services, supports, environmental changes, partnerships, policies, and other methods needed to make beneficial behavior realistic and worthwhile. Messages and services should be pretested with intended audiences, implemented carefully, and evaluated for effectiveness, equity, accessibility, and unintended consequences.

Most importantly, social marketing should not treat people as passive targets to be persuaded. It should be ethical, respectful, evidence-informed, and responsive to people's priorities and lived realities. When barriers are created by organizations, institutions, policies, or social conditions, the strategy should address those conditions rather than placing the responsibility for change entirely on individuals.

___You understand that social marketing means to use commercial marketing techniques to try to improve social problems.

___You understand that social marketing helps you reach your target audience.

___You understand that it works.

You understand when you should run a social marketing campaign:

___When you are trying to change the behavior of a large number of people.

___When you are trying to change behavior over a long period of time.

___When you have the resources necessary to manage a comprehensive effort.

You understand how to manage a social marketing campaign:

___You have defined the problem.

___You have defined your goals.

___You have defined your audience.

___You understand your audience.

___You have brainstormed strategies for change.

___You have decided how much time and how many resources you will spend on each of your subgroups.

___You have decided whether to create different strategies for different segments, or just use different messages and mediums.

___You have chosen specific strategies with measurable objectives.

___You have designed messages appropriate to different groups.

___You have selected channels of communication.

___You have pretested your ideas and messages.

___You have established a tracking system.

___You are continuously modifying your work based on results.

___You have celebrated your accomplishments!

Example 1: Metro Trains: Dumb Ways to Die

Public service announcements are known for being boring, so back in 2012, Melbourne Metro Trains decided to liven things up a bit with their visual marketing campaign, and came up with the perfect way. How do you convey a message to avoid deaths caused by train accidents? You add cute cartoons, a catchy tune, and some dark humor, of course! And so they came up with some catchy lyrics about several dumb ways to die – getting your toast out with a fork, doing your own electrical work, keeping a rattlesnake as a pet, selling both your kidneys on the Internet, to name a few.

As expected, the campaign went viral. Within 24 hours, the song reached iTunes Top 10 Charts, and has 140 million views on YouTube as of this date!

Read more about this example from The Yellow Sparrow.

 

Example 2: ALS: Ice Bucket Challenge

This one, you know it just had to be on the list. These challenges were all the rage back in 2013, and your Facebook newsfeeds were flooded with people pouring ice cold water on themselves, nominating people to do the same, and then donating some amount for the ALS Association. But here’s the best part: ALS never planned this campaign!

Wait, what?!

Yup, a golfer from Florida, Chris Kennedy, nominated a friend to participate in the Ice Bucket Challenge, which had nothing to do with ALS at the time.

Read more about this example from The Yellow Sparrow.

 

• Why listen to the people whose experiences and behaviors matter?

• Who are the people you need to listen to?

• How do you reach and invite people to participate?

• How do you listen and conduct formative research?

Imagine that a community environmental coalition launches a campaign to reduce fossil-fuel use and improve access to cleaner transportation and energy. The coalition creates attractive advertisements about public transportation, walking, bicycling, energy efficiency, and renewable energy.

Months later, however, little has changed.

One reason may be that the coalition designed the campaign before understanding the experiences of the people whose decisions and daily lives were involved. Some residents may not have reliable public transportation. Others may have disabilities, caregiving responsibilities, long commutes, jobs that require a vehicle, concerns about cost, or housing situations in which they cannot make energy upgrades themselves.

Some proposed changes may also depend less on individual behavior than on decisions by transportation agencies, employers, landlords, utilities, developers, or policymakers.

The lesson is not simply that the coalition chose the wrong advertisements. It is that effective social marketing begins with listening.

Social marketing is more than telling people what an organization wants them to do. It requires understanding people's experiences, goals, motivations, barriers, environments, competing priorities, and ideas about what would make beneficial behavior realistic.

Why listen to the people whose experiences and behaviors matter?

The first reason is respect.

Professional expertise, research evidence, or organizational experience may provide important information, but they do not give an organization complete knowledge of how other people experience an issue or what they value.

People affected by an issue hold knowledge that professionals may not have: knowledge about daily routines, relationships, barriers, community history, trust, culture, safety, stigma, resources, and the consequences of proposed changes.

Listening helps avoid designing programs around assumptions.

The second reason is effectiveness. Strategies are more likely to be useful when they reflect the realities of the people expected to use a service, adopt a behavior, support a policy, or participate in an initiative.

Formative research can help you understand:

• What people already know
• What matters to them
• What benefits they value
• What barriers they experience
• What alternatives or competing priorities exist
• Whom they trust
• What services or supports they need
• What communication channels they use
• What unintended consequences a proposed strategy might create

Listening should not be treated simply as a technique for discovering the right words to persuade people. Community input may show that your proposed solution is incomplete, inaccessible, or inappropriate. It may reveal that your organization, another institution, or a policy needs to change rather than the people you originally expected to influence.

Commercial marketers also use research to understand customers, test ideas, and improve products. Social marketing can use similar research methods, but it carries additional responsibilities because campaigns may involve health, safety, stigma, public policy, inequality, or other matters with significant consequences for people's lives.

For that reason, listening should be grounded in respect, transparency, ethical practice, and meaningful participation.

Who are the people you need to listen to?

Begin with people who are directly affected by the issue or whose behaviors and decisions are relevant to the outcome. Then consider the people, organizations, and systems that influence their choices or control important conditions.

For example, a community effort to prevent youth violence might listen to:

• Young people who have experienced violence, caused harm, witnessed violence, or been involved in prevention efforts
• Parents, caregivers, family members, peers, and other trusted adults
• Residents of neighborhoods affected by violence
• Teachers, school staff, counselors, youth workers, coaches, mentors, and community health workers
• Health care and emergency-response professionals
• Violence-prevention and survivor-support organizations
• Faith and spiritual community leaders
• Law-enforcement, probation, court, or restorative-justice representatives where relevant
• Employers, housing organizations, transportation providers, or other institutions connected to underlying conditions
• Elected officials and policymakers

The goal is not to label one group as "the problem." Violence and many other community issues emerge from interactions among individual experiences, relationships, institutions, environmental conditions, policies, and broader social and economic factors.

Use existing knowledge carefully

Your organization may already know important things about the community. That knowledge can help identify people to involve and questions to explore.

However, do not turn general impressions into assumptions about entire groups.

A neighborhood's race, ethnicity, income, religion, immigration history, disability prevalence, or other demographic characteristics should not by themselves be used to predict people's beliefs, motivations, health behaviors, or willingness to participate.

When disparities exist, examine the conditions associated with them rather than implying that group identity itself causes the outcome.

For example, people may experience different health outcomes because of differences in health care access, environmental exposure, discrimination, housing, employment, transportation, food access, insurance, or other conditions. Understanding these pathways is more useful than relying on broad demographic generalizations.

Use current and appropriate secondary data

Existing data can help identify community conditions and possible audiences.

Sources may include:

• U.S. Census Bureau and American Community Survey data
• Federal, state, tribal, territorial, and local public-health data
• Labor, housing, education, transportation, environmental, and economic data
• Peer-reviewed research
• Community health and needs assessments
• Public agency reports and meeting records
• Aggregated organizational or program data that may appropriately be used for planning
• Community-generated research and assessments

Use current sources whenever possible and consider how data were collected, whose experiences may be missing, and whether categories or measures accurately represent the community.

Do not assume that access to a dataset means every use of that information is appropriate. Protect privacy, follow applicable law and organizational policy, and avoid using identifiable information for outreach or marketing without a legitimate basis.

Learn from community knowledge

Residents, participants, community leaders, advocates, service providers, businesses, schools, cultural organizations, and other community partners may hold information that formal datasets do not capture.

Community knowledge can help you identify:

• Historical experiences that affect trust
• Emerging issues that are not yet visible in formal datasets
• Services that people find useful or inaccessible
• Informal community networks
• Trusted messengers and institutions
• Local strengths and assets
• Conflicts or concerns that could affect implementation

Look beyond the people expected to change an individual behavior

Some of the most important audiences may be people or institutions whose actions shape the environment in which individual decisions occur.

These might include:

• Employers whose schedules affect access to services
• Landlords or property owners who control housing conditions
• Health care organizations whose policies affect access
• Businesses whose products or practices influence behavior
• School systems
• Transportation agencies
• Media organizations
• Policymakers
• Organizations that control funding or other resources

Ask who has the ability to remove barriers, create opportunities, or change the conditions surrounding the issue.

Decide whose perspectives you need

You may not have the resources to engage every possible audience equally. Prioritize based on the purpose of the research and the decisions that need to be made.

Consider:

• Who is most directly affected?
• Who experiences the greatest barriers or inequities?
• Whose perspectives have historically been missing from decision-making?
• Who controls important services, policies, resources, or environmental conditions?
• Who can provide relevant knowledge about implementation?
• Are there important differences in behavior, experience, access, or motivation that require listening to several audience segments?

When seeking community-wide input, do not assume that one classroom, workplace, congregation, neighborhood association, or community organization represents an entire community. Use several sources and actively look for perspectives that may otherwise be overlooked.

How do you reach and invite people to participate?

Once you identify the people you need to hear from, plan outreach that is accessible, respectful, and appropriate to the community.

Communicate in accessible languages and formats

Use the languages people prefer and formats they can access. Depending on the audience, this may require:

• Translation and interpretation
• Plain-language materials
• Large print
• Captions or transcripts
• Screen-reader-compatible digital materials
• Audio or video formats
• Accessible meeting locations
• Phone, text, online, or in-person participation options

Do not assume that English proficiency, literacy, disability, or access to technology is the same throughout an audience segment.

Use communication channels people actually use

Outreach may occur through:

• Community organizations
• Schools and libraries
• Health care and human service organizations
• Faith and spiritual communities
• Cultural organizations
• Disability organizations
• Workplaces
• Community events
• Email
• Text or messaging platforms
• Websites and social media
• Print materials
• Community radio, newspapers, or other local media
• Trusted interpersonal networks

CDC communication guidance recommends identifying intended audiences, conducting audience research rather than guessing or assuming, choosing formats and channels based on how audiences actually receive information, and building in time for pretesting.

Respect community schedules, customs, and responsibilities

Ask when and where participation is convenient rather than assuming one meeting time or location will work.

Consider:

• Work schedules
• School schedules
• Religious or cultural observances
• Caregiving responsibilities
• Transportation
• Disability access
• Digital access
• Safety

Work with trusted community partners

Trusted community organizations and leaders may help introduce the project, explain its purpose, identify gaps in outreach, and advise on respectful engagement.

Do not use trusted intermediaries simply to increase compliance with your request. Their role can also include challenging the research design, advising against inappropriate outreach, or helping the organization better understand community concerns.

Be clear about why you are asking

Tell people:

• Why you want their input
• How the information will be used
• Whether participation is voluntary
• What information will be recorded
• How privacy and confidentiality will be handled
• Whether results may be shared publicly
• Whether compensation or participant support is available
• How they can ask questions or raise concerns

People should not be told that their input will shape a decision if the organization has no intention or authority to use it. Be honest about what can and cannot change.

Consider compensation and participation supports

Community members are contributing time and expertise. When resources allow and compensation is appropriate, consider honoraria, stipends, gift cards, meals, transportation, childcare or dependent-care support, interpretation, or other assistance that reduces the burden of participation.

Compensation should recognize people's contributions without creating inappropriate pressure to participate.

How do you listen and conduct formative research?

Formative research helps you understand how people experience an issue and how they may respond to different strategies.

It can be quantitative, qualitative, or mixed-method.

Quantitative approaches can help identify patterns and estimate how common certain responses are. Qualitative approaches can provide deeper understanding of experiences, motivations, language, context, and meaning. Neither is automatically better; choose methods based on the decisions you need to make.

Distinguish community listening from formal research

A listening session conducted to improve a local program is not necessarily the same thing as human-subjects research. Requirements depend on the purpose, design, funding, institution, intended use of the findings, and applicable law and policy.

If your activity may constitute human-subjects research, determine whether institutional review board or other ethics review is required before beginning.

When federal human-subjects protections apply, informed consent generally requires appropriate disclosure, understanding, and voluntary participation unless an applicable regulatory exception or approved waiver applies.

Even when formal research regulations do not apply, good community-engagement practice still supports transparency, voluntariness, privacy, appropriate data protection, accessibility, and respect.

Use existing or secondary information

Secondary data can provide useful context before collecting new information.

Examples include:

• Census and demographic data
• Health surveillance data
• Environmental data
• Service-use data
• Existing surveys
• Published research
• Community assessments
• Public policy and administrative information

Avoid drawing strong conclusions about people's beliefs or motivations from indirect indicators alone.

For example, a high rate of bicycle ownership does not necessarily show that a community strongly values physical fitness. Bicycles may be used for transportation, recreation, employment, affordability, or many other reasons. Use secondary data to develop questions, not stereotypes.

Observation and ethnographic methods

Observation can help researchers understand environments, routines, interactions, service settings, and other contextual factors.

Observation may be structured or more ethnographic and may involve greater or lesser participation by the researcher.

Before conducting observation, consider:

• Whether observation is appropriate to the setting
• Whether people reasonably expect privacy
• Whether consent or notice is required
• Whether children or other populations requiring additional safeguards are involved
• Whether photographs, audio, or video are truly necessary
• How recordings and notes will be protected
• Whether the researcher's presence may influence what occurs
• Whether observation could stigmatize or place participants at risk

Do not assume that being in a public place automatically makes covert observation or recording appropriate.

Community members and staff who already spend time in a setting may provide valuable contextual knowledge, but that knowledge should not be treated as unrestricted permission to document other people's private or sensitive experiences.

Conduct in-depth interviews

In-depth interviews are individual conversations designed to explore experiences, motivations, barriers, decisions, and ideas in detail.

They can be particularly useful when:

• The issue is sensitive
• Privacy is important
• People's experiences vary substantially
• You need to understand how and why decisions occur
• Group discussion might discourage candid participation

Interviews may take place in person, by phone, by video, or through another accessible format. Participants should understand the purpose of the conversation, what will happen with their information, and whether the session will be recorded.

Convene focus groups or listening sessions

Focus groups bring together a small number of people to discuss an issue under the guidance of a facilitator.

Groups may be organized around a meaningful shared characteristic or experience when doing so helps people speak comfortably or enables useful comparison.

Relevant characteristics might include:

• Experience with a service or behavior
• Geographic context
• Language preference
• Age or life stage
• Disability or accessibility experience
• Role in an organization or community
• Other characteristics directly relevant to the research question

Demographic similarity is not automatically necessary. Design the group around the question you need to answer and the conditions most likely to support meaningful participation.

Facilitators should explain the purpose of the discussion honestly. Do not intentionally hide material information simply because you believe participants will provide "better" answers if they do not understand what is being studied.

For sensitive discussions, explain the limits of confidentiality. Researchers can ask participants not to repeat what others say, but they generally cannot guarantee that every participant will maintain confidentiality after leaving the group.

If audio or video recording is planned, explain that clearly and obtain appropriate permission.

Existing groups can sometimes participate in listening sessions, but consider how existing relationships, authority, supervision, or power differences could affect what people are willing to say.

Conduct surveys

Surveys can gather information from larger numbers of people and can include closed-ended and open-ended questions.

Surveys may be delivered:

• Online
• By phone
• Through text messaging
• By mail
• In person
• Through community organizations or service settings
• Through another accessible method appropriate to the audience

Survey quality depends on more than the number of responses.

Consider:

• How participants were selected
• Who had an opportunity to respond
• Who may have been excluded
• Nonresponse
• Question wording
• Language and accessibility
• Whether the sample supports the conclusions you want to make
• Privacy and confidentiality

A convenience survey may still provide useful information, but be transparent about its limitations and avoid presenting it as representative of an entire community when it is not.

Decide what you need to learn

A useful way to develop research questions is to begin with the decisions you expect the findings to inform.

Ask:

• What decision will this information help us make?
• Who will make that decision?
• How will community members or participants contribute to interpreting the findings?
• What information is actually necessary?
• Are we collecting sensitive information that we do not need?
• How will we use the information after it is collected?

Possible decisions might include:

• Whether a social marketing approach is appropriate
• Which behavior to prioritize
• Whether institutional or policy change is needed alongside individual behavior change
• Which audiences or partners should be involved
• Which barriers should be addressed first
• What services or supports should change
• Which benefits or outcomes matter most to intended audiences
• Which communication approaches are likely to be accessible and trusted

Identify the information needed for those decisions

Depending on your purpose, you may need to understand:

• What decisions people face when considering the behavior
• What information they already have and what information they want
• What people, organizations, experiences, or conditions influence their decisions
• What barriers affect their ability to act
• What benefits they value
• What competing behaviors or priorities exist
• How ready or able they are to act under current conditions
• What services or supports would make action easier
• Which communication sources they trust
• Which communication formats they use
• What concerns they have about the proposed strategy

Social marketing benchmark guidance similarly emphasizes behavior, audience orientation, theory, insight, exchange, competition, segmentation, and a mix of methods rather than communication alone.

Choose an appropriate level of analysis

Research does not need to be large or expensive to be useful, but the strength of your conclusions should match the strength of your methods.

A small organization may use several listening sessions and interviews to understand likely barriers and improve a local program. It should not present those conversations as statistically representative of an entire county or population.

When quantitative conclusions are important, seek appropriate statistical expertise. Universities, public-health departments, evaluation partners, nonprofit technical-assistance organizations, consultants, and community research partners may be able to help.

Do not rely on intuition alone when an important decision requires reliable evidence. At the same time, do not dismiss community knowledge simply because it is qualitative.

Develop respectful questions

Questions may be:

• Direct: "What makes it easier or harder for you to attend this program?"
• Exploratory: "Tell me about the last time you tried to use this service."
• Follow-up or probing: "You mentioned transportation. Can you tell me more about how that affects you?"
• Rating questions: "How important is cost when deciding whether to use this service?"
• Hypothetical: "If evening appointments were available, would that change how likely you would be to use the service? Why or why not?"
• Comparative: "Which of these two approaches would be more useful to you, and what makes you prefer it?"

Avoid assuming that indirect or deceptive questions automatically produce more truthful answers. People may answer differently for many reasons, including uncertainty, memory limitations, social expectations, privacy concerns, misunderstanding, or changes in circumstances.

Good facilitation creates enough trust and clarity for people to explain their experiences without feeling judged.

Ask about decisions and barriers

A behavior that appears simple from the organization's perspective may require several decisions or tradeoffs for participants.

Someone considering a program might need to think about:

• Work schedules
• Transportation
• Childcare or dependent care
• Cost
• Privacy
• Safety
• Stigma
• Disability access
• Family responsibilities
• Previous experiences with similar services

Questions such as "What would make this difficult?" and "What would make this easier?" often reveal more useful information than simply asking whether someone intends to participate.

Ask what information people need

Find out what people already understand, what remains unclear, and what information would actually support a decision.

Avoid framing lack of information as ignorance or personal failure. People may not have received accessible, trustworthy, culturally relevant, or timely information.

Ask who and what influences decisions

Influence may come from:

• Family and friends
• Peers
• Community leaders
• Health professionals
• Teachers
• Faith and spiritual leaders
• Employers
• Community organizations
• Online communities
• News and entertainment media
• Social media
• Policies and institutional practices

Do not assume which messenger people trust. Ask.

Test different messages and approaches

Participants can review draft messages, images, services, incentives, websites, enrollment processes, or other parts of an intervention.

Ask:

• What do you think this means?
• What stands out?
• Is anything confusing?
• Is anything inaccurate or unrealistic?
• Does anything feel stigmatizing, judgmental, or disrespectful?
• What information is missing?
• Would this help you make a decision or take action?
• What would make it more useful?

CDC recommends building time and resources into communication development for pretesting with intended audiences and revising materials based on what is learned.

Understand readiness without assuming a single linear pathway

People may differ in their knowledge, priorities, confidence, opportunity, intention, and ability to act.

Useful questions might explore:

• What people know about the issue
• Whether the issue matters to them
• Whether they are considering the behavior
• Whether they believe the behavior is realistic under current conditions
• Whether they have attempted it previously
• What would support initiation or continuation

Behavioral theories and stages-of-change models can help organize thinking, but avoid assuming that everyone progresses through the same sequence or that lack of action necessarily means lack of motivation. A person may be highly motivated and still face barriers that make action impossible.

Understand costs, benefits, and exchange

Behavior change can involve financial, practical, emotional, social, and physical costs.

Examples may include:

• Paying for services
• Traveling to appointments
• Losing work time
• Arranging childcare or dependent care
• Giving up convenience
• Experiencing withdrawal from nicotine or another substance
• Losing social connection associated with an existing behavior
• Concern about stigma or disclosure
• Physical discomfort

Ask what people consider an ideal or meaningful outcome and what supports would reduce burdens.

Do not assume that individuals should accept substantial personal costs simply because professionals consider the behavior beneficial. The intervention itself may need to change.

Ask which communication channels people actually use

Communication habits change quickly, so do not rely on assumptions about television, newspapers, radio, or social media.

Ask where people currently obtain:

• Health information
• Community news
• Service information
• Recommendations
• Information they trust enough to act on

Different audiences may use different combinations of interpersonal, digital, community, and traditional media.

Analyze, interpret, and return what you learn

After gathering information, analyze it systematically and document important limitations.

Whenever possible, involve community members or participants in interpreting findings. Researchers and organizations may interpret comments differently from the people who provided them.

Ask:

• What patterns appear?
• What important differences exist?
• Whose perspectives may be missing?
• Are there explanations other than the one we first assumed?
• What findings require a change in our original strategy?
• What should not be generalized beyond the participants involved?

When appropriate, share findings back with participants and community partners in an accessible format and explain how their input affected the strategy.

Listening should create a feedback loop rather than function as a one-time extraction of information.

In Summary

Effective social marketing begins by listening to the people whose experiences, decisions, and behaviors are connected to the issue. It also requires listening to the people and institutions that shape the conditions in which those decisions occur.

Formative research can include secondary data, interviews, focus groups, listening sessions, surveys, observation, community-engaged research, and other methods. Choose methods according to the questions you need to answer, the community context, available resources, and the level of confidence needed for the decisions being made.

Listening should be ethical, accessible, transparent, and respectful. Protect privacy, avoid unnecessary collection of sensitive information, use appropriate consent and research oversight where required, compensate community expertise when appropriate, and avoid stereotypes or assumptions about demographic groups.

Most importantly, listening should be capable of changing your plan. If community members tell you that the real barrier is transportation, discrimination, unaffordable services, inconvenient hours, unsafe conditions, or an organizational policy, the answer is not necessarily a more persuasive message. The better social marketing strategy may be to change the service, system, policy, or environment.

Why should you listen to those whose behavior you're trying to change?

___You listen out of simple respect.

___You listen because it will improve both your campaign and its chances of success .

Who are the people to whom you need to listen?

To identify those to whom you need to listen:

___You use your knowledge of the community.

___You use publicly available government information.

___You read the latest research about your issue.

___You use information from the community itself.

___You look for indirect targets.

___You consider how much of the potential target population you want to reach.

___You aim at the whole community if necessary.

How do you contact those whose behavior matters?

___You use language the target group understands.

___You put your message where the target group will get it.

___You know and respect the culture and customs of those you're trying to reach .

___You use trusted intermediaries.

___You make as much personal contact as possible.

___You let people know you're interested in what they think.

How do you listen to those whose behavior matters?

___You know the forms research can take:

• Indirect sources
• Non-participant observer ethnographic studies
• Participant observer ethnographic studies
• Depth interviews
• Focus groups
• Surveys

Determine which questions to ask:

___You identify the decisions that will need to be made as a result of the research , and who will make them.

___You determine what information the decision-makers need in order to design and run an effective campaign.

___You check with the decision-makers to make sure that what you've come up with is what they really need.

___You decide what kind of analysis you'll need to complete your study.

___You determine the questions you need to ask to get the information you need.

• What is audience segmentation?
• When might you segment an audience?
• How can you segment an audience?

Suppose you are developing a social marketing effort to reduce youth violence in your community.

Many people and institutions may influence that goal, and the changes needed may differ considerably:

• Young people affected by violence may need safer environments, supportive relationships, opportunities, conflict-resolution resources, trauma-informed services, or other forms of support.
• Young people who have caused harm may need credible alternatives to violence, opportunities for accountability and repair, and access to appropriate services and supports.
• Families and caregivers may need resources that strengthen safety, communication, stability, and supportive relationships.
• Schools, youth-serving organizations, health care providers, community organizations, and law-enforcement or justice institutions may need to change policies, practices, or services.
• Employers, housing organizations, transportation systems, funders, and policymakers may influence economic and environmental conditions connected to violence.

These groups do not all have the same experiences, responsibilities, motivations, barriers, or influence over the issue. A single message or intervention is therefore unlikely to be equally useful for everyone.

Audience segmentation helps identify meaningful groups and determine whether different strategies, services, supports, partnerships, or communications are appropriate for each.

Segmentation should not be used simply to identify which people are easiest to persuade. It should help social marketers develop more relevant, ethical, equitable, and effective approaches.

Small organizations can use segmentation as well as large organizations. The process may be simple or complex depending on the issue, available evidence, number of audiences, and organizational capacity.

A successful effort may use community conversations, existing research, program data, low-cost digital or print communication, trusted interpersonal networks, service improvements, policy changes, or other methods. What matters is not the size of the campaign but whether the strategy is evidence-informed, audience- and community-centered, ethically designed, and responsive to the conditions affecting behavior.

What is audience segmentation?

Audience segmentation is the process of identifying groups within a broader audience that differ in ways relevant to the behavior, service, issue, or intervention.

The purpose is not to place people into categories for their own sake. A segment is useful when the characteristics shared by its members help explain why a different approach may be appropriate.

For example, people may differ in:

• Current behavior
• Motivations
• Benefits they value
• Barriers they experience
• Access to services or resources
• Trust in institutions or messengers
• Knowledge and experience
• Social influences
• Geographic circumstances
• Preferred languages or communication formats
• Readiness or opportunity to act

Demographic characteristics may also be relevant, particularly when they help identify inequities or differences in access. However, race, ethnicity, age, gender, religion, disability, income, or another demographic characteristic should not automatically be treated as evidence that people share the same beliefs or will respond to the same intervention.

Use formative research and community insight to determine whether a proposed segment actually requires a distinct strategy.

Segmentation and the marketing mix

Segmentation may help you think more carefully about the traditional marketing concepts of product, price, place, and promotion.

Different audience segments may:

• Need different products or services, or the same service delivered differently
• Experience different costs or burdens, including money, time, transportation, effort, stigma, risk, or inconvenience
• Need different places or access points for services, information, and support
• Prefer different communication channels or approaches

Segmentation can also help identify differences in exchange, competition, social influence, organizational barriers, and environmental conditions.

The goal is to make strategies more relevant and accessible, not to reinforce stereotypes.

When might you segment an audience?

A broad strategy may sometimes be appropriate. For example, a community-wide communication about a new public service may use one core message when the information is equally relevant and accessible to most residents.

Segmentation becomes more useful when meaningful differences affect whether people can benefit from or respond to the strategy.

When some communities experience greater burden or inequity

Data may show that certain communities experience higher rates of a health or social outcome, more severe consequences, or greater barriers to services and resources.

In these cases, segmentation may help develop a more equitable response.

Do not stop at identifying which demographic group has the highest rate of an outcome. Ask what conditions contribute to the difference.

These may include:

• Access to health care
• Insurance coverage
• Housing conditions
• Transportation
• Employment conditions
• Environmental exposures
• Discrimination
• Geographic access to services
• Language access
• Differences in institutional treatment

Segmentation should help address those conditions rather than imply that identity itself explains the difference.

When formative research reveals meaningful differences

Interviews, surveys, focus groups, listening sessions, community-engaged research, service data, and other sources may show that people who initially appeared to form one audience actually have substantially different experiences.

One group may already value the proposed behavior but face cost and transportation barriers. Another may have access but see little benefit. Another may distrust the organization providing the service because of previous experiences.

Those differences may call for different interventions.

When different behaviors or decision-makers are involved

Sometimes segmentation is useful because several distinct behaviors influence the same community goal.

For example, increasing childhood vaccination may involve:

• Parents and caregivers making vaccination decisions
• Health care organizations offering convenient appointments
• Clinicians communicating clearly and respectfully
• Schools providing accurate requirements and referral information
• Public-health agencies addressing access and supply

These audiences need different strategies because they control different parts of the system.

When some people are not being effectively reached

If existing communication or services consistently fail to reach certain communities, segmentation may help identify why.

The issue may involve:

• Language
• Disability access
• Transportation
• Digital access
• Service location or hours
• Trust
• Institutional history
• Immigration-related concerns
• Stigma
• Communication channels

Do not describe people themselves as "hard to reach" without examining whether organizations and systems have failed to reach or serve them effectively.

When you have the capacity to tailor the strategy meaningfully

Segmentation requires resources. Multiple audience strategies may require additional formative research, partnerships, service adaptations, translations, accessibility work, communication materials, implementation capacity, and evaluation.

Do not create segments that your organization cannot meaningfully serve.

If resources are limited, it may be more effective to prioritize one or two important differences than to create many narrowly defined groups with superficial variations in messaging.

How can you segment an audience?

Contemporary social marketing may use combinations of demographic, geographic, behavioral, psychographic, environmental, experiential, and service-use information.

No single category should automatically determine the segmentation strategy.

Behavioral

Behavioral segmentation is often especially useful because it relates directly to what people are currently doing and what the intervention seeks to influence.

Relevant differences might include:

• Whether people currently engage in the behavior
• How often they engage in it
• Whether they have attempted to change before
• Whether they currently use a particular service
• Whether they have access to the resources needed to act
• Whether they intend to act
• Whether they need support maintaining a beneficial behavior

For example, a tobacco-cessation effort might distinguish among people who smoke and are actively seeking help to quit, people considering quitting, people not currently interested in quitting, and people who recently stopped smoking and want support maintaining cessation.

These groups may need different services and communication.

Barriers and enabling conditions

People may be engaging in the same behavior for very different reasons.

One person may lack transportation. Another may have experienced discrimination in a service setting. Another may not be able to afford the service. Another may have concerns about privacy.

Segmenting according to meaningful barriers can help develop interventions that address actual conditions rather than simply changing the message.

Motivations, values, and perceived benefits

People may value different outcomes.

For example, an active-transportation initiative might find that some people value health benefits, others value lower transportation costs, others value environmental benefits, and others value convenience or social connection.

These differences may help shape services and communication.

Avoid assuming motivations based on race, age, religion, political identity, or another demographic characteristic. Ask people what matters to them.

Readiness, confidence, and opportunity

People differ in their willingness, confidence, and practical ability to act.

Behavioral theories may help explain these differences, but avoid assuming that everyone progresses through a single fixed sequence from awareness to permanent change.

Someone may understand an issue, value the behavior, and strongly want to act but lack transportation, money, safe housing, supportive policies, or another necessary resource.

Segmentation should therefore consider both motivation and opportunity.

Geographic and environmental context

Where people live, work, study, obtain services, or spend time may influence access and behavior.

Relevant geographic distinctions may include:

• Urban, suburban, rural, or frontier areas
• Neighborhoods
• Service areas
• School districts
• Transit corridors
• Areas with different environmental conditions or infrastructure

Geographic information systems and other mapping tools can help identify patterns involving services, transportation, environmental conditions, health outcomes, and other community characteristics.

Use aggregated or appropriately protected data and avoid maps or analyses that unnecessarily expose sensitive information about individuals or small groups.

Geographic patterns should also be interpreted carefully. A map may show where an outcome occurs but not explain why.

Demographic characteristics

Demographic information may include:

• Age or life stage
• Gender, when relevant
• Race and ethnicity
• Household composition
• Income or economic circumstances
• Education
• Employment
• Disability
• Preferred language
• Immigration or citizenship status when legitimately relevant

These characteristics can help identify inequities, understand service access, or ensure that important populations are represented in formative research and evaluation.

They should not automatically be used to predict attitudes, values, intelligence, political beliefs, health behaviors, or willingness to change.

Consider intersectionality as well. People's experiences may be shaped by several interacting circumstances rather than one category alone.

Experiences and service history

Previous experiences may affect people's expectations and decisions.

Relevant experiences might include:

• Previous use of a service
• Previous attempts to change a behavior
• Experiences with discrimination or stigma
• Previous interactions with institutions
• Caregiving responsibilities
• Experience with a health condition
• Exposure to violence or trauma, when directly relevant and handled sensitively

Collect sensitive information only when necessary and use appropriate privacy, consent, and data-protection practices.

Social influence and trusted relationships

People's decisions may be influenced by family members, peers, clinicians, educators, community leaders, online communities, employers, faith and spiritual leaders, or other relationships.

Research can help determine whether influential audiences should be engaged alongside the people whose behavior is directly involved.

Do not assume which messenger people trust based on demographic identity alone.

Communication preferences

Some segments may prefer different languages, communication formats, channels, levels of detail, or sources.

Consider:

• Preferred language
• Literacy and health-literacy needs
• Disability access
• Digital access
• Privacy
• Trusted messengers
• Use of social media, text, email, community media, interpersonal networks, or other channels

Do not simply translate an existing message and assume the strategy is culturally appropriate. Involve intended audiences in developing and pretesting communication.

Costs and burdens

People may experience different financial, practical, emotional, social, or physical costs when adopting a behavior.

Examples include:

• Fees
• Transportation
• Time away from work
• Childcare or dependent care
• Privacy concerns
• Stigma
• Social consequences
• Physical discomfort
• Technology requirements

A segment defined by a shared barrier may require a service or environmental change rather than a different advertisement.

Openness to new approaches and social influence

Some people may adopt new practices earlier than others. Others may prefer to see evidence, observe trusted peers, or wait until a service becomes more familiar.

These differences can be useful when planning implementation, but avoid labeling people as irrational, resistant, conformist, or not worth engaging.

Instead ask:

• What information or experience would increase confidence?
• Whose experience matters to them?
• What risks do they perceive?
• What barriers make experimentation difficult?

Influential audiences and partners

The people whose behavior is directly involved may not be the only audience requiring attention.

A social marketing strategy may also need to engage:

• Family members
• Peers
• Clinicians
• Educators
• Employers
• Community leaders
• Businesses
• Service organizations
• Policymakers

In some situations, changing the behavior of an institution or decision-maker may have greater impact than asking individuals to adapt to barriers the institution controls.

Deciding which segments to focus on

After identifying meaningful segments, determine which ones require distinct strategies and how resources should be distributed.

Commercial marketing has traditionally used criteria such as measurability, accessibility, substantiality, and actionability. These ideas can still be useful in social marketing, but they should be interpreted alongside public benefit, ethics, equity, and community priorities.

Identifiability and relevance

Can you identify the segment well enough to understand its experiences and determine whether a different strategy is needed?

The question is not simply whether a group is large enough to justify attention. A smaller group may still deserve focused resources because it experiences severe inequity, exclusion, risk, or barriers.

Ability to engage and serve the audience

Can the organization communicate with and provide meaningful support to the segment?

If the answer is no, ask why.

A community should not automatically be deprioritized because your organization currently lacks trusted relationships, language capacity, accessible services, or appropriate communication channels.

Instead consider whether you can:

• Build partnerships
• Hire or compensate people with relevant language or community expertise
• Improve accessibility
• Modify services
• Build trust over time
• Share decision-making with community organizations

Significance to the community goal

Consider how important the segment is to the issue and what benefit may result from addressing its needs.

Significance may reflect:

• Number of people affected
• Severity of impact
• Degree of inequity
• Influence over systems or environments
• Community priorities
• Potential for meaningful benefit

Do not use expected numerical "return" as the only basis for prioritization.

Ability to design a meaningful response

A useful segment should differ in ways that lead to a meaningful change in strategy.

If two demographic groups face the same barriers, value the same benefits, use the same services, and prefer the same communication channels, separate campaigns may not be necessary.

If two groups differ significantly in access, motivation, trust, service needs, or environmental conditions, tailored approaches may be justified.

Equity

Include equity explicitly when deciding which audiences receive attention and resources.

Equal investment in every group does not necessarily produce equitable outcomes. Some communities may require greater investment because they face greater barriers or have historically had less access to resources.

Ask:

• Who is currently benefiting from our services?
• Who is missing?
• Who experiences the greatest barriers?
• Would focusing only on the easiest audiences widen existing inequities?
• Are community members involved in deciding how resources should be prioritized?

Readiness and opportunity

Readiness can help tailor a strategy, but it should not be used as a reason to abandon people who face substantial barriers.

Someone may be ready to act but unable to do so because the service is unavailable, unaffordable, inaccessible, unsafe, or incompatible with their responsibilities.

Assess motivation together with opportunity, capability, and environmental conditions.

Addressing audience segments

Once you have identified useful segments, decide how much tailoring is appropriate.

Broad-audience strategy

A broad-audience strategy uses a common core approach across several audiences.

This may be appropriate when:

• The same information is relevant to most people
• Barriers and benefits are broadly similar
• The primary goal is community-wide awareness
• Resources do not support extensive tailoring

Even broad strategies should be checked for accessibility, cultural relevance, unintended stigma, and whether important groups are being excluded.

Tailored-audience strategy

A tailored strategy develops different approaches for several meaningful audience segments.

Tailoring might involve:

• Different service locations
• Different schedules
• Different languages
• Different trusted messengers
• Different benefits emphasized
• Different barrier-reduction strategies
• Different communication channels

Tailoring should be based on formative research rather than stereotypes.

For example, do not assume that all young people want fast-paced videos or slang-heavy communication, that older adults prefer traditional media, or that people from one racial or cultural group share the same values.

Ask intended audiences and pretest the strategy.

Focused-audience strategy

A focused strategy concentrates resources on one or a small number of audiences.

This may be appropriate when:

• One audience experiences particularly severe inequity or barriers
• One group's behavior has an especially strong influence on the outcome
• The organization has limited resources
• A pilot effort is being tested before broader implementation
• One audience has been consistently underserved by existing approaches

Be explicit about what will not be addressed and why. A focused strategy should not make other affected groups invisible.

Language and communication

Provide information in the languages people prefer and in formats they can access.

Plain language, translation, interpretation, captions, screen-reader-compatible materials, large print, audio, and other formats may be needed.

Language should be natural and respectful. Avoid trying to imitate presumed slang or cultural style without direct input from the people involved.

Cultural context

Culture can influence communication, family relationships, health practices, community leadership, beliefs, and decision-making.

Cultural responsiveness does not mean assuming that everyone who shares a cultural, racial, ethnic, or religious identity thinks alike.

Work with community members to understand the specific values and practices relevant to the issue.

Sensitive or contested issues

Some issues involve deeply held moral, religious, political, or personal beliefs.

Social marketing should not stereotype people according to group membership or manipulate those beliefs.

Listen to the communities involved, provide accurate information, respect autonomy, and make clear where organizational or public-health goals differ from individual beliefs.

Knowledge and familiarity

People with extensive knowledge of an issue may need different information from people encountering it for the first time.

Match information to what people actually need without treating unfamiliarity as a deficiency.

Economic circumstances

Economic conditions can affect access to transportation, technology, health care, childcare, housing, time, and other resources.

Do not assume that lower-income audiences should contribute labor while higher-income audiences contribute money. Ask what forms of participation are appropriate, voluntary, and realistic for different people.

Organizational and policy audiences

Sometimes the segment requiring a different approach is not a group of individual community members but an institution or decision-making audience.

Employers, clinicians, educators, service providers, business leaders, funders, and policymakers may respond to different evidence, responsibilities, incentives, and community expectations.

Tailor engagement to their actual roles and decision-making context rather than reducing their motivations to personal or political self-interest.

In Summary

Audience segmentation is the process of identifying meaningful groups within a broader audience when those groups differ in ways that affect the behavior, service, issue, or intervention.

Useful segmentation may consider behavior, barriers, motivations, benefits, readiness, opportunity, geography, service history, social influence, communication preferences, environmental conditions, and relevant demographic characteristics.

Demographics can help identify inequities and ensure representation, but they should not be used as shortcuts for assuming what people believe, value, or will do.

When deciding which segments require focused attention, consider not only whether they can be identified, reached, and served effectively, but also the severity of the issue, community priorities, structural barriers, and equity.

A segment that is harder or more expensive to engage may require greater investment rather than less if existing systems have historically failed to reach or serve that community.

Organizations may use a broad-audience strategy, tailored strategies for several audiences, or a focused strategy for one or a few priority audiences. The appropriate approach depends on the issue, evidence, community input, resources, and the meaningful differences among audiences.

Above all, segmentation should improve the relevance and fairness of a social marketing strategy rather than simply make people easier to persuade. Listen to the people involved, test assumptions, protect sensitive information, address barriers and structural conditions, and involve communities in decisions about how they are understood and engaged.

Example 1: From Stilettoes to Moccasins

This music video was developed to give a voice to Aboriginal women healing from drug abuse, addiction, and problems with the law. Its form and content allow it to specifically reach out to young, Native women.

The video is part of a community-based research project conducted by the University of Saskatchewan (U of S), National Native Addictions Partnership Foundation (NNAPF), and the Canadian Centre on Substance Abuse (CCSA). Please see the project website for more information.

___You have segmented the market for the behavior change you seek, dividing people into groups based on shared criteria. these shared qualities may be or relate to:

___Demographic

___Geographic

___Physical/personal history

___Psychographic

___Bahavior

___Third party influences

___You have decided which segment to focus on, using five criteria:

___Measurability

___Accessibility

___Substantiality

___Actionability

___Position on the change scale

___You have chosen the type of social marketing campaign you will conduct,  which is one of these types:

___Undifferentiated marketing

___Differentiated marketing

___Concentrated marketing

• What is effective social marketing communication?

• What are tools for reaching intended audiences?

• How do you address common barriers to effective social marketing communication?

• How do you develop effective messages?

Imagine that a community health organization wants to increase participation in a preventive health service. It creates an attractive campaign explaining the benefits of the service and distributes the materials widely.

Yet participation changes very little.

The problem may not be that people failed to notice or understand the campaign. The service might be difficult to reach, unavailable during convenient hours, unaffordable, inaccessible to people with disabilities, offered only in one language, or associated with previous experiences of disrespect or mistrust.

Communication matters, but communication alone cannot solve barriers created by services, systems, policies, environments, or institutions.

Effective social marketing communication therefore begins with understanding the intended audience and the conditions surrounding the behavior. Messages should be accurate, clear, accessible, respectful, relevant, and connected to realistic opportunities for people to act.

What is effective social marketing communication?

Communication is the process of sharing information, ideas, experiences, and meaning among people and organizations.

In social marketing, effective communication helps intended audiences understand information, recognize its relevance, make informed decisions, and take action when they choose and are able to do so.

Communication should not be viewed simply as a way to persuade people. It is also a way to listen, explain, build understanding, provide useful information, support access, and maintain relationships.

Communication is two-way

Do not assume that people understand a communication simply because it seems clear to the people who created it.

Formative research and pretesting can help determine whether intended audiences:

• Notice the communication
• Understand its main message
• Interpret words, numbers, images, and recommendations as intended
• Consider the information relevant
• Know what action, if any, is being suggested
• Believe the proposed action is realistic
• Encounter barriers that the communication has overlooked

Use clear and accessible language

Communicate in the languages people prefer and use plain language appropriate to the intended audience.

Clear communication may involve:

• Common, familiar words
• Short, direct sentences
• Clear headings
• Limited jargon and unexplained acronyms
• Concrete explanations of unfamiliar terms
• Appropriate translation and interpretation
• Examples that help people understand what information means in practice

Plain language does not mean oversimplifying complex issues or talking down to people. It means making information as understandable and usable as possible.

Make communication accessible to people with disabilities

Accessibility should be considered from the beginning rather than added after materials have already been produced.

Depending on the format, consider:

• Captions for video
• Transcripts for audio
• Alternative text for meaningful images
• Sufficient visual contrast
• Readable type size
• Logical headings and document structure
• Keyboard accessibility
• Screen-reader compatibility
• Avoiding information conveyed by color alone
• Sign-language interpretation when appropriate
• Large-print, audio, Easy Read, or other alternative formats when needed

Digital communication should follow current accessibility standards and be tested with people who use assistive technologies when possible.

Consider nonverbal communication and representation

Images, tone of voice, music, pacing, clothing, setting, body language, and visual design all affect how communication is interpreted.

Consider whether those elements support the intended message and whether the people, settings, and experiences shown are represented respectfully and accurately.

Representation can signal who is expected to use a service or participate in an initiative, but avoid assuming that simply showing someone who shares an audience member's race, age, disability, or other identity will automatically create trust.

Understand cultural context without stereotyping

Cultural traditions, community history, values, language, social relationships, and experiences with institutions can affect communication.

Learn about those factors through community engagement and formative research rather than assuming that everyone who shares a cultural, racial, ethnic, religious, or geographic identity communicates in the same way.

Cultural responsiveness is an ongoing process of listening, learning, testing, and adapting.

Choose channels people actually use

Communication cannot be useful if intended audiences do not encounter it or cannot access it.

Research where people currently obtain information and which sources they trust. The answer may differ according to the issue, audience, location, age, technology access, privacy needs, and other circumstances.

Make the main message easy to identify

People encounter large amounts of information every day. Communication should make its main point clear without relying on sensationalism or unnecessary fear.

Ask:

• What is the most important thing people need to know?
• What action, if any, are we asking them to consider?
• What information do they need in order to act?
• What barriers might prevent them from acting?
• Where can they obtain additional information or support?

Tools for reaching intended audiences

Communication channels continue to change. A useful social marketing strategy may combine digital, interpersonal, community, print, news, entertainment, and paid-media approaches.

Choose channels because intended audiences use and trust them, not simply because those channels are familiar to your organization.

Digital communication

Digital channels may include:

• Websites
• Social media platforms
• Email
• Text messaging
• Messaging applications
• Podcasts
• Streaming audio or video
• Online communities
• Search and online advertising
• Mobile applications

Consider mobile usability, privacy, accessibility, searchability, digital literacy, internet access, platform changes, misinformation, and whether people will realistically encounter and use the content.

Do not assume digital communication reaches everyone. Some communities may have limited broadband, limited data plans, shared devices, privacy concerns, inaccessible technology, or different communication preferences.

Paid advertising

Paid advertising may include:

• Digital advertising
• Search advertising
• Social media advertising
• Print advertising
• Radio
• Television
• Streaming media
• Outdoor advertising
• Transit advertising

Organizations may also ask media outlets whether donated, discounted, or public-service placements are available. Do not assume broadcasters are required to provide free public service announcements.

Print and physical materials

Printed communication can still be useful, particularly when materials are placed in settings people already use.

Options may include:

• Posters
• Flyers
• Brochures
• Fact sheets
• Postcards
• Signs
• Community newsletters
• Educational materials

Provide current contact information using methods appropriate to the intended audience, such as phone numbers, text numbers, websites, QR codes, email addresses, or physical service locations.

Print materials should also be designed for accessibility and readability.

Community and interpersonal communication

Trusted interpersonal communication can be especially useful when an issue is complex, sensitive, unfamiliar, or connected to trust in institutions.

Channels may include:

• Community health workers
• Peer educators
• Community organizations
• Cultural organizations
• Faith and spiritual communities
• Schools and libraries
• Health care organizations
• Youth organizations
• Neighborhood groups
• Employers and workplaces
• Community events

Community outreach works best when messengers have appropriate knowledge, relationships, training, and support. Do not rely on unpaid community members simply because they have trusted relationships.

News and earned media

News and community media may help explain an issue, highlight new information, share stories, or direct people to services and opportunities.

Approaches may include:

• News releases
• Interviews
• Media briefings
• Opinion essays
• Letters to editors
• Community-news contributions
• Podcasts or radio interviews
• Local television or streaming programs

Make sure people whose experiences are featured understand how their information, names, images, or stories will be used.

Events and public engagement

Community events, conferences, fairs, public meetings, demonstrations, workshops, performances, and other gatherings can provide opportunities for dialogue rather than one-way messaging.

Consider accessibility, transportation, language access, safety, scheduling, childcare or dependent-care needs, and whether participants are being asked to contribute unpaid labor or personal stories.

Entertainment and storytelling

Film, television, theater, interactive media, music, podcasts, games, and storytelling can explore community issues and influence social norms.

Entertainment can be especially effective when people are involved in creating stories rather than merely being represented by outsiders.

Avoid reducing complex issues to simplistic moral lessons or using people's traumatic experiences primarily to generate emotional impact.

Trusted interpersonal communication

Information often spreads through families, friends, peers, coworkers, community organizations, and other social networks.

Social influence can help normalize beneficial behavior, but avoid assuming that a small number of "influencers" automatically represent an entire community.

Formative research can help identify which relationships matter and whether peer, family, professional, or community communication should be part of the strategy.

Message design

Message design includes what a communication says, how it is organized, how it looks and sounds, and what people are expected to do with it.

Visual elements

Consider:

• Clear hierarchy and organization
• Readable typography
• Sufficient contrast
• Meaningful use of images
• Alternative text for digital images
• Representation
• Avoidance of unnecessary graphic or distressing imagery
• Mobile and small-screen usability
• Whether visuals support rather than distract from the main message

Bright colors, unusual images, animation, and other visual devices can draw attention, but attention alone does not make communication effective.

Design should fit the subject and intended audience and should not interfere with comprehension or accessibility.

Representation and implicit visual cues

Images can communicate who belongs, who is expected to participate, and how an organization understands a community.

Review materials for:

• Unnecessary stereotypes
• Token representation
• Missing disability representation
• Gender stereotypes
• Racialized or class-based assumptions
• Images that portray people primarily through deficits, illness, or crisis

Authentic representation should come from audience research, community participation, and respectful design rather than simply matching visible demographic characteristics.

Sound elements

Music, speech, sound effects, pacing, and silence can shape attention and emotional response.

Use sound intentionally and accessibly.

Consider:

• Whether speech is easy to understand
• Whether background music interferes with comprehension
• Whether the tone matches the subject
• Whether captions and transcripts are provided
• Whether emotional cues are appropriate rather than manipulative

Music can strengthen attention, emotion, memory, and cultural relevance, but it should not be described as bypassing people's ability to think critically.

Use of messengers and spokespersons

Some campaigns use messengers or spokespersons to communicate information, share experiences, model behavior, or establish credibility.

Ask intended audiences whom they consider credible rather than assuming that authority, celebrity, or shared identity automatically creates trust.

Community messengers

Community messengers may include:

• Community health workers
• Peer educators
• Youth leaders
• Participants with relevant lived experience
• Faith and spiritual community leaders
• Local business or civic leaders
• Educators
• Clinicians
• Advocates

People with lived experience should not be expected to disclose personal information or represent an entire community. Participation should be voluntary, informed, appropriately supported, and compensated when possible.

Public figures and celebrities

A public figure may increase attention but can also create risk if the person's behavior, reputation, or relationship to the issue changes.

Before choosing a public figure, consider:

• Whether they have a credible relationship to the issue
• Whether intended audiences trust them
• Whether their participation could overshadow community voices
• Whether there are reputational or political risks
• Whether the arrangement involves compensation, disclosure, or contractual requirements

Subject-matter experts and institutional leaders

Clinicians, researchers, educators, organizational leaders, and public officials may be appropriate messengers when expertise or institutional responsibility is relevant.

Expertise alone does not guarantee trust. People may respond differently according to previous experiences with institutions, perceived conflicts of interest, communication style, and the issue being discussed.

Linking communication to familiar themes and values

Messages are often easier to understand when new information connects to experiences or values people already recognize.

For example, a lead-exposure initiative might begin with a shared interest in healthy housing and children's well-being before explaining specific testing or remediation options.

Use familiar themes respectfully. Do not assume that everyone in an audience shares the same values or use emotional values merely as a way to manipulate people into accepting a predetermined conclusion.

Audience research can help identify values and concerns that are genuinely relevant.

How do you address common barriers to effective social marketing communication?

Limited awareness or unfamiliarity

People may be unfamiliar with an issue because information has not reached them, has been difficult to understand, has not seemed relevant, or has competed with many other priorities.

Provide enough context for people to understand:

• What the issue is
• Why the information may matter to them
• What is known and uncertain
• What options are available
• Where they can obtain additional information or services

Avoid alarmist communication simply to force attention.

Competing demands for attention

People encounter large amounts of information and have limited time and attention.

Communication may be overlooked because:

• The issue is not currently a priority
• The message is unclear
• The channel is rarely used
• The information appears irrelevant
• People have encountered the message too often
• Other responsibilities require more immediate attention

Make the communication useful rather than merely louder.

Low relevance or poor channel fit

People may avoid or ignore communication that appears unrelated to their lives or is distributed through channels they do not use.

Research where people actually receive information and why they use those sources.

If a communication repeatedly fails to reach a community, examine your own channels, partnerships, accessibility, and relationships before describing the community as difficult to reach.

Fear and risk communication

Health and safety communication sometimes involves serious risks. Do not assume that making a message more frightening will automatically make it more effective.

When communicating risk:

• Be accurate about the severity and likelihood of harm
• Provide practical actions people can take
• Avoid exaggeration
• Put numbers in understandable context
• Acknowledge uncertainty when it exists
• Communicate empathy
• Pretest messages with intended audiences

Fear without a realistic path to action may increase distress, avoidance, stigma, or disengagement.

Trust and misinformation

People may encounter conflicting information from media, peers, institutions, commercial interests, social networks, and online sources.

Build trust by:

• Being transparent about evidence and uncertainty
• Correcting mistakes
• Identifying sources
• Avoiding exaggerated claims
• Explaining why recommendations change when evidence changes
• Working with credible community partners
• Responding respectfully to questions

Values, beliefs, and disagreement

Social marketing may address issues connected to moral, cultural, political, or religious beliefs.

Do not assume that disagreement means people misunderstand their own values or that the goal of communication is to defeat those values.

Instead:

• Learn what people actually believe rather than assuming based on group identity
• Distinguish factual disagreements from value disagreements
• Correct inaccurate factual information respectfully
• Identify shared values where they genuinely exist
• Explain the goals and evidence behind your recommendation
• Respect autonomy and lawful differences in belief
• Avoid stigmatizing people or communities because they disagree

Faith and spiritual community leaders or other trusted messengers may participate when appropriate, but they should not be recruited simply to pressure people into changing deeply held beliefs.

How do you develop effective messages?

The following steps build on longstanding social marketing communication principles while incorporating current audience-research, accessibility, and communication practices.

1. Set specific, measurable communication objectives

Define what the communication is expected to accomplish.

Objectives might involve:

• Increasing awareness
• Improving understanding
• Increasing use of a service
• Supporting adoption of a beneficial behavior
• Helping people maintain a behavior
• Increasing participation in a community process
• Changing an organizational or institutional practice

Choose measures appropriate to the objective. Exposure to a message is not the same as understanding, and understanding is not the same as behavior change.

2. Develop communication from audience and community insight

Use formative research to understand:

• What people already know
• What information they need
• What benefits matter to them
• What barriers affect action
• What questions or concerns they have
• What communication they currently encounter
• Which sources and messengers they trust

Communication should emerge from what you learn rather than from assumptions about what people ought to find persuasive.

3. Consider competing messages and influences

People may receive information that conflicts with your communication.

Competition may include:

• Commercial marketing
• Misinformation
• Social norms
• Convenience
• Existing habits
• Financial incentives
• Personal experiences
• Distrust
• Competing priorities

Understand these influences rather than dismissing people as irrational or uninformed.

4. Select appropriate formats and channels

Choose communication formats based on the intended audience, message, behavioral objective, accessibility needs, privacy concerns, and how people actually obtain information.

A campaign may use several complementary channels rather than depending on one platform.

5. Tailor communication when meaningful differences exist

Different audience segments may need different information, languages, examples, service supports, messengers, or communication channels.

Tailoring should be based on meaningful differences identified through research, not stereotypes based on race, ethnicity, age, disability, gender, religion, income, or another demographic characteristic.

6. Pretest communication with intended audiences

Before broad distribution, ask people from intended audiences to review the material.

Test whether they:

• Understand the main message
• Understand what action is suggested
• Find the information relevant
• Can use the format
• Notice anything confusing or inaccurate
• Find anything stigmatizing or disrespectful
• Encounter barriers the communication does not address

Revise based on what you learn. A message should not be retained simply because its creators like it.

7. Coordinate communication across the initiative

Major facts, recommendations, and organizational commitments should be consistent across websites, social media, print materials, staff communication, media interviews, outreach, and other channels.

Consistency does not mean every audience must receive identical language. Tailored communication may differ while remaining accurate and aligned with the same overall strategy.

8. Integrate communication with the rest of the social marketing strategy

Communication should match what people will actually experience.

Do not advertise convenient services when appointments are unavailable, encourage use of transportation that does not exist, promote accessibility that has not been provided, or promise benefits the program cannot deliver.

Communication, services, environments, partnerships, policies, and other parts of the intervention should reinforce one another.

9. Evaluate outcomes

Evaluate communication according to its original objectives.

Measures may include:

• Reach
• Comprehension
• Recall
• Trust
• Service use
• Behavioral outcomes
• Accessibility
• Differences in reach or effectiveness across communities
• Unintended consequences

Avoid assuming that a change in behavior was caused by communication alone when services, policies, environmental changes, media coverage, or other influences were also involved.

10. Revise, retest, and adapt

Communication environments, platforms, community conditions, language, evidence, and behaviors change.

Review materials periodically and update them when:

• Evidence changes
• Services change
• Intended audiences change
• Communication channels change
• Materials become outdated or overused
• Evaluation identifies problems
• Community feedback shows that another approach would be more useful

Not every campaign needs to continue indefinitely. Communication may be concluded, reduced, institutionalized into routine services, or replaced when the original objective has been achieved or circumstances have changed.

In Summary

Communication is an important part of social marketing, but it is not the entire strategy. Effective communication begins with audience and community research and is connected to realistic services, supports, environments, policies, and opportunities for action.

Useful communication is clear, accurate, accessible, relevant, respectful, and distributed through channels intended audiences actually use. It takes language preferences, disability access, cultural context, trust, privacy, representation, and differing information needs into account without stereotyping people.

Messages should be developed and pretested with intended audiences rather than built solely from professional assumptions. Trusted messengers can help, but credibility should be established through research rather than assumed from authority, celebrity, or shared identity.

Risk and emotionally difficult topics require particular care. Communicate risks accurately, provide realistic actions, acknowledge uncertainty and people's concerns, and avoid using unnecessary fear, shame, stigma, or manipulation simply to attract attention.

Finally, evaluate whether communication actually helps people understand information and take useful action. Learn from feedback, revise materials and channels when needed, and remember that when people cannot act because of cost, transportation, discrimination, inaccessible services, organizational practices, or other structural barriers, the solution may be to change those conditions rather than produce a more persuasive message.

Example #1: The Fifth Guy

This video is part of a social marketing campaign implemented by the Florida Department of Health in May 2007 to increase awareness of the importance of hand-washing to prevent the spread of illness.

Example #2: Film from SOS Children's Villages Norway

If you saw a boy without a coat shivering alone at a bus stop, what would you do? SOS Children's Villages Norway, seeking to raise awareness and funds to help Syrian children in need, created this moving film. They set up a hidden camera and placed Johannes at a bus stop, in Oslo, Norway, and it's moving to see how people respond. An SOS rep shared, "The goal was to touch upon the fear of becoming numb to crises that don't affect you directly."

(To view in English, choose English on the captions icon in media player in YouTube.)

Read more on Adweek

 

Example 3: Metro Trains: Dumb Ways to Die

Public service announcements are known for being boring, so back in 2012, Melbourne Metro Trains decided to liven things up a bit with their visual marketing campaign, and came up with the perfect way. How do you convey a message to avoid deaths caused by train accidents? You add cute cartoons, a catchy tune, and some dark humor, of course! And so they came up with some catchy lyrics about several dumb ways to die – getting your toast out with a fork, doing your own electrical work, keeping a rattlesnake as a pet, selling both your kidneys on the Internet, to name a few.

As expected, the campaign went viral. Within 24 hours, the song reached iTunes Top 10 Charts, and has 140 million views on YouTube as of this date!

Read more about this example from The Yellow Sparrow.

 

Example 4: ALS: Ice Bucket Challenge

This one, you know it just had to be on the list. These challenges were all the rage back in 2013, and your Facebook newsfeeds were flooded with people pouring ice cold water on themselves, nominating people to do the same, and then donating some amount for the ALS Association. But here’s the best part: ALS never planned this campaign!

Wait, what?!

Yup, a golfer from Florida, Chris Kennedy, nominated a friend to participate in the Ice Bucket Challenge, which had nothing to do with ALS at the time.

Read more about this example from The Yellow Sparrow.

 

What is effective social marketing communication?

___Your communication is two-way: your audience understands your message as you meant it.

___Your communication is accessible.

___Your communication is noticeable.

What are tools for reaching the target audience?

___You carefully choose and mix the channels for your message.

___You carefully consider visual and/or sound elements and the overall design of your message.

___You choose appropriate spokespersons.

___You link your message to themes and values familiar to the target audience.

How do you approach common barriers to effective social marketing communication ?

___You recognize and know how to address each of the common barriers to effective social marketing communication:

___Ignorance

___Selective inattention

___Selective inexposure

___Principle

How do you develop effective messages?

___You set up outcome-linked, measurable objectives for your communication strategy.

___You develop messages that emerge from the target audience, recognizing message competition.

___You select appropriate channels.

___You develop different communications for different segments.

___You pretest every message.

___You integrate your communications program internally.

___You integrate your communications program with everything else in the marketing mix.

___You evaluate outcomes by your original criteria.

___You repeat the process.

• What do we mean by making behavior change easier and more rewarding?

• Why should you make beneficial behavior easier and more rewarding?

• When should you address benefits and costs?

• What are some ways to understand the benefits of behavior change?

• What are some ways to understand the costs and barriers to behavior change?

• How do you make beneficial behavior easier and more rewarding?

Imagine a parent who wants to enroll in a health care training program as a step toward a new career. The program seems promising: it could lead to employment, increased income, new skills, and opportunities for further education.

But the classes are across town and require a long trip on public transportation. Reliable childcare is unavailable. The class schedule conflicts with caregiving responsibilities. During intake, a staff member emphasizes how difficult the program will be rather than explaining available supports or expressing confidence in the participant's ability to succeed.

The person may decide not to enroll even though the long-term benefits are meaningful.

It would be easy to interpret that decision as a lack of motivation. A closer look shows something different: transportation, childcare, scheduling, service design, previous experiences, confidence, and staff interactions all affect whether participation is realistically possible.

Social marketing can help identify these benefits and barriers. But the goal should not simply be to make the program sound more attractive. Whenever possible, the organization should change the conditions that make beneficial behavior unnecessarily difficult.

What do we mean by making behavior change easier and more rewarding?

People make decisions within real social, economic, organizational, cultural, and physical environments. A behavior may appear beneficial and still be difficult or impossible because people lack the necessary resources, opportunity, skills, support, or access.

Making a beneficial behavior easier and more rewarding therefore means:

• Understanding what benefits people actually value
• Identifying financial, practical, social, psychological, environmental, and structural barriers
• Reducing unnecessary burdens
• Strengthening people's opportunity and capability to act
• Providing appropriate information and support
• Creating services, environments, and policies that make beneficial behavior realistic
• Respecting autonomy rather than manipulating people into choices

A classic social marketing framework: SESDED

Alan Andreasen described a classic social marketing approach summarized as SESDED: Superior Exchange, Socially Desirable, Easily Done.

The framework remains useful as a historical way of thinking about benefits, social context, and ease of action. In contemporary practice, however, these ideas should be applied ethically and alongside broader behavioral and systems thinking.

Value-based exchange

Social marketing refers to exchange as the balance people perceive between what they gain and what they must give up, risk, or overcome.

Benefits may include better health, convenience, safety, financial savings, social connection, greater independence, learning, belonging, or another personally meaningful outcome.

Costs may include money, time, effort, transportation, stigma, physical discomfort, loss of privacy, social consequences, uncertainty, or competing responsibilities.

A strong strategy seeks to increase meaningful benefits and reduce unnecessary costs. It should not merely make legitimate burdens appear less important.

Social support and social norms

Other people's attitudes and behaviors can influence decisions. Family, friends, peers, colleagues, professionals, community members, online networks, and social institutions can make a behavior easier or harder to adopt.

Social marketing may therefore strengthen supportive norms or involve trusted relationships when appropriate.

Avoid using social pressure, shame, or fear of exclusion to force conformity. Social influence should support informed and voluntary action.

Feasibility and accessibility

Beneficial behaviors are more likely when people have the capability and opportunity to carry them out.

This may involve:

• Reducing fees
• Providing transportation
• Providing childcare or dependent-care support
• Offering accessible locations
• Providing remote or mobile options
• Changing schedules
• Making enrollment easier
• Providing interpretation and translation
• Improving disability access
• Building skills
• Improving service quality and respectful treatment
• Changing organizational policies

Contemporary behavioral science provides several ways to analyze these conditions. One widely used framework, COM-B, asks whether a behavior is supported by sufficient capability, opportunity, and motivation. The point is not that one model replaces every other model, but that behavior should not be reduced to motivation alone.

Why should you make beneficial behavior easier and more rewarding?

There are two basic reasons: barriers can often be changed, and those barriers may determine whether people can act on their intentions.

Formative research can identify what matters

Interviews, surveys, focus groups, listening sessions, observation, community-engaged research, service data, and other methods can help you understand:

• What people value
• What they see as the main benefits of the behavior
• What costs or risks concern them
• Which barriers are practical or structural
• Which supports would make action easier
• What competing behaviors or priorities exist
• How social norms and relationships influence decisions

Use this information to improve the intervention rather than simply to discover a more persuasive message.

Organizations can often change the conditions surrounding behavior

Not every barrier is under the organization's control, but many can be influenced.

You may be able to:

• Reduce or eliminate fees
• Provide transportation or childcare
• Change hours or locations
• Simplify enrollment
• Make services culturally and linguistically responsive
• Improve disability access
• Train staff
• Improve privacy protections
• Create safer environments
• Change policies
• Work with partners that control resources or systems your organization does not

Conditions in which people live, work, learn, and age can substantially affect their opportunity to practice beneficial behaviors. These broader social and structural conditions should therefore be considered when designing a social marketing intervention.

When should you address benefits and costs?

Consider benefits, costs, capability, opportunity, and motivation throughout the entire planning and implementation process.

The original stages-of-change tradition has often described people as moving through a sequence from awareness to concern, desire, confidence, action, and maintenance. Stage-based models may be useful for some purposes, but people do not necessarily move through one universal sequence.

Someone may strongly want to act but lack transportation. Another person may have opportunity and skills but see little benefit. Someone who previously adopted a behavior may stop because conditions changed.

Rather than deciding that benefits matter at one stage and costs at another, assess the combination of factors relevant to the audience and behavior.

Ask:

• Do people understand the behavior and its likely consequences?
• Do they value the potential benefits?
• Do they have the skills or knowledge needed?
• Do they have practical opportunity to act?
• What costs or risks concern them?
• What social influences matter?
• What supports would help initiate or sustain the behavior?

Continue asking these questions after implementation begins because benefits, barriers, and circumstances can change.

What are some ways to understand the benefits of behavior change?

Benefits that seem obvious to program planners may not be the benefits people themselves value most.

Formative research can help distinguish among immediate and long-term benefits, benefits to the individual, and benefits to families, communities, organizations, or society.

Immediate individual benefits

Depending on the behavior, benefits may include:

• Feeling better physically
• Increased comfort
• Saving money
• Saving time
• Convenience
• Learning a useful skill
• Enjoyment
• Greater independence
• Social connection
• Increased confidence
• Relief from a current problem or burden

Immediate benefits to other people

Some behaviors benefit family members, peers, coworkers, or community members as well as the person acting.

Examples may include:

• Reducing other people's exposure to secondhand tobacco smoke
• Increasing safety
• Strengthening family or caregiving relationships
• Improving the accessibility or quality of a community service
• Increasing participation or representation in a community process

Long-term individual benefits

These may include:

• Improved health and quality of life
• Greater skills and knowledge
• Improved employment or economic stability
• Stronger relationships
• Increased confidence or self-efficacy
• Greater independence
• Satisfaction from acting consistently with personal values

Long-term community or societal benefits

Examples may include:

• Improved opportunities and well-being for children and future generations
• Healthier physical and social environments
• Reduced inequities
• Greater access to services or opportunities
• Stronger community relationships
• Environmental protection
• Greater fairness and inclusion

Be careful when emphasizing benefits primarily to other people or society. Individuals may be asked to carry substantial immediate burdens for benefits that are distant or widely distributed. Where possible, reduce those burdens rather than simply asking people to sacrifice more.

What are some ways to understand the costs and barriers to behavior change?

Costs are not limited to money.

A behavior may require time, effort, transportation, childcare, privacy, emotional energy, physical discomfort, social risk, or access to services that are not currently available.

What looks minor to an organization may be a major barrier to the person being asked to act.

Financial costs

These may include:

• Fees for services
• Transportation
• Childcare or dependent care
• Equipment or supplies
• Time away from paid work
• Changes in household expenses

Some decisions can also affect people's financial security. Whistleblowing, workplace organizing, leaving unsafe employment, seeking safety from an abusive partner, or participating in advocacy may involve real economic risks. Do not minimize those risks in communication.

Physical costs

These may include:

• Physical effort
• Discomfort
• Side effects
• Withdrawal symptoms
• Pain associated with a medical procedure
• Fatigue

Accurate information and appropriate medical or other professional support may reduce some of these burdens, but do not describe real discomfort as merely a matter of perception.

Time and logistical costs

These may include:

• Transportation time
• Waiting time
• Childcare or dependent-care arrangements
• Scheduling changes
• Competing work or school responsibilities
• Family responsibilities
• Administrative requirements
• Technology or internet requirements

Psychological and emotional costs

These may include:

• Fear about a medical result or procedure
• Uncertainty about one's ability to succeed
• Stress associated with major life changes
• Stigma
• Concerns about disclosure or privacy
• Previous negative experiences with institutions
• Coping with cravings or withdrawal associated with substance dependence

Programs can sometimes reduce these costs through respectful service, clear information, privacy protections, counseling, peer support, trauma-informed approaches, and appropriate professional care.

Social costs

Behaviors can affect people's relationships and social identities.

Costs may include:

• Losing contact with people connected to an existing behavior
• Disapproval from family or peers
• Conflict within relationships
• Loss of belonging
• Changes in established roles or routines
• Stigma or discrimination

In situations involving abuse or violence, safety should take priority over social-marketing concepts such as exchange or social approval. Connect people with appropriate survivor-centered services and safety resources.

Structural and environmental barriers

Some of the most important costs are created by systems rather than by the behavior itself.

These may include:

• Lack of affordable services
• Inadequate transportation
• Unsafe environments
• Discrimination
• Inaccessible buildings or technology
• Lack of insurance
• Restrictive workplace policies
• Housing instability
• Limited access to healthy food
• Lack of paid leave
• Administrative or eligibility barriers

Social determinants and wider systems can expand or limit people's opportunities to practice beneficial behaviors. When these conditions are central to the problem, changing them should be part of the intervention rather than placing all responsibility on individuals.

How do you make beneficial behavior easier and more rewarding?

Start with formative research

Ask intended audiences what they value and what makes the behavior easier or harder.

Explore:

• What benefits matter most?
• Which benefits are immediate and which are long-term?
• What costs are acceptable?
• What costs are prohibitive?
• Which barriers could the organization change?
• What supports are missing?
• What other behaviors or priorities compete with the desired behavior?
• What social relationships influence decisions?
• What skills or information are needed?

Understand the benefits behind preferences

When people say they prefer a particular service feature, ask why.

For example, participants may prefer small training groups because they value:

• More individualized attention
• Greater privacy
• More opportunity to ask questions
• Stronger relationships with instructors
• Reduced anxiety

Understanding the underlying benefit helps you design the service more effectively than simply copying the requested feature.

Ask how people prefer services to be delivered

If behavior depends on access to a program or service, consider:

• Location
• Hours
• Cost
• Enrollment requirements
• Transportation
• Childcare or dependent care
• Language access
• Disability access
• Privacy
• Remote or in-person options
• Staffing and interpersonal treatment

For example, a recycling program might compare curbside pickup, neighborhood drop-off locations, shared collection sites, and different sorting requirements. The most useful approach will depend on local infrastructure, cost, accessibility, environmental goals, and resident experience.

Understand social influences

Ask whether family members, friends, peers, clinicians, faith or spiritual leaders, educators, employers, community organizations, or others influence decisions.

Do not infer susceptibility to social influence from education, income, race, culture, or another demographic characteristic.

Different kinds of social influence affect people across communities. Formative research can help determine which relationships are actually relevant.

Identify the point at which costs become barriers

Questions can help identify which conditions materially affect participation:

• Would you participate if transportation were provided?
• Would evening or weekend hours make participation easier?
• Would childcare support change your ability to attend?
• What costs would make the program unaffordable?
• What concerns would make you decide not to participate?

Be careful not to use research merely to determine the greatest burden people will tolerate. The objective should be to understand what would make participation equitable and feasible.

Ask what support people need

Supports may include:

• Transportation
• Childcare or dependent-care assistance
• Financial assistance
• Accessible technology
• Interpretation or translation
• Flexible scheduling
• Training
• Counseling
• Peer support
• Mentoring
• Health care
• Safer environments

Develop a strategy using benefits, opportunity, capability, and social context

SESDED can still provide a simple historical reminder to consider exchange, social support, and feasibility. Contemporary intervention planning can broaden this analysis by asking:

• Benefits and exchange: Does the behavior provide benefits people actually value?
• Capability: Do people have the knowledge and skills needed?
• Opportunity: Do services, environments, resources, and policies make the behavior possible?
• Motivation: Do people see the behavior as worthwhile and consistent with their priorities?
• Social context: Do relationships and social norms support or discourage it?
• Equity: Do some groups face substantially greater barriers than others?

Provide accurate and usable information

People need enough information to understand their options, likely benefits, risks, costs, and available support.

More information is not always better. Information should be:

• Accurate
• Relevant
• Understandable
• Accessible
• Timely
• Appropriate to the decision people are making

Build capability

People may need skills, practice, confidence, or professional support.

Examples include:

• Learning how to communicate with young people about substance use
• Learning how to participate in public meetings
• Understanding health information
• Developing coping strategies for cravings or stress
• Learning CPR
• Developing employment or technology skills

Training, coaching, mentoring, peer support, clinical treatment, demonstrations, and practice opportunities may all contribute to capability.

Improve opportunity and access

Review whether the environment supports the behavior.

Improvements might include:

• Free or lower-cost services
• Transportation support
• Childcare
• More convenient hours
• More convenient locations
• Remote options
• Accessible facilities
• Language access
• Faster enrollment
• Reduced waiting lists
• Safer locations and routes
• Better privacy protections

Increase meaningful benefits

Benefits can sometimes be increased directly.

Examples include:

• Adding job-placement assistance to workforce training
• Providing participant compensation or stipends
• Offering professional development or credentials
• Providing useful meals or refreshments during lengthy activities
• Creating opportunities for social connection
• Improving service quality
• Treating participants with respect and dignity

Incentives may be appropriate in some interventions, but they should be ethical, proportionate, and designed so they do not create inappropriate pressure.

Explain benefits people may not know about

Communication can help people understand consequences they may not have considered.

For example, tobacco cessation communication might discuss benefits such as:

• Improved respiratory and cardiovascular health
• Reduced exposure of household members to secondhand smoke
• Financial savings
• Improvements in taste and smell
• Better physical endurance

Use benefits supported by current evidence and relevant to the intended audience rather than trying to exploit appearance, romantic relationships, shame, or social insecurity.

Reduce actual costs before reframing them

The strongest way to reduce a barrier is usually to change the barrier itself.

Examples include:

• Subsidizing fees
• Providing transportation
• Providing childcare
• Changing location
• Adjusting schedules
• Reducing paperwork
• Providing counseling or peer support
• Improving safety

Communication can clarify tradeoffs or correct inaccurate beliefs, but it should not tell people that a genuine financial, emotional, safety, or logistical burden is unimportant.

Understand competing influences

In social marketing, competition refers broadly to behaviors, services, products, demands, norms, or other factors that compete with the desired behavior.

Competition may include:

• Convenience of the current behavior
• Habits
• Cravings associated with substance dependence
• Time pressures
• Social expectations
• Misinformation
• Commercial marketing
• Alternative services
• Lack of trust
• Financial incentives

Analyze why the competing option is attractive or easier and determine whether your strategy can reduce that advantage.

When health treatment is involved, distinguish between evidence-based care, complementary practices, and unproven or misleading treatments. Do not dismiss cultural or spiritual practices simply because they differ from your approach, but communicate clearly when delaying effective medical care could create serious risk.

Build supportive social environments

Social norms can influence behavior, but the goal should not be to pressure people through shame or exclusion.

You may:

• Share accurate information about supportive norms
• Engage trusted community messengers
• Support peer networks
• Highlight examples of beneficial behavior without stigmatizing people who have not adopted it
• Work with organizations and institutions whose practices shape social expectations

Policies and regulations can also influence behavior by changing prices, access, safety, availability, and environmental conditions. Their purpose should not be described only as making a behavior socially acceptable; they may directly change the opportunity structure in which decisions occur.

Remove barriers

Review barriers systematically rather than assuming motivation is the main obstacle.

These may involve:

• Money
• Transportation
• Childcare
• Location
• Time
• Safety
• Disability access
• Language access
• Privacy
• Wait times
• Stigma
• Previous negative experiences
• Digital access
• Institutional policies

CDC describes social determinants of health as the conditions in which people are born, grow, work, live, and age, along with broader systems and forces that shape those conditions. These factors can expand or limit opportunities to practice healthy behaviors. Social marketing strategies should therefore address structural conditions when those conditions are part of the barrier.

Pretest and continue learning

Before broad implementation, test the strategy with people from the intended audiences.

Ask:

• Do the proposed benefits matter?
• Have we identified the major barriers?
• Does the strategy actually reduce those barriers?
• Is participation realistic?
• Are supports sufficient?
• Is anything stigmatizing, coercive, confusing, or inaccessible?
• Are some groups facing burdens that others do not?

Revise based on what you learn.

Pretesting does not guarantee that an intervention will succeed. Continue monitoring implementation, participation, access, outcomes, equity, and unintended consequences after launch.

In Summary

People consider many kinds of benefits and costs when deciding whether to adopt or maintain a behavior. Those considerations may be financial, practical, physical, psychological, social, environmental, or structural.

Social marketing can help identify benefits people value and barriers that make beneficial behaviors difficult. The strongest interventions do more than communicate that benefits outweigh costs: they reduce unnecessary costs, improve access, build skills, strengthen opportunity, and make services and environments more supportive.

Classic social marketing concepts such as exchange, competition, social support, and ease of action remain useful. They should be used alongside contemporary approaches that consider capability, opportunity, motivation, ethics, equity, community context, and the wider systems shaping behavior.

Whenever possible, reduce real barriers before trying to change people's perceptions of them. Transportation problems, unaffordable services, lack of childcare, discrimination, unsafe environments, inaccessible facilities, inflexible schedules, and long waiting lists are not communication problems.

Finally, listen to the people involved. Use formative research and community participation to understand what they value, what burdens they experience, and what changes would make beneficial behavior realistically possible. Pretest the strategy, evaluate it after implementation, and continue adapting as conditions and community needs change.

What do we mean by making behavior change easier and more rewarding?

___You apply SESDED to your campaign.

Why should you address benefits and costs in social marketing?

___You're prepared to gain information through market research.

___You're willing to make changes to control benefits and costs.

___You know that the balance of benefits and costs is crucial to the process of change.

When is the best time to address benefits and costs?

___You address benefits and costs when you know people are contemplating change.

___You address benefits in the early stages of contemplation.

___You address costs in the later stages of contemplation.

What are some ways to look at the benefits of behavior change?

___You find out what the real benefits are that people are seeking.

___You look at benefits over both the short and the long term.

___You consider both benefits that affect the target population itself, and those that affect others.

What are some ways to look at the costs of behavior change?

___You determine what members of the target population consider the real costs of the desired change.

___You look at:

• Economic costs
• Physical costs
• Logistical costs
• Psychological costs
• Social costs

How do you make behavior change easier and more rewarding?

You conduct market research to find out:

___The real reasons people are contemplating change.

___How they would prefer to accomplish that change.

___Whether others' opinions would influence that change, and, if so, whose.

___What benefits or costs could make the difference.

___What kind of support people need to make the change.

You develop a strategy by:

___Starting with SESDED

___Thinking about what the target population needs to make the change possible : information, market conditions, and/or skills.

___Maximizing benefits.

___Minimizing costs.

___Addressing the competition.

___Making the change socially desirable.

___Making the change easily done.

___You pretest your strategy before putting it into practice.

• Why should you monitor progress and make adjustments in a social marketing campaign?

• What aspects of the campaign should you monitor?

• How do you monitor and adjust a social marketing campaign?

Imagine that a community HIV prevention initiative has operated for several years. During that time, HIV prevention and treatment options have changed, community needs have shifted, new data have become available, and different groups may now experience different levels of access to testing, treatment, PrEP, condoms, sterile injection equipment, and other prevention resources.

Those changes do not necessarily mean that one community no longer needs attention and another should simply become the new focus. Instead, the organization should examine current epidemiologic data, service access, inequities, community feedback, prevention coverage, treatment outcomes, and emerging needs and then adjust its strategies and resources accordingly.

The same principle applies to other social marketing initiatives. Conditions change. People change. Technology changes. Programs mature. New barriers emerge. Services improve or become less accessible. Policies change. Funding changes. A communication strategy that worked several years ago may no longer be relevant.

Monitoring and evaluation help an organization understand what is happening and decide whether to continue, adapt, expand, scale back, redesign, or conclude parts of an initiative.

Why should you monitor progress and make adjustments in your social marketing campaign?

A social marketing strategy should not be treated as fixed once it has been launched.

Ongoing monitoring can help determine:

• Whether activities are being implemented as intended
• Whether intended audiences are being reached
• Whether people can actually access the services, resources, or opportunities connected to the campaign
• Whether communication is understandable, relevant, accessible, and trusted
• Whether the desired behaviors or other outcomes are changing
• Whether outcomes differ across communities or audience segments
• Whether unintended benefits or harms are occurring
• Whether resources are being used effectively
• Whether community priorities or conditions have changed
• Whether the strategy remains consistent with the organization's mission and ethical responsibilities

Community and demographic conditions change

Neighborhoods and communities may change because of housing patterns, migration, displacement, development, population aging, economic conditions, institutional changes, or other factors.

Monitor whether those changes affect:

• Who is being reached
• Who is being missed
• Where services should be located
• Which languages and accessible formats are needed
• What barriers people experience
• Which organizations and community partners should be involved

Do not interpret demographic change as a reason simply to move resources away from one population and toward another. Examine continuing needs, inequities, and service gaps before changing priorities.

Community priorities and experiences change

An issue that receives substantial attention at one point may receive less attention later, while another issue becomes more urgent.

Changes in attention do not necessarily mean that the original issue has been solved.

Use current data and community engagement to understand whether:

• Conditions have actually improved
• People have become less concerned despite continuing risk
• New barriers or competing priorities have emerged
• Services have become easier or harder to access
• The campaign itself has become less relevant

Historical and generational context changes

Different generations may have different experiences with an issue, but do not assume what people know or believe simply because of their age.

Formative research can help identify whether changes in collective experience, technology, policy, treatment, media coverage, or community history are affecting people's understanding or behavior.

Communication channels change

Communication platforms and information habits change rapidly.

People may use:

• Search engines
• Social media
• Messaging platforms
• Text messaging
• Podcasts
• Streaming audio and video
• Community organizations
• Health professionals
• Schools or workplaces
• Community media
• Trusted interpersonal networks

Do not select channels based only on broad assumptions about age or demographic identity. Monitor how intended audiences actually obtain and use information.

Services and organizational capacity change

Monitoring should include the organization itself.

A campaign may have excellent communication but still fail if:

• Services are unavailable
• Waiting lists are excessive
• Staff capacity is inadequate
• Participants experience disrespect or discrimination
• Transportation is unavailable
• Hours are inconvenient
• Technology is inaccessible
• Costs prevent participation
• Funding is insufficient to sustain the promised service

Monitoring should therefore examine both communication and the actual program, services, systems, and conditions supporting the behavior.

What aspects of the campaign should you monitor?

Three traditional questions remain useful: Is the campaign effective? Are resources being used efficiently? Is the overall strategy still appropriate?

Contemporary evaluation can broaden those questions to include implementation, reach, equity, participant experience, unintended consequences, and sustainability.

Implementation

Ask whether the campaign and related services are being delivered as intended.

Consider:

• What activities were actually implemented?
• Were they delivered at the intended frequency and quality?
• Were appropriate staff, partners, and resources available?
• Did implementation vary by location or audience?
• What helped or interfered with implementation?
• Did the program need to adapt during implementation?

A strategy cannot be fairly judged as ineffective if major parts of it were never implemented or were implemented very differently from what was planned.

Reach and access

Determine whether the people and organizations relevant to the campaign are actually encountering and able to use the intervention.

Ask:

• Who is being reached?
• Who is not being reached?
• Who begins using services?
• Who continues participating?
• What barriers affect access?
• Are communication and services accessible to people with disabilities?
• Are language needs being met?
• Are costs, schedules, transportation, or technology excluding some people?

Effectiveness and outcomes

Determine whether the initiative is achieving the outcomes it was designed to influence.

Measures may include:

• Knowledge or understanding
• Beliefs or attitudes when relevant to the behavioral objective
• Service use
• Specific behaviors
• Organizational practices
• Policy changes
• Environmental changes
• Health or community outcomes

Distinguish outputs from outcomes.

The number of flyers distributed, advertisements viewed, social media impressions, events held, participants enrolled, or website visits can describe reach or activity, but those measures alone do not show that the desired outcome occurred.

Similarly, an increase in an outcome after a campaign does not automatically prove that the campaign caused the change. Other programs, policies, economic conditions, media coverage, social trends, or events may also have contributed.

If determining causal impact is important, use an evaluation design capable of estimating what likely would have happened without the intervention.

Equity

Overall success can hide substantial differences among communities.

For example, service use may increase overall while remaining unchanged among people facing transportation barriers, people who prefer languages other than English, people with disabilities, rural residents, or other groups experiencing barriers.

Ask:

• Who benefits?
• Who does not?
• Are outcomes improving equitably?
• Are some groups carrying greater burdens?
• Are existing inequities narrowing, remaining unchanged, or widening?
• Does the evaluation itself include perspectives that have historically been excluded?

Participant and community experience

Satisfaction can provide useful information, but it should not be treated as the only measure of quality.

Consider:

• Respectful treatment
• Trust
• Accessibility
• Safety
• Privacy
• Cultural and linguistic responsiveness
• Ease of participation
• Perceived usefulness
• Whether participants believe their concerns are heard

Quality, safety, ethics, and professional standards should still be maintained even when participants do not identify them as priorities. For example, inadequate clinical quality is not acceptable simply because respondents rank another service feature as more important.

Unintended consequences

Monitor for outcomes the program did not intend.

These might include:

• Stigma
• Misinformation
• Privacy concerns
• Increased barriers for a particular group
• Unanticipated staff workload
• Diversion of resources from other important work
• Reduced trust
• Harmful incentives

Efficiency and resource use

Efficiency asks what resources are being used and what outcomes those resources help produce.

Consider:

• Staff time
• Media and communication costs
• Technology
• Community-partner costs
• Participant supports
• Training
• Service-delivery costs
• Administrative costs

Measures might include cost per participant reached, cost per service completed, cost per desired outcome, or another metric appropriate to the intervention.

Economic evaluation may include cost analysis, cost-effectiveness analysis, cost-benefit analysis, or cost-utility analysis. Select the approach based on the question being asked rather than translating every social marketing outcome into a commercial "return on investment."

Mission alignment

Efficiency should not encourage organizations to serve only people who are easiest or least expensive to reach.

Performance-based funding can sometimes create incentives to prioritize participants who are already most likely to meet the required outcome, while people facing greater barriers receive less support.

Monitor whether financial incentives, performance measures, or efficiency targets are unintentionally pulling the organization away from its mission or widening inequities.

Sustainability

Ask whether effective parts of the strategy can continue for as long as they are needed.

Consider:

• Funding
• Staffing
• Community partnerships
• Technology
• Institutional support
• Policy environment
• Participant demand
• Whether the behavior or service should become part of routine practice

Strategy and relevance

Periodically ask whether the original strategy still makes sense.

Conditions may have changed enough that the organization needs to:

• Change its behavioral objectives
• Add or remove audience segments
• Change services
• Shift communication channels
• Address a newly identified structural barrier
• Build new partnerships
• Scale an effective intervention
• Reduce or conclude an intervention that is no longer needed

How do you monitor and adjust a social marketing campaign?

Begin with a clear description of the program

Before deciding what to measure, describe what the initiative is intended to do and why.

A logic model, theory of change, program roadmap, or similar framework can identify:

• Resources
• Activities
• Intended audiences
• Outputs
• Short-term outcomes
• Intermediate outcomes
• Long-term outcomes
• Important contextual factors
• Assumptions about how change is expected to occur

Making these assumptions explicit helps determine whether disappointing results reflect a problem with implementation, the underlying strategy, or the assumptions connecting activities to outcomes.

Decide what decisions the monitoring and evaluation should inform

Do not collect information simply because it is easy to count.

Begin by asking:

• What do we need to decide?
• Who will use the findings?
• What evidence would actually help make that decision?
• What information do community members and participants consider important?

Evaluation might be used to decide whether to:

• Continue the strategy
• Change a message
• Redesign a service
• Expand access
• Address an inequity
• Shift resources
• Scale the program
• End an ineffective or unnecessary activity

Engage people affected by the work

Monitoring and evaluation should not be designed only by program staff or funders.

Depending on the initiative, involve:

• Participants
• Community members
• Staff
• Community partners
• Service providers
• Funders
• Policymakers
• Others who will use or be affected by the findings

These perspectives can help identify meaningful questions, interpret unexpected results, identify inequities, and prevent the organization from drawing conclusions that do not match community experience.

Establish indicators before implementation when possible

Decide how progress will be measured and, when appropriate, establish baseline information before the intervention begins.

Indicators should connect directly to the program's goals.

Avoid relying only on easily available metrics such as impressions, clicks, number of brochures distributed, or attendance when the real goal involves behavior, access, health, policy, or another outcome.

Monitor implementation as the campaign operates

Ongoing performance monitoring can identify problems before a formal evaluation is complete.

Depending on the program, a monitoring system might track:

• Participation
• Service availability
• Waiting times
• Communication reach
• Referral completion
• Program completion
• Spending
• Staff capacity
• Accessibility
• Complaints or concerns
• Demographic or geographic patterns when relevant and collected appropriately

Protect privacy and collect only the information necessary for legitimate program and evaluation purposes.

Evaluate outcomes

Outcome evaluation asks whether intended changes occurred.

Compare results with:

• Baseline conditions
• Predetermined goals
• Appropriate benchmarks
• Previous program performance
• Relevant population data

When useful, compare outcomes with another population, location, or period, but recognize that simple comparisons do not automatically establish that the campaign caused the difference.

Use impact evaluation when causal attribution matters

If you need to know whether the intervention itself caused an outcome, use an evaluation design appropriate for causal inference.

Depending on the setting and available resources, this may involve:

• Randomized designs
• Quasi-experimental designs
• Carefully selected comparison groups
• Interrupted time-series approaches
• Other methods appropriate to the evaluation question

Seek evaluation or statistical expertise when causal conclusions will influence major policy, funding, or program decisions.

Gather participant and community feedback

Quantitative measures rarely explain everything.

Use interviews, surveys, listening sessions, advisory groups, focus groups, community meetings, complaint and suggestion systems, and other appropriate methods to understand people's experiences.

Ask:

• What is working?
• What is not?
• What barriers remain?
• What feels inaccessible or burdensome?
• Are people being treated respectfully?
• What has changed since the program was designed?
• What should be changed?

Do not recruit only highly satisfied participants. Include critical, disengaged, former, and underserved participants when appropriate so that feedback does not systematically exclude people who had poor experiences.

Use participant or community advisory groups

An ongoing advisory group can provide feedback at several stages rather than being consulted only once.

Members may help:

• Identify evaluation questions
• Review materials
• Interpret results
• Identify unintended consequences
• Recommend adaptations

Consider compensation for community expertise when resources allow. Make participation accessible and periodically review whether membership adequately reflects the perspectives needed.

Assess service quality directly

Participant experience matters, but it should not determine whether basic standards of quality, safety, accessibility, ethics, or professional competence are optional.

For example, a health clinic should maintain appropriate clinical standards even if survey respondents do not list provider competence as their highest priority.

Quality review may involve:

• Professional standards
• Clinical guidelines
• Safety requirements
• Accessibility standards
• Staff training and supervision
• Program fidelity or implementation quality
• Participant outcomes

Distinguish inaccurate perceptions from valid criticism

Negative views of an organization should not automatically be classified as a public-relations problem.

Investigate the underlying reason.

If information about the organization is inaccurate, provide transparent evidence and correct the information respectfully.

If criticism reflects a real problem - such as disrespectful staff behavior, inaccessible services, misleading communication, weak program quality, discrimination, privacy problems, or excessive use of fear or guilt - acknowledge the issue and address the cause.

Depending on the seriousness of the problem, responses may include:

• Training
• Supervision
• Policy changes
• Service redesign
• Accountability processes
• Changes in staffing through appropriate organizational procedures

Review costs and resource use

Examine how resources are being used and what outcomes they support.

Questions might include:

• What does the intervention cost?
• Which activities consume the most resources?
• Which activities produce meaningful outcomes?
• Could the same outcome be achieved with fewer resources?
• Would reducing cost undermine quality, access, or equity?
• Are participants being asked to absorb costs that should be included in the program budget?

For fundraising campaigns, financial return may appropriately be part of the analysis. For health and community interventions, however, financial return is only one consideration and may not be the primary measure of value.

Watch for performance incentives that undermine equity or mission

Funding systems can sometimes reward organizations for serving people who are easiest to enroll, retain, or move toward a specified outcome.

This can unintentionally discourage organizations from serving people facing greater barriers.

Monitor:

• Who is being enrolled
• Who is being screened out
• Who leaves the program early
• Whether performance measures create unintended incentives
• Whether funding structures adequately account for participants with different levels of need

Where possible, work with funders to develop performance expectations that reward meaningful outcomes without discouraging equitable service.

Review geographic reach

Ask whether services and communication are located where they are needed.

Examine:

• Where participants live or spend time
• Transportation access
• Service gaps
• Rural and urban differences
• Neighborhood change
• Geographic inequities

Avoid assuming that resources should simply be moved to areas with the highest numbers. Severity of need, inequity, historical underinvestment, and barriers to access may also affect decisions.

Review audience segmentation

Ask whether your current audience segments remain useful.

Consider whether differences in:

• Behavior
• Barriers
• Motivation
• Access
• Trust
• Language
• Geography
• Service experience

still require distinct approaches.

Do not prioritize only people who are easiest or most ready to change. If one audience experiences greater barriers, the appropriate response may be to invest more resources or change the environment rather than shift attention away from that audience.

Review communication and service-delivery channels

Determine whether current channels are still appropriate.

Examine:

• Reach
• Trust
• Accessibility
• Cost
• Privacy
• Language
• Engagement
• Changes in technology or platform use

Consider communication and service channels together. A successful advertisement for a service that people cannot access is not a successful intervention.

Reassess competing influences

Social marketing uses the concept of competition broadly.

Competing influences may include:

• Existing habits
• Competing demands on time
• Cost
• Convenience
• Commercial marketing
• Misinformation
• Lack of transportation
• Unavailable services
• Social norms
• Policy barriers
• Insurance or benefit structures

Ask what actually makes the alternative behavior or inaction easier or more attractive.

For example, someone may strongly want to participate in workforce training and employment but face loss of health coverage, childcare costs, transportation problems, or schedules incompatible with caregiving. The important competing condition is not necessarily a lack of interest in employment; it may be the financial and institutional consequences of taking the available job.

Monitor organizational strategy

Social marketing strategy should remain connected to the organization's overall mission and strategy.

Ask:

• Is the issue we are addressing still important?
• Are our goals still appropriate?
• Has new evidence changed what we understand about the problem?
• Have community priorities changed?
• Are we still the appropriate organization to do this work?
• Should we partner with another organization?
• Are we duplicating services that already exist?
• Are emerging technologies or policies changing how the work should be done?
• Do our current activities still advance our mission?

Monitor longer-term trends

Strategic planning should consider developments that may affect the work over several years.

Depending on the issue, these may involve:

• Population change
• Economic conditions
• Technology
• Climate and environmental conditions
• Health trends
• Laws and policies
• Funding
• Workforce changes
• Communication platforms
• Community institutions

Forecasting is uncertain, so do not assume one predicted future will occur. Scenario planning can help organizations consider several plausible developments and prepare flexible responses.

Conduct a periodic strategic review

A periodic social marketing and program review can bring these questions together.

Review:

• Community and environmental context
• Behavioral objectives
• Audience segmentation
• Formative research and community insight
• Service design
• Communication
• Partnerships
• Implementation
• Reach
• Outcomes
• Equity
• Costs
• Unintended consequences
• Sustainability
• Alignment with organizational mission

The traditional 4 Ps - product, price, place, and promotion - may be included in this review, but they should not be the only framework used to judge the strategy.

Act on findings

Evaluation is useful only if findings inform decisions.

Possible actions include:

• Continuing what is working
• Correcting implementation problems
• Changing communication
• Improving accessibility
• Removing service barriers
• Changing staffing or training
• Reallocating resources
• Building new partnerships
• Expanding an effective intervention
• Redesigning an ineffective intervention
• Addressing inequitable outcomes
• Ending activities that are ineffective, harmful, unnecessary, or no longer aligned with community priorities

Communicate findings transparently

Share findings with appropriate participants, partners, staff, funders, board members, community members, and others who have an interest in the work.

Report:

• What was evaluated
• What methods were used
• What was found
• Important limitations
• Differences across communities when relevant
• Unintended consequences
• What the organization plans to change

Do not report only favorable findings. Transparency strengthens accountability and makes evaluation more useful.

Continue learning and adapting

Monitoring and evaluation are ongoing learning processes rather than one final judgment about whether a campaign "worked."

Continue asking:

• What have we learned?
• What has changed?
• What assumptions were wrong?
• What should we preserve?
• What should we change?
• Who is still being missed?
• What new questions have emerged?

In Summary

Monitoring and adjusting are essential parts of social marketing. Community conditions, behaviors, technologies, services, resources, and communication environments change, so a strategy that was appropriate at one point may need to be adapted later.

Monitoring should examine more than whether a message is visible or whether participation numbers increase. Organizations should consider implementation, reach, accessibility, effectiveness, equity, participant and community experience, unintended consequences, efficiency, sustainability, and alignment with mission.

Outputs such as advertisements delivered, people reached, or participants enrolled are useful, but they should not automatically be treated as outcomes. Outcome evaluation can determine whether intended changes occurred, while stronger impact-evaluation designs may be needed when the organization needs to determine whether its intervention caused those changes.

Financial and operational efficiency also matter, but efficiency should not be pursued by systematically excluding people who face greater barriers or by reducing service quality. Resource decisions should be considered alongside mission, equity, accessibility, and community benefit.

Community and participant feedback should be part of monitoring, but satisfaction is not the only standard of quality. Safety, ethics, accessibility, professional standards, evidence, and equitable outcomes remain important even when they are not the highest-ranked concerns in a satisfaction survey.

Finally, monitoring should lead to action. Organizations should use what they learn to improve services, communication, partnerships, access, resource allocation, and strategy. A successful social marketing initiative is not one that continues unchanged indefinitely; it is one that continues to learn, respond to evidence and community experience, and remain effective, equitable, ethical, and relevant as conditions change.

Why should you monitor progress and make adjustments in the social marketing campaign?

___You understand that social and other conditions change over time, and that a social marketing campaign has to change with them to remain successful.

You pay careful attention to:

___Demographics

___Consumer preferences

___Trends and social conditions

___Social memory

___Communication channels

What aspects of the campaign should you monitor?

You know that you have to monitor both your campaign and your organization for:

___Effectiveness

___Efficiency

___Strategy

How do you monitor and adjust a social marketing campaign?

___You measure campaign and organizational effectiveness by using one or more of the following:

• Sales analysis
• Market share analysis
• Expense-to-sales ratio
• A basic attitude measure
• A simple satisfaction/dissatisfaction scale
• A derived dissatisfaction measure
• Importance/performance ratings

You monitor efficiency by examining how well you're using and responding to:

___Territory

___Market segment

___Distribution channels

___Competition

You monitor strategy by looking at:

___Current social, political, economic, and other conditions, issues and trends in the larger world.

___Current issues and trends in your field.

___Current issues and trends in the community and among the target population.

___Long-term issues and trends in the larger world.

___Long-term issues and trends in your field.

___Long-term issues and trends in the community and among the target population.

___Depending upon the results of your monitoring, you make changes in the message, distribution, tone, or direction of your campaign or in the methods, systems, personnel, or general operation of your organization in order to continue to reach and meet the needs of the target population and to continue to conduct a successful social marketing effort.

Tool #1: A Sample Market Audit

(From Strategic Marketing for Nonprofit Organizations, by Philip Kotler and Alan Andreasen.)

This tool is meant as a guide for conducting a formal marketing audit. You can use it to help you think about what areas you need to look at as you review your social marketing effort; you can use pieces of it as they stand here; or you can actually try to carry part or all of it out in a formal way. A lot depends on your resources, the size of your marketing effort (and of your organization), and the overall importance of your social marketing effort to the work you do.

Part I. Marketing Environment Audit

Macroenvironment

• Demographic
  • What major demographic developments and trends pose opportunities or threats for this organization?
  • What actions has the organization taken in response to these developments?
• Economic
  • What major developments and trends in income, prices, savings, and credit have an impact on the organization?
  • What action has the organization taken in response to these developments and trends?
• Ecological
  • What is the outlook for the cost and availability of natural resources and energy needed by the organization?
  • What concerns have been expressed about the organization's role in conservation, and what steps has the organization taken?
• Technological
  • What changes are occurring in the relevant product, service, and process technology? What is the organization substitute that might replace this product or service?
• Political
  • What new legislation could affect this organization? What federal, state, and local agency actions should be watched?
  • What action has the organization taken in response to these developments?
• Cultural
  • What changes are occurring in consumer life-styles and values that might affect this organization?
  • What actions has the organization taken in response to these developments?

Task Environment

• Markets
  • What is happening to market size, growth, and geographical distribution?
  • What are the major market segments? What are their expected rates of growth? Which are high-opportunity and low-opportunity segments?
• Customers
  • How do current customers and prospects rate the organization and its competitors, particularly with respect to reputation, product quality, service, sales force, and price?
  • How do different classes of customers make their buying decisions?
  • What are the evolving needs and satisfactions being sought by consumers in this market?
• Competitors
  • Who are the major competitors? What are the objectives and strategies of each major competitor? What are their strengths and weaknesses? What are the sizes and trends in market shares?
  • What trends can be seen in future competition and substitutes for this product?
• Distribution and Dealers
  • What are the main distribution channels bringing products to customers?
  • What are the efficiency levels and growth potentials of the different distribution channels?
• Suppliers
  • What is the outlook for the availability of different key resources used in production?
  • What trends are occurring among suppliers in their pattern of selling?
• Facilitators and Marketing Firms
  • What is the outlook for the cost and availability of transportation services?
  • What is the outlook for the cost and availability of warehousing facilities?
  • What is the outlook for the cost and availability of financial resources?
  • How effectively is the advertising agency performing?
• Publics
  • What publics (financial, media, government, citizen, local, general, and internal) represent particular opportunities or problems for the company?
  • What steps has the company taken to deal effectively with its key publics?

Part II. Marketing Objectives and Strategy Audit

• Organization's Objectives
  • Is the mission of the organization clearly stated in market-oriented terms? Is the mission feasible in terms of the organization's opportunities and resources?
  • Are the organization's various objectives clearly stated so that they lead logically to the marketing objectives?
  • Are the marketing objectives appropriate, given the organization's competitive position, resources, and opportunities?
• Marketing Strategy
  • What is the core marketing strategy for achieving the objectives? Is it a sound marketing strategy?
  • Are enough resources (or too many resources) budgeted to accomplish the marketing objectives?
  • Are the marketing resources allocated optimally to prime market segments, territories, and products of the organization?
  • Are the marketing resources allocated optimally to the major elements of the marketing mix, that is, offer quality, service, sales force, advertising, promotion, and distribution?

Part III. Marketing Organization Audit

• Formal Structure
  • Is there a high-level marketing officer with adequate authority and responsibility over those organizational activities that affect the customer's satisfaction?
  • Are the marketing responsibilities optimally structured along functional, product, end user, and territorial lines?
• Functional Efficiency
  • Are there good communication and working relations between marketing and sales?
  • Is the product management system working effectively? Are the product managers able to plan profits or only sales volume?
  • Are there any groups in marketing that need more training, motivation, supervision, or evaluation?
• Interface Efficiency
  • Are there any problems between marketing and operations that need attention?
  • What about marketing and R & D?
  • What about marketing and financial management?
  • What about marketing and purchasing?

Part IV. Marketing Systems Audit

• Marketing Information System
  • Is the marketing intelligence system producing accurate, sufficient, and timely information about developments in the marketplace?
  • Is marketing research being adequately used by managers?
• Marketing Planning System
  • Is the marketing planning system well-conceived and effective?
  • Are sales forecasting and market potential measurement soundly carried out?
  • Are sales quotas set on a proper basis?
• Marketing Control System
  • Are the control procedures (monthly, quarterly, etc.) adequate to ensure that the annual plan objectives are being achieved?
  • Is provision made to analyze periodically the profitability of different products, markets, territories, and channels of distribution?
  • Is provision made to periodically examine and validate various marketing costs?
• New Product Development System
  • Is the organization well organized to gather, generate, and screen new product ideas?
  • Does the organization do adequate concept research and business analysis before investing heavily in a new idea?
  • Does the organization carry out adequate product and market testing before launching a new product?

Part V. Marketing Productivity Audit

• Profitability Analysis
  • What is the profitability of the organization's different products, customer markets, territories, and channels of distribution?
  • Should the organization enter, expand, contract, or withdraw from any market segments, and what would be the short- and long-run profit consequences?
• Cost-Effective Analysis
  • Do any marketing activities seem to have excessive costs? Are these costs valid? Can cost-reducing steps be taken?

Part VI. Marketing Function Audits

• Products
  • What are the product line objectives? Are these objectives sound? Is the current product line meeting these objectives?
  • Are there particular products that should be phased out?
  • Are there new products that are worth adding?
  • Are any products able to benefit from quality, feature, or style improvements?
• Price
  • What are the pricing objectives, policies, strategies, and procedures? To what extent are prices set on sound cost, demand, and competitive criteria?
  • Do the customers see the organization's prices as being in line or out of line with the value of its offer?
  • Does the organization use promotional pricing effectively?
• Distribution
  • What are the distribution objectives and strategies?
  • Is there adequate market coverage and service?
  • Should the organization consider changing its degree of reliance on distributors, sales reps, and direct selling?
• Advertising, Sales Promotion, and Public Relations
  • What are the organization's advertising objectives? Are they sound?
  • Is the right amount being spent on advertising? How is the budget determined?
  • Are the ad themes and copy effective? What do customers and the public think about the advertising?
  • Are the advertising media well chosen?
  • Is sales promotion used effectively?
  • Is there a well-conceived public relations program?
• Sales Force
  • What are the organization's sales force objectives?
  • Is the sales force large enough to accomplish the organization's objectives?
  • Is the sales force organized along the proper principle(s) of specialization (territory, market, product)?
  • Does the sales force show high morale, ability, and effort? Are they sufficiently trained and incentivized?
  • Are the procedures adequate for setting quotas and evaluating performances?
  • How is the organization's sales force perceived in relation to competitors ' sales forces?

• What do we mean by supporting and maintaining behavior change?

• What types of behavior changes may require support?

• What are barriers to taking action and changing behavior?

• How do you address barriers and support action?

• What are barriers to maintaining behavior change?

• How do you support behavior over time?

Deciding to change a behavior is often only the beginning. People may understand the benefits of a behavior and genuinely want to act, yet still encounter practical, financial, social, health-related, or structural barriers that make action difficult.

For example, a person who wants to stop smoking may benefit from evidence-based cessation medication, counseling, quitline support, digital tools, encouragement from others, or a combination of approaches. The difficulty of quitting does not mean that the person lacks motivation or self-discipline. Nicotine dependence, withdrawal, stress, social environments, routines, access to treatment, and other factors can all affect the process.

Similarly, someone working toward nutrition, physical activity, or other health goals may need more than information or motivation. Time, cost, chronic health conditions, neighborhood conditions, food access, caregiving, work schedules, stress, disability access, and other factors can affect whether a behavior can be initiated and sustained.

Effective social marketing therefore does more than encourage people to act. It also considers what capability, opportunity, services, resources, environments, relationships, and ongoing support are needed to make beneficial behavior realistic over time.

What do we mean by supporting and maintaining behavior change?

Supporting behavior change means helping create the conditions that make action possible. Support may involve information, skills, services, treatment, financial assistance, accessible environments, transportation, reminders, technology, social support, changes in organizational practice, or policy changes.

Maintaining behavior change means supporting beneficial behavior after it has begun. Maintenance does not necessarily mean that a person must perform a behavior perfectly or continuously for the rest of life.

Behaviors may change as people's health, responsibilities, environments, resources, relationships, and priorities change. Some people may experience lapses or recurrence and later re-engage. A useful strategy helps people continue, adapt, or resume beneficial behavior rather than treating anything short of uninterrupted performance as failure.

Contemporary behavioral approaches often consider the interaction among:

• Capability: Does the person have the knowledge, skills, physical ability, and psychological capacity needed?
• Opportunity: Do the person's environment, resources, services, relationships, and circumstances make the behavior possible?
• Motivation: Does the person see value in the behavior, intend to act, and have habits or expectations that support it?

Social marketing can use this kind of analysis alongside audience research, exchange, competition, social influence, service design, and other approaches.

What types of behavior changes may require support?

Behaviors differ in how frequently they must occur and how long support may be needed. The categories below can be useful for planning, although not every behavior fits neatly into one category.

One-time actions

Some goals require a single action.

Examples might include:

• Registering for a service
• Installing a smoke or carbon-monoxide alarm
• Making a disaster-relief contribution
• Completing an advance directive

People may need information, transportation, assistance completing forms, financial support, accessibility accommodations, or other help to take the initial action. Follow-up may also be appropriate even when the behavior itself does not need to be repeated.

Repeated but time-limited actions

Other goals require several actions over a defined period.

Examples may include:

• Completing a workforce or educational certificate program
• Participating in a scheduled series of health or rehabilitation appointments
• Completing a multistep application or enrollment process
• Participating in a time-limited community project

Support may need to continue throughout the entire process. A person who can attend the first session but cannot obtain transportation for later sessions has not been adequately supported simply because participation began successfully.

Ongoing behaviors and practices

Some beneficial behaviors are practiced repeatedly over long periods.

Examples might include:

• Maintaining tobacco cessation
• Participating in regular physical activity appropriate to one's health and ability
• Following a sustainable nutrition plan
• Conserving energy or reducing household waste
• Participating regularly in civic or community activities
• Following an ongoing treatment or self-management plan developed with appropriate health professionals

Long-term support may involve habits, social networks, services, environmental changes, treatment, reminders, feedback, and opportunities to adapt the behavior as circumstances change.

Recurring or context-dependent behaviors

Some behaviors are needed only when particular situations occur.

Examples might include:

• Using a seat belt on each vehicle trip
• Arranging a sober driver or alternative transportation when alcohol will be used
• Using appropriate safer-sex and sexually transmitted infection prevention practices
• Following emergency or safety procedures when a relevant situation occurs

These behaviors may require preparation, reminders, access to necessary resources, supportive norms, and an environment in which the safer choice is practical.

What are barriers to taking action and changing behavior?

Barriers vary substantially by behavior, audience, community, and environment. Formative research can help identify which barriers actually matter rather than assuming the answer.

The behavior is inaccessible or infeasible under current conditions

A person may want to act but lack a realistic opportunity.

Barriers may include:

• Transportation and geography. Services may be too far away, public transportation may be inadequate, routes may be unsafe, or travel may take too much time.
• Financial barriers. Fees, transportation, childcare, equipment, lost work time, insurance limitations, or other costs may make participation unaffordable.
• Service availability. The necessary treatment, program, equipment, professional, medication, class, or other resource may not be available.
• Waiting times. A technically available service may function as an unavailable service if waiting lists are extremely long.
• Disability access. Physical spaces, transportation, websites, communication, or program procedures may be inaccessible.
• Language access. Interpretation, translation, or appropriate multilingual services may be unavailable.
• Caregiving responsibilities. Childcare or dependent-care needs may prevent participation.
• Scheduling. Service hours may conflict with work, school, caregiving, religious observances, transportation schedules, or other responsibilities.
• Safety. People may face unsafe transportation routes, interpersonal violence, harassment, or other threats.

These are not failures of individual motivation. They are conditions the intervention should attempt to change whenever possible.

The behavior or process is unnecessarily complex

Programs may require too many forms, appointments, steps, passwords, approvals, instructions, or unfamiliar skills.

Complexity may come from poor service design rather than from the abilities of participants.

Ask:

• Can steps be eliminated?
• Can information be written more clearly?
• Can several requirements be completed at one time?
• Can staff provide navigation or technical assistance?
• Can people practice unfamiliar skills before being expected to use them independently?
• Are language, literacy, disability, or technology needs being accommodated?

People need additional capability or support

Some behaviors require skills, treatment, practice, confidence, or continuing professional or peer support.

Examples include:

• Managing nicotine dependence
• Learning a new job skill
• Learning to use unfamiliar technology
• Developing communication or conflict-resolution skills
• Managing a chronic health condition
• Building a new routine

Avoid framing these situations as a simple lack of willpower or self-discipline.

The behavior requires substantial time or competes with other responsibilities

Time burdens may include:

• Long individual sessions
• Frequent recurring appointments
• Long travel time
• Extended training requirements
• Competing employment or caregiving demands
• A long delay before meaningful benefits appear

Do not assume that people who decline a time-intensive activity lack commitment. The program may need to become more flexible.

The behavior is not currently a priority

People may understand an issue and still decide that another need is more urgent.

A person worried about housing, food, employment, safety, caregiving, debt, or health may reasonably prioritize those needs over the behavior your organization is promoting.

Formative research can help determine whether:

• The benefits are unclear
• The behavior appears irrelevant
• More urgent needs are competing for attention
• People disagree with the proposed goal
• The service or intervention itself needs to change

The answer should not automatically be to persuade people that your priority is more important than theirs.

Remembering or organizing repeated action is difficult

People may intend to act but forget because of competing responsibilities, stress, complex schedules, cognitive load, unfamiliar routines, or other factors.

Examples include:

• Missing appointments
• Forgetting medication
• Forgetting exercises recommended as part of rehabilitation
• Forgetting administrative deadlines

Design systems that make remembering easier rather than assuming that forgetting reflects a lack of concern.

How do you address barriers and support action?

Improve access

When transportation or geography is a barrier, consider:

• Providing or subsidizing transportation
• Offering services at additional community locations
• Using mobile services
• Providing home-based services when appropriate
• Using telehealth, video conferencing, online learning, messaging, or other remote options when appropriate and accessible
• Coordinating services so people need fewer separate trips

Remote services are not automatically accessible. Consider broadband, devices, privacy, digital literacy, disability access, language access, and people's preferences.

Reduce financial barriers

Possible approaches include:

• Reducing or eliminating fees
• Providing sliding-scale options
• Providing transportation, childcare, dependent-care support, equipment, or necessary supplies
• Obtaining grants or other funding
• Sharing facilities, equipment, or services with partner organizations
• Using donated or refurbished resources when they are safe, appropriate, and reliable

Be cautious about reducing the quality or completeness of a service simply to increase the number of participants. Consider whether a lower-cost model still provides meaningful benefit and meets appropriate standards.

Expand unavailable services or resources

If the necessary service does not exist or does not have enough capacity, consider:

• Expanding your own service
• Partnering with another organization
• Creating referral relationships
• Developing community-based or remote alternatives
• Training additional providers or facilitators
• Advocating for funding, policy changes, or additional public services

Long waiting lists and service shortages may be evidence that systems need additional capacity rather than that people need stronger motivation.

Make services and environments accessible

Consider:

• Physical accessibility
• Accessible websites and digital tools
• Interpretation and translation
• Plain-language communication
• Childcare and dependent-care support
• Privacy
• Transportation
• Scheduling
• Cultural responsiveness
• Respectful treatment by staff

Simplify complex tasks

If a behavior requires several unfamiliar steps:

• Remove unnecessary requirements
• Break the process into manageable steps
• Provide foundational information first
• Demonstrate skills
• Allow practice
• Use plain language and visual instructions
• Provide navigation or coaching
• Make help available when people encounter problems

Complexity should not be treated as evidence that participants lack intelligence or education. Often the process itself needs redesign.

Provide appropriate support

Different behaviors require different kinds of support.

Options may include:

• Individual counseling
• Group counseling
• Peer-support or mutual-help groups
• Mentoring or coaching
• Evidence-based medication or clinical treatment when appropriate
• Telephone quitlines or helplines
• Text messaging
• Secure online or app-based support
• Classes and skills training
• Community health workers or navigators
• Family or social support when the participant wants it

For tobacco cessation, for example, evidence-based medications and behavioral counseling can each help adults quit smoking, and using them together generally provides the strongest support.

Avoid assuming that a particular mutual-help program, counseling model, medication, or support group is right for everyone.

Reduce time burden

Consider:

• Shorter sessions
• Flexible scheduling
• Evening or weekend options
• Remote participation
• Drop-in options
• Combining appointments or services
• Breaking long-term goals into manageable milestones

Clarifying the actual time commitment can be helpful when people have inaccurate expectations, but do not dismiss a time burden that participants identify as real.

Understand why the behavior is not a priority

If people are not interested in the behavior, ask why before developing a stronger promotional campaign.

You may learn that:

• The proposed benefit is not meaningful
• The behavior does not address the problem people care about
• More immediate needs take priority
• People distrust the organization
• The service is inconvenient or inaccessible
• People understand the proposal and simply disagree with it

Provide accurate information and explain relevance when needed, but respect informed disagreement and autonomy.

Use reminders thoughtfully

Reminders may include:

• Calendar reminders
• Text or app notifications
• Automated phone calls
• Pill organizers or medication-management tools
• Appointment reminders
• Visual cues
• Habit-linked routines
• Peer or family reminders when the participant wants them

Ask permission before using reminders that could disclose sensitive information. Consider privacy, frequency, accessibility, and whether people can easily opt out.

What are barriers to maintaining behavior change?

Initiating a behavior does not guarantee that the same behavior will remain feasible, useful, or desirable over time.

Maintenance can be affected by changing health, stress, work, finances, caregiving, services, relationships, environments, motivation, habits, and unexpected consequences.

Expectations and outcomes do not match

People may stop a behavior when:

• Expected benefits do not appear as quickly as anticipated
• Benefits are difficult to observe
• Benefits are primarily long-term
• The behavior is intended to prevent an outcome, so success is difficult to see directly
• The original expectations were unrealistic

Set realistic expectations from the beginning and identify meaningful ways to monitor progress when possible.

Negative consequences are greater than expected

The behavior or intervention may produce burdens or side effects that were underestimated or not anticipated.

Examples might include:

• Medication side effects
• Physical discomfort
• Increased costs
• Work or scheduling problems
• Stress
• Conflict within relationships
• Stigma

When health care is involved, changes to medication or treatment should be discussed with an appropriate health professional rather than managed through a social marketing campaign alone.

Social environments do not support the behavior

Friends, family members, coworkers, peers, community norms, workplaces, and institutions may make maintenance easier or harder.

Social support can help, but do not assume participants should involve family or community members when doing so would compromise privacy, autonomy, or safety.

Services or systems stop supporting the behavior

Maintenance may become difficult because:

• Services end
• Insurance coverage changes
• Transportation disappears
• Work schedules change
• Childcare becomes unavailable
• Program hours change
• Supplies become unavailable
• Digital tools become inaccessible
• Staff relationships change

Maintenance strategies should therefore address the reliability of the surrounding system, not merely personal motivation.

The behavior becomes more difficult

Stress, illness, injury, changing responsibilities, cravings, changes in mental health, fatigue, or other circumstances can affect capability and motivation.

Build flexibility into the plan so that people can adjust rather than viewing any disruption as failure.

Lapses or recurrence occur

Some behaviors involve periods in which a person returns temporarily or repeatedly to a previous behavior.

This can occur in tobacco cessation, substance-use recovery, physical activity, nutrition, medication routines, and many other areas.

A lapse does not necessarily erase previous progress. Help people identify what changed, what they learned, what additional support is needed, and how they want to proceed.

For smoking cessation, for example, people may make more than one quit attempt. Current guidance encourages people who have tried before to continue trying and to use effective treatments and support.

How do you support behavior over time?

Anticipate potential barriers

Use formative research, previous program experience, evidence, and conversations with participants and community partners to anticipate what might interfere with maintenance.

Consider:

• Changes in motivation
• Changes in access
• Financial barriers
• Stress
• Changes in health
• Social influences
• Service interruptions
• Expected and unexpected side effects
• Changes in work or caregiving

Be transparent about benefits, burdens, and uncertainty

People should receive accurate information about:

• Likely benefits
• Possible risks or side effects
• How long meaningful results may take
• What support is available
• What options exist if the first strategy does not work
• What remains uncertain

Avoid overstating likely results simply to motivate participation.

Set realistic expectations

Unrealistically high expectations can make normal progress feel like failure.

Establish goals and benchmarks appropriate to the behavior, the evidence, and the individual's circumstances.

Health-related goals should be individualized with appropriate clinical guidance when needed rather than relying on universal targets.

Make progress visible when appropriate

Feedback can help people understand whether their efforts are producing benefits.

Examples may include:

• Tracking personally meaningful health or activity measures
• Tracking financial savings
• Recognizing completed milestones
• Sharing community-level environmental improvements
• Reporting what donations or volunteer efforts accomplished

Avoid excessive monitoring or measures that increase anxiety, stigma, or unhealthy behavior. Use measures appropriate to the individual and the goal.

Provide continuing support

Continuing support may include:

• Counseling
• Clinical treatment
• Follow-up appointments
• Peer support
• Coaching
• Mentoring
• Quitlines or helplines
• Text or app-based support
• Community health workers
• Skill-building opportunities
• Family or social support when wanted

Support should match the behavior and the person's needs rather than assuming one model works for everyone.

Maintain supportive systems and environments

If the environment that enabled the behavior disappears, maintenance becomes harder.

Organizations should consider whether they can sustain:

• Affordable services
• Transportation
• Childcare
• Accessible facilities
• Appropriate hours
• Language access
• Clinical or professional support
• Safe environments
• Equipment or supplies
• Follow-up communication

Plan for setbacks and changing circumstances

Ask in advance:

• What might make the behavior difficult later?
• What early signs would indicate that additional support is needed?
• What alternatives are available?
• Who can the participant contact?
• How can the plan be adapted?

Avoid all-or-nothing thinking. If a person cannot maintain the original plan, an adapted form of the behavior may still provide meaningful benefit.

Respond to negative consequences

Do not simply encourage people to tolerate consequences that are serious, harmful, or unacceptable.

Instead:

• Investigate what is happening
• Provide accurate information
• Modify the intervention when possible
• Offer alternative services or strategies
• Refer to appropriate professionals
• Address organizational or environmental causes

For medication or other clinical issues, encourage participants to consult an appropriate health professional.

Engage supportive relationships when participants want them

Family members, peers, clinicians, community health workers, coaches, and other people may help sustain behavior.

Ask participants which relationships are helpful rather than assuming who should be involved.

In situations involving controlling, unsafe, or abusive relationships, prioritize safety and appropriate survivor-centered support rather than attempting to gain the other person's approval of the behavior change.

Use incentives carefully

Financial or nonfinancial incentives can support participation or particular behaviors in some settings.

Consider:

• Whether the incentive is evidence-informed
• Whether it is proportionate
• Whether it creates inappropriate pressure
• Whether benefits continue after the incentive ends
• Whether the incentive is distributed equitably

Do not assume that behavior supported by an external incentive is automatically less meaningful or less likely to last. Evaluate what happens in the specific program and whether other supports and enabling conditions remain in place.

Continue formative research and evaluation

Maintenance should be evaluated rather than assumed.

Ask:

• Are people continuing the behavior?
• What makes continuation easier?
• What makes it harder?
• Have circumstances changed?
• Are services and supports still accessible?
• Are some groups experiencing greater barriers?
• Are unexpected harms or burdens occurring?
• What adaptations would participants find useful?

Use what you learn to improve the intervention rather than simply intensifying messages telling people to continue.

In Summary

Beneficial behavior change often involves two related challenges: making action possible in the first place and creating conditions that help people sustain, adapt, or resume the behavior over time.

Barriers to action may involve transportation, cost, service availability, disability access, language access, caregiving, safety, complexity, time, skills, health needs, competing priorities, memory, or other circumstances. These barriers should not be reduced to a lack of motivation or self-discipline.

Organizations can respond by improving services and environments, reducing financial and logistical burdens, simplifying processes, building capability, providing evidence-based treatment or support where appropriate, and making beneficial actions easier to integrate into people's lives.

Maintenance also depends on realistic expectations, meaningful benefits, continued access, supportive environments, changing circumstances, social relationships, and the ability to respond to lapses or setbacks. A return to a previous behavior does not necessarily erase progress or mean that an intervention has failed.

Social marketing should therefore support people rather than simply persuade them. Listen to participants, identify what actually makes behavior possible, provide honest information, strengthen capability and opportunity, address structural barriers, and continue adapting the strategy as people's circumstances and community conditions change.

___You have conducted, and will continue to conduct, market research to find out what factors are likely to get in the way of the target population's making and maintaining the desired changes, whose opinions they value, and what kinds of support they need in order to accomplish and maintain the desired behavior changes.

Providing support for action:

___You address the issues that make action impossible by providing transportation or changing location to deal with geography; reducing or subsidizing costs; making the unavailable available; or changing circumstances.

___You address actions that are too complex by simplifying them to the extent possible .

___You address actions that are too hard by providing support to people to help them through difficult behavior change.

___You minimize the importance of the time element by more efficient and more creative and flexible planning and scheduling.

___You increase the target population's perception of the urgency of the desired behavior change.

___You institutionalize reminders, so that people are less likely to forget to take action.

Providing support for maintaining change:

___You use market research to monitor the target population's satisfaction with the changes they've made.

___You try to anticipate and plan for any possible negative consequences of change .

___You are totally honest with the target population about possible negative consequences of change, and about what can be done about them.

___You address unsatisfactory consequences by helping to adjust unrealistic expectations ; making hard-to-detect outcomes visible or adjusting change to improve outcomes; making deferred outcomes easier to live with by establishing benchmarks and breaking them down into a series of reachable goals; and using your marketing message to discuss the consequences of lack of the presence of those events or circumstances the changes are meant to prevent.

___You address excessive negative consequences by trying to prepare people for them beforehand, by helping them acquire tools - skills, education, training, information - to deal with them, and by formulating alternatives to them.

___You deal with negative feedback from important people by marketing change to those people as well.

___You address behavior control that is less than expected by creating systems that provide support and help people develop their internal resources.

Tool # 1: Chart of barriers to action and strategies for removing them

Barriers to Action

Strategies for Removing Barriers

Action is impossible because circumstances won't permit it. The necessary action is too complex. The action is too hard for people to undertake on their own. The action takes too much time. The action isn't important to the target population. The action is regularly forgotten.

Address the issues that make action impossible (change the circumstances). Simplify the action, either by breaking it down into manageable pieces, or by providing the background necessary to understand it. Support people - with support groups, mentoring, etc. - in taking difficult action . Use more efficient or more creative and flexible planning and scheduling. Use marketing to increase the urgency of the action in the target population's perception. Institutionalize reminders so that people can remember to act.

 

Tool #2: Chart of barriers to maintaining change and strategies for removing them

Barriers to Maintaining Change

Strategies for Removing Barriers

The consequences are unsatisfactory: Unrealistic expectations aren't met Outcomes are hard to detect Outcomes are deferred Outcomes are hard to see because they're the absence of something There are excessive negative consequences, either greater than anticipated, or unexpected. Influential people give negative feedback about the change. Behavior control is less than expected because of the system or the self.

For unsatisfactory consequences: Clarify realistic expectations Make the invisible visible, or adjust behavior to obtain the desired results Break along-term goal up into manageable pieces, with benchmarks Emphasize the consequences of the presence of what you're trying to prevent Help people control negative consequences with information, alternative plans, and skills. Market to influential people as well as the target population from the outset. Set up the system to provide support and to help develop internal personal resources .