Friday, October 3, 2008

Hilton Hotel-Conference Headquarters

Brighton beach activity

Word Social Marketing Conference Presentation 30Sep08

Address to World Conference on Social Marketing
Brighton, England September 30, 2008

Towards a US National Strategy for Social Marketing in Public Health:
Is the US Ready for a Community of Practice?

Robert Marshall, PhD, Rhode Island Department of Health
Clinical Associate Professor of Community Health, Brown University

Good morning everyone, and thank you for that kind introduction. Also, I would like to express my appreciation to the conference hosts, the National Social Marketing Center in London for the invitation to address this group and tell you about the status and plans for social marketing in the US—especially in this time of change.

This morning I want to talk about the need for and some key elements in a US national strategy for social marketing and present some preliminary data from a web-hosted survey about a professional association for social marketing practitioners in the US—following the “community of practice” approach (Wenger, 1998).

The key elements draw from the published literature and from work produced by other groups, including our colleagues in the National Social Marketing Center. They include: a clear definition of the field, some benchmarks to distinguish the practice from other approaches to changing human behavior, the nature of the profession (exclusive or participative), the need for a professional organization, the role of applied research., the need for funding streams, training, a strategic national plan and finally, the role of federal policy.

To borrow a phrase from my colleague, Jeff French, what is “driving” the process of change in the US? Many things, but let me mention a few examples: reports on the status of US health, movements to reform health care AND transform health, the US Presidential election and the US financial meltdown (I am uncertain how this will affect public health, but it probably won’t be good!!!)

The Milken Foundation, a private organization, was established in 1982 “to discover and advance inventive and effective ways of helping people help themselves and lead productive and satisfying lives.” Milken produced a report in 2007 laying out the burden of chronic disease and the choices we have as a nation. The avoidable treatment costs and “output losses” by 2023 are staggering: $1.1 trillion in direct and indirect losses, not to mention the $5.7 trillion impact (-17.6%) on GDP by 2050. I don’t know about you, but when people start talking about “trillions of dollars”, I begin to worry – a lot!!!

Milken recommends good health as an investment in economic growth, a new effort to promote prevention and early detection, and most of all, a national commitment to ‘healthy body weight.”
If the foregoing sounds familiar, it should. I learned about much of it from the National Social Marketing Center. During the summer of 2007, my wife and I spent 6 weeks in London, through a Fulbright Senior Specialist scholarship, working with the Center and Kings College London, looking at social marketing as a “best practice.” Again to borrow from Jeff (both the thoughts and the slides), England went through a process of reports predicting the effect of chronic disease and health behaviors on the National Health Service. This was followed by Choosing Health (2004) proposing a social marketing approach to health in a consumer society. Why social marketing? Because of its inherently democratic principles, the shift away from expert elites and towards consumer choice and a track-record of successful application across the world.

The National Consumer’s Council in England followed this with a review of social marketing finding (1) that other current approaches are unlikely to deliver the required policy goals, (2) that there is potential to use available recources and mobilize assets more effectively (3) that social marketing can improve impact and effectiveness (4) that social marketing capacity and capability are currently under-developed. I submit that these conclusions are no less applicable to the United States and probably to many of the nations represented at this conference. So here again, the parallels between England and the US were astounding. But the situation is not identical.

In fact, I found two different models, or rather two differential fulfillments of the model that social marketing offers to public health. First (and this is just my personal perspective) England has a very strong head-start on the policy, standards, credentialing and funding streams end of the social marketing continuum. Clive Blair-Stevens from the NSMC reminded me this morning that this systematic building of key elements is described as “strategic social marketing.” How appropriate (given the current weather) that I should characterize this as an “umbrella.”

The US, on the other hand, has less of a policy focus and more of a well-spring of social marketing capability in applied research and in prevention research centers, such as the one at the University of South Florida; education through several university training programs in social marketing and the collection of “best practices” through “grass roots“ project and demonstrations at the federal, state and local public health agency level.

The point here is NOT (necessarily) that one is further along than the other, but that both nations seem to be following the same model, starting at different places and facing national challenges driving them in the same direction. I wonder how many other delegates here recognize this situation as one characterized in their own nation? (A retorical question only, but worth thinking about.) So why not combine the elements of the two experiences into a comprehensive strategy or model for social marketing?

A group of us looked at the US situation from this perspective and understood that we could not realistically anticipate a “national policy relying exclusively on a social marketing approach” to transform the nation’s health, but that we did need an American equivalent of the National Social Marketing Center in England, to drive the process forward and provide a supportive infrastructure—in other words, a professional association.

Our ad hoc group (including Jay Bernhardt, Mike Rothschild, Carol Bryant, Craig Lefebvre and many others) charted out some next steps, and then hosted a discussion session at the 2008 National Conference on Social Marketing in Clearwater, FL. Functioning as a sort of “professional focus group” with pre-established questions and invited participants (in addition to other interested professionals) the group hit on several themes about the size of the tent (who should be in the association), the national/international scope, the definition of social marketing, a stand-alone or affiliated organization and other topics. In true social marketing fashion, the next step involved an audience survey—meaning a web-based survey sent to potential respondents such as at the Georgetown Social Marketing listserv subscriber, attendees at the 2008 Health Marketing Conference and the 2008 National Conference on Social Marketing and many others.
Over the past couple of weeks, 300 respondents completed and submitted the survey on-line. As you can see, they are mostly female, career and executive/manger level professional representing universities, government and non-profit, private agencies. Most were seasoned professionals in public health working in health communication, social marketing and health promotion. They also had a lot to say in the various comments sections at the end of the survey—data that we haven’t yet analyzed.

The overwhelming percentage of respondents expressed interest in a professional social marketing organization as a place to network, exchange science and practice information, and gain training, but there was not much interest in “competencies,” a “clear identity” or “recognition” for social marketing as a field, as benefits of joining. Most wanted a world-wide professional organization, although many commented that they understood that there would have to be national and/or regional organizations first. Respondents wanted a moderate broad focus on social marketing and closely related fields—not just social marketing itself. They also wanted to include public health communication, health promotion and education, environment and environmental health, eHealth communication and media/journalism in the mix of fields.
Most indicated a preference for a stand-alone organization, even though many wanted to be affiliated with the APHA, SOPHE or other well-known American organizations. Finally, respondents were interested in a voluntary credentialing process that is based on a core-competency approach—despite a previous lack of interest in competencies as a “benefit” of joining. Understanding what this means will take more analysis of the data.

So the “take away” message is that respondents want to include a range of others, value the networking and other benefits, want to fit into a global community of practitioners, focus on related fields in a stand-alone organization with a core-competency based credentialing process.
We plan to keep the website active for a few more weeks and gather more data. Next we will do more analysis by looking at responses by career level, primary field, practice organization and other characteristics to find out if there are segments that respond differently—such as new vs. more experienced professionals. Then we plan to share this information with the social marketing community, organize a steering group and move forward with developing an organizational strategy, source of support, develop a plan and seek partnerships.

We sincerely hope that each of you, our global colleagues, will monitor our progress and provide advice and examples along the way. This meeting demonstrates that in spite of our cultural and national differences, human nature is the same across the globe, that people everywhere want good health for themselves and their families and that using an approach that begins with the wants and needs (or what I call “hopes and dreams”) of the people we serve is the best way to promote a safe and healthy world for all.

Thank you.