can social marketing be a force for good?

PowerPoint Presentation

Can social marketing be a force for good in tackling the burden of disease?

Blaise Connolly, Senior Partnerships Manager, Public Health England

We know the power that marketing can have in influencing behaviour. Public health marketing is not about getting people to spend more money, but helping them to make the right decisions to live a healthier and longer life .

In the PHE marketing team, our role is to change the behaviours of individuals, families, workforces, communities and businesses, so that it becomes easier forus all to live healthier, longer and more fulfilled lives. We do this by: Gaining insight into why people behave as they do Deploying learning from the behavioural sciences to change behaviour Understanding the needs of local communities Developing impactful creative campaigns Making innovative use of new digital communications channels Mining data, to anticipate peoples needs and to measure impact1

The ContextThe AudienceThe Role of Marketing The Brand and The LaunchResults so farThe NHSThe AskQuestions Agenda

On 7 March 2016, for the first time, Public Health England launched a new campaign that talks to adults directly about all of the things they could do to improve their health in one place

This was the most significant new health campaign to launch in the last eight years, since Change4Life

The scale of the campaign is unprecedented and will become the friendly voice of adult health across England

Today I will talk to you about how we developed this new brand, how partners across the NHS are using it in their work, and how you can get involved

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The ContextThe AudienceThe Role of Marketing The Brand and The LaunchResults so farThe NHSThe AskQuestions Agenda

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1. https://www.england.nhs.uk/ourwork/futurenhs/deliver-forward-view/sop/red-prem-mort/php/ 2. NHS England Enhancing Quality of Life for People with LTCs 3. Living Well for Longer HM Government 2014

The cost of illness resulting from health inequality is in excess of 5.5 billion per year

PHE Global Burden of Disease report showed that lifestyle factors drive poor health outcomes, with diet overtaking smoking for the first time There is a social gradient in lifestyle illness, with lower socioeconomic groups suffering disproportionatelyThe gap between the most deprived and least deprived areas of England shows little sign of reducing.THE CASE FOR PREVENTION

The latest data suggests 40% of all deaths in England are caused by modern day lifestyle choices, costing the NHS more than 11 billion annually. Smoking is still the biggest single cause of preventable death and ill-health within England and costs the NHS an estimated 2billion per year. Physical inactivity causes an estimated 17% of premature mortality in the UK and moderate obesity reduces life expectancy by an average of three years.

Helping adults make better choices today can have a huge influence on health, and could prevent conditions like type 2 diabetes, cancer and heart disease, and reduce the risk of suffering a stroke or living with dementia, disability and frailty in later life.4

The ground swell

If the nation fails to get serious about prevention then recent progress in healthy life expectancies will stall, health inequalities will widen, and our ability to fund beneficial new treatments will be crowded-out by the need to spend billions of pounds on wholly avoidable illnessNHS 5 year forward view October 2014/15

Many problems that we have assumed to be due to ageingresearch now proves to be due to loss of fitness, preventable disease and loss of moraleSod 70 foreword by Sally Davies Chief Medical Officer NICE identifies the 40-60 year age group as a key window of opportunity to engage adults in their own health to prevent disease in later lifeDisability, Dementia and frailty in later life. Midlife approaches to prevention

The evidence from NICE, the World Health Organisation and others show that the loss of ability typically associated with ageing is only loosely related to a persons chronological age. There is no typical older person.A longer life is an incredibly valuable resource. It provides the opportunity for rethinking not just what older age might be, but how our whole lives might unfold.Yet the extent of the opportunities that arise from increasing longevity will depend heavily on one key factor: health. If people are experiencing these extra years of life in good health, their ability to do the things they value will be little difference from that of a younger person. If these added years are dominated by declines in physical and mental capacity, the implications for older people and for society are much more negative.

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The ContextThe AudienceThe Role of Marketing The Brand and The LaunchResults so farThe NHSThe AskQuestions

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40-60 years age group is a key window of opportunity to engage adults in their own health to prevent diseases in late yearsCore

C2DE 40-60 year oldsTotal 40-60 year oldsTotal adults (18+)

NICE has identified those aged between 40-60 as being a key window of opportunity to engage adults in their own health to prevent diseases in late years.

C2DE 40-60 years olds 6,948,000Total 40-60 years olds 15,222,000Total adults (18+) 44,659,366

Health is not just linked to the health service. Life expectancy and premature mortality rates vary across the country higher rates are strongly linked to socioeconomic deprivation. The focus on people within the C2DE social grade helps address this inequality.

Attitudes to health from our audienceStrong sense of community Not wanting to stand out TraditionPut needs of others before their own providersFinancial pressures add stress to their livesWork patterns make planning and routine difficultUnhealthy living is gradually normalisedMixed messaging around health encourages stasisDelayed gratification: disengaging with future consequencesThe future is abstract

Social and community norms reinforce unhealthy behaviours, as going for a run or eating differently from those around you would negatively stand out while denying food would seem impolite. Although many recognise that being overweight is a sign that they are unhealthy, equally overweight friends normalise it and make it hard to recognise unhealthy living.Stay away from faddy health marketing, but they also end-up wedded to their traditional roles and are unwilling to change; distinction between genders.Sandwich generation; their own well-being is neglected; over-catering and having well-stocked cupboards; they live through their children.Debt and low pay mean having to work extra shifts; long-term stress; limit their ability to gain control over their health.Low skilled shift work; high stress with little reward; irregular shift patterns make setting new routines difficult; this means they are reactive about life rather than proactive; diets consist mostly of ready meals and frozen food; exercise is avoided; they seek rewards; alcohol and tobacco become vices.More concerned with the impact on today; many do not engage with this as equally overweight friends normalise it and make it hard to recognise unhealthy living; others absorb size into personalityContradictory marketing leads to lack of confidence in their own assessment; want quick fix solutions, but know that these are unlikely to work; only measure of health that can be trusted is a doctor.Can only plan for the week ahead; future in a piecemeal, rather than in a holistic manner; health is important in the future but only as a determinant of the age they will die.8

The ContextThe AudienceThe Role of Marketing The Brand and The LaunchResults so farThe NHS The AskQuestions

Public health marketing campaigns are a key way of helping people to help themselves to live healthier for longer. In doing so they will contribute to not only the sustainability of the NHS, but greatly enhance the quality of life for millions of adults in this country.

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The role of marketing

Currently a large proportion of adults in this country believe they will get old and infirm and they will die soon after, so deteriorating quality of life does not matter

This is a dangerous assumption

The average life expectancy for men is 80 years and women it is 83 years

So in reality you are going to get old and live a long, time. How well you live in later life is largely up to you. Our ambition is to reframe ageing and make change easier, more desirable and more achievable.

To do this we needed to create a brand and a campaign powerful enough that people would come to us and want to engage.

Our budgets were smaller than we would traditionally have thrown at an ambition as grand as this therefore more than ever, its about partnership, creativity and content not the perfect 30 second TV ad.

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The ContextThe AudienceThe Role of Marketing The Brand and The LaunchResults so far The NHS The AskQuestions

Key insight: in order to value your health you need to value yourself.

The target audience has de-prioritised their own health and perceives that its just too difficult to change (many have tried and failed)

The campaign needed to reframe the value of health provide positive messages about why its important, and;Reframe the way to health provide support that makes change easier and more manageable

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Working over the past 12 months with the target audience to develop a brand that really cuts through and encourages reappraisal, three major rounds of consumer testing

One You brand performed very strongly throughout testing. People intuitively understood what it meant:

Simple colour palette uses teal as the lead colour, and yellow as the secondary tint (hints of NHS/C4L suggests health to people without screaming it)

Distinctive typographical approach uses two fonts, and manages to be both authoritative (really clear, straight font) and friendly (handwritten font emphasises the positive and talks to you direct)

The feel is straight-talking and sympathetic.

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The meaning people take from the brand is threefold:

Theres only one you - you matter (important for an audience that deprioritises its health)You only get one chance - sense of jeopardyPositivity its in your power to make a change.One You is an ally there to motivate and support with new hints, tips, tools and programmes to help you get back to the real you. 13

A focus on the critical behavioursChecking yourselfMoving more

Being smokefreeEating wellManaging stressSleeping better

Drinking lessNHS Atlas of Risk (http://www.nhs.uk/Tools/Pages/NHSAtlasofrisk.aspx)Notes: Causes of death based on deaths registered in England 2007; risk factors based in attributable factors from WHOWorld Health Report 2002 and HSCIC on smoking 2006Global Burden of Disease Changes in health in England Analysis by region and areas of deprivation 1990-2013 Professor John Newton, Chief Knowledge Officer, Public Health England, September 2015.

Top searched topics on NHS Choices

One You helps adults avoid preventable death and future disease caused by lifestyle factors. These are everyday habits and behaviours, such as eating too much unhealthy food, drinking more than is recommended, continuing to smoke and not being active enough. The NHS spends more that 11bn a year on treating illnesses caused by the effects of diet, inactivity, smoking and drinking alcohol.How to improve sleep and how to reduce stress levels are some of the most searched for terms on the NHS choices website. While there are no quick-fix cures for stress or sleeping trouble, eating a better diet, exercising and drinking less alcohol can help.Many people sleepwalk gradually into ill health. Taking a small amount of time periodically to monitor our own health is vital.

One You will be there to help you tackle one or all of the things that could help you live a little bit more healthily, every day

Prompting the reappraisal moment at launch

Part of the One You offer is the How are you quiz which is a health related marketing quiz (not a medical or clinical diagnostic tool) that starts a conversation about an individuals health, lets people know how theyre doing and drives to product(s) they can use to change behaviours.

We promoted How Are You through all of the national advertising during the launch of One You and beyond.

First part of the quiz focuses on the broad question how are you? - asking a person to choose between different statements on a slider e.g. lean and mean vs fat and flabby / down in the dumps vs over the moon.

Or what stops you taking care of your self highlight relevant icons e.g. I dont have the time, I dont have the money.

Top health priorities have more energy, fit into my jeans, feel young etc.

The next set of questions then starts to work through the key behaviours. E.g. smoking, do you?, how many? Frequency?

The output of these questions are the results and we deliver users with an overall score out of 10 and red, amber, green score on the individual behaviours.16

Eating wellChecking yourself

Support for the behaviours

DRINK TRACKER APPACTIVITY APPWEBSITEMoving more

Being smokefreeManaging stressSleeping better

Drinking less

QUIT APP

EASY MEALS APP

Support in a variety of ways

Driving people to take the How Are You? quizServing up apps and activities Snackable content on all the key behavioursPartner offersLinks to content from partners and on NHS ChoicesClick through to Local Authority hubs17

The ContextThe AudienceThe Role of Marketing The Brand and The LaunchResults so far The NHSThe AskQuestions

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NHS organisations are an integral part of One You.

We set out to build a flexible brand that could be used locally to inspire change and engagement with community-led services, helping patients and local residents address the One You key behaviours.

Weve seen a wide range of responses, from face to face One You events, to buying out-of-home advertising to support the launch, to the complete rebranding of services.

Many local authorities have used One You insights and assets to overhaultheir corporate public health web pages and create a clearer route for residentsinto local services and national digital products. As well as signposting throughprimary care services, the NHS has also supported in its capacity as amajor employer.19

The nhs and one you

Kent Community Health NHS Trust Foundation is a great example of localised messaging and incorporating the One You tone of voice across their channels. They have used a personal approach and balanced local imagery with the national campaign identity to make One You really feel like it belongs in Kent.

Torbay and South Devon NHS Foundation Trust run the Healthy Lifestyles Service in Torbay and South Devon. They have recently rebranded this service as One You Torbay offering support across all of the seven core lifestyle behaviours that are covered by the One You campaign.

Pennine Care NHS Foundation Trust are commissioned to run Tamesides Health and Wellbeing service. They have recently been reconfigured to include smoking cessation support, weight management, physical activity and community health development activity. They have used the One You brand to create a coherent offer for local residents.

Hounslows One You service is delivered in partnership by the Council and Hounslow and Richmond Community Healthcare Trust. Its team of Health Advisors help local residents to move more, eat well, drink less alcohol and be smoke free. It also provides information on how local people can reduce their stress levels and sleep better. 20

The nhs and one you

Lots of support through social media21


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The ask

Order free one you resources

Co-brand services with one you

We have created a bespoke tool kit for use in hospitals or GP Surgeries. This contains posters, conversation starter leaflets and guide on how One You can help start conversations with patients about healthier lifestyle changes. Visit our Campaign Resource Centre to order yours today.

There are also opportunities where we feel One You can support NHS organisations by co-branding.These are:1. Internally One You can be used either as an over-arching brand for workplace well-being or as a supporting brand where the NHS organisation already has itsown recognised health and well-being campaign in place for staff. 2. Externally One You can be used as a co-brand where a local authority has commissioned an NHS organisation to run health and well-being services for thepublic. It will be up to the local authority commissioning the service to decide if the One You brand is applied to their service communications.23


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