social marketing recommendations · 2020. 10. 1. · washington state department of health | social...

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Social Marketing RecommendationsC+C | Washington State Department of HealthSeptember 2020

Table of Contents

Executive Summary C

Social Marketing Overview 11

Background 15

Step 1: Purpose, Goals & Objectives 17

Step 2: Behavior Change 19

Step 3: Priority Audience 28

Step 4: Research 31

Step 5: Barriers, Benefits & Motivators 37

Step 6: Message Strategy 48

Step 7: Social Marketing Intervention 53

Step 8: Partnerships 64

Step 9: Marketing Plan 68

Step 10: Evaluation Plan 82

Appendix 1: Social Marketing Planning Process Timeline 85

Appendix 2: Secondary Research Sources 89

Appendix 3: Topline Research Results 99

Executive Summary

1WASHINGTON STATE DEPARTMENT OF HEALTH | SOCIAL MARKETING RECOMMENDATIONS

The Washington State Department of Health (DOH) has funded this project with the intention of developing strategic community-based social marketing recommendations designed to motivate Washington residents to adopt specific behaviors that will help flatten the Coronavirus (COVID-19) curve, and help them protect themselves, their families, and their community from contracting and spreading COVID-19.

This process was instigated by the COVID-19 Public Outreach Campaign team at DOH. The DOH team worked hand-in-hand with a team of social marketing experts to conduct this research and complete the planning process.

The process was organized around 10 planning steps used in social marketing. The team used a combination of secondary research, primary research and social marketing planning principles to arrive at the recommendations. The 10 steps and key findings around each step are outlined in the chart below:

STEP 1 What is Success? Identify Purpose, Goals & Objectives

Purpose: Save lives and reduce serious illness related to COVID-19.

Goal: Flatten the curve of COVID-related deaths and illness in Washington.

Objectives: Increase levels of protective behaviors.

SUMMARY OFFINDINGS

STEP 2 The What. Identify the Desired Behavior Change

• Wear a mask when not at home

• Gather with 5 people or less, avoid inside locations

• Keep six feet away from others

• Wash or sanitize hands before, during & after being in public

SUMMARY OFFINDINGS

STEP 3 The Who. Choose and Prioritize Audiences

• Young adults (18-24)

• People with conservative values (18-45)

SUMMARY OFFINDINGS


STEP 4 Stop, Look and Listen. Conducting Research

• Secondary research review

• Primary qualitative research

• Monitoring of ongoing WA state quantitative research sources

SUMMARY OFFINDINGS

STEP 5 Why They Do What They Do. Map Barriers, Benefits and Motivations

• Key Barriers: Justifications, implicit social contracts, seeking relief from anxiety and depression, inconsistent information, physical discomfort, messenger outweighs the message, venue influences, behavior not worth the impact on society, think they are doing it right

• Key Benefits: Help end the pandemic, social acceptance, first-hand personal experiences, living their values

• Key Motivators: Protecting others, peer pressure, real people/real stories

SUMMARY OFFINDINGS

STEP 6 What’s the Hook? Create an Effective Message Strategy

• Address “justifications” & “excuses”

• Create formula messaging/visual: three behaviors, together

• Create social norming + thank you message

• Utilize “not forever, but for now” more

• Focus on motivation of protecting others including: “It’s not worth betting someone’s life…”

• Give people help and resources to make good choices (behavior help hub)

• Use real people and real stories to communicate messages

SUMMARY OFFINDINGS


STEP 7 The How.Plan your Social Marketing Intervention

• Commitments: Add a three-behavior pledge.

• Social norms: Share information about how many people have adopted behaviors.

• Prompts: Provide signage and other materials for mandates, three behaviors, pledge and social norms in partner toolkits.

• Social diffusion for people to make good choices and add to partner toolkit.

• Communications: Disseminate messaging and information about tools through strategies outlined in the marketing plan.

• Incentives: Encourage partners to give out campaign-branded masks and sanitizer.

• Convenience: Encourage partners to make it easy for people to practice the behaviors by setting up things like hand sanitizing stations.

• Feedback/recognition: Thank people for doing the behaviors, report back on how many people have taken the pledge.

• Mandates: Encourage policy-makers to continue mandates and partners to enforce rules.

SUMMARY OFFINDINGS

STEP 8 Who Else Can Help? Identify and Enlist Partners

Continue existing partnerships and expand partner network.Provide partners with tools, engage them with new components of the campaign (social norming and pledge) and offer training and support for implementation.

SUMMARY OFFINDINGS


STEP 9 Chart the Right Path.Develop a Marketing Plan

Marketing Strategies:• Build commitments

• Behavior-help hub

• Partner campaign toolkit

• Media relations

• Paid advertising

• Organic social media

• Influencer outreach

SUMMARY OFFINDINGS

STEP 10 Are We There Yet? Create an Evaluation Plan

Inputs: Resources allocated to the campaign

Outputs: Program activities conducted

Outcomes: Behavior adoption measured through quantitative surveys and observation

Impact: Changes in the curve (cases, hospitalizations, deaths)

SUMMARY OFFINDINGS


Several significant themes emerged during this project. These themes combined with social marketing behavioral science principles led us to the recommendations outlined in this document. The section below summarizes these themes, as well as our recommended tools and strategies.

We have the foundation for a social norm:Most people in Washington report doing the desired behaviors of wearing a mask, staying six feet apart, gathering in small groups and washing/sanitizing hands, most of the time.

Incorporate social norm and a “thank you” strategy into the campaign: Notifying people that most others are doing these behaviors and thanking people for complying, can be a powerful strategy to get others to adopt the behaviors: e.g. “XX% of Washingtonians are wearing a mask. Thank you!”

People are justifying when they don’t do the behaviors:People are making excuses for why they don’t need to practice the behaviors and justifying that there are other factors that reduce the risk, therefore making it okay to not comply in certain settings. “It’s okay…

…if we are not 6 feet apart if we are outside.”

…to gather in a large group if it’s with family.”

…to not wear a mask if other people are not wearing them.”

Address justifications & excuses head on: Address the justifications/excuses head on in the statewide campaign messaging (e.g. “COVID-19 LOVES excuses”).

What We Learned

What We Learned

What We Recommend

What We Recommend

SPREAD OUTEven in the great outdoors

Even if you’re wearing masksEven if everyone feels healthy

6 feet

MASK UPEven if it’s uncomfortable

Even if it fogs up your glassesEven if others aren’t

KEEP GROUPS SMALL

Even with family & friendsEven if it’s your birthdayEven if you’re outdoors


People are picking and choosing which behaviors to follow:While there is high self-reported compliance with the desired behaviors, people are not doing them all together. They don’t see the behaviors as a package. They think doing one or two of the behaviors is enough and pick and choose which behaviors to follow: “If I wear a mask, I don’t need to be six feet apart.”

Add a commitment/pledge component to the campaign that communicates that all three behaviors must be done together: Make the three behaviors into a formula with the message and a simple visual that they must be done together. Make this idea into a commitment strategy (see below) that asks people to take a pledge. This pledge campaign would be the cornerstone of a new partner toolkit and would be included in the statewide campaign.

Why Commitments?One of the most documented ways to develop new social norms is

to seek public and durable commitments. A commitment is when

someone agrees to or pledges to do a behavior. Behavioral science

indicates that the act of making the commitment makes it more likely

that a person will follow through with the behavior. The more public

and durable the commitment, the more effective it is likely to be.

Commitments that are public are visible to others in the community,

while durable commitments are witnessable for a long period of time.

Commitments that include feedback are even

more effective. Feedback involves providing

people that took the pledge with recognition

of their efforts and a report back on how many

others also pledged so that they hear about the

cumulative impact and feel a part of a social norm.

Bonus:

6 feet

DISTANCEMASK

SMALLGATHERINGS I PLEDGE

TO FIGHT COVID THREE WAYS EVERY DAY

What We Learned

What We Recommend


People want this over with:We learned that one of the strongest motivators for both audiences was the very strong desire to have the pandemic end. This was coupled with people’s willingness to engage in behaviors that they don’t like if they believe it will help get this over sooner. “Not forever, but for now” resonated very well with research participants in terms of tapping into this motivation.

Incorporate “Not forever, but for now” more widely in the campaign: Giving people hope that there is an end and that they can be part of the solution is tapping into a key emotional motivator that should both drive behavior change and help sustain behaviors that people are already doing.

People are more motivated by protecting others than protecting one’s self:Of the motivators uncovered in the research, the strongest emotional hook involved people’s strong desire to protect others. People do not want to be responsible for making someone else sick. This was true for protection of family and friends but also more generally around protecting others in the community who are vulnerable. “It’s not worth betting someone’s life…” was a phrase that had a strong impact when tested among participants.

Focus more on the motivator of “protecting others”: The idea of protecting others should be prioritized over protecting one’s self in messaging. Incorporate “It’s not worth betting someone’s life…” or other messaging that focuses on the protection of others into campaigns.

What We Learned

What We Learned

What We Recommend

What We Recommend


Implicit social contracts can overcome even the best intentions:Strong barriers for both audience groups were implicit social contracts and peer pressure.

For young adults, they are uncomfortable practicing behaviors if they do not see others doing them and are unlikely to ask their peers to change their behaviors. These social contracts also come into play in family settings – they feel pressure to act in ways that are expected of them by their family members. For people with conservative values, they want to do the right thing and follow the rules – for them it is part of being a good citizen and community member. However, they will also conform based on how their peers are acting.

Utilize commitments, norms and educational tools to address social contracts: Influencing social contracts and overcoming peer pressure is very challenging. We recommend using a three-pronged strategy to help overcome implicit social contracts:

› Creating a commitment to the three-behaviors

› Fostering social norms through normative messaging and partner outreach

› Providing tools and education regarding gatherings to help people make good decisions and stick with their decisions in the moment

If young adults enter a situation with the intent of practicing the desired behaviors, they will often change their minds if they see that others are not practicing them.

Similarly, if people with conservative values go to a setting with their peers and do not see others practicing the behaviors, many will be influenced to change their behaviors to conform with what they see others doing.

What We Learned

What We Recommend


The messenger matters:The research conducted demonstrated that who the messenger is matters for both audience groups. Some of the population is wary of COVID-19 messages due to distrust and inconsistent information (they note that the advice keeps changing). There is also some concern that there is an “agenda” behind the messages. These audiences responded best to local, trusted messengers in their referent groups (friends/family, people they work/go to school with, people in their geographic vicinity). In particular, young adults want to hear from their peers. People with conservative values want to hear from local, trusted people in their community network.

Use a diversity of messengers in the campaign: Wherever possible, include real people and local voices. Share real people’s stories and experiences related to COVID-19. This will help increase the believability of and trust in the messages.

Partnerships work:The trust in referent groups can be leveraged through partnerships. The DOH leadership team has developed many partners for the COVID-19 outreach campaign. These partnerships have had a significant impact on getting messages out to key priority audiences across the state including local health jurisdictions and vulnerable communities. DOH has also partnered with business and other state agencies to disseminate information through their networks and existing communications channels.

Continue the “one to many” strategy: Partnerships should continue to be used to help amplify the impact of the campaign as we deploy the social marketing strategies. We recommend

What We Learned

What We Learned

What We Recommend

What We Recommend


continuing to leverage existing partnerships that reach people in their communities while also creating new partnerships. This will be key in helping disseminate the messages and tools that come from the social marketing recommendations.

Washing/sanitizing hands is already a habit: Washing/sanitizing hands before, during and after being out in public was perceived differently than the other key behaviors in the study. There are not strong barriers except for the physical ones (no washroom or sanitizer on hand). And, people think they already do this behavior.

Do not include washing/sanitizing hands as one of the priority behaviors for the social marketing campaign.

Mandates are effective: Mandates are driving behavior change. People want to follow the rules and are community-minded about doing their part and being a good citizen. If there is a mandate, they do not necessarily need to understand why or agree – they will follow the rules.

Mandates should continue to be part of the behavior change strategy: We recommend that policymakers continue the use of mandates like stay at home orders and masking. Part of the campaign strategy should continue to be to encourage partners to post reminder signage and enforce rules.

What We Learned

What We Learned

What We Recommend

What We Recommend

Social Marketing Overview


The practice of social marketing is built on a significant base of research that shows awareness and education alone rarely change behaviors. Instead, strategies that aim to overcome barriers and provide people with personal, relevant motivators to act must be used to create meaningful, sustainable behavior change. This approach will increase the efficiency and effectiveness of marketing efforts by identifying the specific behaviors that must change to achieve a program’s goals, segmenting audiences based on who has the highest probability of changing the desired behavior (or who is not yet participating), and addressing the barriers to behavior change while also ensuring that an audience is sufficiently motivated to act.

The following recommendations describes how community-based social marketing can be used to overcome barriers and motivate residents to adopt behaviors that will reduce the risk of spreading COVID-19. This 10-step process, used in developing social marketing campaigns, was used by the team in this recommendations document.

Step #1: Identify project purpose, goals and objectives. Develop a road-map for the project, with a focus on defining what success looks like, including measurable objectives.

Step #2: Identify desired behavior changes. Determine the specific desired behavior changes that are the most direct path to achieving the program’s goals. This is often done by mapping which behaviors have the highest impact on the goal and the highest probability of change.

Step #3: Define priority audiences. Define the priority audiences that are likely to be most receptive to changing their behaviors.

Step #4: Research. Good campaigns and materials are grounded in research. Research should be used to understand priority audiences’ current actions and identify what they think and feel about the subject matter and behaviors.

Step #5: Identify barriers, benefits and motivations for the desired behavior changes. Once you know what behaviors you want people to adopt, the next step is to analyze the barriers that are preventing them from doing the desired behaviors, and the possible benefits and motivators that could overcome those barriers. Motivation can be increased in several ways including incentives or by speaking to what people find beneficial (e.g., protecting those we love, being a good citizen). This is a key part of the process and one that often provides a reality check. If the motivators for a particular behavior change are not strong enough to overcome the barriers, we will want to re-think that behavior change. The goal here is to set you up for success—pick the achievable behaviors and focus your efforts there.


Step #6: Create a messaging strategy. A succinct and compelling message strategy is critical to help ensure the success of social marketing efforts. We live in a world where the average person is exposed to between 2,000 and 3,000 marketing messages each day. We have about three-to-five seconds to catch someone’s attention so that they continue reading or viewing to learn more. In this step it is important to identify key value propositions and messaging to motivate the desired change.

Step #7: Social Marketing Intervention. This step is the culmination of the process where we prioritize and choose what social marketing tools will work best to influence behaviors among the priority audience groups. Sample tools are listed and explained later in this section.

Step #8: Identify partners. Partnerships can help create demand for a program by providing access to a larger audience, incentives for program participants and adding credibility to the cause. Good potential partners have a complementary mission and audiences that overlap with the campaign’s priority audiences.

Step #9: Develop a Marketing plan. A fully developed marketing plan is crucial to the success of social marketing efforts. This plan shares how to operationalize the social marketing tools, deliver the program’s message to the priority audiences, and define the outreach strategies and tactics that will deliver on the program’s goals and objectives. It is often advised to launch a social marketing program with a pilot campaign so that feedback on effectiveness can be gathered prior to broad-scale implementation.

Step #10: Create an evaluation plan. The evaluation plan is designed to track the program’s progress, celebrate successes and make necessary changes along the way. It includes measurements of campaign inputs, outputs, outcomes, return on investment and overall campaign impact.


Based on research in psychology and other social sciences, community-based social marketing has identified a set of tools for promoting behavior change. These tools are often most effective when used in combination with one another. The tools include:

Commitments – Making a commitment to change a behavior makes it more likely that people will follow through.

Social Norms – People will change their behaviors if they believe everyone else has done so.

Social Diffusion – Peer and referent groups spread behavior change through conversations, interactions and observation of each other.

Prompts – Placing reminders to act as close to the location of behavior as possible (for example, floor signage showing six feet of distance in public, or mobile/text prompts).

Communication – Seeks to capture attention, overcome barriers with motivators and highlight benefits. Disseminate through channels that reach priority audiences.

Incentives – Providing a tool or discount that helps overcome a barrier to trying the behavior.

Convenience – Making it easy to do the behavior (for example, providing free masks and sanitizing stations in public locations).

Recognition/Feedback – People want to know that their behavior is making a difference. Report back with messages like, “XX% of people or groups have committed to do the behavior” or “Thank you, you helped flatten the curve.”

The process described above is scaled to the scope of each program. No matter the scale or scope of the campaign, the essence of the planning process is to clarify the objectives and how we will measure success, identify the target audiences most likely to act, create messaging that cuts through the clutter, and create a plan to deliver that messaging at the right time, in the right place. These basic steps ensure that outreach and communications efforts have the maximum impact possible for the resources invested.

Background


DOH has been conducting a suite of comprehensive strategies to address the COVID-19 pandemic. These strategies have included policies, partnerships, local support and a statewide education campaign. The education campaign was launched in March of 2020 and continues today. The goal of the campaign has been to educate residents about COVID-19 and encourage behaviors that protect people and the community. Throughout this effort, DOH has employed social marketing principles when possible in the creation of materials and messaging in addition to principles from community engagement and risk communication. However, they realized that the urgent need to get messaging to residents created challenges in doing all steps of a social marketing process in the development of the campaign. To help address this, DOH created a parallel social marketing planning effort for the campaign so that they could employ research and social marketing planning alongside the implementation of the campaign.

This report is the culmination of a 2-month social marketing process which included 10 weekly planning sessions with core members of the social marketing team including DOH experts Laura Blaske, Kristen Haley and Lydia Guy-Ortiz and industry social marketing experts including Doug McKenzie-Mohr, Nancy Lee and Julie Colehour.

Appendix 1 includes a detailed look at the process used to create these recommendations.

Step 1:Purpose, Goals & Objectives


The DOH team established the following guiding framework for the campaign:

OBJECTIVESIncrease Levels

of ProtectiveBehaviors

Social marketing campaigns are designed to have an impact by

identifying and influencing behaviors that will contribute to

achieving campaign goals. For this campaign, we will set

objectives around each of the selected behaviors.

This goal statement expresses, more concretely, the positive

impact the campaign is intended to achieve. For this

campaign, the goal is to “flatten the curve” related to the

number of COVID-19 cases, deaths, and hospitalizations.

PURPOSE

GOALFlatten the Curveof COVID-RelatedDeaths & Illnesses

in WA State

Save Lives andReduce SeriousIllness Relatedto COVID-19

This purpose statement answers the questions,

“What is the potential impact of

a successful campaign?”

“Why are we doing this?”

Step 2:Behavior Change


Based on input from DOH and the review of the secondary research, the following behaviors were chosen for this research project:

› Wear a mask when not at home;

› Gather with 5 people or less, avoid inside locations;

› Keep six feet away from others; and

› Wash or sanitize hands before, during & after being in public

In social marketing, it is important to realize that many behaviors can be divided into distinct steps that people must take to get to the end-state desired behavior.

For example, to get someone to wear a mask, they must first have the intent/desire to do so, then get/purchase a mask, remember to bring it when they leave home, remember to put it on, wear it properly and then ideally either dispose of it or wash it before they use it again.

Each of these decision points is a potential place where the behavioral chain can break down. Social marketing can be used at various points to help ensure people stay on the path to the desired behavior. In this example, an overarching strategy might involve using commitments to build intent to wear a mask, providing free masks (incentives), prompts to remind people to wear the mask and communications to educate about disposal and washing.

The behavior chain maps on following pages outline the steps for each of the four behaviors that were part of this process. They are color coded to indicate which social marketing tool could be deployed at various steps in the chain.

Intent towear amask

Get orpurchasea mask

Rememberto bring

from home

Rememberto put it on

Wear itproperly

Dispose ofor wash it

#1

#2

#3 #4

#5

#6

To get someone to wear a mask, there are many steps:

COVID-19Behavior Chains


Intent

Dispose

Wash

Acquire mask

Research price & location

Place in specific locations

Remember to use when

guests in home

Remember to take when

leaving home

Return masks to place(s)

Donation Wear mask

Purchase online

Transport to store

Commitment Prompt Communications Incentive

Wear a mask around other people (you don’t live with): EVERYONE



Intent

Separate group, leave, cancel

Enjoy!

Enjoy!

Invite people

Research & make a

plan**

If >5 people arrive

If 5 or less people arrive

Arrange outdoor or

indoor seating 6ft apart

Travel/Attend*

Host

Gather with five people or less: HOST

*Pack accordingly (Mask, hand sanitizer, etc.)

**Additional considerations: Bathroom access, the formula,

temperature checks, etc.



Intent Travel*


Enjoy!

Accept an invite/assist

with planning/research**

If >5 people arrive


Attend

Gather with five people or less: GUEST/PARTICIPANT/ADULT






Intent


Enjoy!

If >5 people arrive


Attend

Gather with five people or less: GUEST/PARTICIPANT/YOUNG ADULT




Invite people

Make a plan

Research

Show up somewhere

Spontaneously gather


Intent

Maintain

Maintain

Maintain

Maintain

Maintain

Understand*

Establish 6ft distance


Follow guidance

Follow guidance


Prompted

Not prompted

Enforce distance

Advocate for space

Advocate for space

Stay home, with visitors

Leave house


Keep at least 6 ft apart: EVERYONE

Public

Errands & Social:

Recreation

Wor

kpla

ce

Social: Private

*Understand• 6ft spacing• When applicable• Where applicable

Advocate for space• Research how• Practice what to

say


Intent Refill

Acquire hand

sanitizer

Research price & location

Place in specific

location(s)

Remember to use when exposed to

surfaces

Remember to take when

leaving home

Donation

Repeat as needed

Purchase online

Transport to store


Wash or sanitize hands before, during & after being in public: EVERYONE

Stored in the home

Stored in the car/purse/

external

Opportunity: More hand

sanitizing stations in public places

Step 3: Priority Audience


The team conducted a secondary research review to identify the priority audience in terms of demographics, behaviors and attitudes. Our initial findings indicated that there were two types of audiences:

› Those who may require structural or policy interventions, such as WA residents with poor social determinants of health, essential workers, front line workers, those with multi-generational family care responsibilities, and those living in high-density (urban) areas.

› Those who may require communication-based interventions, such as people with a low level of health literacy and people who have the ability to follow COVID-19 prevention behaviors, but don’t.

The secondary research indicated that the following attributes were more likely to characterize those who have the ability to follow COVID-19 prevention behaviors, but don’t:

› People with conservative values (white, young men in particular)

› Single men

› Young adults (18 – 24)

› People living in counties with fewer cases

Based on these findings, the team set out learn more about the attitudes of young adults (18 – 24) and people with conservative values (18-45) relative to COVID-19 and the key behaviors.

We found that young adults (18 – 24):

› Have suffered significant disruption in lifestyle during COVID-19

› Require social connections to feel secure about their identity and place in the world (developmentally)

› Feel that adults have not protected them from serious threats such as climate change, school shootings and mental health

› Are in a mental health crisis – 50 percent have depression/anxiety and suicide is the #2 cause of death

› Complied early with key behaviors because they felt a sense of “togetherness” to defeat COVID-19

› Have concerns about the impact of COVID-19 on their education

› Are more concerned about the impact of COVID-19 on loved ones and American society than themselves


We found that people with conservative values:

› Have a strong sense of personal freedom

› Feel a responsibility and are motivated to help those who they think have made sacrifices for the community (police, firefighters, healthcare workers, veterans)

› More often misunderstand and are misinformed about how the virus and protective measures work than other populations surveyed

› Men in this group tend to see wearing a mask as shameful, not cool, a sign of weakness and a stigma

› Are very community minded, They want to do their part to help protect their community.

These attitudes help to explain why these audiences are less likely to comply with the behaviors. Based on this analysis we selected these two audiences as the subjects for the primary research:

› People with conservative values (18 – 45)

› Young adults (18 – 24)

In both cases the audience represents people who have “intent” or “receptivity” to practice the behaviors, but who need support to overcome the barriers and give them tools to help them practice the desired behaviors. We do not recommend focusing on the audience groups who do not have intent. For these groups, mandates, rules and fines should be considered.

Audiences Chosen for Qualitative Research:

• People with conservative values (18-45)

• Young adults (18-24)

Step 4: Research


SECONDARY RESEARCH APPROACHThe team first conducted an extensive secondary research review with the objectives of:

› Defining the priority audience

› Identifying key behaviors

› Understanding barriers and motivators that should be tested

We used the following types of sources during the secondary research review:

› Government data and research

› Academic research

› Public health and health behavior studies

› Various consumer polls and message testing results

An extensive list of sources used can be found in Appendix 2. The research was conducted at the beginning the project, but we have continued to evaluate sources on an ongoing basis. The Gates Foundation polling has been particularly helpful in tracking behavior adoption in Washington state.

PRIMARY RESEARCH

ObjectiveThe objective of the primary research was to understand barriers and potential motivations to complying with COVID-19 safe behaviors among the two priority audiences.

In a way that:

› Drives clarity about if/how barriers andmotivations are different for the twoaudiences and key behaviors

› Helps to assess which barriers andmotivations are strongest by audience and key behavior

› Provides direction for messaging context, tone and feel for both audiences

› Provides insight into how likely the audience segments would be to changetheir behavior

Understand barriers and potential motivations to complying with COVID-19 safe behaviors among the two priority audiences.


Respondent Recruitment & ProfilesThe team contracted with Focus Vision to manage the recruitment of respondents by using a screener that was written based on the priority audience descriptions.

PEOPLE WITH CONSERVATIVE VALUES (N=26)

1 African American/Black, 1 Hispanic/Latinx, 2 Asian, 2 Pacific Islander

YOUNG ADULTS, 18-24 (N=21)

1 African American/Black, 2 Hispanic/Latinx, 3 Asian, 1 Pacific Islander

To ensure research respondents had relevant behaviors/experiences, all respondents had to report that they:

› Leave their home two times a week or more for things other than work

› Do not always comply with the key behaviors

One lesson learned during this project was that our initial screening criteria around frequency of the behaviors was too narrow and was not delivering us sufficient respondents for the study. We loosened the criteria to allow respondents who said they sometimes did the behaviors, enabling us to recruit the diverse group we were seeking.

Rural Urban & Suburban

Values Men Women Men Women

Conservative 2 3 4 4

Liberal 0 3 3 3

Rural Urban & Suburban

Values Men Women Men Women

Conservative 2 3 4 4

Liberal 0 3 3 3


MethodologyModerators conducted a 4-day, online qualitative research study with 47 research participants using the Revelation™ platform. Each respondent was expected to spend 30 – 45 minutes per day completing the research activities.

Because the topic of compliance with key COVID-19 safety behaviors can be emotionally charged, the research was conducted as a series of one-on-one discussions. The research firm compensated respondents who completed all research activities with a payment of $150.

Quick-Turn ApproachA high priority for this research project was being able to review research results as quickly as possible. To enable this, the team conducted respondent recruitment and research simultaneously. Instead of recruiting all the respondents before conducting the research, as soon as a respondent agreed to participate, they were brought onto the research platform and commenced interaction with the moderators.

Each week, for three weeks, the team reviewed the findings with WA DOH and the social marketing team. This process is illustrated below.

APPROACH DIAGRAM

Week 0

Week 1

Week 2

Week 3

Week 4

Week 5

• Screener written and approved

• Discussion guide written, approved an uploaded

• First topline

• Second wave of respondents complete research activities

• Executive summary presentation

• Wrap-up loose ends with respondents

• Second topline

• Third wave of respondents complete research activities

• Start recruitment

• First wave of respondents complete research activities


Research ActivitiesTo meet all the research objectives, a discussion guide was crafted that included 4-days of research activities. These activities were designed to keep respondents engaged while providing insights that met the research objectives. The diagram below summarizes the type of research activities throughout the four days.

TOP 9 KEY FINDINGS UNCOVERED IN THE RESEARCH1. People want this over with: People know about the desired behaviors and

they want to do the right thing. Both audiences are really tired of COVID-19 and they just want it to be over so things can go back to “normal.” Believing that the behaviors will help end this is a strong motivator.

2. People are justifying: When people from both audiences don’t comply with the behaviors, they justify why. They are thinking about compliance to multiple behaviors in terms of perceived risk, and seem to use their own “formula” for determining which behaviors to comply with in any given situation.

3. Wearing masks has a strong emotional toll: Wearing masks makes people from both audiences feel bad because it’s hard to communicate verbally and via facial expressions. Masks are also physically uncomfortable, which was another strong barrier for both audiences.

4. Long distance is tough: Physical distancing is also a difficult behavior emotionally, although not as difficult as wearing masks. Both audiences are somewhat accepting of this behavior and have used it in relation to other viruses. However, they justify not complying with physical distancing with close friends and family members they don’t live with.

5. Washing/sanitizing hands is already a habit: Washing/sanitizing hands before, during and after being out in public is perceived differently than the other key behaviors in this study. There are not strong barriers except

DAY 1 DAYS 2 & 3 DAY 4

› Introductions

› Current attitudes about key behaviors

› Situational analysis of their own compliance with key behaviors

Response to 3 ads per audience

› Informative

› Relevant

› Believable

› Engaging

› Motivating

For 3 Key Behaviors

› Self-assessment of barriers – which ones best reflect their perspective

› Projective techniques to drive out more potential barriers and motivations


for the physical ones (no washroom or sanitizer on hand). And, people think they already do this behavior – it’s something that is expected when fighting a virus.

6. Don’t underestimate peer pressure: Implicit social contracts and peer pressure are the strongest barriers for young adults but also exist for people with conservative values. These social contracts exist within families and among friend groups. People want to see that others are complying with the key behaviors, and that they are not outliers. This is both a barrier and a potential motivator for both audiences.

7. Lack of trust is preventing adoption: Barriers that are stronger among people with conservative values are inconsistent information that is driving doubt; a lack of trust in the messengers, which leads to feeling manipulated; and the belief that the behaviors aren’t worth the cost to society.

8. Mandates work: People with conservative values are motivated by mandates – they tend to be rule followers, and will comply with a mandate because they want to be a good citizen even if they don’t agree with the behavior.

9. Using a variety of messaging tones is effective: The audiences reacted differently to different messaging tactics. People with conservative values reacted well to the straightforward educational style of messaging. Young adults react well when the messaging and visuals are crafted for them and are empathetic to how they are feeling. Scary messages are polarizing – some react well, others are turned off.

The topline research results can be found in Appendix 3.

Step 5: Barriers, Benefits& Motivators


To successfully foster behavior change, it is critical that for the priority audience, the benefits of doing the desired behavior outweigh the costs or barriers to doing it. The primary research sought to gain an understanding of the priority audiences’ perceived barriers, benefits, and motivators as a key to designing the right interventions to motivate behavior change.

BarriersThe barriers that emerged from the primary research fell into one of three categories:

1. Barriers that are founded in social constructs, attitudes and beliefs. These barriers tended to exist within both young adults and people with conservative values, however not necessarily with the same intensity.

2. Barriers that are circumstantial in nature. These barriers had more to do with the limitations of the immediate surroundings.

3. Barriers that are related to personal judgement or habits.

CATEGORY 1: Barriers Founded in Social Constructs, Attitudes and Beliefs

The following barriers are those that are founded in social constructs, attitudes and beliefs.

JustificationResearch respondents know the behaviors they should be doing to help reduce the spread of COVID-19. They do care and have heard the message about what they are supposed to do. However, they are often confused about the combination of the behaviors and factors driving the right decision.

They tend to justify or make an excuse when they are not doing a key behavior.

They do this by assessing a scenario to determine what they think is acceptable behavior based on the following factors:

› Who is there? Are they people I know? Will they judge me or accept me? Do I think they have been “following the rules?”

› Am I inside or outside?

› What are other people doing? Are they wearing masks and physical distancing?


› Size of crowd?

› What does the physical space enable/allow?

› Is there a mandate in this space?

Three patterns of justification emerged:

The ‘pick two’ rule When I’m inside, I can pick two out of three.

WEAR A MASK

PHYSICAL DISTANCE

GATHER IN SMALLER GROUPS

Balancing Behaviors They know all of the factors below are important, and they pick a few to do.

LOCATION Outside is better than inside.

PHYSICAL DISTANCE Keep six feet apart.

MASKS Wear them!

CROWD SIZE Five people or less / small groups.

Familiarity When I’m with people I know I can relax the rules.

FRIENDS Those in my immediate “bubble.”

FAMILY Immediate and extended.

1

2

3


Implicit Social ContractsA social contract is the idea that a person’s moral and/or political obligations are dependent upon an actual or hypothetical contract or agreement among the members of a society. An implicit social contract is an unspoken social contract. Implicit social contracts exist in friend groups, families, and broader communities.

Young adults in particular don’t typically have an explicit conversation before they congregate to determine their group’s ‘moral obligation’ relative to the key behaviors – they assume that others in their friend group will share their own position on the necessity of complying with all key behaviors. When a member of a friend group sees others not complying with key behaviors, they assume the whole group is aligned. They are reticent to speak out against their peers because:

› Challenging friends risks rejection;

› They don’t want to hurt others’ feelings;

› They want to demonstrate trust and support for their friends;

› They don’t want to stand out in a crowd as the outlier, drawing unwanted attention; and

› They don’t want to be rude, which breaks a broader societal contract.

Families have their own unique social contracts and structures. These can be based on long-held family traditions, religious influences, cultural norms, and the immediate communities’ expectations of familial roles and responsibilities. Family members’ interactions are often influenced by these implicit social contracts. Research respondents found it hard to conform to key behaviors at family functions because:

› Milestone celebrations are hard to avoid without being seen as disrespectful, especially to elders in the family;

› Saying no to family risks rejection from our first and strongest social bonds; and

› In fact, often times the expectation is that family obligations outweigh personal choices.

Finally, broader community social contracts can be a barrier to complying with key behaviors. For example, in our research we saw less resistance to physical distancing and washing/sanitizing hands because both of those behaviors are seen

Implicit social contracts exist both among peer groups and within families.


as “normal” ways to stop the spread of a virus. Wearing a mask is a new behavior in the U.S., and that contributes to some people’s skepticism. Breaking with the norms of a community is a barrier because it can result in:

› Being ostracized;

› Labeled as rude; and

› Alienation from some members of the group.

Seeking Relief from Anxiety and DepressionThe changes to how we socialize due to COVID-19 are causing people to feel social isolation. All three key behaviors studied with young adults (wearing masks, physically distancing and gathering with five people or less, outside) contribute to social isolation and can be particularly hard on young adults, who have a developmental need for social interaction.

› MASKS: Make it hard to read facial expressions and to share a smile

› PHYSICALLY DISTANCING: People are missing physical touch with friends and family

› GATHERING WITH FIVE OR LESS, OUTSIDE: Choosing who to meet with among friends is stressful

Research respondents reported feeling elevated levels of anxiety and depression. Thus, seeking relief from anxiety and depression is a barrier to complying with the key behaviors.

Inconsistent InformationThe confluence of the evolution of scientific information and communications with vastly different information from a variety of so-called experts results in people hearing inconsistent information about all aspects of COVID-19. Respondents also say they trust scientific information, but they simply don’t know what sources to trust to bring them the most accurate scientific information. Many of the studies they hear seem to contradict each other.

These inconsistencies cause research respondents to feel skeptical about the validity of information and confused about what they really need to do relative to the key behaviors. Even seemingly reliable sources of information change recommendations over time.

Physical distancing is particularly hard on young adults who have a developmental need for social interaction.


The Messenger Outweighs the MessageMany respondents, especially people with conservative values, think that COVID-19 is being politicized. They believe that communications regarding COVID-19 are being leveraged by politicians/political parties to meet their own agendas. Some have commented that COVID-19 is being used to distract people from other, more important issues. This leaves many research respondents feeling manipulated.

A number of research respondents have also expressed that the way these new measures (especially wearing masks) are being implemented puts their rights at risk.

The Behaviors are not Worth the Impact on SocietyResearch respondents expressed concern that the impact of doing the key behaviors for this extended time will have a detrimental effect on the “American Psyche” and our way of life. Specific issues that were raised include:

› The current atmosphere of fear is unhealthy and contributing to divisive conversations;

› The absence of normal social interactions is doing harm to people’s mental health; and

› The consequences on the economy, particularly local and small businesses.

This barrier was raised by both young adults and people with conservative values. However, it seemed more intense among people with conservative values.

CATEGORY 2: Circumstantial Barriers

The following barriers are those that are circumstantial in nature.

Physical DiscomfortSome of the key behaviors have potential to cause physical discomfort.

› Wearing masks makes it hard to breathe, and can cause skin issues

› Washing/sanitizing hands can cause them to be chapped

People with conservative values trust science, but inconsistencies in information and messengers perceived as untrustworthy makes it hard for them to know if the science being reported is true.


› A number of people also expressed concern that they would hurt their immune system by over-washing

› Physical distancing can be uncomfortable when there is limited space, for example, in a narrow aisle of a store

Venue InfluencesThere are times when the location or venue has limitations that make it difficult to comply. Specific examples include:

› When passing others on a narrow hiking trail there might not be enough room to remain six feet apart

› Some venues may be set up in a way that makes physical distancing difficult

› Some venues don’t have restrooms available for hand washing

› Some venues don’t make sanitizer available

Other People’s BehaviorSome respondents commented that how other people behave when they, themselves, are complying can be problematic. For example:

› There are times when other people don’t seem to make an effort at physical distancing, and it takes two;

› When other people aren’t wearing masks, it makes some respondents feel like the mask they are wearing is pointless; and

› If someone goes to a social event that was supposed to be a small group, but more people show up, it’s not always easy to leave or take other precautions.

CATEGORY 3: Barriers Resulting from Personal Judgement or Habits

Think I’m Doing it RightPeople with conservative values assumed that pre-COVID-19 frequency of hand washing/sanitizing, or slightly more, is sufficient. They do not believe they need to change that behavior.

When all barriers were identified, the research was used to do an assessment of how intense each barrier was by audience (young adults and people with conservative values) and by key behavior. The results of that assessment are captured in the table on the next page:


BARRIER WearingMasks

PhysicallyDistancing

Washing/Sanitizing Hands

Gathering:<5 or Outside

JUSTIFICATION

PHYSICAL DISCOMFORT

VENUE INFLUENCES

NOT EVERYONE COMPLIES

IMPLICIT SOCIALCONTRACTS

SEEKING RELIEF FROM ANXIETY & DEPRESSION

INCONSISTENT INFORMATION

MESSENGER OUTWEIGHS THE MESSAGE

BEHAVIORS NOT WORTH IMPACT ON SOCIETY

REQUIRES PROACTIVE PLANNING / FORGETTING

I THINK I’M DOING IT RIGHT (BUT NOT)

People with Conservative Values Young AdultsKEY:

INTENSITY OF BARRIER BY BEHAVIOR BY AUDIENCE


Benefits and MotivatorsThe primary research also helped the team identify benefits and motivators that could be leveraged with the priority audiences to increase compliance with key behaviors. In social marketing, benefits are one of the tools used to increase motivation for the priority audience to act.

Ending the PandemicBoth audiences have a strong desire to “get back to normal.”

Virtually every respondent expressed that if they knew the key behaviors would hasten the return to

normal, they would comply.

The most common benefits from returning to normal that were mentioned are:

› Having unencumbered social interactions

› Doing activities that they can’t do now, like attending concerts or playing sports

› Returning to a “normal” school day

› Healing the local economy and small businesses

Peer PressurePeer pressure works both ways. In the same way that implicit social contracts can cause the audience to ignore key behaviors, peer pressure can motivate people to comply with the key behaviors. Either way, it’s uncomfortable to be the minority among peers. And, being accepted by peers is a human need. This is true for both young adults and people with conservative values, but young adults feel the “pressure” in peer pressure more than people with conservative values.

The Desire to Protect OthersBoth audiences expressed a desire to protect those around them because caring for others is an important value/moral obligation. They feel very strongly that they don’t want to be the cause of someone else’s pain. Young adults in particular feel a strong sense that protecting community takes precedence over self.

Additionally, both audiences are very aware that people who have compromised

Protecting others is a stronger motivator than protecting one’s self.


immune systems have a higher chance of catching COVID-19 and suffer more severely from it. Research respondents are motivated to comply with the key behaviors because they “never know” if people nearby are particularly vulnerable.

Finally, some research respondents felt that complying with the key behaviors was not enough of a burden to risk being the cause of someone else succumbing to COVID-19. This would also cause them to feel very guilty.

Personal Experiences/Connections with COVID-19When research respondents have first-hand experience with a loved one who has suffered through COVID-19, they are more likely to comply with the key behaviors. Seeing someone they know or care about with COVID-19 makes it real. When large scale information about COVID-19 is communicated it is somewhat impersonal, and less impactful.

Living Your ValuesBoth audiences expressed a desire to “do what’s right.” They felt that even if they didn’t agree with the rationale, as long as there is a chance that the key behaviors will help decrease the incidence of COVID-19, complying with the key behaviors is the right thing to do.

Both audiences have a strong desire to “do what is right” for the community.

› Some people with conservative values describedthis as “the patriotic thing to do”

› Young adults believe that the right thing to do iswhatever is best for society overall – which wouldbe to comply with behaviors as described above

Being Considerate/RespectfulAnother specific way of “living your values” that was discussed by research respondents is through being considerate and showing respect.

Being considerate and respectful are important values for both audiences. This is important because being considerate and respectful preserves social norms during a time when some social norms are inhibited by the key behaviors.

Some respondents from both audience groups added to the depth of this conviction by expressing that complying with the key behaviors was actually not such a big sacrifice relative to doing what is right.


Mandates and RemindersPeople with conservative values tend to be rule followers, so when the mask mandate was enacted, they complied. They also want to avoid negative consequences of non-compliance. Both young adults and people with conservative values found that when there were physical reminders, like stickers on the floor or hand sanitizer at the check-out, they would comply.

When respondents were asked what helps them remember to bring their masks with them when they left the house, a few mentioned that keeping these items by their keys was a good reminder to bring them every time they leave the house. Many people also commented that leaving hand sanitizer in their car helps remind them to use it.

When all the motivators were identified, the research team did an assessment of how intense each motivator was by audience (young adults and people with conservative values) and by key behavior. The results of that assessment are captured in the following table.

INTENSITY OF MOTIVATOR BY BEHAVIOR BY AUDIENCE


PhysicallyDistancing

Washing/Sanitizing Hands

Gathering:<5 or Outside

WANT PANDEMIC TO END

SOCIAL NORMS/PEER PRESSURE

PROTECTING OTHERS

FIRST HAND / PERSONAL EXPERIENCE

VALUES / PATRIOTISM /COMMUNITY MINDED

BE CONSIDERATE / RESPECTFUL

MANDATES & REMINDERS

People with Conservative Values Young AdultsKEY:

Step 6: Message Strategy Recommendations


The primary research showed that awareness of our priority behaviors is high. Additional messaging isn’t needed to educate about masks, distancing, and keeping groups small. Across audiences, they understand what the behaviors are, why they are needed, and in most cases, they are trying to comply with the desired behaviors.

The research also indicated the importance of messaging that positions COVID-19 as the “enemy” we are collectively fighting. Some groups indicated that they view behaviors/restrictions as the enemy, which makes it more difficult to spur behavior change. Where possible, emphasize the behaviors as the way that we will beat our real enemy: the virus.

Broad commonalities among research responses leads us to a message strategy that doesn’t require a lot of customization by audience – except where noted, messaging opportunities are relevant for broad audience groups.

MESSAGING APPROACH1. Address ExcusesWhile people know about the behaviors and say they do them, the research shows that people are not doing all the desired behaviors consistently. Rather, many use excuses and rationales when they fall short to help themselves justify it. Messaging to overcome this should focus on calling out the importance of doing the desired behaviors even when tempted to justify otherwise, using one or more common excuses that emerged in the research.

Audiences understand what the desired behaviors are and why they are needed, and in most cases, they are trying to comply.

Key Message:

Mask up, spread out, and keep groups small.

Even...…if others aren’t …if it’s uncomfortable…if everyone seems healthy…when you’re outside…when you’re with family or close friends


2. Emphasize “AND” not “OR”Similar to the justifications messaging,we need to also focus on the“formula” of adding all the behaviorstogether to protect yourself andothers. This addresses the issue ofpeople picking and choosing whichbehaviors to do at different times.With the “formula,” we “bundle”behaviors for success, wheresuccess = doing all three behaviorstogether, all the time. This messagingwill also be the formula for thecommitment part of the campaign.

3. Establish a social normAcross audiences (and particularly with young adults), the research showed thatpeople are more likely to engage in behaviors when they believe others are doingthem as well. We also learned that positive messaging resonated well, rather thanmessaging that could be interpreted as scolding or fear-based. Combining theseinsights into messages that celebrate progress and thank residents for their workto beat COVID-19 will serve to establish a norm that most people ARE engaging indesired behaviors and recognizing the work that it takes to make that happen.

MASK UPSPREAD OUT

SMALL GROUPSNot forever, but for now.

Learn More

Creative developed during research process when the theme of picking and choosing behaviors emerged.

Key Message:

[XX%] of [community] residents are wearing masks, distancing, and keeping groups small.

Thank you for doing your part to beat COVID-19

Thank you, [community], for masking up, spacing out, and keeping groups small. Your work is helping us beat COVID-19.


4. Use emotion to emphasize protecting othersOne common motivator across audiences, and particularly with young adults, is the idea of protecting others in our families, friend groups, or communities. Keeping others safe can overcome resistance to doing the desired behaviors – even if someone does not feel at risk themselves, they still don’t want to be the reason that someone else gets sick. Messaging that taps into this emotion-rooted motivator can be very effective because helping others stay safe and healthy is a strong emotional benefit.

Audience-specific notesWhile most messaging opportunities are common to general audiences, a few stood out as being particularly relevant to either people with conservative values or young adults:

People with Conservative Values: › This group reacted positively to straightforward, educational styles of

messaging. This is likely tied to sensitivity to any sense that they are being manipulated. They prefer fact-based, informational styles – a “tell it to me straight” approach. Campaign developers should keep this in mind when communicating about new guidance or behaviors that are needed.

Key Message:

Before you decide to [skip the mask//get a little too close//go to that big gathering//], ask yourself – would you bet someone else’s [life//health] that you don’t have COVID-19?

Even if you feel fine, you can still spread COVID-19, It’s not worth risking someone else’s [life//health].

Calls to action:• Protect your people.• Protect people you care about.

?? ?


› This group reacted negatively to messages based on fear (such as emphasizing COVID-19 symptoms, risks, etc.) – believing this type of messaging to be fear-mongering and manipulative.

Young Adults: › Young Adults react positively to messaging and visuals that demonstrate

empathy to how they are feeling about doing the behaviors – recognizing that changing the way we live our lives is hard.

› This group positively reacts to creative that represents them and their friends – they want to see people and situations that look like them and more fully represent their experiences.

MESSENGERS MATTER MOSTMany people are wary of COVID-related messages because of distrust and inconsistency – they trust information less because recommendations have shifted over time. This feeds into concerns that there may be political “agendas” behind messages. To overcome this, where possible, information should come from people and organizations that audiences trust. In many cases, these are local people in friend, family and community groups (referent groups). Young adults, in particular, value hearing from their peers.

Diversify messengers: Include a variety of voices in outreach materials and advertising, including:

› Community leaders such as clergy, neighborhood leaders and community-based organizations;

› Employ stories about “real people” that audiences can relate to, doing desired behaviors in a variety of settings; and

› Ensure messengers are reaching audiences in their preferred languages and social/cultural reference points.

Encourage “social diffusion”: Social engagement strategies help people share information and further establish a social norm of doing the desired behaviors. (Social and community strategy recommendations are outlined elsewhere in this document).

Step 7: Social Marketing Intervention


Based on the results of the research, the team mapped the social marketing tools that could be most impactful in influencing COVID-19 related behaviors among our two audience groups. As explained in the social marketing overview section, the mapping flows as shown below:

We start with the four key behaviors, define the audiences for those behaviors, map the barriers to the audiences doing the barriers and define the benefits, tools and motivators we can offer to overcome the barriers. With the tools identified, we then define how those tools could be operationalized as part of DOH’s outreach efforts. The chart below is organized with this process in mind. In this case because there is such strong consistency of barriers, we start with barriers and then map the behaviors and audiences against each barrier and define the tools that would best overcome each barrier.

JUSTIFICATION

Behavior Audience Barrier Benefit Tool/Motivator

How to Operationalize

Tools

Audience

Key Barriers

Key Benefits

Behaviors

• “I always wear my mask, unless I’m around people I trust.”

• “We don’t have to worry about having a lot of people over, everyone is family.”

• People with conservative values

• Young adults

• Wear a mask

• Stay six feet apart

• Gather in small groups

• Helping to get pandemic over with

• Social acceptance

• First-hand personal experiences


How toOperationalize

Tools

Key Motivators/S.M. Tools

• Social norm/peer pressure

• Behavior “formula” prompts

• Communication

• Real people, real stories

POTENTIAL ACTIVITIES• Norms messaging

• Close in time and space to the behavior (signs everywhere that indicate the majority of people are complying)

• Thank you messaging for complying integrated into the campaign

• Include: “Not forever, but for now”

• Justification messaging ”COVID-19 loves excuses….”

• Create visual representation of formula (all three behaviors, together)

• Create a commitment strategy (public, durable and group if possible)

• Create visual representation of formula (all three behaviors, together)

• This becomes foundation for pledge and toolkit materials

• Integrate into campaign assets

• Resources for gatherings

• Website with resources to help people make good decisions about gatherings (includes a checklist – a tool that people fill out to help guide decisions)

• Promote key components of content and links to website through social media and advertising

• Include holiday season content

• Ask partners to push out link through networks

• PR strategy to promote the partners that have signed on to the commitment

PARTNER ENGAGEMENT• Opportunities for partners:

• Participate in feedback loop system for commitments between audience and DOH


• Toolkit items:

• Gatherings package (tools and website)

• Templates for normative materials and signage

• Templated formula materials and signage (include embedding other behaviors into 6-foot message stickers)

• Explanation about why these tools are most effective

OTHER RECOMMENDATIONS• Group family texts – we agree to keep gatherings small – create

a template and promote it

• “I don’t like wearing a mask if I’m the only person doing it.”

• “I can’t just not invite someone, that’s rude.”

• Young adults

• People with conservative values for masks

• Wear a mask




• Living their values (community minded)

• Commitment

• Social norms/peer pressure

• Social diffusion

• Prompts

POTENTIAL ACTIVITIES• Commitment strategy as outlined under “justifications” barrier

• Gatherings webpage that includes reasons to not gather, refusal language/guidance and encouragement for people to practice

IMPLICIT SOCIAL CONTRACT

Audience

Key Barriers

Key Benefits

Behaviors



Tools


• Since it is uncomfortable for people to speak up and go against others, provide tools that allow them to say it without saying it – buttons, masks, stickers with messages


• Partners can order and distribute branded masks/hand sanitizer. Recommend that partners ask an intention question with it (asking this question will increase behavior adoption).

• Engage students at colleges and universities. Incorporate virtual and in-person displays of public commitments.

• Develop tailored “refusal skills” using local/relevant influencers

• Toolkit items:

• Templates for branded mitigation materials and simplified purchase steps

• Templates for prompts

OTHER RECOMMENDATIONS• Opt-in text programs – have someone else push out

• Once available, build receptivity for contact tracing and contact tracing app since implicit social contracts will work against people sharing their contacts

• “Masks rub against the back of my ears.”

• “Seeing people in masks gives me anxiety.”

• Young adults


• Wear a mask


Audience

Key Barriers

PHYSICAL DISCOMFORT

Behaviors

Key Benefits



• Rule enforcement

• Mandates

• Social norm/peer pressure

POTENTIAL ACTIVITIES• Norms messaging:

• Close in time and space to the behavior (signs everywhere that indicate the majority of people are complying)

• Thank you messaging for complying integrated into the campaign

• Include: “Not forever, but for now”


• Promote or distribute masks to communities

• Practice trauma-informed principles to accommodate individuals with anxiety and depression triggered by masks. (e.g., promote crisis line resources when distributing masks.)

• Support policies that enforce masks

• Toolkit items:

• Templates for normative materials and signage

OTHER RECOMMENDATIONS• Continue mandates and rule enforcement

• More comfortable mask options


Tools

MESSENGER OUTWEIGHS THE MESSAGE• “When I hear a politician promote these behaviors,

I don’t trust their motives.”

• “I only trust what my peers say about COVID-19.”


• Wear a mask

• Stay six feet apartBehaviors

Audience

Key Barriers


Key Benefits



Tools

• First-hand personal experience


• Real stories/real people

• Commitments

• Social diffusion

• Communications

• Prompts


POTENTIAL ACTIVITIES• Continue helping Local Health Jurisdictions incorporate

local spokespeople into materials (build off COVID is real:Community voices project)

• Continue influencer strategy

• Social engagement strategy: “I wear a mask because_____.”“I keep six feet apart for ______.”

• Utilize messengers who are relevant to many populations –trusted voices, local, real people like me

Online commitments

• Social media pledges

• Push out through social media influencers


• Encourage people to talk to their networks, give themtools to do so (e.g., gatherings webpage)

• Ask partners to act as “messengers” (congregations,workplaces, public agencies, community organizations, etc.)

• Collect commitments that span a range of circumstances

• Ask partners to place declarative commitmentsignage in public places

• Participate in and promote social engagement strategy

• Toolkit items:

• Tailor to various types of organizations (congregations,workplace, public agencies, etc.)


• Include public and durable commitments. Commitments that are public are visible to others in the community, while durable commitments are witnessable for a long period of time. It is recommended that partners share those commitments to help establish social norms and gather group-based commitments if possible.

• Templates for six-foot prompt sticker that also includes other two behaviors (formula)

• “Being around my friends like normal is the only way I can cope right now.”

• Young adults


• First-hand personal experiences

• Helping to get pandemic over with

• Real stories/real people

POTENTIAL ACTIVITIES• “Not forever, but for now” messaging

• Provide suggestions for managing anxiety and depression – health and wellness, support structures, ways to have other meaningful connections


• Support the Health Care Authority with their campaigns/link messaging

• Continue addressing root causes (food insecurity, homelessness, family instability, etc.). e.g., If social distance itself is causing the anxiety, promote a safe buddy.

• Promote virtual alternatives to gathering that support mental health and wellbeing. Colleges or universities

Behaviors

Audience

Key Barriers


Key Benefits



Tools


could host movies, trivia games, or dance parties using remote technology.

OTHER RECOMMENDATIONS• Continue to update resources on coronavirus.wa.gov

• Acknowledge that there may be other root causes and address where possible – food insecurity, homelessness, racism, etc. Utilize trauma-informed lens.

• “If the bar doesn’t expect me to wear a mask, why should I?”

• Young adults

• Wear a mask


• Living their values


• Mandates

POTENTIAL ACTIVITIES• Toolkit item:

• Venue signage (dorms, bars, etc.)

OTHER RECOMMENDATIONS• Enforce rules at venues

• Branded masks

• “People used to say masks are harmful, now they say we have to wear them. Which is it?”

• “Is it 50 people or 5 people? The changes make it seem arbitrary.”

VENUE INFLUENCES

Key Benefits

Behaviors


Audience

Key Barriers

Key Barriers


Tools



Key Benefits

Key Benefits

Behaviors

Behaviors



Audience

Audience


Tools


Tools


• Young adults

• Wear a mask



• Facts

• Mandates

POTENTIAL ACTIVITIES• Incorporate facts and numbers where possible;

always require a source

• Develop a citations page on coronavirus.wa.gov website

OTHER RECOMMENDATIONS• Continue mandates and rule enforcement

• “I have always washed my hands all the time.”


• Wash or sanitize hands

• None

• Incentives

• Prompts

POTENTIAL ACTIVITIES• Low priority messaging around hand washing –

focus on other three behaviors


THINK THEY ARE DOING IT RIGHTKey Barriers


• Recommend to pair sanitizer with mask giveaways

• Consider installing more sanitizer stations throughout public spaces (beyond front door and cash register)

• Promote behavior as “wash or sanitize hands” and encourage before, during, and after being in public

• Toolkit item:

• Signage for stores, etc.

OTHER RECOMMENDATIONS• Branded hand sanitizers

• Look at app options that provide reminders when people leave their homes

Step 8: Partnerships


While the Washington State Department of Health has funding and capacity to incorporate a few strategies into their existing campaign, to be more effective and far-reaching they will rely on partners. All partners will be encouraged to use resources provided in the partner toolkit to disseminate or create social marketing tools that inspire behavior change in their communities.

Recognizing not all partnerships are identical, this strategy will engage the following three types of partners to empower, assist, and learn from their efforts across Washington.

1. Mutual Partners

Local Health Jurisdictions, state agencies, community-based organizations, etc.

Strong existing relationship with DOH; similar funding stream as DOH; responsive to mandates and directives; shared mission and vision, particularly with serving vulnerable communities; ability to serve large populations; and feedback loops exist with DOH, allowing for ongoing information and resource sharing.

• Provide funding through existing Interagency Agreement, consolidated contracts, or community grants to expand campaign reach and tailor messaging in communities.

• Share lessons learned and suggested activities with each other to develop more effective strategies.

• Elevate and promote each other’s messages and strategies.

Examples

Defining Characteristics

Potential Leveraging

Opportunities


2. Common-Cause Partners

Churches, school systems, college and university systems, business associations, insurance companies, healthcare providers, etc.

Shared mission and vision with DOH (in respect to COVID-19); some existing relationship with DOH; motivated to end COVID-19 pandemic; exist as part of a larger system; serve relatively large, albeit typically homogeneous populations; able to utilize materials from DOH, but not able to produce own materials.

• Disseminate toolkit materials

• Provide clear guidance/training on use of materials

• Tailor strategies for their audiences

• Provide information to DOH about strategy adoption and any audience feedback

3. Influential Partners

Teachers, social media influencers, local leaders, large workplaces, sports teams, celebrities, media outlets, etc.

Exist as individuals or small systems; have ability to reach significant volume of people or profoundly impact a population of people; consistently reach captive audiences; willing to promote or develop messaging in alignment with DOH mission and vision for COVID-19 response.

• Disseminate toolkit materials

• Use their platforms to promote key social marketing strategies.



Opportunities

Examples



Opportunities

Examples


By utilizing existing channels, DOH will engage these partners to expand the reach of existing strategies and/or adopt additional strategies for their communities/audiences. Engagement may include activities such as the following (list is not exhaustive):

› Inform development of toolkit items

› Disseminate toolkit, provide feedback about ongoingneeds from community

› Send electronic letter to healthcare providers informingthem about toolkit

› Submit a newsletter article through Office ofSuperintendent of Public Instruction monthly distributionto all school district employees

› Present to statewide associations (WA Hospital Association,WA Business Association, etc.) to encourage use of toolkitand promote value of key social marketing tools

› Present at bi-weekly Local Health JurisdictionCommunicator call

› Develop short recorded webinars describing toolkit,campaign strategy, and opportunities for collaboration.Disseminate to existing partner networks

Step 9: Marketing Plan


IntroductionThe goal of this social marketing recommendations document is to change how people behave – not just what they think, or how aware they are of the risks of spreading COVID-19. In order to increase knowledge, change attitudes, and change peoples’ everyday behaviors, we will need to utilize a combination of several social marketing tools.

While residents self-report high participation in the three behaviors, deeper investigation found that many are picking and choosing subsets of the three behaviors in different settings, and are heavily influenced by social norms within different groups and settings.

We need to “close the gap” to make sure residents are doing all three of the behaviors, all of the time. This means we need to create a new social norm.

By leveraging residents’ beliefs and motivators, and educating them about the real dangers and appropriate steps, there is a significant opportunity for widespread adoption. By fostering a social norm that is consistent with the desired behaviors, all outreach activities can become efficient and more effective.

The wheel below shows the journey a resident will have to go through to consistently engage in all three behaviors. On these issues, DOH and its partners will need to move them successfully around the wheel, from awareness to action. As more people adopt the desired behaviors, the social norm will shift.

Washington State Department of Health | 7

BEHAVIOR CHANGE CONTINUUM

Audience becomes aware of COVID-19

Audience is educated about COVID-19 and protective behaviors

Audience becomes loyal to

the behavior; influences peers;

social norm develops

Audience is satisfied with experience;

feedback drives habit

Audience consciously

changes behavior

Audience develops personal connection; benefits overcome the barriers for each behavior


To successfully change the social norm to “all three, all the time,” the path forward will require two tracks working in tandem with one another:

Track 1: Building Receptivity (Messaging)In order to build a new community norm of doing all three behaviors, all the time (rather than picking and choosing which behaviors to do when), DOH and partners will need a campaign to raise widespread awareness of the importance of combining all three. DOH will also need to address the most common justifications head-on. This will require an ongoing communications campaign that leverages the findings from the research and the tools of social marketing.

Track 2: Garnering Public, Durable Commitments (Pledging)Study after study has demonstrated the power of commitments (or pledging) in fostering positive behavior change. When people say they will do something, their perception of themselves changes. They feel responsible for the commitment they’ve made, and, are more inclined to follow through in order to maintain consistency with their new self-perception. When that commitment is shared publicly, within their community, the dedication to follow-through increases.

Pledging is a powerful tool when it comes to building a new social norm. It also hits at the heart of the yearning for belonging and acceptance, which we heard about so clearly from research participants. We know that right now, the longing to “fit in” often leads to spotty adoption of the three behaviors in group settings. Public pledging offers a way to radically change what it means to “fit in,” once your family, your church, or your rotary club, for example, have taken the pledge. We strongly recommend a comprehensive pledging effort throughout Washington state.

The Importance of PartnershipsAs the research findings on messengers shows, the Department of Health can’t do this effort alone - it will require the participation of trusted partners working together to spread the message and recruiting residents to take action. Different partners will have different tools that work best within their communities, so to be effective, the strategy will need to be tailored by community and by partner (e.g., different approaches in churches vs. health clinics vs. universities, etc.).

The plan outlined below will follow this model to effectively drive behavior change:

Create a campaign

with the purpose of reducing

COVID-19 risk in communities

Build a framework

that can be adopted and customized

for local communities

Establish a social norm for combined risk

reduction behaviors,

community by community

Partner with local organizations to

create and implementthe effort


Messaging StrategyA few key themes emerged from the research to help guide message and creative development. More detail can be found in Step 6 of this document.

Messages to help build receptivity to widespread adoption of our three behaviors: › Addressing Excuses – many residents are not doing the desired behaviors

all the time, and are using excuses to rationalize their behavior when they fall short. Creative that focuses on doing the behaviors, “even if/when” they are tempted to rationalize, will help build awareness of the specific desired behavior.

› Focus on “And” rather than “Or” – bundling the three behaviors (masking, distancing and keeping gatherings small) will help overcome the current barrier that many residents are picking and choosing which behaviors to do rather than doing all of them together.

Messages to build a strong social norm of engaging in our desired behaviors: › Recognition messages – positive messages celebrating progress and

thanking people for doing our desired behaviors create a positive association and feedback loop, e.g., “95% of WA residents are masking up, distancing and keeping groups small – thank you for doing your part to help stop the spread of COVID-19.”

› Public commitment – a huge opportunity is to overlay a public commitment/pledge, e.g., “I pledge to fight COVID-19 – Three Ways, Every Day.”

A note on messengers: Many people are wary of COVID-related messages because of distrust and inconsistency – they trust information less because recommendations have shifted over time. This feeds into concerns that there may be political “agendas” behind messages. To overcome this, where possible, information should come from people and organizations that audiences trust. In many cases, these are local people in friend, family and community “referent” groups.

Reaching All WashingtoniansTo effectively flatten the curve, it will be critical to ensure all Washingtonians have access to the information and tactics provided in this campaign. We recommend considerations such as:


› Translating materials to make the campaign accessible to residents with language barriers

› As possible, transcreating the campaign approach to make it culturally relevant to different groups, who may also have different barriers and motivators

› As possible, developing a dedicated approach for traditionally underserved groups, including but not limited to tribal, Black, and LGBTQ+ communities

The robust COVID-19 public outreach campaigns that WA DOH started in March 2020 included materials and tactics transcreated in up to five languages. Partnerships extended campaign reach to underserved communities. This model can be utilized and built upon as the campaign unfolds.

KEY STRATEGIESIn this section, we will recommend strategies to:

› Build receptivity to the development of a social norm by emphasizing the importance of doing all three behaviors every day (and call out any current/existing efforts to do this)

› More firmly establish the norm with a commitment campaign that includes public pledges to do all three behaviors

› Promote public commitments to doing the desired behaviors

Building CommitmentsThese marketing recommendations are designed to support establishing a social norm around our priority behaviors of masking, distancing and keeping groups small, with an emphasis on strategies for developing and launching a public commitment (or “pledge”). Current campaign activities are working to address

A “public and durable” commitment that is visible to peers, friends and family will make it much more likely that people will follow through on the behaviors.

Key Recommended Strategies:

• Commitments

• Behavior Help hub

• Partner Campaign Toolkit

• Media Relations

• Paid Advertising

• Organic Social Media

• Influencer Outreach


one key barrier of “justification” – picking and choosing one or two behaviors and rationalizing that choice using various excuses. In addition to discouraging the use of excuses, this effort is building receptivity to the idea of doing ALL three behaviors as the norm. Integrating a public commitment will further cement the behaviors as a norm by tackling one of our key barriers: people not want to be seen as the “only one” engaging in the behaviors and are more likely to not do the behaviors if they see others not doing them. A “public and durable” commitment – visible to peers, friends and family – makes it much more likely that people will follow through and is the evolution of tactics designed to raise awareness and build receptivity.

Behavior Help Hub* Note: this is currently in development by DOH.

Establish an online hub to support people in doing the desired behaviors. Content on the website could change throughout the year, focusing first on “Smart Celebrating” as the fall and winter holidays approach.

The first round of content will focus on “fewer, smaller, shorter, safer” interactions, helping people do all three priority behaviors while gathering, and/or establishing new traditions that don’t require gathering in groups.

Site content includes:

› Checklist for safely gathering to celebrate holidays, game days, birthdays or other milestones - tangible ways to practice “all three” behaviors

› Tips and ideas for fun and creative alternatives to gatherings

› Content modeling ‘tough conversations’ – like how to decline an invitation respectfully, set ground rules for gathering, etc.

Social media engagement ideas include:

› Asking people to share their family’s commitment: “My family is staying safe this holiday season by_____” with a sharable link to social channels

› Inviting people to submit their family ideas, photos and videos showing them celebrating in COVID-safe ways

Develop mini partner-sharing toolkit that includes promotion assets (social and digital ad templates, social/sharing copy and visuals)


Partner Campaign Toolkit This effort is designed to be implemented at the local level. We recommend DOH develop a toolkit that can be used both to build receptivity and to encourage residents to take the pledge. Utilizing established campaign branding and messaging, the toolkit would provide turnkey tactics for implementation in each community. The suite of tactics will encourage behavior change and offer partners the ability to leverage the outreach channels they find most relevant to their communities.

The toolkit graphics will hinge on the visual representation of all three behaviors together, with additional graphics representing thank you messaging for complying integrated into the campaign.

The toolkit would include:• Implementation recommendations

• Pledge text (e.g., “I pledge to…”)

• Social media and newsletter content (graphics/text)

• Social badges (e.g., “I took the pledge”)

• Advertising templates

• Text for publishing recognition of the pledgers online or in other forums (e.g., “Thank you to these groups and individuals, who have made the commitment to keep our community safe by doing these behaviors...”)

• Templates for visible prompts to encourage all three behaviors at once, and to thank people for complying. For example:

• For local businesses and organizations with in-person locations, provide window clings, posters, and floor stickers that include all three behaviors

• For online stores and social media accounts, provide web graphics

• Info for how partners can order and distribute branded masks/hand sanitizer

The toolkit could be supported with a by-community advertising strategy to elicit broad-based awareness, a full turnkey social calendar with pre-populated posts for implementation, and local campaign planning support.


Media RelationsMedia relations can help reinforce the campaign messages and extend social diffusion.

Recommended tactics include:

› Establish a goal: Local partners have the opportunity to band together to announce a shared vision of what a safe community looks like and to ask people to join the effort. Local stories can share success throughout the campaign. For example, driving 100 group sign-ups and/or 1,000 individual sign-ups (with benchmark numbers dependent on the size of the community). This could also be a statewide media push to announce which organizations have signed onto the pledge program.

› Real people, real stories: It’s a natural tendency for humans to copy one another, even without realizing it – we like to be a part of social communities. People want to see and hear about others in the community. In each community, we recommend finding ways to showcase successful people or projects. For example, we could pitch local media with stories highlighting businesses, organizations, and people who take the pledge. There are also opportunities to find seasonal “hooks” around how families and residents are planning to gather for upcoming holidays.

› Community leaders: Pitch interviews and bylined articles to local print and online media with community leaders (clergy, community organizations, neighborhood leaders, business leaders, etc.) about their personal experiences learning that all three behaviors are necessary to be successful in the fight against COVID-19. This could be coupled with a call to action to join them in taking the pledge.

Paid Advertising Paid advertising can support all elements of the effort to build receptivity to and establish a social norm around our three priority behaviors. Advertising messaging and tactics can be:

Awareness-based: To educate a broad audience about the importance of doing our three behaviors together and not using excuses to justify picking and choosing

Targeted: To move audiences further along the behavior change continuum by integrating messages and tactics customized by geography and (when needed) audience segment


Recommended tactics include:

Paid Social: This tactic is versatile – it works for broad awareness (ideal for our receptivity-building efforts) and targeted efforts to spur engagement, response and action (which works well for pledge-driving and social norm building). Different platforms and ad units within each platform help achieve different goals.

Facebook: Reaches the broadest and deepest audiences – you can prioritize by geography, demographics, interest level/activity, language, and can even prioritize “lookalike” audiences by using existing affiliations.

› In-feed ads – features a variety of call-to-action (CTA) buttons to help spur direct action. Can use video, animation or static visuals.

› Carousel ads – a slide-show format good for awareness and building receptivity to our behaviors, and can build up messaging and touch on more than one idea.

Instagram: Visually-focused and good for animation, video and graphics designed to educate and raise awareness, with some direct response/action capability.

› In-feed ads – support video, animation or static visuals. Great for receptivity and social norm-building efforts. Sponsored posts can include specific CTA buttons to help people engage in commitments/pledges.

› IG stories – sponsored stories, similar to Facebook carousel ads, allow you to tell a story to educate and build receptivity to desired behaviors. Some have a “swipe up” option to learn more/take action, which can help drive pledge participation.

Digital: Digital advertising offers almost endless flexibility on messaging, formats, and options to meet objectives. Primary tactics to support building receptivity to and adoption of our priority behaviors include:

Display: Typically run through Google or other ad network, digital display ads are ideal for building awareness and educating about a topic.

› You can target by demographic, geography, interests and even consumer behavior.

› To drive participation in a pledge or commitment, creative. would focus on a strong CTA to drive clicks to a place where people could

$


pledge or act right away.

› Formats include static, video display or “pre-roll” (which plays yourvideo ad before a video with related content) or animation.

Search: Search marketing reaches people at an ideal time – when they are actively looking for information about a subject. Search ads and terms can be created to help people do the desired behaviors. For example, directing them to content that can support safe holidays and gatherings or find the latest distancing recommendations.

Digital radio: Because of the ability to “click” on a digital radio ad, they offer more options to drive behavior change action than traditional broadcast (“click/tap here to join your neighbors to take the pledge!”) and to combine visuals with the audio message. The ability to geo-target makes it a good fit for messaging to celebrate local achievements and use localized messengers or spokespeople.

Broadcast TV and Radio: Consider using broadcast TV and radio to support social norming messages and creative – celebrating milestones, demonstrating that most people are doing the behaviors and thanking those who are doing their part to stop the spread of COVID-19.

Print: Print ads in local and community newspapers can serve to educate and inform. Depending on the goal, this channel can:

› Build receptivity to our social norm through messaging that addressesexcuses and not doing all three of our behaviors all the time

› Promote social norm by thanking residents for doing their part to stopthe spread of COVID-19

› Encourage public commitments by spotlighting local residents,businesses or organizations who have pledged to perform andpromote COVID-safe behaviors

Outdoor: Billboards and transit are ideal for broad messages that educate and inform. Recommend utilizing these tactics for social norming messaging establishing that most people are doing our desired behaviors and thanking people for doing their part.


Organic Social Media Organic social media (non-advertising social) can play a significant role in building receptivity to and establishing social norms. In particular, it allows us to help people make and share public commitments to engage in a behavior. Organic social also allows for partners to amplify messages and provides the ability to engage directly with audiences, answering questions, providing encouragement and correcting misinformation.

Suggested tactics include: • Personal statements of commitment – ask followers to fill in the blanks to

show their commitment and share with friends and family:

› “I wear a mask because_____”

› “I keep six feet apart for ______”

› “I’ll stay in small groups because _______”

• Spotlight success – share photos, videos and stories of real people and their reasons for committing to the desired behaviors. Focus on local voices and a diverse mix so people can see themselves in the actions taken.

• Promote challenges between towns/counties, institutions, business sectors, or community organizations to see how many people pledge to do the desired behaviors.

• Create partner toolkit – spur partner engagement by providing a social toolkit for partners to use, including:

› Sample post copy/messaging

› Graphic templates and image options

› Additional social engagement ideas

Influencer OutreachEngaging with trusted digital influencers is an innovative, effective way to deliver on the messaging strategy – with so many people wary of “official” messengers, engaging with people who have existing platforms and audiences who trust them can help:

• Build receptivity to a new social norm through content that addresses common justifications and excuses, and emphasizes the importance of doing all three behaviors together

• Firmly establish a pledge through their own public commitments and encouraging others to participate and spread the word


Elements to a strong influencer strategy include:

• Audience match: Their audience must match up with the priority audience. With influencers, segmenting by audience can be very effective – what works for college-age adults won’t be the same for new parents or retirees. Some influencers, like musicians or athletes, may cut across audience groups. Also keep geography in mind – if someone has 100,000 followers but most of them are outside the state or community of focus, those are wasted impressions.

• Audience Engagement: The size of an influencer’s following is less important than the level of engagement the influencer has with their audience. A huge audience that doesn’t engage is worse than a smaller audience that follows the influencer’s content closely, engages and is more likely to take action. Depending on budget, followings from 1,000 to a million could be effective.

• Variety of Channels: Engage influencers with a variety of focus areas and channels – a mix of subjects and channels will ensure that different audience segments are reached across all platforms.

› Focus areas: Fashion, food, health, lifestyle, photography, sports, travel

› Popular channels: Instagram, Tik Tok, blogs, YouTube

• Give creative freedom: Influencers know best what resonates with their audiences, so it’s important to provide them the freedom to deliver the message in a manner that is authentic to their brand and their communities. Ideas for influencer content frameworks could include:

› Telling a personal story about what stopping the spread of COVID-19 means to them, pledging to do all three behaviors all the time, and calling on their followers to do the same.

› Influencers could come clean about times they’ve used justifications or excuses to rationalize not masking, distancing AND keeping groups small, and pledge to fight COVID-19 by doing all three, all the time. The influencer would then ask their followers to take the pledge and share it with their own friends and family.

› Challenging another influencer to a competition to see how many followers they can each inspire to take the pledge to do all three behaviors.


Suggested TimelineTo continue to flatten the curve, it is critical for DOH and community partners to keep responding and moving forward as quickly as possible. The following schedule is recommended:

September October November December

WA

DO

H

“All 3” Commitment Campaign:

› Develop pledge

› Develop ads

› Develop toolkit

Gatherings Campaign:

› Develop messaging

› Finalize website

Justifications:

› Continue running new creative


› Launch campaign

› Distribute toolkit to partners


› Distribute messaging to partners

› Launch ads

Justifications:

› Continue running new creative


› Continue running


› Continue ads

Social Norms/ Thank You:

› Develop messaging and creative


› Continue running

› Add feedback to messaging


› Continue ads

Social Norms/ Thank You:

› Run ads

Partn

ers

› Let existing partners know about commitment campaign

› Expand partner base as appropriate

Holiday Messaging:

› Ask partners to push out through their channels

Commitment campaign:

› Launch pledge through their channels and networks

Holiday Messaging: › Ask partners to

push out through their channels

Commitment campaign: › Continue

promoting pledge through their channels and networks

› Provide feedback to their pledgers

› Provide DOH with feedback

Holiday Messaging: › Ask partners to

push out through their channels

Commitment campaign: › Continue

promoting pledge through their channels and networks

› Provide DOH with feedback

› Provide feedback to their pledgers


Use of Social Marketing ToolsThe recommendations leverage the following marketing tools:

If Partner buys maskor sanitizer

PartnerMaterials

Communication SocialNorms

SocialDiffusion Convenience FeedbackCommitments

Commitment CampaignToolkit

Public andMediaRelations

PaidAdvertising

OrganicSocial Media

InfluencerOutreach

Prompts Incentives

Step 10: Evaluation Plan


The purpose of the campaign evaluation includes: › To conduct iterative evaluation so the campaign can be improved as it is

implemented

› To report on resource expenditures

› To report on campaign Outcomes and Impact

› To use these findings to inform future efforts, especially communication messages, messengers, and media channels, as well as intervention tools and partnerships

KEY VARIABLES TO EVALUATE AND REPORT ON

INPU

TSO

UTC

OM

ESO

UTPU

TS

Resources allocated to the campaign:

INFORMATION RESOURCE:

Program activities conducted to influence audiences to perform the desired behavior:


Program activities conducted to influence audiences to perform the desired behavior:


• Money• Staff time• Existing materials used• Distribution channels utilized

• Existing partner contributions

Internal documents and dataPartnership Reports

• Number of materials disseminated, websites created, social media tactics employed

• Paid media impressions• Reach and frequency of communications• Earned media coverage• Number of special events

Internal Records

Changes in knowledge, attitudes and behaviors that can be attributed to campaign outputs. Changes related to:• Mask wearing• Keep six feet apart• Gather in small groups

Quantitative survey of Washington State audiences, with options for methodology discussed below

CONT’D


IMPA

CT

Indicators that show levels of impact on the social issue that was the focus for the effort:


Changes in numbers of COVID-related:• Deaths• Cases

• Hospitalizations

DOH data on COVID-related deaths, cases, hospitalizations

Options for Measuring Outcomes to Consider1. Develop and implement a custom survey that establishes related

awareness, knowledge, attitudes, and behaviors prior to campaignlaunch, and then repeat the survey post campaign.

2. Explore potential collaboration with the Gates Foundation to add desiredquestions to their ongoing survey that would report on levels of knowledge,attitudes and behavior change related to this campaign and its outcomeswith priority audiences. It is understood that we might need to have largersample sizes for our priority audiences than they currently have in their survey.

Appendix 1: Social Marketing Planning Process Timeline


Date Activity Focus

7/6-7/14 Conduct secondary research review

› Review more than 40 research sourcesto help define needs for this effort

› Initial focus on priority audiences

7/15 Planning session #1 › Confirm purpose & goals

› Review results of secondary researchreview related to priority audiences

› Choose priority audiences

› Initial prioritization of behavior changes

7-15-7/20 Continue secondary research review

› Focus on identification ofbarriers and motivators

7/21 Planning Session #2 › Review results of secondaryresearch review related tobarriers and motivators

› Outline barriers andmotivators for testing

› Present and confirmresearch approach

7/30 Planning session #3 › Finalize research approach

› Finalize barrier statements for testing

› Determine research recruitment criteria

8/5 Planning session #4 › Finalize research approach

› Finalize barrier statements for testing

› Determine research recruitment criteria

Appendix 1The process the team used to create these recommendations is outlined below:

CONT’D


Date Activity Focus

8/6-8/19 Research preparation and launch

› Recruit research participants

› Finalize discussion guides

› Train moderators

› Begin research panel

› Conduct first wave of synthesis

8/20 Planning session #5 › Present first wave of research findings

8/25 Planning session #6 › Present third wave of findings

8/21-8/26

Continue research › Continue research panel

› Conduct second wave of synthesis

8/27 Planning session #7 › Final presentation of top-line research findings

8/27-9/2 Continue research › Continue research panel

› Conduct third wave of synthesis

9/3 Planning session #7 › Final presentation of top-line research findings

9/4-9/9 Social marketing synthesis › Three sub-committee sessions to synthesize barriers, motivators, benefits and map to social marketing tools

› Create recommendations to operationalize social marketing tools

› Evaluate new secondary quantitative research available to the DOH team

9/10 Planning session #8 › Synthesize social marketing recommendation framework

› Define recommendations document outline

CONT’D


Date Activity Focus

9/11-9/15

Draft recommendations › Draft social marketing recommendations document

9/16 Planning session #9 › Review of draft social marketing recommendations

9/17-9/23

Finalize documents › Develop social marketing recommendations (this document)

› Compile final research report

9/24 Planning session #10 › Final social marketing recommendations

› Final research report

› Final topline research report

Post 9/24 Next steps › Share findings

› Implement recommendations

Appendix 2: Secondary Research Sources


Appendix 2: Secondary Research Sources

“Most Americans say they regularly wore a mask in stores in the past month; fewer see others

doing it”, Pew Research, 23 June 2020

• https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-stores-in-the-past-month-fewer-see-others-doing-it/

“New April Guidelines Boost Perceived Efficacy of Face Masks”, Gallup, 13 May 2020

• https://news.gallup.com/poll/310400/new-april-guidelines-boost-perceived-efficacy-face-masks.aspx

“Public Attitudes, Behaviors, and Beliefs Related to COVID-19, Stay-at-Home Orders, Nonessential

Business Closures, and Public Health Guidance — United States, New York City, and Los Angeles,

May 5–12, 2020”, CDC, 12 June 2020

• https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e1.htm?s_cid=mm6924e1_w

“Americans Still Social Distancing, but Less Vigilant”, Gallup, 30 April 2020

• https://news.gallup.com/poll/309611/americans-social-distancing-less-vigilant.aspx

“Most Americans Are Wearing Masks. Those Who Don’t Are Far More Likely to Be Socializing in

Public Places.”, Morning Consult, 3 June 2020

• https://morningconsult.com/form/face-mask-wearing-in-public/

“Polarization and Public Health: Partisan Differences in Social Distancing during the Coronavirus

Pandemic”, Allcott, Boxwell, Conway, Gentzkow, Thaler & Yang; July 2020

• http://web.stanford.edu/~gentzkow/research/social_distancing.pdf

“Republicans, Democrats Move Even Further Apart in Coronavirus Concerns”, Pew Research, 25

June 2020

• https://www.pewresearch.org/politics/2020/06/25/republicans-democrats-move-even-further-apart-in-coronavirus-concerns/

https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-st

https://www.pewresearch.org/fact-tank/2020/06/23/most-americans-say-they-regularly-wore-a-mask-in-st

https://news.gallup.com/poll/310400/new-april-guidelines-boost-perceived-efficacy-face-masks.aspx

https://news.gallup.com/poll/310400/new-april-guidelines-boost-perceived-efficacy-face-masks.aspx

https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e1.htm?s_cid=mm6924e1_w

https://news.gallup.com/poll/309611/americans-social-distancing-less-vigilant.aspx

https://morningconsult.com/form/face-mask-wearing-in-public/

http://web.stanford.edu/~gentzkow/research/social_distancing.pdf

https://www.pewresearch.org/politics/2020/06/25/republicans-democrats-move-even-further-apart-in-cor

https://www.pewresearch.org/politics/2020/06/25/republicans-democrats-move-even-further-apart-in-cor


“Coronavirus: Social distancing accepted when people understand exponential growth”,

EurekaAlert, 29 June 2020

• https://www.eurekalert.org/pub_releases/2020-06/uoc-csd062920.php

“Why some Americans won’t wear face masks, in their own words”, Advisory Board, 19 June 2020

• https://www.advisory.com/daily-briefing/2020/06/19/mask-wearing

•

“The effect of messaging and gender on intentions to wear a face covering to slow down

COVID-19 transmission”, Capraro & Barcelo, 16 May 2020

• https://psyarxiv.com/tg7vz

“Gender Differences in COVID-19 Related Attitudes and Behavior: Evidence from a Panel Survey

in Eight OECD Countries”, Galasso, Pons, Profeta, Becher, Brouard & Foucault; National Bureau of

Economics Research, June 2020

• https://www.nber.org/papers/w27359.pdf

“The Role of Cognitive Dissonance in the Pandemic”, Anderson & Tavris, 12 July 2020

• https://www.theatlantic.com/ideas/archive/2020/07/role-cognitive-dissonance-pandemic/614074/

“Axios-Ipsos poll: There is no new normal”, Talev, 7 July 2020

• https://www.axios.com/axios-ipsos-poll-coronavirus-index-15-weeks-e4eb53cc-9bc8-4cac-8285-07e5e5ef6b2b.html

“Coronavirus: new survey shows how Republicans and Democrats are responding differently”,

van de Linden, Panagopoulos & Kerr, 12 May 2020

• https://theconversation.com/coronavirus-new-survey-shows-how-republicans-and-democrats-are-responding-differently-138394

https://www.eurekalert.org/pub_releases/2020-06/uoc-csd062920.php

https://www.advisory.com/daily-briefing/2020/06/19/mask-wearing

https://psyarxiv.com/tg7vz

https://www.nber.org/papers/w27359.pdf

https://www.theatlantic.com/ideas/archive/2020/07/role-cognitive-dissonance-pandemic/614074/

https://www.theatlantic.com/ideas/archive/2020/07/role-cognitive-dissonance-pandemic/614074/

https://www.axios.com/axios-ipsos-poll-coronavirus-index-15-weeks-e4eb53cc-9bc8-4cac-8285-07e5e5ef6b

https://www.axios.com/axios-ipsos-poll-coronavirus-index-15-weeks-e4eb53cc-9bc8-4cac-8285-07e5e5ef6b

https://theconversation.com/coronavirus-new-survey-shows-how-republicans-and-democrats-are-respondin

https://theconversation.com/coronavirus-new-survey-shows-how-republicans-and-democrats-are-respondin


“A novel idea: Ask students what they think about returning to campus: University of Connecticut

professor surveyed students for their ideas”, Smith-Barrow, 17 July 2020

• https://hechingerreport.org/a-novel-idea-ask-students-what-they-think-about-returning-to-campus/

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• https://www.theatlantic.com/ideas/archive/2020/07/colleges-are-getting-ready-blame-their-students/614410/

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• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313499/

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“National Center for Health Statistics, Mental Health: Household Pulse Survey”, CDC, July 2020

• https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm

“How 2020 is Impacting Gen Z’s Worldview”, Morning Consult, 2020

• https://morningconsult.com/form/gen-z-worldview-tracker/

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Baicker, Willer, et.al, 30 April 2020

• https://www.nature.com/articles/s41562-020-0884-z

https://hechingerreport.org/a-novel-idea-ask-students-what-they-think-about-returning-to-campus/

https://hechingerreport.org/a-novel-idea-ask-students-what-they-think-about-returning-to-campus/

https://www.theatlantic.com/ideas/archive/2020/07/colleges-are-getting-ready-blame-their-students/61

https://www.theatlantic.com/ideas/archive/2020/07/colleges-are-getting-ready-blame-their-students/61

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7313499/

https://www.npr.org/sections/health-shots/2020/07/04/885546281/why-some-young-people-fear-social-iso

https://www.npr.org/sections/health-shots/2020/07/04/885546281/why-some-young-people-fear-social-iso

https://www.cdc.gov/nchs/covid19/pulse/mental-health.htm

https://morningconsult.com/form/gen-z-worldview-tracker/

https://www.wired.com/story/colleges-prepare-to-test-thousands-of-students-for-covid-19/

https://www.wired.com/story/colleges-prepare-to-test-thousands-of-students-for-covid-19/

https://www.nature.com/articles/s41562-020-0884-z


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during the COVID-19 pandemic”, Pfattheicher, Nockur, Böhm, Sassenrath & Bang Petersen, 23

March 2020

• https://psyarxiv.com/y2cg5/

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2019

• https://www.tandfonline.com/doi/full/10.1080/10410236.2018.1563032

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and Suicide”, Well Being Trust & The Robert Graham Center for Analysis, 2020

• https://wellbeingtrust.org/areas-of-focus/policy-and-advocacy/reports/projected-deaths-of-despair-during-covid-19/

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COVID-19 Outbreak”, Ruiz, Horowitz & Tamir; Pew Research, 1 July 2020

• https://www.pewsocialtrends.org/2020/07/01/many-black-and-asian-americans-say-they-have-experienced-discrimination-amid-the-covid-19-outbreak/

“For Black Men, Fear That Masks Will Invite Racial Profiling”, Bryson Taylor, 14 April 2020

• https://www.nytimes.com/2020/04/14/us/coronavirus-masks-racism-african-americans.html

“Preventing suicide in the context of the COVID -19 pandemic”, McIntyre & Lee, 11 May 2020

• https://onlinelibrary.wiley.com/doi/10.1002/wps.20767

https://morningconsult.com/form/coronavirus-outbreak-tracker/#section-49

https://psyarxiv.com/y2cg5/

https://www.tandfonline.com/doi/full/10.1080/10410236.2018.156303

https://wellbeingtrust.org/areas-of-focus/policy-and-advocacy/reports/projected-deaths-of-despair-du

https://wellbeingtrust.org/areas-of-focus/policy-and-advocacy/reports/projected-deaths-of-despair-du

https://www.pewsocialtrends.org/2020/07/01/many-black-and-asian-americans-say-they-have-experienced-

https://www.pewsocialtrends.org/2020/07/01/many-black-and-asian-americans-say-they-have-experienced-

https://www.nytimes.com/2020/04/14/us/coronavirus-masks-racism-african-americans.html

https://www.nytimes.com/2020/04/14/us/coronavirus-masks-racism-african-americans.html

https://onlinelibrary.wiley.com/doi/10.1002/wps.20767


“We Need Better Masks”, Dhillon, Karan, Beier & Srikrishna, 18 June 2020

• https://hbr.org/2020/06/we-need-better-masks

“In another Covid-19 disparity, Black and Hispanic Americans are dying at younger ages than

white Americans”, Cooney, 10 July 2020

• https://www.statnews.com/2020/07/10/covid-19-disparity-black-hispanic-americans-deaths-under-65/

“Black U.S. adults follow many COVID-19 news topics more closely, discuss the outbreak more

frequently”, Mitchell & Jurowitz; Pew Research, 5 June 2020

• https://www.pewresearch.org/fact-tank/2020/06/05/black-u-s-adults-follow-many-covid-19-news-topics-more-closely-discuss-the-outbreak-more-frequently/

“Black Americans face higher COVID-19 risks, are more hesitant to trust medical scientists, get

vaccinated”, Gramlich & Funk; Pew Research, 4 June 2020

• https://www.pewresearch.org/fact-tank/2020/06/04/black-americans-face-higher-covid-19-risks-are-more-hesitant-to-trust-medical-scientists-get-vaccinated/

“The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States”,

Geno Tai, Shah, Doubeni, Sia & Wieland, 10 July 2020

• https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa959/5869621

“College students return to campus in a few weeks. We wanted to know their thoughts about

quarantine, symptom tracking, contact tracing, and mask wearing on campus, so my grad

student and I did focus groups to find out.”, Pagoto & Groshon; Twitter Thread, 11 June 2020

• https://threadreaderapp.com/user/DrSherryPagoto

“Correcting misperceptions of exponential coronavirus growth increases support for social

distancing”, Lammer, Crusius & Gast, 15 June 2020

• https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-616883

https://hbr.org/2020/06/we-need-better-masks

https://www.statnews.com/2020/07/10/covid-19-disparity-black-hispanic-americans-deaths-under-65/

https://www.statnews.com/2020/07/10/covid-19-disparity-black-hispanic-americans-deaths-under-65/

https://www.pewresearch.org/fact-tank/2020/06/05/black-u-s-adults-follow-many-covid-19-news-topics-m

https://www.pewresearch.org/fact-tank/2020/06/05/black-u-s-adults-follow-many-covid-19-news-topics-m

https://www.pewresearch.org/fact-tank/2020/06/04/black-americans-face-higher-covid-19-risks-are-more

https://www.pewresearch.org/fact-tank/2020/06/04/black-americans-face-higher-covid-19-risks-are-more

https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa959/5869621

https://threadreaderapp.com/user/DrSherryPagoto

https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-616

https://search.bvsalud.org/global-literature-on-novel-coronavirus-2019-ncov/resource/en/covidwho-616


“Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino

Communities in the U.S.”, Substance Abuse and Mental Health Services Association, 2020

• https://www.samhsa.gov/sites/default/files/covid19-behavioral-health-disparities-black-latino-communities.pdf

“How behavioral science can promote positive actions during COVID-19”, Quartz, 10 June 2020

• https://www.weforum.org/agenda/2020/06/behavioral-science-social-distancing

“How Masks Went From Don’t-Wear to Must-Have”, Molteni & Rogers, 2 July 2020

• https://www.wired.com/story/how-masks-went-from-dont-wear-to-must-have/

National Institute of Mental Health, Suicide Prevention & COVID-19

• https://www.nimh.nih.gov/topics/topic-page-suicide-prevention.shtml

“Morbidity and Mortality Weekly Report: Public Attitudes, Behaviors and Beliefs Related to

COVID-19, Stay-at-Home Orders, Nonessential Business Closures and Public Health Guidance –

United States, New York City and Los Angeles” CDC, 12 June 2020

• https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e1.htm?s_cid=mm6924e1_w

“Most Americans Say the Current Economy Is Helping the Rich, Hurting the Poor and Middle

Class”, Igielnik & Parker; Pew Research, 11 Dec 2019

• https://www.pewsocialtrends.org/2019/12/11/most-americans-say-the-current-economy-is-helping-the-rich-hurting-the-poor-and-middle-class/

“Quarantine Fatigue is Real”, Marcus, 11 May 2020

• https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-help/611482/

https://www.samhsa.gov/sites/default/files/covid19-behavioral-health-disparities-black-latino-commun

https://www.samhsa.gov/sites/default/files/covid19-behavioral-health-disparities-black-latino-commun

https://www.weforum.org/agenda/2020/06/behavioral-science-social-distancing

https://www.wired.com/story/how-masks-went-from-dont-wear-to-must-have/

https://www.nimh.nih.gov/topics/topic-page-suicide-prevention.shtml

https://www.cdc.gov/mmwr/volumes/69/wr/mm6924e1.htm?s_cid=mm6924e1_w

https://www.pewsocialtrends.org/2019/12/11/most-americans-say-the-current-economy-is-helping-the-ric

https://www.pewsocialtrends.org/2019/12/11/most-americans-say-the-current-economy-is-helping-the-ric

https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-he

https://www.theatlantic.com/ideas/archive/2020/05/quarantine-fatigue-real-and-shaming-people-wont-he


“Reuters Institute Digital News Report 2020”, Newman, Fletcher, Schulz, Andi & Nielsen, 2020

• https://reutersinstitute.politics.ox.ac.uk/sites/default/files/2020-06/DNR_2020_FINAL.pdf

“Some Americans refuse to mask up. Rules, fines and free masks will change that, experts say.”,

Shannon, 12 July 2020

• https://www.usatoday.com/story/news/nation/2020/07/12/coronavirus-should-i-wear-mask-pressure-fines-rules/5378625002/

“Social Distancing during the COVID-19 Pandemic: Who Are the Present and Future

Noncompliers?”, Pederson & Favero, 22 May 2020

• https://onlinelibrary.wiley.com/doi/full/10.1111/puar.13240

“Act Now To Get Ahead Of A Mental Health Crisis, Specialists Advise U.S.”, Noguchi, 13 May 2020

• https://www.npr.org/sections/health-shots/2020/05/13/850665769/act-now-to-get-ahead-of-a-mental-health-crisis-specialists-advise-u-s

“The Dudes Who Won’t Wear Masks”, Marcus, 23 June 2020

• https://www.theatlantic.com/ideas/archive/2020/06/dudes-who-wont-wear-masks/613375/

“The Fullest Look Yet at the Racial Inequity of Coronavirus”, Oppel Jr., Gebeloff, Lai, Wright &

Smith, 5 July 2020

• https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-americans-cdc-data.html

“The Psychology Behind Why Some People Refuse To Wear Face Masks”, Wong, 1 July 2020

• https://www.huffpost.com/entry/psychology-why-people-refuse-wear-face-masks_l_5efb723cc5b6ca970915bc53

https://reutersinstitute.politics.ox.ac.uk/sites/default/files/2020-06/DNR_2020_FINAL.pdf

https://www.usatoday.com/story/news/nation/2020/07/12/coronavirus-should-i-wear-mask-pressure-fines-

https://www.usatoday.com/story/news/nation/2020/07/12/coronavirus-should-i-wear-mask-pressure-fines-

https://onlinelibrary.wiley.com/doi/full/10.1111/puar.13240

https://www.npr.org/sections/health-shots/2020/05/13/850665769/act-now-to-get-ahead-of-a-mental-heal



https://www.theatlantic.com/ideas/archive/2020/06/dudes-who-wont-wear-masks/613375/

https://www.theatlantic.com/ideas/archive/2020/06/dudes-who-wont-wear-masks/613375/

https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-americans-cdc-data.htm

https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-americans-cdc-data.htm

https://www.huffpost.com/entry/psychology-why-people-refuse-wear-face-masks_l_5efb723cc5b6ca970915bc

https://www.huffpost.com/entry/psychology-why-people-refuse-wear-face-masks_l_5efb723cc5b6ca970915bc


“U.S. Media Polarization and the 2020 Election: A Nation Divided”, Jurkowitz, Mitchell, Shearer &

Walker; Pew Research, 24 Jan 2020

• https://www.journalism.org/2020/01/24/u-s-media-polarization-and-the-2020-election-a-nation-divided/

“Situation Report 9: COVID-19 transmission across Washington State”, Etzioni, Ferres, Burstein,

Hynh, et.al, 17 July 2020

• https://covid.idmod.org/data/WA_Situation_Report_9_COVID-19_transmission_across_Washington_State.pdf

“Three Months In, Many Americans See Exaggeration, Conspiracy Theories and Partisanship in

COVID-19 News”, Mitchell, Jurkowitz, Oliphant & Shearer, 29 June 2020

• https://www.journalism.org/2020/06/29/three-months-in-many-americans-see-exaggeration-conspiracy-theories-and-partisanship-in-covid-19-news/

“Tie Strength, Embeddedness, and Social Influence: A Large-Scale Networked Experiment”, Aral

& Walker, 21 April 2014

• https://pubsonline.informs.org/doi/10.1287/mnsc.2014.1936

“Analyzing barriers for implementation of public health and social measures to prevent the

transmission of COVID-19 disease using DEMATEL method”, Maqbool & Khan, 14 June 2020

• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293847/

“Health Equity Considerations & Racial & Ethnic Minority Groups”, CDC, 24 July 2020

• https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fracial-ethnic-minorities.html

“Coronavirus Disease: People Experiencing Homelessness”, CDC, 10 August 2020

• https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/homelessness.html

https://www.journalism.org/2020/01/24/u-s-media-polarization-and-the-2020-election-a-nation-divided/

https://www.journalism.org/2020/01/24/u-s-media-polarization-and-the-2020-election-a-nation-divided/

https://covid.idmod.org/data/WA_Situation_Report_9_COVID-19_transmission_across_Washington_State.pdf

https://covid.idmod.org/data/WA_Situation_Report_9_COVID-19_transmission_across_Washington_State.pdf

https://www.journalism.org/2020/06/29/three-months-in-many-americans-see-exaggeration-conspiracy-the

https://www.journalism.org/2020/06/29/three-months-in-many-americans-see-exaggeration-conspiracy-the

https://pubsonline.informs.org/doi/10.1287/mnsc.2014.1936

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293847/

https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/race-ethnicity.html?CDC_AA_refVal=




https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/homelessness.html

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/homelessness.html


“Coronavirus Disease: Pregnancy & Breastfeeding”, CDC, 25 June 2020

• https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

“Coronavirus Disease: People with Disabilities”, CDC, 7 April 2020

• https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-disabilities.html

“Structural diversity in social contagion”, Ugander, Backstrom, Marlow & Kleinberg, 17 April 2012

• https://www.pnas.org/content/109/16/5962#sec-1

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/pregnancy-breastfeeding.html

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-disabilities.html

https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-disabilities.html

https://www.pnas.org/content/109/16/5962#sec-1

Appendix 3: Topline Research Results

WA DOH COVID-19Topline Research ResultsSeptember 3, 2020

Methodology

Research Objectives

• Goal: To understand barriers and potential motivations to complying with COVID-19 safe behaviors among the priority audience

• In a way that:• Drives clarity about if/how barriers and motivations are different for audience sub-segments• Identifies important influencers for audience sub-segments• Provides direction for messaging context, tone and feel for audience sub-segments• Provides insight into how likely the various audience sub-segments would be to change their

behavior

• So that: We can create an effective social marketing campaign that increases compliance by the priority audience

Methodology

• Online qualitative discussion boards using Revelation platform

• Customized with a rolling recruitment approach to allow for real time identification of themes

• Designed to:• Get at the underlying “truths” of the audience

• Identify and manage bias (ours and theirs)• Identify aspiration vs actual

• Be a discussion, not a Q&A, to get at what’s important to the audience

• Participants feel comfortable sharing their opinions in this venue because the look & feel is similar to social media platforms

• Participants engage from the comfort of their homes, and at times that are convenient for them

• Moderators gather deeper information by using a robust suite of tools including individual discussions, writing exercises, interactive heat maps, picture projection, etc.

Quick-Turn Approach

Week 1 Week 3

Week 4

Week 5

Week 2

• Screener written and approved• Discussion guide

written and approved

• First wave participants

• Topline • Second wave

participants

• Topline • Third wave

participants

• Topline • Fourth wave

participants

Week 6

• Topline • Fifth wave

participants

Those with Conservative Values: 26 Young Adults: 18 - 24: 21

Participant Specifications

Rural Urban/Suburban

Age Men Women Men Women18 - 29 1 3 8 330 - 45 1 3 2 5

Rural Urban/Suburban

Values Men Women Men WomenConservative 2 3 4 4Liberal 0 2 3 3

• 1 African American/Black, 1 Hispanic, 2 Asian, 2 Pacific Islander

• 1 African American/Black, 2 Hispanic, 3 Asian, 1 Pacific Islander

Discussion Guide: Participant Experience

DAY 1 DAY 2 DAY 4

• Introductions• Context Setting• General

Attitudes about behaviors

• General Influences on behaviors

Response to 3 ads• Understandable• Informative• Relevant• Believable• Engaging• Motivating

Key Behaviors 1 & 2• Pros and Cons• Barrier

Statements• Potential

Motivators

DAY 3

Key Behavior 3• Pros & Cons• Barrier

Statements• Potential

MotivatorsProjective Exercises • Motivators for 3

Behaviors

The Emotional Context

How are people feeling about the key behaviors?

People with Conservative Values

Wearing masks cues feelings of anger, fear and sadness

COVID IS LITERALLY ‘IN THEIR FACE’ CONSTANTLY• Makes people feel unnecessary danger

and fear • Adds to isolation because they hinder

communication• Loss of control / feeling manipulated• It’s just uncomfortable

SOME ACKNOWLEDGE THE BENEFITS• Helps to keep others safe• Helps to end the pandemic• Provides security / safety

Physical distancing can be difficult, but not as distressing as wearing masks

THE NEGATIVE FEELINGS ADD UP• Avoiding people is lonely & isolating • It’s awkward, frustrating & hard to do • Can’t controll others• It’s a reminder of the situation

HOWEVER, IT IS SEEN AS REASONABLE• Many like the social distance• Safe but not invasive• It’s a way to be compassionate• Might help end the pandemic – it fits

with typical ways to handle a virus

Hand sanitizing/washing is important & they think they are doing a sufficient job

SOME ISSUES WITH INCREASING WASHING / SANITIZING• Not always convenient• Forget hand sanitizer• Hurts immune system• Concerned about not doing enough

BELIEVE THEY ALREADY DO THIS AND IT MAKES SENSE• They think they already do this behavior• Seen as typical way to not spread germs • They like the physical feeling of having

clean hands

Young Adults

Wearing masks is difficult physically and emotionally

THERE IS A LOT TO COMPLAIN ABOUT• Difficult to breathe & uncomfortable

• It’s a hassle to remember & inconvenient when forgotten

• Makes social interactions challenging

• It’s frustrating when others don’t wear masks & isolating to be the only one wearing a mask

DESPITE ISSUES, WILLING TO MAKE THE EFFORT• Hopeful that wearing masks will stop the spread • Satisfied knowing that they’re doing their part

to slow the spread• Caring for others • At peace with reality of having to wear masks

Physical distancing takes a toll, but benefits are understoodTAKES A TOLL & NOT ALWAYS EASY• Lonely & isolating to avoid people• Awkward to greet and say goodbye• Frustrating not to be physically close• Hard to do – can’t always judge

accurately & sometimes don’t have room• Annoying when others aren’t complying• A reminder of the situation

UNDERSTAND / EMBRACE THE BENEFITS• Some prefer to stay distanced from others• Compassionate by caring for others• Sends the right message to others• Feels safe without feeling invasive• Seems logical & can help end this

Limiting gatherings is hard to execute FRUSTRATING AND DIFFICULT• Adds to isolation• Understand distancing with strangers,

but not friends• Annoying & stressful to constantly try and

assess 6ft of distance• Long lines & limited capacity are

frustrating• Isn’t wearing a mask enough?

TRY TO COMPLY TO BE GOOD CITIZEN• Relieved knowing that they’re at a safe

distance• Some didn’t like being close to people

before, anyway• A sign of showing care and respect for

others

Barriers


Physical Distancing

WashingSanitizing Hands

Gathering w/5 -, Outside

JUSTIFICATION

IMPLICIT SOCIAL CONTRACTS



MESSENGER OUTWEIGHS THE MESSAGE

BEHAVIORS NOT WORTH IMPACT ON SOCIETY

Intensity of barrier by behavior by audience

YOUNG ADULTS PEOPLE WITH CONSERVATIVE VALUES


Physical Distancing

WashingSanitizing Hands


PHYSICAL DISCOMFORT

REQUIRES PROACTIVE PLANNING / FORGETTING

VENUE INFLUENCES

NOT EVERYONE COMPLIES

I THINK I’M DOING IT RIGHT (BUT NOT)

Intensity of barrier by behavior by audience


Justification: Three key ways people justify

1. THEY MANAGE RISK BASED ON COMBINATIONS OF FACTORS• LOCATION: Outside is better than inside• PHYSICAL DISTANCE: Keep six feet apart• MASKS: Wear them!• CROWD SIZE: Five people or less

2. RULES ARE RELAXED WITH FRIENDS & FAMILY• FRIENDS: Those in my immediate “bubble”• FAMILY: Immediate & extended

3. WHEN INSIDE, THEY PICK TWO OUT OF THREE• Wear a mask• Physically distance• Gather with a smaller group

DON’T WANT TO GO AGAINST MY PEERS/FRIENDS• Reluctant to challenge friends, or say

no• Don’t want to hurt anyone’s feelings

YOUNG ADULTS DON’T HAVE “THE CONVERSATION”• Make assumptions about friend

behavior• “Trust” friend group

Implicit social contracts: friends, family & society

DON’T WANT TO ROCK THE BOAT • Don’t want to stand out in a crowd• Read and respond to social cues • Don’t want to be rude

FAMILIES HAVE THEIR OWN SOCIAL STRUCTURES• Milestone celebrations are hard to

avoid• Saying no risks rejection from our first

and strongest social bonds• Cultural norms play a role

Seeking relief from social isolation and depression

SOME OF THE BEHAVIORS IMPACT RELATIONSHIPS

• MASKS: Make it hard to read facial expressions and to share a smile

• PHYSICAL DISTANCING: People are missing physical touch with friends and family

• GATHERING WITH FIVE OR LESS, OUTSIDE: Choosing who to meet with among friends is stressful

Inconsistent Information

IT’S HARD TO KNOW WHAT TO BELIEVE

• Confluence of the evolution of science with hearing vastly different information from a variety of so-called experts

• Trust science, but can’t seem to find a messenger that seems sincere• Even reliable sources change over time

The messenger outweighs the message

POLITICIANS WITH THEIR OWN AGENDA

• COVID is being leveraged by politicians/political parties

• The WAY these new measures are being implemented—they feel their rights are at risk

WE ARE BEING MANIPULATED• Politicians who want to win the election

• Distract us from more important issues

CONCERN ABOUT NEGATIVE IMPACT ON THE AMERICAN PSYCHE & WAY OF LIFE

• People are living in fear, and that’s not necessary

• The absence of normal social interactions is doing harm to people’s mental health• The impact to the local economy

The behaviors are not worth the impact on society

Motivators

MOTIVATORS WearingMasks

Physical Distancing

Washing/ Sanitizing Hands


PROTECTING OTHERS


LIVING OUR VALUES –PATRIOTISM / COMMUNITY MINDED

WANT PANDEMIC OVER WITH

FIRST HAND / PERSONAL EXPERIENCE

SOCIAL NORMS / PEER PRESSURE


Intensity of motivation by behavior and audience


Protecting others

PROTECT OTHERS (YOU DON’T WANT TO BET SOMEONE ELSE’S LIFE)• Caring for others is an important value

• Don’t want to be the cause of someone else’s pain

• You never know if you’ll cross paths with someone vulnerable

• It’s a small sacrifice

Be considerate and respectful


• You never know who might be vulnerable• Don’t want to make others uncomfortable

• Helps preserve social norms

Living our values -- Patriotism, community minded

LETTING CORE VALUES BE THE GUIDE

• Some people with conservative values say complying is patriotic

• Young adults are very community minded, and want to behave in a way that demonstrates this• There’s no significant downside

Get this over with!

DO WHATEVER WE CAN TO GET THIS OVER WITH ASAP (NOT FOREVER, BUT FOR NOW)

• Strong desire to get social needs met

• Miss all the activities they can’t do now

• Don’t like the current emotional atmosphere

Personal experiences / connections

WHEN IT HITS HOME PEOPLE WILL RE-THINK THEIR BEHAVIOR CHOICES

• Seeing someone you know or care about suffering

• It’s not about the masses, it’s about the individuals

• Knowing a friend or family member’s story is the most impactful

Peer pressure

SOCIAL ACCEPTANCE / SOCIAL NORMS

• It’s uncomfortable to be in the minority – not doing the key safety behaviors

• Need to be accepted by peers

• Peer pressure works both ways (to do behavior, or not do it)

Mandates & reminders


• They will respect the law, even if they disagree

• Stickers on the floor and sanitizer at the register help them remember to do things that are not habitual

• Some have adopted personal habits to remember masks –like always having it by the car keys

Response to Ads

Young adults:response to ads

AttributeYoung Adults

Believable

Relevant

Engaging

Informative

Motivating

Symptoms ad got a favorable response from young people, especially vs. those with conservative values

MOSTLY POSITIVE FOR YOUNG ADULTS• Gave them a perspective about how it affects

others – building on how they care more for others

• Liked the varied voices and seemed realistic• Made them think twice about their behaviors• Liked the overall style

Watch ad here: Symptoms

https://www.youtube.com/watch?v=pI_GzKgryvs

Attribute Young Adults

Believable

Relevant

Engaging

Informative

Motivating

Survival Guide was believable and relevant, but not very engaging, informative or motivating

GOOD CONTENT, BUT VOICE OVER WAS NOT WELL RECEIVED• Was seen as relevant• Scored low on motivating • Some thought a bit juvenile• The use of “literally saves lives” had a big

negative impact• Want more scientific confirmation

Watch ad here: Survival Guide

https://www.youtube.com/watch?v=CrcFYIUbChU

“Wanna Bet?” resonates strongly with the young adult audience

Attribute Young Adults

Believable

Relevant

Engaging

Informative

Motivating

WANNA BET? PERFORMED EXTREMELY WELL• Very positive response to this ad• Believable, relatable, engaging & motivational• Honest about how the audience feels• “Not forever, but for now” and “It’s not worth betting

someone else’s life” are very motivating• No new information, but very validating• A few negative reactions from young men

Watch ad here: Wanna Bet?

People with conservative values: response to ads

Symptoms relied too much on scare tactics for most people with conservative values

NOT VERY MOTIVATING FOR PEOPLE WITH CONSERVATIVE VALUES• Makes true statements, but no new information• Trying to manipulate using scare tactics• Not “real people” is suspect• Some were moved because made them think of

loved ones that they would not want to suffer

AttributePeople w/

Conservative Values

Believable

Relevant

Engaging

Informative

Motivating Watch ad here: Symptoms

https://www.youtube.com/watch?v=pI_GzKgryvs

“Mask-up” was the most motivating overall

APPRECIATED THE POSITIVE TONE & FEEL• Liked the way it wasn’t all about fear• Liked the upbeat tone of voice • Some people actually said they would change

their behavior• Some new information about washing masks• A few people did not like this concept; did not

believe the messages

AttributePeople w/

Conservative Values

Believable

Relevant

Engaging

Informative

MotivatingWatch ad here: Mask-Up

https://www.youtube.com/watch?v=-fQKhyR33OQ

“Goodbye” was polarizing

SOME FELT IT USED EMOTION TO MANIPULATE• Overall it is believable, demonstrating what

people have heard before• Very emotional – reaches the mind and heart• Very motivating to people who are already

trying • Some people reacted very negative to scare

tacticWatch ad here: Goodbye

AttributePeople w/

Conservative Values

Believable

Relevant

Engaging

Informative

Motivating

https://www.youtube.com/watch?v=mEXtfNaSP0I

Key Themes

Top Themes

1. People want this “over with”: People know about the desired behaviors and they want to do the right thing. Both audiences are really tired of COVID-19 and they just want it to be over so things can go back to “normal.”

2. People are justifying: When people from both audiences don’t comply with the behaviors, they justify why. They are thinking about compliance to multiple behaviors in terms of perceived risk, and seem to use their own “formula” for determining which behaviors to comply with in any given situation. They think they will be okay if they do one or two of the behaviors. They don’t see them as a package of behaviors that should be done all together.

3. Wearing masks has a strong emotional toll: Wearing a mask makes people from both audiences feel bad because it’s hard to communicate verbally and via facial expressions. Masks are also physically uncomfortable, which was another strong barrier for both audiences.

Top Themes

4. Long distance Is tough: Physical distancing is also a difficult behavior emotionally, although not as difficult as wearing masks. Both audiences are somewhat accepting of this behavior and have used it in relation to other viruses. However, they justify not complying with physical distancing with close friends and family members they don’t live with.

5. Washing/sanitizing hands is already a habit: Washing/sanitizing hands before, during and after being out in public is perceived differently than the other key behaviors in this study. There are not strong barriers except for the physical ones (no washroom or sanitizer on hand). And, people think they already do this behavior – it’s something that is expected when fighting a virus.

6. Don’t underestimate peer pressure: Implicit social contracts and peer pressure are strong barriers for young adults but also exist for people with conservative values. These social contracts exist within families and among friend groups. People want to see that others are complying with the key behaviors, and that they are not the outlier. This is both a barrier and a potential motivator for both audiences.

Top Themes

7. Lack of trust is preventing adoption: Barriers that are stronger among people with conservative values include the perception of Inconsistent information which is driving doubt, a lack of trust in the messengers which leads to feeling manipulated and the belief that the behaviors aren’t worth the cost to society.

8. Mandates work: People with conservative values are motivated by mandates – they tend to be rule followers, and will comply with a mandate because they want to be a good citizen even if they don’t agree with the behavior.

9. Using a variety of messaging styles is effective: The audiences reacted well to different messaging tactics. People with conservative values reacted well to the straightforward educational style of messaging. Young adults can tell and react well when the messaging and visuals are crafted to them and are empathetic to how they are feeling. Scary messages are polarizing – some react well, others are turned off.

Thank You.Julie [email protected] Western Avenue, Suite 702 | Seattle, WA 98104

social marketing recommendations · 2020. 10. 1. · washington state department of health | social...

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