Utilizing Social Marketing Utilizing Social Marketing and Motivational and Motivational

Interviewing to improve Interviewing to improve DiabetesDiabetes

MED INF 401Bonnie Livingston

Kristina Rogers

Week 9 – May 28, 2008

What is Diabetes Mellitus?What is Diabetes Mellitus?Disease in which insulin is either not

produced or ignored by the bodyIt is a chronic diseaseThere are two types:

◦Type I◦Type II

Type I DiabetesType I Diabetes• Most Commonly seen in children or

young adults• Also known as juvenile onset or insulin-

dependent diabetes• It is an autoimmune disorder in which

the body is unable to produce insulin• Approximately 5-10% of diabetics have

type I diabetes

Type II DiabetesType II Diabetes• Also known as Adult onset or non-

insulin dependent diabetes• It is the result of insulin resistance• An estimated 85-90% of type II

diabetics are overweight or obese• Increased # of fat cells contributes

to ineffectiveness of insulin, and glucose remains in circulation

• Now becoming more prominent in children as childhood obesity rises

Potential complications of diabetes include:

Heart diseasePeripheral neuropathy/amputationsKidney failure, dialysisRetinopathy which can lead to vision loss

More on DiabetesMore on DiabetesIn 2007, an estimated $174 billon was

spent on diabetes◦The annual cost per person was approximately

$11,744Prevalence rates are on the rise:

◦1980: 2.5%◦2002: 4.2%◦2007: 5.8%◦2050: estimated to be 12%

An alarming trend: pre-diabetes

54 million people Will most likely turn into DM if ignoredBlood glucose is elevatedMay have diabetic-type complications

Medical InterventionsNo cure for diabetesGlucose monitoring Medication

◦Type I – insulin◦Type II – oral medications or insulin

Lifestyle – diet and exerciseType II diabetics can slow progression or

reverse effects of their disease by maintaining a healthy weight

What is Social Marketing?What is Social Marketing?Essentially began in 1792Used to inform the American public of

governmental initiatives, proposed laws, legislation and policy

The term “Social Marketing”◦Created by Kolter and Zaltman in 1971◦Defined as:

“the application of commercial marketing technologies to the analysis, planning, execution and evaluation of programs designed to influence voluntary behavior to target audiences in order to improve their personal welfare and that of their society” (Andreasen 1995, pg. 7)

What is Social Marketing?What is Social Marketing?Designed to benefit individuals or a societyIt is a bottom-up approachConsumer-centered approachLimits:

◦Not effective on genetic or addictive disorders

Strengths:◦Effect on helping people sustain healthy, behavior change

Principles of Social MarketingPrinciples of Social MarketingThe Marketing Conceptual FrameworkRecognition of the CompetitionConsumer OrientationFormative ResearchSegmentation of the PopulationFeedback and Evaluation

Current Social MarketingCurrent Social Marketing“Sunny Side of Truth”

◦Anti-smoking campaign

“Above the Influence”◦Anti-drug campaign

Social Marketing and DiabetesSocial Marketing and DiabetesBenefits:

◦Weight loss, reduced stress, lower risk of stroke and heart disease, patient empowerment, increase self-esteem and increased life expectancy

What does it cost to the individual?◦Change old habits◦An alternative to fast food

Promote healthy lifestyles by using flyers, television and radio

What is Motivational Interviewing?What is Motivational Interviewing?

Defined as “a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence.”

Initially developed by William Miller in 1983 to help problem drinkers, and was further developed in 1991 by clinical psychologists Professor Bill Miller and Professor Stephen Rollnick.

Non-judgmental, non-confrontational and non-adversarial.

Motivational Interviewing con’t Through the MI technique, counselors attempt to raise their

clients’ awareness of risks and consequences of the behaviors they wish to change. Using directive communication, counselors attempt to help clients envision a better future and achieve behavior changes.

Components of MI include: - seeking to understand the client’s frame of reference - expressing affirmation - reinforcing the client’s own motivational desire- monitoring the client’s readiness to change

- affirming client’s freedom and self-direction

Decisional Balance Tool

STAY THE SAME MAKE SOME IMPROVEMENT

BENEFITS I like: I will like:

COSTS I don’t like: I won’t like:

What specific behavior change are you considering?_____________________

Does it work? Trial results

227 subjects, all in diet/exercise program Randomized to 2 groups: MI or an attention placebo

After 2 sessions, MI group had greater weight loss (5.4kg versus 3.9kg)

After 12 months, MI group maintained greater loss (4.7kg versus 2.7kg)

MI group also demonstrated better glycemic control

More studies being conducted, one to be completed in 2008

Conclusion….

Social Marketing and Motivational Interviewing may have a positive impact on the health outcomes of a population struggling with diabetes and possibly other behavior-related chronic diseases.

THANK YOU FOR YOUR TIMETHANK YOU FOR YOUR TIME

QUESTIONS???QUESTIONS???