COVID-19 has rapidly sparked one of the largest behaviour change campaigns in history, one on which countless lives (and economies) globally, depend. Governments all over the world are reacting and increasingly trying to find solutions to achieve population level behavioural compliance with a range of behaviours including “hand hygiene”, “respiratory etiquette”, “lockdown” and “social distancing”. People need to comply with vital changes to their everyday lives. However, to do so, it seems governments need to do more than provide information, statistics and coercion through regulation.
There are well established arguments that public health campaigns rely heavily on treating all people as the same using education (show me) and law (make me) while overlooking one of the most effective ways to achieving change – marketing (help me).
Many people don’t like being told what to do and reactance occurs when tight regulation measures that people don’t agree with are in place, resulting in non-compliance
In Australia, there are some, who continue to disregard advice communicated through government messaging and behave as though nothing has changed. The medical and epidemiological professionals – using education and law approaches, have led conversations about behaviour change and compliance. But many people are not complying despite the evidence. Groups of teenagers are meeting at car rallies, families are going to the beach and people continue to hold house parties. While it is easy to put some of the non-compliance down to a lack of understanding, it is clear that not everyone is on board. Contrary to popular beliefs, knowing and regulating cannot move everyone to comply. More people respond positively when offered solutions that meet their needs and wants.
Marketing, used for decades to offer people solutions, is a powerful approach for achieving social good. In simple terms, marketing can create solutions where everyone wins.
I win – you win – we all win
Different groups of people respond differently to available offers and calls to action. People not only differ by age and gender, but also by their values and lifestyles. This is why we have so many products and services on the market. Communicating to people to start a new behaviour is also different from getting someone to give up an old behaviour. Getting people to wash their hands before they enter a supermarket is very different from getting someone to give up smoking. To develop and communicate our solutions effectively, we must understand how people think and feel about the behaviours we are asking them to start or stop. We need to put aside our own assumptions and be ready to really listen and learn.
“Nothing about me without me” is a well-known tagline of the human centred-design movement in participatory health care.
People with large backyards and full pantries will experience the changes required to respond to COVID-19 in an entirely different way to those living alone with limited finances or those now without a job. For each group, communicating and supporting the desired behaviours (and the undesirable ones) need different approaches using different types of media and proposing different solutions; based on deep insight gained by listening to each group. For example, we see in the UK calls to open up golf courses and school playing fields to provide spaces to enable people without backyards to practice social distancing while they exercise and avoid overcrowding in public parks.
Governments also need to communicate something of value to each and every segment so they can understand, engage and comply with the desired behaviours. Using marketing can help people understand and find meaning in these behaviours including social isolation and staying at home and may also assist in charting a course to minimise the mental health tsunami that is no doubt developing in our communities.
Identifying how to find the right messages and support tools for each group is where the art of marketing comes in. We are asking people to give up many regular behaviours they value and enjoy, and to engage in a set of behaviours they may not. The job at hand is to identify what the value of each behaviour or set of behaviours might be to each group, and to bundle that up and offer it in exchange for compliance. It is also important to remember, these ‘value offerings’ will vary between groups. Marketing is a voluntary approach and when applied there is less reactance to marketing approaches than there are to education or law approaches.
For example, rather than just tell people to stay at home and self-isolate, you could market the idea to music festival fans of staying at home very differently during a Pandemic “This year’s best festival is on Couchella”.
When people adopt these offerings, observations of the desired outcomes (e.g. staying at home to practice social distancing) are more likely. Michael Rothschild offered a guide (see Figure 1) to help understand which of the three main approaches (marketing, law, education) should be used and under what conditions. We explain each of these approaches in detail below.
Why marketing matters in a crisis
1. Marketing
Exchange sits at the core of marketing, reflecting the understanding that in order for exchange to occur there are two parties, both of whom receive something they value and win when they transact over time.
Rothschild proposes that marketing is appropriate for helping people when people are motivated and able to adopt desired behaviours, but are resistant to behave due to absence of environmental opportunities, in the form of supportive infrastructure or tangible products or services which enable the behaviour.
For example, when people are unable to purchase hand sanitiser, no matter how motivated they are or how much knowledge they have around correct handwashing techniques, without access to hand sanitiser they cannot comply. This is where marketing has stepped in to innovate with new ways of producing necessary goods and services.
The speed at which companies have adapted their production in response to the COVID-19 pandemic demonstrates how parties can come together to win. Faced with declining or zero business, some corporations have radically shifted their focus to deliver products and solutions needed to serve our communities and reduce the spread of COVID-19. For example, many Australian distilleries have switched from making booze to hand sanitizer. Companies such as Detmold (South Australia) are changing their production lines to deliver 145 million face masks while Triple Eight Race Engineering refocussed their capacity following the cancellation of the Australian Grand Prix. They are currently working on developing a low-cost ventilator prototype. These examples demonstrate how marketing develops solutions to problems and enable people to participate in the desired behaviour, in the case of health workers, enabling them to wear protective clothing and equipment required to perform their health and medical care roles.
As stated before, just as firms apply marketing to make a profit, its application can also deliver beneficial social, health and environmental outcomes. Evidence reviews abound showcasing marketing’s capacity to deliver outcomes benefitting people and the planet. Programs, products and services can continue to be implemented online in COVID-19 times include alcohol programs, health and wellbeing programs, training services, concerts and the House Party App to deliver positive health and social outcomes.
Beyond Blue is increasing capacity through developing new service offerings such as dedicated COVID-19 online support communities to assist people experiencing increased anxiety and mental health issues caused by societal changes resulting from the COVID-19 pandemic. Beyond Blue are advertising their new services through a range of channels to ensure people needing them are aware of the options they can access to gain support during the pandemic. Social Marketing Associations around the world have also developed guidelines on responding to pandemics available below.
European Social Marketing Association COVID-19 Best practice Guidance
European Centre for Disease Control (ECDC) Technical Guide to Social Marketing
Effective Evidence Based Communication in Outbreak management tools
2. Education
Rothschild proposes that education or communication-only approaches to promote socially desirable behaviour are appropriate for showing people when the target audience is motivated, able, and perceives their environment supports the behaviour. The only component missing is awareness of benefits of, or how to “do” the promoted behaviour. Education, for example, reduced the incidence of Sudden Infant Death Syndrome (SIDS) by educating parents to put their infants to sleep on their back. Examples of education in response to this crisis abound as various Governments work to manage public health.
For example, the Australian Government, the UK’s NHS have released tool kits outlining the series of behaviours people need to do including washing hands for 20 seconds, maintaining social distance and more.
Similarly, Vietnam has distributed cards to educate the public on preventive behaviours in a visual form.
Other education efforts are being implemented to further reduce COVID-19 impacts. For example, the Queensland Government is encouraging citizens to get a flu shot with dedicated materials produced for communities at the highest risk of catch flu and Asthma Australia is producing materials for health professionals to assist people with asthma during the pandemic.
These resources assist to raise awareness and remind people who are highly motivated to perform behaviours that can assist to slow the spread of the COVID-19 virus, and they provide critical services for people in need. As new evidence emerges, the resources delivering guidance to the community served are updated.
When you can’t regulate maintenance of hand hygiene, you can only communicate the benefits of behaviours or regulate to control the behaviours. Education approaches that provide information can:
- Show people how to wash their hands
- Remind people to wash their hands
- Scare people about the consequences of poor hand hygiene
Information approaches adopted globally show celebrities and popular figures washing hands to the tune of their favourite songs. Sun Hung Kai Properties in Hong Kong has undertaken several such initiatives to promote hand hygiene in their malls to reduce the spread of COVID-19 infections.
3. Law
Rothschild (1999) reminds us there will always be a need for law to enforce the behaviour to make the last few who are unwilling to change their behaviours, despite perceptions of ability, presence of opportunities in the environment, and awareness of benefits of the promoted behaviour. Governments around the world are using the ‘make me’ approach. For example, New South Wales has imposed self-isolation measures for the foreseeable future that come with stiff penalties if violated. House parties still held after policy changes showcase why there is a need for law. Despite 24-7 news coverage and large-scale promotion to notify the public of new rules, some people continue to hold house parties, indicating everyone is not on board. Police agencies have redeployed staff to increase presence and in doing so, will be more able to enforce to slow the spread of COVID-19.
Concluding thoughts
We know there are difficult times ahead of us and there is an important need for ongoing programs to protect our citizens and particularly, our most vulnerable people (homeless, victims of domestic violence, those suffering decline in mental health, people with disabilities and their carers, the aged, and so many more). No one solution will adequately address the wicked challenge of COVID-19 and its short and long-term consequences. Marketing, education and law are all tools in our kit to use simultaneously to develop effective solutions to help most people comply with required behaviours to stop the spread.
These multi-solution approaches require the involvement and cooperation of multiple stakeholders across all levels of government, business and the community. This significant challenge invites innovation to find solutions using a range of integrated approaches and together, we can stop the spread.
Authors: Dr. Joy Parkinson, Prof. Sharyn Rundle-Thiele, Assoc Prof. Sameer Deshpande, Dr. Timo Dietrich
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