Emerging from COVID-19 lockdown: advice for change agents - Social Marketing @ Griffith

As Australia, and many other parts of the world start to emerge from lockdown, we asked social marketing thought leader Professor Jeff French for his opinion on what behavioural strategies are needed for the phases ahead. Jeff is the CEO of Strategic Social Marketing and a Professor of Social Marketing at Brighton University Business School in the UK, and he shared his advice for governments and change agents for the next phases of the COVID-19 pandemic.

Let’s start with the current state of play.

Although advances are being made, we do not yet have a safe and effective vaccine. Without a vaccine, the key to reducing the social and economic impact of COVID-19 will be influencing the behaviour of citizens, and those who work to protect them.

Mass testing will be a tremendous help. Testing will identify those with some immunity, it will indicate the overall level of population immunity, and importantly, it will identify those who need to be isolated to break the chain of transmission. But by itself, testing cannot halt the disease. Effective communication and other forms of behavioural influence will be needed when priorities for testing change, when wider access to testing becomes available and subsequently when access to a vaccine occurs. Communication and potentially further intervention is also necessary as we see more people gathering to protest isolation measures. These will be key communication and behavioural influence challenges.

The good news is that we have a great deal of knowledge to draw on. Behavioural influence in the health sector, and specifically in relation to infectious disease has been studied, applied and researched for many years. The advice in this blog draws on research from a wide range of disciplines such as; health promotion, social marketing and health education, it is not limited to just behavioural psychology or behavioural economics.

How should we build on the actions that governments have taken so far?

The strategy encapsulated in the message ‘Stay home, save lives’ or ‘do our bit, stay home to stop the spread’, is a well evidenced immediate strategy for the current ‘lockdown’ phase. A Centre for Health Economics and Social Marketing @ Griffith led study suggests this message is working with Australians staying home 90% of the time during Stage 1. This nationwide survey has been set in place to help understand what people are doing here in Australia.

Results from Week 1 indicated that many Australians worked from home (70% ‘All of the time’), chose to avoid meeting friends (70% ‘All of the time’) and non-household family members (50% ‘All of the time’). Fewer Australians avoided public places like shops and parks (40% ‘All of the time’) but almost all abandoned their usual regular use of public transport (~90% ‘All of the time’).

Many countries have been consistently applying this messaging, continuously repeating and amplifying the message through both traditional and social media—which is a strategy backed by evidence from the field of health promotion, communication studies, advertising and social marketing.

In most countries, there has been an open and honest account of why the current measures have been adopted to fight the COVID-19 virus in the early stage of the pandemic. The current narrative being used to persuade people to comply with behaviours is based on expert supported statistical probability modelling combined with findings from intervention studies demonstrating the efficacy of specific measures to reduce contagion. This ‘driven by the science’ and ‘strong control from the top’ narrative is powerful in the short term when trust and concern is high, and it has had a significant impact on population level behaviour in many countries. However, as we ‘flatten the curve’, and move into a contagion management phase, there is a need to develop a more strategic long-term social marketing, communication and behavioural influence strategy as a central part of easing lockdowns over the coming months.

What strategies do we need to add as we move into the next phases?

As restrictions start to ease, we will need to supplement central direction with sustained community driven action. Consulting the scientific data on COVID-19 and communicating directions from the top should be maintained, but we need to supplement this with an additional narrative—one that speaks to the total community response that will be required over the medium and long term. This complementary narrative will be needed to reinforce and sustain the current mass participation in social distancing and hygiene imperatives when lockdowns start to be eased. The overall behavioural aim will be to sustain and, in some cases, permanently change behaviours over the long-term.

Based on research and practice in tackling other infectious and chronic health challenges, and published government and international best practice, we know that successful sustainable population influence strategies need to include actions that are valued, promoted and reinforced by the community rather than just a reliance on dictates imposed by governments and other forms of top-down management. This means investing in understanding about what will and what will not motivate different groups to comply and sustain protective behaviours.

We know that people need to believe that what they are being asked to do is likely to be effective and proportionate especially if the social, health and economic cost is high. We also know that one size does not fit all, different groups may need to perform different behaviours, and the influence strategies will need to be targeted for those groups. Consider the difference that compliance with social distancing recommendations makes for different age groups.

Diagram one indicates that behavioural awareness and intention data will be needed to develop targeted messaging and influencing strategies. For example, if an element of age-related easing of the lockdown is a part of the overall strategy, specific messaging will be needed for the designated cohort and the rest of the population about what people need to do to make it work. Developing a long-term social marketing communication and influencing strategy will need a clear segmentation model building on basic age and risk parameters set out in diagram one—but also going beyond that. Australia has launched an app to support contact tracing, as other countries develop distancing apps these will need targeted specific strategies to support uptake by different segments of the population.

How can we ensure our behavioural influence strategies are as effective as possible?

Remember the overall behavioural aim will be to sustain and, in some cases, permanently change behaviours over the long-term. We know that most of us are not mathematicians but story tellers and listeners. Promoting personal accounts and stories that feature relatable citizens and front-line workers can be a powerful way to sustain behaviours. It is good to see that ‘testimonial’ approaches are beginning to be used around the world. Modelling good behaviours and embedding them will ensure they become new social norms. Regular reporting of positive social norms data to the population will act as positive reinforcement to sustain and embed new social norms of behaviour.

The words and messaging used to frame the next phases of action to reduce harm will also be critical. Current framing such as ‘Shielding’ needs to be extended into the next phases of the communication strategy. The framing of each phase of the path to a new normal will need careful consideration. Framing that is tailored for, and that resonates with the different population subgroups will need to be tested prior to use. In terms of developing a new overarching narrative—a key focus will be on community action and community ownership of necessary behaviours.

How should we develop a sustainable, phased and community-driven strategy?

Given what we know works, the next medium to long-term phases of the social marketing, communication and influence strategy will need to:

1. Involve tailored programs for different segments of the population
2. Encourage and enable community action and ownership of the solution

These twin approaches will need to be based on data-driven deep insights about what will persuade citizens to comply. It will need to provide ongoing feedback about compliance with protective behaviours and community action—this will encourage and support others to maintain these behaviours. The social marketing, communication and influencing strategy will be a key tool to enable a smooth transition from the lockdown phase into subsequent phases. Developing a behavioural influence strategy suitable for each phase is needed to support the overall exit strategy from lockdown into subsequent phases of dealing with the pandemic.

Table 1. Phased behavioural influence strategy to support transition through the pandemic phases.

	Influence Focus	Main Communication and influence focus	Possible Message Focus
Pre-Lockdown Phase	• Case finding and isolation	Threat awareness and reporting	Fear, Reciprocity, Philanthropy
Lockdown Phase	• Self and social protection	• Physical distancing • Self-isolation • Wash hands • Shield the vulnerable • Key care staff get tested	Salience, Reciprocity, Philanthropy, Social norms, Loss of gains made, Trust
Partial Lockdown Phase	• Self and social protection • Assist others	• Physical distancing • Self-isolation • Wash hands • Wear face covering • Shield the vulnerable • Key care staff and key workers get tested	Feedback, Reciprocity, Philanthropy, Social Norms, Trust, Priming
Opening Up Phase	• Self and social protection • Assist others • Personal infectious status	• Physical distancing • Self-isolation • Wash hands • Wear face covering • Shield the vulnerable • Key care staff and key workers get tested • Support community action • Use distancing App	Feedback, Social Norms, Trust, Priming, Potential loss of freedoms
Vigilance and Management Phase	• Self and social protection • Assist others • Personal infectious status	• Physical distancing • Self-isolation • Wash Hands • Wear face covering • Shield the vulnerable • Key care staff and key workers get tested • Support community action • Use distancing App • Phased population testing • Know your status	Feedback, Social Norms, Priming, Potential loss of freedoms
Future Preparedness Phase	• Self and social protection • Assist others • Personal infectious status • Vaccine access by priority group	• Physical distancing • Self-isolation • Wash hands • Wear face covering • Shield the vulnerable • Key care staff and key workers get tested • Support community action • Use distancing App • General population testing • Know your status • International travel safety	Social Norms, Personal vigilance

The strategy should be developed drawing on the wide range of social marketing, communication, health promotion, behavioural sciences and other forms of behavioural influence (such as design and public relations expertise) that is available in each country and this should be supplemented by international support and guidance. The strategy should also be tested with communities to ensure it resonates with different population subgroups, and enhancements made based on community input to increase the likelihood of effectiveness.

Once developed, how should a phased behavioural influence strategy be managed?

In the spirit of community action and open and transparent government action, the strategy should also be placed in the public domain. All relevant commentators, marketers, behavioural scientists, and others with understanding about influencing behaviour should be encouraged to provide constructive comment and provide recommendations for improvement.

Developing a community driven prolonged community action program will need:

• Clear specific national guidance based on the best available science and data.
• Mechanisms for coordination ongoing national programs with locally driven community programs.
• Capacity at local level to encourage, support local community action by professional agencies and also by local for-profit and not-for-profit organisations, community associations and NGOs.
• A differentiated strategy that recognises different needs and risks in different communities and allows for local variation in responses.
• Mechanisms for monitoring, capturing and sharing learning about effective practice.

Such a community driven and owned response should also be informed by the following six design principles drawn from the health promotion, public health and social marketing literature:

1. People centric focus: An understanding of what would motivate people and professionals of all kinds to comply with behaviour that are required.
2. Setting of explicit social goals: Specific measurable behavioural, awareness, and attitudinal goals are set out for each segment of the population.
3. Value proposition delivery via the Social Marketing intervention mix: Data about what will and what will not motivate specific segments of the population to comply with recommended behaviour is used to frame, communicate and influence behaviour using a full mix of intervention strategies that range from informing to enforcement.
4. Theory, insight, data & evidence informed audience segmentation: The population is segmented in relation to behavioural objectives and targeted strategies developed to influence each segment.
5. Competition/Barrier and asset analysis: An understanding of barriers and competitive forces that are creating resistance to the adoption of protective behaviour for individuals and groups should be used to develop interventions to reduce the impact of these forces. Coalitions from all sectors should be developed and coordinated to achieve the specific behavioural goals of the program.
6. Critical thinking, reflexivity, and ethical practice: On-going challenge mechanisms should be adopted to test the strategy at every stage that draw on a broad range of theory, evidence and ethical principles.

Finally, the behavioural influence strategy needs to be continuously evaluated and refined based on the tracking of public attitudes, beliefs, knowledge, understanding and behaviour. The strategy should be adjusted and informed by this data. Evaluation will be enhanced by the setting of specific measurable goals relation for public attitudes, beliefs, knowledge, understanding and behaviour. These objectives should be placed in the public domain and progress towards meeting them, published on a regular basis to provide feedback and encourage compliance among citizens.

And that’s a wrap!

We thank Jeff for so generously sharing his thoughts and advice with us—so that we can share it with you! There are several resources available to assist social marketers and change agents as they work to assist all of us during the COVID-19 pandemic, and we have included some important ones below.

You can also keep in touch with Jeff’s work on the Strategic Social Marketing website and through the following channels:

• Twitter
• LinkedIn
• Link

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Content provided by: Professor Jeff French

Article compiled by: Dr Julia Carins