What To Do

Individual behavior contributes to many health problems. In Step 1.2, you probably listed at least one behavioral cause of the health problem you’re interested in.

Social marketing seeks to influence people to change behavior. Programs that succeed in changing behavior are often based on scientific theories of behavior change.

Behavioral science theories specify determinants that lead people to act in certain ways. In this step, you will read about these theories, think about how your program could influence the determinants that motivate behavior, and narrow the list of determinants that your program could address. (See Determinants of behavior in Definitions)

You will also find out what others have done to address your health problem and what worked for them. Formal evaluations have shown that some of these “best practices” can actually change behavior. Others may have only anecdotal evidence of effectiveness, but they can still spur your thinking.

You will return to the theories and best practice examples you assemble in this step during the upcoming market research phase. They are a good source of market research questions.

How To Do It

Read about the behavioral science theories, especially the ones with determinants of behavior that match the causal factors you identified.

If you want to learn more about how a particular theory applies to your health problem, find a review article in the published literature that discusses various applications of the theory.

Think about how you would use theory in social marketing. See description of the "review articles."

Ask:

• How do specific behavioral determinants relate to various problem behaviors?
• What does each theory suggest about modifying behavior with an intervention?

You may also want to look at articles about the target audience(s) you have identified.

Some social marketing programs have used a single theory, but you don’t have to stick to just one.

Several leading behavioral scientists, each with his own respected theory, came to consensus on the following “short list” of determinants (See SOC_NIMH_theorist_consensus.pdf):

Internal:

• Knowledge and beliefs
• Attitudes
• Perceived risk
• Perceived consequences
• Self efficacy

External:

• Policies
• Access
• Skills
• Actual consequences
• Cultural beliefs and values
• Another short list draws from various theories to explain what goes on in the contemplation stage of behavioral change. Why do people decide to act? “B-COS,” where b: behavior, c: cost, o: others, and s: self-efficacy. (Suggested by Alan Andreasen via posting on the Georgetown Social Marketing listserv, November 16, 2004)
• Finally, social marketers who have worked on behaviors like hand washing feel that Applied Behavioral Analysis can give you the most bang for your theoretical buck. It emphasizes observation to uncover cues for behavior, behaviors that precede and are linked to the health behavior you want to change, and the consequences of behavior.

Dig deeper into applied behavioral analysis.

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But don’t stop with theory!

Read articles and reports about past programs related to your problem. Find out what worked with similar audiences from published information about “best practices.” (See Best practices in the Categorized Index)

Dig deeper into past programs.

Also, ask program managers who have attempted this work about:

• selecting a target audience
• selecting a behavior (and other causal factors) to target
• their budget
• their challenges
• the data they have on their audiences
• whether their program was successful and why
• what they would do differently

These colleagues can give you lots of leads for the market research you’ll do in the next Phase.

In some cases, branding has been a best practice. Find out if this approach has been useful with your target audience or health problem.(See Branding/branding public health in the Categorized Index)

Knowledge Check

Test Your Knowledge

Complete My Plan

Now revisit My Plan and, in the space for Step 1.4, record the theories and best practices you want to use.

Complete My Model

Then go to My Model and fill in the blanks for the behavior you think you want to change and the major determinants of that behavior that you know about so far.