**3.2. Phases 2–4: Formative research**

Formative research findings provide the primary idea for intervention. This data determines the target audience and its properties, the specific objectives, the primary idea for intervention, and communicating manners to the audience. Data are collected through qualitative approaches (focus group discussions (FGDs) and in-depth interviews) and quantitative surveys. After collecting and analyzing the formative research data, social marketers describe the target audience: who they are, what is important to them, what influences their behavior, and what would enable them to engage in the desired behavior. Formative research consists of audience, channels, and market analysis as below:

• Audience analysis: In this step, identification of the general target audience, segmentation, defining the special target segment, and then studying their needs, wants, and preferences were done. Learning about demographic, psychosocial, and behavioral variables through qualitative and quantitative methods is necessary for segmenting the primary general target audience into smaller and more homogenous subgroups and developing the particular interventions needed to modify risky behaviors. When we have a general and heterogeneous audience, their points of view about the target behavior, benefits, and barriers to perform behavior, and channels for communicating to the audience, are different. So, the segmentation of a general and large audience group to small and relatively homogeneous subgroups helps the planners to design an effective program. In this way, it is possible to develop marketing strategies customized to the unique characteristics of each subgroup and have better outcomes. We will discuss about segmentation later in formative research and market analysis. The target audiences were asked about the costs and benefits of performing the intended behavior, desires, and values. Qualitative and quantitative studies provide data for knowing the consumer's perspective before starting the strategy design. The data can be collected through surveys, focus groups, and in-depth interviews.

with some barriers that may result in highlighted desirability or perceived relative value of other options. So, thinking about competition is a major requirement in a successful social

A health intervention defined as: "Any health-related measure taken to improve the health of an individual or a community; this may involve diagnosing, preventing, treating, and managing disease conditions, injury, or disability" [6]. In practice, understanding the key components of social marketing is not sufficient and we need to use social marketing planning models. Some of these models are the Social Marketing Assessment and Response Tool (SMART) model of Neiger & Thackeray (1998), Andreasen's model (1995), a framework suggested by Walsh, Rudd, Moeykens, and Moloney [15], and Weinreich's model (1999) [12]. All of them have practical phases and researchers can design the intervention step by step. The SMART model is a social marketing planning model developed by Neiger in 1998 and is applied to some researches in the health field [13, 14]. This model has seven phases as below:

Preliminary planning includes identification of the intended health problem, developing the goals, preparing the evaluation plan, and estimating the program costs. Like other programs, the first step is determining the health problems and selecting the prioritized ones. To get ready, behavioral aspects of the intended health problem were considered and the target health behavior was determined. According to this health behavior, we set the program goals. Evaluation planning, or determining measures of success, would include identifying and comparing measures before and after the intervention. Social marketers must estimate the monetary and nonmonetary costs and try to provide them. Remember that social marketing programs are usually

Formative research findings provide the primary idea for intervention. This data determines the target audience and its properties, the specific objectives, the primary idea for intervention, and communicating manners to the audience. Data are collected through qualitative approaches (focus group discussions (FGDs) and in-depth interviews) and quantitative surveys. After collecting and analyzing the formative research data, social marketers describe the target audience: who they are, what is important to them, what influences their behavior, and what would enable them to engage in the desired behavior. Formative research consists

• Audience analysis: In this step, identification of the general target audience, segmentation, defining the special target segment, and then studying their needs, wants, and preferences were done. Learning about demographic, psychosocial, and behavioral variables through qualitative

expensive interventions and advocacy with decision-makers is required.

marketing program.

46 Selected Issues in Global Health Communications

**3.1. Phase 1: Preliminary planning**

**3.2. Phases 2–4: Formative research**

of audience, channels, and market analysis as below:

**3. Planning of social marketing interventions**

• Market analysis: For analyzing the market, the partners, the competitors, and the components of marketing mix are identified. Partners are those people or organizations who can help achieve the program goals. They have common, but not the same, goals and can provide the resources and support the activities. Competitors are those who provide similar products and services and may lose their benefits during our programs. So, they are vying for individual audience members' time and attention. Market analysis is not completed without marketing mix establishment. Marketing mix is also referred to as the 4Ps: product, price, place, and promotion. Product refers to the set of benefits associated with the desired behavior or service usage. To be successful, the product must provide a solution to problems that consumers consider important and must offer them a benefit they truly value. So, we need to research to understand people's wants, needs, and preferences. The marketing objective is to discover which benefits have the greatest appeal to the target audience and to design a product that provides those benefits. The product can be a tangible good or an intangible one. In the case of social marketing, behaviors are common products. The product can include ideas and behavior changes or something offered to the consumer to satisfy a want or need. Examples may include educational programs, screenings, environmental changes, self-care programs, and so on. Price refers to the cost for the promised benefits or the barriers that may prevent the consumer from taking action. This cost is always considered from the consumer's point of view. Costs can include money, time, opportunity, energy, social, behavioral, geographic, physical, structural, psychological factors, and convenience or pleasure. So, price is not always monetary and usually encompasses intangible costs. In setting the right price, it is important to know if consumers prefer to pay more to obtain "value-added" benefits and if they think that products given away or priced low are inferior to more expensive ones. Place: For tangible goods, place refers to the distribution system and the location of sales and for intangible products such as services or behaviors, it refers to the location where consumers can obtain information about the product. Promotion is often the most visible component of marketing. It includes the type of persuasive communication that marketers use to deliver the product benefits of tangible goods or intangible products and services. Promotional activities may encompass advertising, public relations, printed materials, promotional items, signage, special events and displays, face-to-face selling, and entertainment media [15]. For the exchange to take place, the social marketer must understand consumers' preferences regarding the 4Ps.

• Channel analysis: Identification of the best way to communicate to the target audience and know about their preferred sources of information is the main mission of channel analysis. Channels can be people, institutions, organizations, and specific communication techniques, such as mass media, personal communication, or public events. Social marketers may consider printed materials (e.g., pamphlet and brochures), printed media (e.g., newspapers and magazines), and mass media (e.g., radio and television programs, websites contents, social networks, and mobile applications).

framework for improving health both at the individual level and at the wider environmental and policy levels [17]. Morris and Clarkson [18] reviewed the studies using a social marketing framework for changing healthcare practice. They found social marketing as a useful solution-focused framework for systematically understanding barriers to individual behavior change and designing interventions accordingly. They argued that the social marketing approaches being adopted in public health may also provide a potent strategy for achieving change from practitioners and concluded that this approach provides a single framework to analyze and address the complex problem of behavior change, systematically using methods proven in commercial marketing [18]. Firestone et al. [19] reviewed the evidence of the effectiveness of social marketing in low- and middle-income countries, focusing on major areas of investment in global health: HIV, reproductive health, child survival, malaria, and tuberculosis. They concluded that social marketing can influence health behaviors and health outcomes in global health; however, evaluations assessing health outcomes remain comparatively limited. Evidence exists that social marketing can influence health behaviors and health outcomes [19]. Luca and Suggs [20] reviewed systematically 17 articles published after 1990. These articles reported social marketing interventions for the prevention or management of some diseases and behavioral risk factors, conducted evaluations, and met the six social marketing benchmarks' criteria. They concluded that there is an ongoing lack of use or underreporting of the use of theory in social marketing interventions and focused on applying and

Social Marketing for Health: Theoretical and Conceptual Considerations

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To obtain newer findings, we searched PubMed database using "social marketing "and found that 1655 articles have been published since 2010 till now. By limiting the search to "Systematic Reviews," 120 articles were determined, and by limiting the search more to behaviors, it showed that in 65 systematic review articles, social marketing interventions focused on behaviors. Application of social marketing to reduce tobacco use (19 articles) and alcohol consumption (18 articles), modify the nutritional practice (16 articles), promote physical activity (14 articles), and increase the condom usage (7 articles) were the most common subjects. Some particular systematic reviews in which "social marketing" has been mentioned

Xia et al. [21] reviewed 92 social marketing interventions published during 1997–2013. They concluded that if the six benchmarks of social marketing interventions (behavior change, consumer research, segmentation and targeting, exchange, competition, and marketing mix) are considered, and if the researchers analyze the audience, make the target behavior tangible, and promote the desired behavior, it is an effective approach in promoting physical activity among adults [21]. In another systematic review done by Luecking et al. [22], they searched PubMed, ISI Web of Science, PsycInfo, and the Cumulative Index of Nursing and Allied Health systematically to identify interventions targeting nutrition and/or physical activity behaviors of children enrolled in early care centers between 1994 and 2016. They concluded that social marketing could be an important strategy for preventing early childhood obesity

Aceves-Martins et al. [23] reviewed 38 non-randomized and randomized controlled trials conducted from 1990 to April 2014 in participants aged 5–17. They searched the PubMed, Cochrane, and ERIC databases to find the studies that contained social marketing strategies to reduce youth obesity in European school-based interventions. They concluded that the inclusion

reporting theory to guide and evaluate interventions [20].

through promoting physical activity and nutrition modification [22].

in their titles are explained as below:
