**2. Key concepts of social marketing**

Health interventions to be considered as social marketing programs need to fulfill some criteria. The benchmark criteria provide a useful framework for assessing the extent to which an intervention is consistent with the social marketing approach and for identifying opportunities to potentially increase the impact of an intervention. Kotler and Lee explained some features of the social marketing approach: (1) focusing on understanding the perspectives of the full range of target audiences necessary to bring about change; (2) developing a research-based program, relying on formative research to develop and test concepts with members of the target audience; and (3) recognizing the need to include all elements of the marketing mix (i.e., product, price, place, promotion) to bring about behavior change [8]:

that were being used to sell products to customers could be used to "sell" ideas, attitudes, and behaviors [2]. Andreasen's defined social marketing as: "The application of commercial marketing technologies to the analysis, planning, execution and evaluation of programs designed to influence the voluntary behavior of target audiences in order to improve their personal welfare and that of their society" [3]. Rothschild believed that social marketing employs the principles of commercial marketing to influence consumer behavior and decision-making and attempts to influence voluntary behavior by offering or reinforcing incentives and/or consequences in an environment that invites voluntary exchange [4]. The Centers for Disease Control and Prevention (CDC) has introduced health marketing as an innovative approach that draws from traditional marketing theories and principles and adds science-based strategies to prevention, health promotion, and health protection. CDC defined health marketing as: "Creating, communicating, and delivering health information and interventions using customer-centered and

science-based strategies to protect and promote the health of diverse populations" [5].

salt intake, consume enough fruit and vegetables, and quit smoking.

who are aware of the need to change but have not considered changing [7].

social marketing approach for health.

44 Selected Issues in Global Health Communications

**2. Key concepts of social marketing**

Healthcare providers supply products (e.g., iron or multivitamin supplements for infants, condoms for sex workers, and contraceptives for teenagers) and provide services (e.g., pap smear testing for early detection of cervical cancer, mammography for diagnosis of breast cancer, and chest X-ray for patients suspected with tuberculosis). But, that is not all. In healthcare systems, the people as consumers or clients are encouraged to perform healthy behaviors and avoid non-healthy behaviors. We ask them have enough physical activity, reduce their

Health behavior is a behavior directed at promoting, protecting, and maintaining health, as well as reducing disease risks and early death. It includes personal attributes such as beliefs, expectations, values, perceptions, prevention, behavior patterns, actions, and habits that relate to health maintenance, restoration, and improvement [6]. In public health, education, marketing, and law enforcement are three main approaches applied to achieve behavior change. For people who consider the behavior change but do not have the required knowledge or skills, education is effective. Enforcement of laws and regulation is appropriate for the entrenched people who have no desire to change and resist deliberately. Marketing can be useful to bridge the gap between these two approaches and will be a good solution for those

Health can be considered as a real market in which consumers pay the monetary and nonmonetary costs and obtain the benefits of health products, services, or behaviors. If the marketing principles and techniques are applied, we can expect to be successful in selling our products, especially health behaviors. This chapter will address the theoretical concepts and practical steps for planning, implementing, and evaluating the interventions based on the

Health interventions to be considered as social marketing programs need to fulfill some criteria. The benchmark criteria provide a useful framework for assessing the extent to which an intervention is consistent with the social marketing approach and for identifying opportunities The National Social Marketing Centre has developed a set of eight social marketing benchmark criteria to promote the understanding and use of core social marketing concepts. They are behavior, customer orientation, theory, insight, exchange, competition, segmentation, and methods mix [9]. According to Andreasen's benchmark criteria [10], for an intervention to be classified as social marketing, at least one of the following components is needed. They are considered as the key concepts of the social marketing approach:


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 marketing program.

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.

Social Marketing for Health: Theoretical and Conceptual Considerations

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• 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.
