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Social Marketing Conference: Changing Behaviour Through
Communications
30 November 2011
www.charitycomms.org.uk
www.twitter.com/CharityComms
www.facebook.com/CharityComms
Behaviour change very much the flavour of the month
You don ’t need to know everything but good to have some understanding
Nuffield Ladder of Interventions is as good a place as any to start…
Public health: the ethical issues, Nuffield Council of Bioethics (2007)
Get your evaluation in early
Insight research
Intervention developmen
t
Implementation
EvaluationBest
practise
PlanningImplementation
Evaluation
Intervention cycle
Project/programme cycle
EvaluationFORMATIVE EVALUATION:
- Insight research
- Baseline
- Pre testing
- Design of process and impact evaluation cycle
PROCESS EVALUATION
OUTCOME or IMPACT EVALUATION
+
DOCUMENTATION OF LEARNING/BEST PRACTICE
School of thought that questions how useful market research is…
“Whether it is company executives seeking to define their corporate strategy or politicians wanting to understand the electorate, the idea that questions answered on a questionnaire or discussed in a focus group can provide useful insights on which to base business decisions is the cause of product failures, political blunders and wasted billions”
Philip Graves, Consumer.ology
92%
87%
69%
62%
88%
Results from our global study on government intervention in 24 countries
% Strongly support/tend to support
Base: c.500 - 1,000 residents aged 16-64 (18-64 in the US and Canada) in each country, November 2010
Provide information
Provide incentives
Make companies act against behaviour
Source: Ipsos Global @dvisor
What, if anything, do you think government should do?
Make behaviour more expensive/ difficult
Ban behaviour
Force of
interventionAverage over all four policy areas
92%
90%
79%
69%
87%
People want financial incentives to save for their pension, and 7 in 10 support being forced to save
% Strongly support/tend to support
Provide information
Provide incentives
Make employers contribute to pension schemes
Source: Ipsos Global @dvisor
Next, thinking about how people plan for retirement. What, if anything, do you think government should do?
Make pension scheme enrolment automatic
Make pension scheme enrolment mandatory
Base: c.500 - 1,000 residents aged 16-64 (18-64 in the US and Canada) in each country, November 2010
But we also gave people the opportunity to say whether the government should not get involved in their behaviour
Half still have a negative gut reaction to the “nanny state”
% Strongly support/tend to support
Not get involved in what people choose to eat
Not get involved in whether or not people choose to live sustainably
Source: Ipsos Global @dvisor
What, if anything, do you think government should do?
Not get involved in what people choose to save for retirement
Not get involved in how people make decisions about smoking
Base: c.500 - 1,000 residents aged 16-64 (18-64 in the US and Canada) in each country, November 2010
Not get involved (average)
Average over all four policy areas
Inconsistent views?
� 53% agreed that “government should not get involved in what people choose to save for retirement”
� 69% agreed that “government should change the law so that everyone has to enrol in a pension scheme”
�AND 36% agreed with both statements!
What people say and how they act is different but…
“A measure which does not have public support is, in general, less likely to succeed”
House of Lords report on Behaviour Change
Putting the customer at the centre is not the same as asking them every time
Source: National Social Marketing Centre
5%
10%
11%
13%
55%
6%
7%
10%
12%
14%
49%
8%
What is relevant to measure?
1 portion
Q Have you eaten any fruit and vegetables in the last 24 hours?
2 portions
3 portions
4 portions
5+ portions
Not stated
Awareness of 5-a-day recommendation
2005 2009 % %
5 portions a day 68 781-4 portions a day 14 86+ portions a day 3 1Don’t know 14 10
Not stated 2 3
Base: All respondents living in core wards (1,732). (2 February 27-March 2009)
Think about what you are trying to achieve
20052009
Just because it is new and creative does not mean it is good
A methodology needs to be fit for purpose rather than just innovative
Our research approach
Secondary research
11 pilot interviews with women in Tower
Hamlets
9 key stakeholder interviews
Peer research: 15 peer researchers speaking to 82
women in their social networks
Ethnographic interviews: 6 detailed video interviews
Primary research
What is peer research?
� a participatory qualitative approach based on training
members of a community (peer researchers) drawn from hard -to-reach groups , to carry out in-depth conversational interviews with individuals from within their own social networks
� by tapping into established relationships of trust peer research generates rich narratives about people’s lives quickly,
providing a depth of insight into how people view their world, conceptualise their behaviour and experiences, and make decision on key issues.
� it also builds channels through which the voices of frequently
excluded groups can be heard, and enables these groups to enter into dialogue with programmes, implementers and decision makers
Our approach to peer research
We recruited 15 peer researchers (through nurseries, schools, housing associations & community
organisations) - 7 Bangladeshi women, 6 white British women and 2 Somali women
All women were invited to two half days of training
The peer researchers were given 2-3 weeks to undertake at least 5 interviews with their friends and family. The
women were given quotas they were asked to fill
They were given a data collection sheet to record the findings of each interview as well as NHS leaflets on the
facts of cervical screening to hand out after the interviews
After each interview they completed, they were asked to phone us to feedback the findings
Findings feedback workshops were held after each group of peer researchers had completed their interviews
Competition analysis – cervical screening
� Internal factors:
– Women’s perceptions of screening as painful, embarrassing or inconvenient
– The fear of detection of cancer
– Lack of awareness of the tests’indications and benefits
– Lack of awareness of the screening procedure (e.g. due to absence of screening in home country)
– Considering oneself not to be at risk of developing cervical cancer
– Linguistic difficulties
� External factors:
– Administrative and process failures (incomplete addresses, reminders not sent)
– System failure (formal and informal opt-outs, no mechanism for chasing non-attenders)
– Inconvenient clinic times
– Unavailability of a female screener
– Lack of information in appropriate language
– Social and cultural norms (which contradict health advice)
Aim is to understand what factors compete for the t ime and attention of the audience, and includes internal (e.g. psycho logical factors) and external (e.g. people and contextual influences ) competition
Aims of the project
� To increase the number of patients seen in A&E whoreceive a brief intervention for alcohol ;
� To effectively engage with health professionals working at A&E departments in Tower Hamlets
� To increase the number of health professionals who believe that delivering the brief intervention for alcohol is effective ;
� To increase the number of referrals from A&E to relevant local services.
� To establish how best to integrate and utilise two new specialist alcohol nurses in A&E
Our research approach
Secondary research
Review of secondary literature, including
previous work in this area and with this audience.
Primary research
Stakeholder interviews
11 Interviews with a range of A&E staff to understand the initial issues around the
delivery of brief interventions.
Ethnography: observation
Shadowing of healthcare professionals during their shifts in A&E to observe
barriers and observations in practice, cross-checking
early findings.
Scoping phase
Access all staff – 11 shifts
Ambulance workers
Shadowed member of staff
Police in the department
Nurses at all levels
Doctors at all levels
GP streamers
Receptionist
We followed one staff member each but accessed
10-20 people each
shift
We accessed A&E at different times of the day and night andweekdays and weekends
Pattern drinking is perceived as binary not on a continuum
The attitude in A&E seems to place drunks in two categories: ‘Problem drinker’ and ‘A few too many’
The danger of ‘Us vs. Them’ – two models
It was very clear that for referrals to work the relationship must be a partnership
Referral
teams
A&E
Referral
teamsA&E
Vs.
Referral system needs to be easy to use and become second nature
The key to the success of the nurses is that they are seen to decrease rather than increase workload
� Fast
� Clear
� Easy to use
� Need limited involvement
� Not need further paperwork
Senior staff really set the tone
Senior staff must be aware how their perception of alcohol affects that of everyone else
Willing to Act
Ability to act High potential and willing
Low potential and unwilling
Segment willingness and ability
1: Positive greensI think it’s important that I do as much as I can to limit my impact
on the environment.18%
High
Low
HighLow
7: Honestly disengaged
Maybe there’ll be an environmental disaster, maybe not. Makes no difference to me, I’m just living life the way I want
to.18%
6: Stalled startersI don’t know much about
climate change. I can’t afford a car so I use public
transport.. I’d like a car though.
10%
5: Cautious participantsI do a couple of things to help the environment. I’d really like to do more, well as long as I
saw others were.14%
2: Waste watchers‘Waste not, want not’ that’s
important, you should live life thinking about what you are
doing and using.12%
3: Concerned consumers
I think I do more than a lot of people. Still, going away is
important, I’d find that hard to give up..well I wouldn’t, so carbon off-
setting would make me feel better.14%
4: Sideline supportersI think climate change is a big problem for us. I know I don’t
think much about how much water or electricity I use, and I forget to turn things off..I’d like to do a bit
more.14%
Existing Examples (1): Defra’s Environmental Segmentation ModelPlotting the Segments
Key principles for segmentation
Segmentation is…1. A practical tool
Key question: What do you want the model to do?
(eg. tightly predict specific behaviours, or show differences/similarities between different audience groups?)
(eg. will you be conducting further research with the segments, or ‘just’targeting them?)
If a behaviour change tool: segment on the behaviou r(s) in question, OR the most proximal determinants of those behaviours
2. An iterative process
Make this as transparent as possible but keep it fl exible
3. As much an art as a science
Focus on practical purposes of the model for divers e stakeholders: more heads are better than one (steering group, adv isory group etc)
Attributes of an effective segmentation model
1. Usability
- Is the model easily understandable, and memorable –can people assimilate and use it?
- Can the segments be reached in the ‘real world’?
2. Replicability
- Can the segments be easily found in subsequent qualitative and quantitative samples?
3. Stability
- Will the segments be relatively stable over time?
1. Scoping Stage / Survey Design
2. Survey Fieldwork, Topline Findings
3. Factor/Cluster Analysis
4. Profiling the Segments
5. Embedding and Replication
A 5 stage process for segmentation
Spending money on the research versus the intervention
Difficult to justify research sometimes when conducting it will take money away
from interventions
Research
Intervention
What can you do to save money?
� Find out what has been done already
– Move away from every population is different
– Contact research companies, government departments, academics
– This means you are filling in the gaps rather than starting afresh
� Is there routinely available data out there?
– Possibly very useful for evaluation
� Who can you team up with to pool resources?
– Shared aims and resources
� Be sure what you need
– The sharper the brief the more you will get back
Developing a theory of change
Outputs:• What will/has
happened/been done as a result of the inputs?
Outcomes (short and medium
term):•What are the interim ways
to measure whether the impacts are likely to occur
Impacts (longer term):
• What is the long term reason for the programme –what is it designed to bring
about
The model sets out the links between the chosen focus of this initiative and the activities, short and longer-term outcomes whose effectiveness is being evaluated.
Inputs:• What resources have been made available for the
programme?
Some examples of when it didn’t work out as expected
� The teenage pregnancy intervention that had a rather different outcome from the one intended
� Introducing sterilising tablets into prisons to clean needles which had an unfortunate side effect
� The initiative to reduce the level of mugging in Deptford which proved unpopular with their neighbours
Unintended consequences show the importance of research
So…
� Start early
� Be clear where you want to get to
� All this is not as new as it seems
� Design a methodology fit for purpose but flexible!
� Think about what data you already have
� Look at what has already been done
� Look to innovation when appropriate
� Always think about unintended consequences
� Good luck!