Social marketing: Pitfalls and promise for change

Background: Since 1971, social marketing (SM) has been adopted as a behaviour change approach to address various social issues, including those of public health and the environment. In a context of proliferating health promotion and intervention approaches, as well as a changing communication environment, SM as a field has had to respond to various challenges. The purpose of this research was to explore the current context of SM, understand the challenges to the practice of SM, and explore its fit as a strategic framework within a broader set of public health oriented social change planning and implementation approaches currently in use. Specifically, the research objectives were to a) explore how the core constructs of SM were being represented and implemented, b) identify the challenges practitioners were facing in adopting and implementing SM, and c) assess the current position of the discipline within the broader social change landscape through three unique assessments. Methods: A multiple methods case study research design was employed to address the research objectives. First, semi-structured interviews were conducted with renowned experts/leaders (n = 16) in the field of SM. Next I carried out a scoping review of literature examining the use of SM in the prevention of chronic disease. Finally, semi-structured interviews with practitioner end users (n = 9) of SM elicited their perspectives and provided, along with the other studies, data for exploring how to design SM so that it is an accessible and desirable tool for social change. Results: Results of each study are reported separately before integration, however, data from across all three resulted in consistent themes. Data from experts, the scoping review, and end users illustrated strong endorsement of the approach, but concerns about its current directions and status were acknowledged. Although SM has reportedly achieved success in its efforts, results highlighted challenges for the discipline of SM. Assertions for SM included the need for consensus about appropriate benchmark criteria, more effectiveness studies, inconsistencies in the application of SM approaches, the need for continued and sustained leadership, and the ability to be innovative in the design and delivery of social marketing efforts. Diffusion of Innovations theory provided a useful framework for summarizing the critical considerations that may enhance the continued sustainability of SM as both an approach to social change in public health and as a discipline. Conclusion: This dissertation provides a unique glance at how SM can be adapted to better serve academics and practitioners in their pursuit of behavioural and upstream change objectives. Relevance, evidence, audience perspective and leadership must all be considered to move SM forward as a primary tool for social change.