Campaign proposal development and implementation guidelines

¶ … message strategies for getting the target audience, at risk mothers, to obtain prenatal care based on social marketing concepts as well as the Health Belief Model (HBM). Andreasen (1995, cited by Evans and McCormack, 2006) defines social marketing as "the application of proven concepts and techniques drawn from the commercial sector to promote changes in diverse socially important behaviors such as drug use, smoking, sexual behavior...This marketing approach has an immense potential to affect major social problems if we can only learn how to harness its power..." Within social marketing are two key message interventions, persuasion and informed decision making (Communication for health). The two message strategies contained in this paper are based on these two types of message interventions and both consider the HBM. The HBM, developed in the 1950s by social psychologists Hochbaum, Rosenstock and Kegels working in the U.S. Public Health Services, is a psychological model that explains the attitudes and beliefs of individuals that will lead them to take a health-related action (Health Belief Model). The initial HBM involved addressing readiness to act based on perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Additions to the initial model include cues to action that would active readiness and stimulate overt behavior as well as self-efficacy to increase one's confidence in the ability to successfully perform an action.

About the Target Audience

The target audience includes at risk mothers primarily from economically disadvantaged backgrounds with limited education (Gosik, 2007, Green, 2006). Health reasons such as preecampsia or pregnancy-induced hypertension, caused by increasing rates of obesity, diabetes, and high blood pressure in the United States, accounts for 18% of maternal deaths in this country (Goski, 2007). Other leading causes of maternal mortality in the United States, according to Goski, include hemorrhage, embolism, infection and complications from pre-existing medical conditions. Infant mortality is most likely to result from babies being born too small or too early (Green, 2006)

Persuasion-Oriented Messaging

Persuasion-oriented interventions should be used when there is clear evidence that the behavior change is likely to benefit the individual, and when society is able to reach consensus about the worthiness of the behavior as a societal goal (Communication for health). Examples include promotion of mammograms for women, teen substance-abuse prevention, and promotion of bicycle helmet use by children (Communication for health). This strategy is believed to be the most appropriate for the problem of infant/maternal mortality where access to appropriate healthcare is a key preventative measure. Further, social marketing messages for health care should be delivered to consumers by trusted sources to enhance credibility and providers have been found to be a trusted source in multicultural and low income settings (Evans and McCormack, 2006}.

Thus, a physician will be used to deliver the following messages to at risk mothers:

in 5 infants die at birth (Green, 2006) in 4,800 women die from pregnancy complications (Gosik, 2007)

As many as half (or whatever the appropriate number is) of these lives could have been saved if only the mother had received appropriate prenatal care

Medical care is expensive, but if you can't afford a doctor there is help (Provide info for how poor women can obtain medical assistance).

Don't let you or your child become a victim of the tragic consequences of inadequate medical care. Your baby needs you and you want your baby to be healthy. If you are pregnant or thinking about having a child you need to see your doctor. You'll be glad you did.

While this messaging is based on a negative emotion (fear), research on AIDS prevention messaging has shown that negative emotion presented the most positive impact on behavior intentions (Marchand and Filatrault, 2002).

With regards to the HBM, perceived susceptibility and perceived severity are addressed by messages number 1 and 2. Number 3 deals with perceived benefits by informing mothers that prenatal care is beneficial. Number 4 identifies a perceived barrier, the cost of medical care, as well as self-efficacy by providing information on where to get help. Number 5 is a cue to action, incenting the mother by reminding her that either she or her baby could be a victim with out proper medical care.

Informed Decision-Making Messaging Strategy

Informed decision-making interventions should be used when persuasion would be inappropriate (Communication for health. Examples include when the evidence is not sufficiently clear to support one behavior over another (e.g., surgical removal vs. watchful waiting for men with a diagnosis of prostate cancer), when an individual's values must be taken into consideration to determine the optimal behavior (prevention of sexual assault), or when society has been unable to reach consensus about the optimal recommended behavior (e.g., prevention of teen pregnancy) (Communication for health). Instead of providing evidence that prenatal care can save lives, it relies on the mother wanting to do the right thing and uses a woman who has lost her child to convince her.

You need to do everything you possible can to keep you and your child safe. Just because you may be feeling well during your pregnancy doesn't mean everything is alright.

Maria: "My baby was born 4 months prematurely and died.

Maria: "My doctor told me that if only I had seen my doctor as soon as I was aware of my pregnancy things might have been different. I could have saved my child's life."

Medical care is expensive, but if you can't afford a doctor there is help (Provide info for how poor women can obtain medical assistance).

Do you really want to risk the health or life of you or your baby? If pregnant or thinking about having a child you need to see your doctor as soon as possible. You'll be glad you did.