Social Marketing and HBM Strategies for Prenatal Care
This paper develops two social marketing message strategies aimed at encouraging at-risk mothers from economically disadvantaged backgrounds to seek prenatal care. Drawing on the Health Belief Model (HBM) and communication frameworks, the paper outlines a persuasion-oriented strategy and an informed decision-making strategy, both tailored to address perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action. The paper also situates these strategies within the broader context of infant and maternal mortality in the United States, identifying racial and economic inequalities in the healthcare system as key underlying barriers to access.
- Introduction: Social marketing and HBM framework overview
- About the Target Audience: At-risk mothers, mortality statistics, risk factors
- Persuasion-Oriented Messaging: Fear-based physician-delivered messages with HBM mapping
- Informed Decision-Making Messaging Strategy: Narrative-based messages and HBM analysis
- Political and Economic Difficulties: Racial inequalities and budget pressures on healthcare
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What makes this paper effective
- The paper clearly applies a recognized theoretical framework — the Health Belief Model — to each message strategy, explicitly mapping individual message components to HBM constructs such as perceived susceptibility, severity, benefits, barriers, self-efficacy, and cues to action.
- It distinguishes between two distinct message intervention types (persuasion and informed decision-making) with clear criteria for when each is appropriate, grounding both in cited communication literature.
- The paper grounds its audience analysis in concrete public health statistics on maternal and infant mortality, adding urgency and specificity to the messaging rationale.
Key academic technique demonstrated
The paper demonstrates applied theory mapping — taking an established behavioral health model (the HBM) and using it as an analytical scaffold to evaluate and justify specific real-world message content. Each proposed message is not simply described but is explicitly tied back to a named HBM component, showing how theory can guide practical communication design.
Structure breakdown
The paper opens with a theoretical introduction covering social marketing and the HBM, then narrows to the target audience and their risk profile. It presents two parallel message strategy sections — each containing sample messages followed by HBM analysis — before closing with a discussion of the systemic political and economic barriers that constrain the effectiveness of any individual-level intervention.
Introduction
This paper presents message strategies for encouraging 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 presented in this paper are based on these two types of interventions, and both incorporate the HBM.
The HBM was developed in the 1950s by social psychologists Hochbaum, Rosenstock, and Kegels, working within the U.S. Public Health Service. It is a psychological model that explains the attitudes and beliefs of individuals that lead them to take a health-related action (Health Belief Model). The initial HBM addressed readiness to act based on perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. Later additions to the model include cues to action — which activate readiness and stimulate overt behavior — as well as self-efficacy, which increases an individual's confidence in their 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 conditions such as preeclampsia and pregnancy-induced hypertension, driven by increasing rates of obesity, diabetes, and high blood pressure in the United States, account for 18% of maternal deaths in this country (Gosik, 2007). Other leading causes of maternal mortality in the United States, according to Gosik, 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 a behavior change is likely to benefit the individual, and when society is able to reach consensus about the value of that 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 considered the most appropriate for the problem of infant and maternal mortality, where access to adequate healthcare is a key preventive measure. Furthermore, social marketing messages for health care should be delivered by trusted sources to enhance credibility; healthcare providers have been found to be a trusted source in multicultural and low-income settings (Evans and McCormack, 2006).
A physician will be used to deliver the following messages to at-risk mothers:
While this messaging is based on a negative emotion — fear — research on AIDS prevention messaging has shown that negatively framed messages produced the most positive impact on behavioral intentions (Marchand and Filatrault, 2002).
With regard to the HBM, perceived susceptibility and perceived severity are addressed by messages 1 and 2. Message 3 addresses perceived benefits by informing mothers that prenatal care is beneficial. Message 4 identifies a perceived barrier — the cost of medical care — and addresses self-efficacy by providing information on where to obtain help. Message 5 serves as a cue to action, motivating the mother by reminding her that either she or her baby could become a victim without proper medical care.
References
Communication for Health. Encyclopedia of Public Health.
Evans, W. D., & McCormack, L. (2006, September 13). Marketing "evidence" to healthcare consumers: Applying social marketing to evidence about the harms and benefits of pharmaceuticals. Agency for Healthcare Research and Quality Conference.
Health Belief Model. University of Twente.
Gosik, A. (2007, October 12). U.S. ranks 41st in maternal mortality. Seattle Post-Intelligencer.
Green, J. (2006, May 10). U.S. has second worst newborn death rate in modern world, report says. CNN. http://www.cnn.com/2006/HEALTH/parenting/05/08/mothers.index/
Marchand, J., & Filatrault, P. (2002, August 1). AIDS prevention advertising: Different message strategies for different communication objectives. International Journal of Nonprofit and Voluntary Sector Marketing, 7(3), 271–287.
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