COVID-19 has been a humbling experience. From a frayed pandemic early-warning system to a shortage of personal protective equipment for front-line workers, public health experts have been playing catch up.
But it has also been a teachable moment. We now know, for example, that the usual approaches to convince fellow citizens to prioritize societal well-being over personal desires are not working. Rates of COVID-19 infection continue to rise rapidly across the United States, but also among Canadians aged 20-29. Public health messaging is clearly not convincing this age cohort to change behaviours.
This is a call to action for social marketing to evolve and leverage powerful behavioural and technological tools that successfully engage hard-to-reach groups. There is compelling evidence from here in Canada that such an approach can work.
Social marketing applies commercial marketing technologies to motivate voluntary social behaviour. These techniques have been used to boost home-based recycling, safe sex, to encourage people to quit smoking and use seat belts, among many other behaviours.
Good social marketing is more important than ever, particularly during a pandemic. In general, however, public health officials have been slow to adopt approaches that have been used successfully in the for-profit world.
The four Ps
In marketing, the shorthand for selling a product or service is “the four Ps”: product, promotion, price and place. Social marketing takes the perspective that selling an idea can be approached in the same way. This includes aligning and customizing messages to specific audiences, rather than assuming everyone will respond the same way.
In the case of COVID-19, data suggest that people don’t share the same perceptions of risk, and this can be seen in their individual behaviour and resistance to public health messages. Similarly, there is a mismatch between the audience and medium. The current approach of relying on traditional news outlets and advertising, media releases and news conferences to communicate critical COVID-19 information is not proving effective at reaching younger adults.
Think of the difference among law, public health and marketing as sticks, promises and carrots. During COVID-19, there have been lots of sticks and promises (“stay home, stay safe”) and not much in the way of carrots. But carrots are needed.
Being confined to your home is a fundamentally unpalatable product for people for whom isolation is a significant psychological burden. Families with small children that are struggling with working, teaching and general caretaking and need specific guidance on how to meet child-care needs safely. Everyone needs access to outdoor space for transportation and recreation, regardless of preferred activity, especially when those correlate with income and race.
At the outset, little attention was paid to recognizing and addressing these barriers to compliance with the desired behaviour. Yet we have a Canadian example of how to take a complicated issue and break down barriers, in the context of physical activity.
ParticipAction has been a worldwide leader for decades in presenting a range of possible activities that people can do in small bursts throughout the day or week to meet recommended guidelines, all without having a gym membership or being part of organized sports.
By recognizing barriers that prevented people from being active, it opened up possibilities to Canadians who considered the product and place of physical activity unattractive.
The social marketing version of price has always been the most challenging of the four Ps to tackle. It is difficult for individuals to change a behaviour they enjoy or one that provides personal benefit, especially when such change may not benefit them directly.
But the behavioural economic concept of “nudging” that includes small financial incentives has proven to be financially more efficient than expensive advertising campaigns in convincing people to change behaviour.
Our research on a now-defunct made-in-Canada mobile app demonstrates the potential for using cutting-edge commercial marketing techniques and technologies to tackle the challenges of social marketing.
Carrot Rewards was a mobile app that gave users points from their loyalty program (such as Aeroplan, Scene and Petro Points) immediately after they completed a health intervention, such as completing an educational quiz, getting information about the flu shot or walking a certain distance or length of time. (Carrot Rewards folded in June 2019 but was purchased later that year by a technology firm with a plan to relaunch the wellness app.)
Canadians love their loyalty programs
Loyalty programs are tremendously popular in Canada. Some 90 per cent of Canadians are enrolled in at least one program. Studies show that, on average, there are four programs per person and 13 per household.
Carrot Rewards leveraged the desire for small financial incentives (in the form of reward points for movies, groceries and the like), and attracted an engaged and involved audience.
It employed a digital platform that allowed for customizable content and high message complexity. Using multiple choice “quizzes” of five to seven questions each, it both involved users through gamification as well as provided additional information on the topic in question.
The app was also able to target content to specific audiences based on demographic characteristics and answers to previous quizzes, as well as track physical movement and location via a smart watch or smartphone.
Engagement stayed high
With an existing base of 1.1 million users across Ontario, British Columbia and Newfoundland and Labrador — and 500,000 active monthly users — Carrot could have quickly expanded into other provinces as a key component of an integrated federal COVID-19 campaign for education, contact tracing and possibly even symptom tracking.
Our research has demonstrated that Carrot rapidly attracted and enrolled users, and maintained consistently high levels of user engagement over time, even as rewards diminished. That engagement remained high even at a modest average reward per user of 1.5 cents per day. The age and demographics of the users varied by loyalty program, and the app provided a relatively representative cross-section of Canadian society in terms of education, income and urban/rural/suburban locations.
All in all, Carrot showed impressive results.
Financial sustainability challenges aside, policy-makers and public health officials would be wise to consider maintaining this modern, data-driven approach to social marketing in their tool box. It would not only prove tremendously useful in the COVID-19 era, but it would place Canada at the forefront of innovation in social marketing around the world.