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Health Communications and
Social Marketing for IPP
Sureyya E. Hornston, PhD, MPHSureyya E. Hornston, PhD, MPH
Centers for Disease Control and Prevention (CDC),Centers for Disease Control and Prevention (CDC),
Division of STD Prevention,Division of STD Prevention,
Behavioral Interventions and Research BranchBehavioral Interventions and Research BranchAtlanta, GAAtlanta, GA
May 17, 2007May 17, 2007
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Session Outline How does mind work? Facts andHow does mind work? Facts and
RealitiesRealities
Effective Health Communication EffortsEffective Health Communication Efforts
Incorporating Social Marketing PrinciplesIncorporating Social Marketing Principles
ResourcesResources
Whats next? Putting it all togetherWhats next? Putting it all together
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My Objectives: Introduce effective healthIntroduce effective health
communications and social marketingcommunications and social marketingprinciplesprinciples
Assist audience in starting to think like aAssist audience in starting to think like a
marketer for future IPP initiativesmarketer for future IPP initiatives
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Newsweek and Discovery
Channel Poll (2000)
83% of the respondents knew83% of the respondents knewabout the harmful effects of sugarabout the harmful effects of sugarand fatty foodsand fatty foods
Only 42% were seriously trying toOnly 42% were seriously trying toimprove their diets.improve their diets.
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Things to ponder about More information in the last 30 yrs. thanMore information in the last 30 yrs. than
in the previous 5000 yrs.in the previous 5000 yrs.
More than 4000 books publishedMore than 4000 books publishedaround the world every day.around the world every day.
As volume increases, is any of theAs volume increases, is any of the
information getting into peoplesinformation getting into peoplesminds???minds???
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Positioning AN
D Re-positioning MIND: The ultimate marketing battlegroundMIND: The ultimate marketing battleground
The better understanding of how mind worksThe better understanding of how mind works= the better positioning= the better positioning
Positioning and rePositioning and re--positioning determine howpositioning determine howpeople will think about your Product/process/people will think about your Product/process/ideaidea Appeal via the benefitsAppeal via the benefits
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Understanding the MI
ND
Minds are limited.Minds are limited.
Minds hate confusion and can loseMinds hate confusion and can losefocus easily.focus easily.
Minds are insecure.Minds are insecure.
Minds dont change easily.Minds dont change easily.
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Minds are limited
First, get through the volume controlFirst, get through the volume control
Second, the message is in shortSecond, the message is in short--termterm
memory (Rule of Seven)memory (Rule of Seven)
Third, it must be transferred to longThird, it must be transferred to long--termtermmemory (80% never gets transferred!)memory (80% never gets transferred!)
WHY?? Because, minds have to be selective.WHY?? Because, minds have to be selective.
Message = Not interesting, not emotional.Message = Not interesting, not emotional.
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Minds hate confusion and can
lose focus easily. Information and dataInformation and data
More information = More confusionMore information = More confusion
SolutionSolution::
Bite size information that is easilyBite size information that is easilyunderstood and KISSunderstood and KISS
Focus on a few powerful informationFocus on a few powerful informationand drive it into the mind.and drive it into the mind.
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Minds are insecure
Most people tend to do what others doMost people tend to do what others do
Principle of social proofPrinciple of social proof
Behavior is correct = others perform itBehavior is correct = others perform it
This can be a conduit to influencingThis can be a conduit to influencingbehaviors by:behaviors by:
TestimonialsTestimonials
Creating a bandwagon effectCreating a bandwagon effect
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Minds dont change easily
Belief systems are important from theBelief systems are important from theperspective of information, because beliefsperspective of information, because beliefs
are thought to provide the cognitiveare thought to provide the cognitive
foundation of an attitude. In order to changefoundation of an attitude. In order to changean attitude, it is necessary to modify thean attitude, it is necessary to modify the
information on which the attitude rests. It isinformation on which the attitude rests. It is
therefore, necessary to change a personstherefore, necessary to change a persons
beliefs, eliminate old beliefs, or introducebeliefs, eliminate old beliefs, or introducenew beliefs.new beliefs.
Attitudes & Perceptions by Drs. Petty andAttitudes & Perceptions by Drs. Petty and
CacioppoCacioppo
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What can we do?
Effective CommunicationEffective Communication
ANDAND
Social Marketing can helpSocial Marketing can help
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Effective healthEffective health
communication effortscommunication efforts
Segment the general populationSegment the general population
andand Target specific audiences with specific healthTarget specific audiences with specific health
messages (Audience segmentation)messages (Audience segmentation)
ONE SIZEONE SIZE DOES NOTDOES NOT FIT ALL!FIT ALL!
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Benefits of audience segmentation
Effective use of resourcesEffective use of resources
Culturally competent, customized strategiesCulturally competent, customized strategies
Appropriate channels of communicationAppropriate channels of communication
Providing pportunity to establish partnershipsProviding pportunity to establish partnerships
with audience focuswith audience focus
Identification of the easier to changeIdentification of the easier to changeaudiences (Diffusion of Innovations Theory)audiences (Diffusion of Innovations Theory)
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Segmenting the general
population DemographicsDemographics
Physical/Medical historyPhysical/Medical history
Behavioral characteristicsBehavioral characteristics(Doers versus Non(Doers versus Non--Doers)Doers)
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Effective health communicationefforts (Contd.)
Develop audienceDevelop audience--centeredcenteredmessages with a consumermessages with a consumerperspectiveperspective
Capture and secure the attention ofCapture and secure the attention ofthe right audiencethe right audience
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Effective health communication
efforts (Contd.) Make messages crystal clear, and includeMake messages crystal clear, and include
easy action stepseasy action steps appropriate for theappropriate for the
audiences stage of readinessaudiences stage of readinessExampleExample::
Target audience at PreTarget audience at Pre--contemplation: Nocontemplation: Noperceived risk/relevanceperceived risk/relevance -- IncreaseIncrease
awarenessawareness Target audience at Contemplation: PromoteTarget audience at Contemplation: Promote
benefits, minimize perceived costsbenefits, minimize perceived costs
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Effective health communication
efforts (Contd.)
For message deliveryFor message delivery
Involve a multiInvolve a multi--pronged systemspronged systemsapproach (Different modes andapproach (Different modes andchannels)channels)
Plenty of repeat messaging (OnePlenty of repeat messaging (One--timetimemessaging does not work!)messaging does not work!)
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Effective health communication
efforts (Contd.)
Base communication interventionsBase communication interventionson a behavioral theory or modelon a behavioral theory or model
Consider using social marketingConsider using social marketingprinciples and techniquesprinciples and techniques
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What is Social Marketing?
Social marketing is...Social marketing is...The application ofThe application ofcommercial marketing techniques to thecommercial marketing techniques to the
analysis, planning, execution,andanalysis, planning, execution,and
evaluation of programs designed toevaluation of programs designed to
influence the voluntary behavior ofinfluence the voluntary behavior of
target audiences in order to improvetarget audiences in order to improve
their personal welfare and that of theirtheir personal welfare and that of their
society.society. Alan AndreasonAlan Andreason
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Social Marketing isthe design, implementation and controlthe design, implementation and control
of programs aimed at increasing theof programs aimed at increasing the
acceptability of a social idea or practiceacceptability of a social idea or practicein one group of target adopters.in one group of target adopters.
Philip Kotler and Gerald ZaltmanPhilip Kotler and Gerald Zaltman
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Social Marketing is not AdvertisingAdvertising
Public relationsPublic relations
Slick packaging of communication materialsSlick packaging of communication materials
Condom distributionCondom distribution
Health educationHealth education
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Difference between HealthEducation/Promotion and Social
Marketing? Health education/PromoHealth education/Promo: Relays: Relays
information, and educates individualsinformation, and educates individuals
about a certain health issueabout a certain health issue
END PRODUCT: Individuals who areEND PRODUCT: Individuals who areeducatededucated
SMingSMing: Focuses on exchange of: Focuses on exchange ofvalue, competition, and carefulvalue, competition, and carefulaudience segmentationaudience segmentation
END PRODUCT: Behavior changeEND PRODUCT: Behavior change
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Social Marketing:
A Model for Interventions that
Facilitate Change
What is the healthproblem?
What actions couldreduce the problem
POLICY/RULES THATINFLUENCETHE ACTION
Policy, rules, legislation
WHOMUST ACTTORESOLVE PROBLEM
Target audienceStakeholder,group,or
individual marketresearch
WHAT ACTION MUSTBETAKEN
Product or Behavior
HOW YOU TELLTHEM ABOUTTHE WHAT, WHY, WHERE,
AND HOW
Promotion or CommunicationPricingIncreasing knowledge
Increasing benefitsDecreasing barriers
Improving self-efficacyIncreasing social pressure
or norms
WHERE (HOW) THEY CAN
DOBEHAVIORPlace
community resourcespartnershipsspecific clinicsproduct offering sites**may be where they learn howto do behavior (training)
classroom teachingmass media messagesmedia advocacysmall group discussionpatient/doctor interactionpoint of purchase displayscommunity meetingsworksite education
ETC,ETC
describing the action in a waythat is relevant to the targetaudience and helps fulfill some
unmet need, but not contraryto science
Social Marketing as a Model for Interventions that Facilitate Change
Dr. Susan D. Kirby, 1995
Methods we can use to increasesocial pressure, provideprotection for public,create action by third parties, andcreate incentives for health
enhancing policies
WHY THEY WANT
TODO IT
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Social Marketing Elements WHOWHO needs to changeneeds to change
WHATWHAT must they DOmust they DO
WHYWHY andand WHYWHY they mightthey mightNOTNOT do this behaviordo this behavior
WHERE or WHENWHERE or WHEN they will getthey will get
access, learn how, or see newaccess, learn how, or see new
behaviorbehavior
HOWHOW you will tell them aboutyou will tell them about
the WHO, WHAT, WHY,the WHO, WHAT, WHY,
WHERE and WHENWHERE and WHEN
Intended AudienceIntended Audience
Specific behavioralSpecific behavioralobjectiveobjective
Key factors influencingKey factors influencingbehavior in audiencebehavior in audience
Interventions thatInterventions thataddress the behavioraladdress the behavioral
influencing factorsinfluencing factors
CommunicationCommunicationcomponent ofcomponent ofintervention plansintervention plans
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Four Ps of Social Marketing
ProductProduct
PricePrice
PlacePlace
PromotionPromotion Pull & Push
Policy
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Four Ps of Social Marketing
(Contd.)Product:
Tangible (e.g. Condoms,Tangible (e.g. Condoms,medication)medication)
Intangible (Behavior change amongIntangible (Behavior change amongcertain target audiences to do thecertain target audiences to do theintended behavior)intended behavior)
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Four Ps of Social Marketing
(Contd.)Price:Price:
Direct cost of the product in $$sDirect cost of the product in $$s
Indirect cost of the productIndirect cost of the product(psychological, social, situational)(psychological, social, situational)
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Four Ps of Social Marketing
(Contd.)Place:Place:
Message dissemination (viaMessage dissemination (viaelectronic or print media, billboards,electronic or print media, billboards,
etc.)etc.)
Product distributionProduct distribution
Going where the customer isGoing where the customer is
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Four Ps of Social Marketing
(Contd.)Promotion:Promotion:
Communicate to the targetaudience(s) that the product is
worth the price.
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Other Ps of Social MarketingPull & Push:Pull & Push:
Two strategies that work togetherTwo strategies that work together Push is aimed at the distributorPush is aimed at the distributor
Pull is aimed at the consumerPull is aimed at the consumer
Reinforcing, synergistic effectReinforcing, synergistic effect
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Exercise One
What is the Price?What is the Price?
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Everyone is tuned into
.WIIIFM.WIIIFM
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Everyone is tuned intoWhatWhat
IsIsInInItItForForMe??Me??
WIIIFMWIIIFM
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Everyone is tuned intoWhatWhat
IsIsInInItIt
ForForMe??Me??
WIIIFMWIIIFM
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WIIIFM in Social Marketing If you do X you will get YIf you do X you will get Y
X is a behaviorX is a behaviorY is something valued byY is something valued by
audienceaudience
tangibletangible
intangibleintangible
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Incorporating WIIIFM Think from audience perspectiveThink from audience perspective
Address influencing factors from theirAddress influencing factors from their
perspectiveperspective Communicate from their perspectiveCommunicate from their perspective
Finding a MATCH between the desiredFinding a MATCH between the desiredprogram behavior and WHY theprogram behavior and WHY theaudience might WANT to do itaudience might WANT to do it
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Whose Payoff?Marketing Dept. ofMarketing Dept. of
XYZ CompanyXYZ Company
GOAL = $$GOAL = $$
DoesDoes notnot tell audiencetell audienceto buy products, so theto buy products, so thecompany will make $$company will make $$
UnderstandsUnderstandsaudienceaudience
Fills an audienceFills an audienceneedneed
Tells audience howTells audience howproduct fills theirproduct fills theirneedneed
Us: Health Education orUs: Health Education orCommunicationCommunicationprogramprogram
GOAL = DecreaseGOAL = Decreaseincidence/(incidence/(--)behavior)behavior
Tells audience thatTells audience thatnumbers are bad andnumbers are bad andthey need to bethey need to bebetterbetter
Tells audiencesTells audienceswhat to do withoutwhat to do withoutany audience viewany audience view
Not framed acc. toNot framed acc. toaudiences needsaudiences needs
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Health is not an end in itselfIt is a means to a valued end
Our job is to translate the value of aOur job is to translate the value of a
behavior into the audiencesbehavior into the audienceslanguagelanguage
Values vary greatly across peopleValues vary greatly across peoplea major reason to segmenta major reason to segment
populationspopulations
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Exercise Two
Whose Benefit?Whose Benefit?
WIIIFM?WIIIFM?
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Resources
STD Communications DatabaseSTD Communications Database
ResearchResearch -- Syphilis EliminationSyphilis Elimination
Effort (SEE) ToolkitEffort (SEE) Toolkit
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What is STD Communications
Database?A webA web--based tool that enhancesbased tool that enhances
formative researchformative research
http://www.cdc.gov/std/commdata/http://www.cdc.gov/std/commdata/
Information on characteristics,Information on characteristics,
knowledge, attitudes, behaviors, andknowledge, attitudes, behaviors, andpractices (KABPs) of various targetpractices (KABPs) of various targetaudiences and ataudiences and at--risk populations onrisk populations on
matters relating to STDsmatters relating to STDs
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What is SEE Community
Mobilization Toolkit?
A toolkit containingA toolkit containingaudienceaudience--specificspecific
productsproducts PurposePurpose: Give state: Give state
and local healthand local healthdepartments thedepartments the
tools to reach outtools to reach outand build necessaryand build necessarycoalitions for syphiliscoalitions for syphiliselimination workelimination work
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WHO?WHO? -- Selected targetSelected target
audiencesaudiences
Policy Makers/Opinion LeadersPolicy Makers/Opinion Leaders
Health Care ProvidersHealth Care Providers
Community RepresentativesCommunity Representatives
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Methodology How?
Literature review and environmental scanningLiterature review and environmental scanning
Formative researchFormative research
Recruitment via snowball sampling techniqueRecruitment via snowball sampling technique
OpenOpen--ended key informant interviews (238ended key informant interviews (238
interviews at nine sites)interviews at nine sites)
Data analysisData analysis
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WHAT? - Research Questions
Perceived severity of syphilisPerceived severity of syphilis
Barriers and overcoming theseBarriers and overcoming these
barriersbarriersSuggested messages, tones,Suggested messages, tones,
spokespersonsspokespersons
Preferred methods and channels ofPreferred methods and channels ofreceiving informationreceiving information
Relationship between HIV and syphilisRelationship between HIV and syphilis
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Findings
A)A)Barriers to recognition of syphilis asBarriers to recognition of syphilis asan important PH issue and toan important PH issue and to
garnering support:garnering support:
Lack of awareness and knowledgeLack of awareness and knowledgeabout syphilisabout syphilis
Characterization of syphilis as aCharacterization of syphilis as asecond class diseasesecond class disease StigmaStigma
Lack of advocacy and spokespersonsLack of advocacy and spokespersons
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Barriers to recognition of syphilis as
an important PH issue and to
garnering support (Contd)
Difficulty of talking about mattersDifficulty of talking about mattersrelating to sex and STDsrelating to sex and STDs
Lack of funds and resourcesLack of funds and resources
Distrust of govt institutionsDistrust of govt institutions
Separate approaches for each STD andSeparate approaches for each STD and
HIVHIV
Competition from other issuesCompetition from other issues
Issues relating to reimbursementIssues relating to reimbursement
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Findings
B) Overcoming these barriersB) Overcoming these barriers
Increase knowledge and awarenessIncrease knowledge and awareness
about syphilis among TAabout syphilis among TA
Increase knowledge and awarenessIncrease knowledge and awareness
about syphilis in general publicabout syphilis in general public Increase fundingIncrease funding
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Suggested messages, tones,
spokespersons (Contd.)
Elected Officials preferred localElected Officials preferred localcommunity leaderscommunity leaders
Opinion Leaders: Local and natlOpinion Leaders: Local and natlcelebrities, political leaders ascelebrities, political leaders asspokespersonsspokespersons
CBOs emphasized the importance ofCBOs emphasized the importance ofclergys role, and culturally sensitiveclergys role, and culturally sensitivemessagesmessages
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Suggested messages, tones,
spokespersons (Contd.)HCP:HCP: Medical authority (Surgeon General, CDC,Medical authority (Surgeon General, CDC,
professional organizations)professional organizations)
Need for clarification of what syphilisNeed for clarification of what syphiliselimination meanselimination means
Simple treatment protocols and guidelinesSimple treatment protocols and guidelines
Info. on prevalence, signs, symptomsInfo. on prevalence, signs, symptoms
Relevance of syphilis to ones practiceRelevance of syphilis to ones practice
Guidance on sexual history takingGuidance on sexual history taking
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Findings
D) Preferred method/channels ofD) Preferred method/channels of
receiving informationreceiving information
CBOs and community leadersCBOs and community leaders: Internet: Internetand mass media, newslettersand mass media, newsletters
HC providersHC providers: Professional literature: Professional literature
and meetings, newsletters, other HCPsand meetings, newsletters, other HCPs Elected OfficialsElected Officials: Internet, mass media,: Internet, mass media,
newsletters from authoritative sourcesnewsletters from authoritative sources
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Summary of FindingsSummary of Findings
Main Gaps in Knowledge and AwarenessMain Gaps in Knowledge and Awareness
Signs and symptoms of syphilis
Syphilis is a disease of yesterday
National Syphilis Elimination Plan
What to do with these
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What to do with these
findings?
Increase knowledge and awarenessIncrease knowledge and awarenessabout syphilis among selected targetabout syphilis among selected targetaudiences and in general publicaudiences and in general public
BY:BY:Developing factDeveloping fact--filled, culturallyfilled, culturally
sensitive communication materials withsensitive communication materials with
a serious tone for all target audiencesa serious tone for all target audiences
ANDAND
facilitate community mobilizationfacilitate community mobilization
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A Sampling of SEEToolkit
MaterialsCommunity Mobilization GuideCommunity Mobilization Guide
Various brochuresVarious brochures
CameraCamera--ready print adsready print ads
Syphilis pocket guide and sexual
history taking pamphlet for healthcare providers (HCPs)
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A Sampling of SEEToolkit
Materials (cont.)
Tip sheetsTip sheets
Contact lists (Local CBOs and PolicyContact lists (Local CBOs and PolicyMakers)Makers)
MSMMSM--specific materialsspecific materials
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Availability of SEE Toolkit
Materials (Contd.) On the web:On the web:
CDC Warehouse (Order by phone or viaCDC Warehouse (Order by phone or viathe order form online)the order form online)
http://www.cdc.gov/std/see/http://www.cdc.gov/std/see/
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In summaryFor each target audience segmentFor each target audience segment
Identify benefits that matter to the target audienceIdentify benefits that matter to the target audience
Consider ALL costs and barriers to the suggested behaviorsConsider ALL costs and barriers to the suggested behaviors
Also consider the WIIIFMAlso consider the WIIIFM
Make the suggested behavior easy to do or break it down toMake the suggested behavior easy to do or break it down to
easy action steps based on the stage of readinesseasy action steps based on the stage of readiness
Deliver messages in a clear, uncluttered and uniform mannerDeliver messages in a clear, uncluttered and uniform manner
For message delivery, involve a multiFor message delivery, involve a multi--pronged systemspronged systemsapproach with plenty of repeat messagingapproach with plenty of repeat messaging
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CDCs Commitment to You
TrainingTraining
Technical assistanceTechnical assistance
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Wrap up & Questions
THANKYOU!
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Exercise Three
Whats next?Whats next?
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