CHAPTER THREE

SOCIAL MARKETING THEORIES

3.1. HEALTH BELIEF MODEL
THEORETICAL CONCEPT
The Health Belief Model (HBM) is by far the most commonly used theory in health
education and health promotion. The underlying concept of the original HBM is that
health behavior is determined by personal beliefs or perceptions about a disease and
the strategies available to decrease its occurrence. Personal perception is influenced
by the whole range of intrapersonal factors affecting health behavior.
THEORETICAL CONSTRUCTS
The following four perceptions serve as the main constructs of the model: perceived
seriousness, perceived susceptibility, perceived benefits, and perceived barriers. Each
of these perceptions, individually or in combination, can be used to explain health
behavior. More recently, other constructs have been added to the HBM; thus, the
model has been expanded to include cues to action, motivating factors, and self-
efficacy.
1.Perceived Seriousness
The construct of perceived seriousness speaks to an individual’s belief about the
seriousness or severity of a disease. The perception of seriousness is often based on
medical information or knowledge, it may also come from beliefs a person has about
the difficulties a disease would create or the effects it would have on his or her life in
general. For example, most of people view the flu as a relatively minor ailment. We
get it, stay home a few days, and get better. However, if you have asthma, contracting
the flu could land you in the hospital. In this case, your perception of the disease
might be that it is a serious disease.

2.perceived Susceptibility
Personal risk or susceptibility is one of the more powerful perceptions in prompting
people to adopt healthier behaviors. The greater the perceived risk, the greater the
likelihood of engaging in behaviors to decrease the risk. Perceived susceptibility
motivates people to be vaccinated for influenza, to use sunscreen to prevent skin
cancer, and to floss their teeth to prevent gum disease and tooth loss.
 When people believe they are not at risk or have a low risk of susceptibility,
unhealthy behaviors tend to result. perception of increased susceptibility or risk is
linked to healthier behaviors, and decreased susceptibility to unhealthy behaviors.

3. Perceived Benefits
The construct of perceived benefits is a person’s opinion of the value or usefulness
of a new behavior in decreasing the risk of developing a disease. People tend to
adopt healthier behaviors when they believe the new behavior will decrease their
chances of developing a disease. Would people strive to eat five servings of fruits
and vegetables a day if they didn’t believe it was beneficial? Would people quit
smoking if they didn’t believe it was better for their health? Would people use
sunscreen if they didn’t believe it worked? Probably not Perceived benefits play an
important role in the adoption of secondary prevention behaviors, such as
screenings.
4. perceived Barriers
Since change is not something that comes easily to most people, the last construct of
the HBM addresses the issue of perceived barriers to change. This is an individual’s
own evaluation of the obstacles in the way of him or her adopting a new behavior. Of
all the constructs, perceived barriers are the most significant in determining behavior
change.
In order for a new behavior to be adopted, a person needs to believe the benefits of
the new behavior outweigh the consequences of continuing the old behavior This
enables barriers to be overcome and the new behavior to be adopted.
3.2. The Trans theoretical Model of Health Behavior Change
This model, popularly known as “stages of change”, has become one of the most
often used models in social marketing programs. this model was being applied by
social marketing programs in the early 1990’s to increase physical activity levels of
community residents.
Stage One: Pre-contemplation ((Not yet acknowledging that there is a problem
behavior that needs to be changed). In the pre-contemplation stage, people are not
thinking seriously about changing and are not interested in any kind of help. People
in this stage tend to defend their current bad habit(s) and do not feel it is a problem.
They do not focus their attention on quitting and tend not to discuss their bad habit
with others.
Stage Two: Contemplation (Acknowledging that there is a problem but not yet
ready or sure of wanting to make a change). In the contemplation stage people are
more aware of the personal consequences of their bad habit and they spend time
thinking about their problem. Although they are able to consider the possibility of
changing, they tend to be ambivalent about it. In this stage, people are on a teeter-
totter, weighing the pros and cons of quitting or modifying their behavior.
Stage Three: Preparation/Determination (Getting ready to change)
In the preparation/determination stage, people have made a commitment to make a
change. Their motivation for changing is reflected by statements such as: “I’ve got
to do something about this — this is serious. Something has to change. What can I
do? “This is sort of a research phase: people are now taking small steps toward
cessation. They are trying to gather information about what they will need to do to
change their behavior. Or they will call a lot of clinics, trying to find out what
strategies and resources are available to help them in their attempt.
Stage Four: Action/Willpower (Changing behavior)
This is the stage where people believe they have the ability to change their behavior
and are actively involved in taking steps to change their bad behavior by using a
variety of different techniques. The amount of time people spend in action varies. It
generally lasts about 6 months, but it can literally be as short as one hour! This is a
stage when people most depend on their own willpower.
Stage Five: Maintenance (Maintaining the behavior change)
Maintenance involves being able to successfully avoid any temptations to return to
the bad habit. The goal of the maintenance stage is to maintain the new status.
People in this stage tend to remind themselves of how much progress they have
made.
3.3 The Theory of Reasoned Action
The theory of reasoned action (TRA) is the most developed type of model and is
widely used in social psychology and consumer decision-making.
Attitude is a function of beliefs about the consequences of the behavior weighted by
an evaluation of each outcome.
Formative research is necessary to identify all of the relevant beliefs with regard to
the consequences of adopting or not adopting the recommended behavior, and
whether these consequences are viewed negatively, positively or neutrally.
Fishbein’s model introduced two important features.
First, the model requires the user to make a clear distinction between attitudes
towards objects, issues or events perse, and attitudes towards behaving in a certain
way towards these objects, issues, events, etc.
Second, the TRA distinguishes between the individual’s beliefs related to the object
or issues perse, and the individual’s beliefs about what other people think about the
issue, and how others think they should behave towards the issue (i.e., normative
beliefs).
3.4 Social Cognitive Theory (SCT)
SCT explains behavior in terms of triadic reciprocity (“reciprocal determinism”) in
which behavior, cognitive and other interpersonal factors, and environmental events
all operate as interacting determinants of each other.
In contrast to the previous theoretical models, SCT explicitly recognizes that
behavior is not determined by just intrinsic factors, or that an individual is a product
of their environment, but that he/she has an influence on what they do, their personal
characteristics, how they respond to their environment, and indeed, what their
environment is.

Processes governing observational learning include:

 Attention: gaining and maintaining attention
 Retention: being remembered
 Production: reproducing the observed behavior
 Motivational: being stimulated to produce the behavior
Other core components of SCT include:
Self-efficacy: a judgment of one’s capability to accomplish a certain level of
performance.
Outcome expectation: a judgment of the likely consequence such behavior will
produce.
Outcome expectancies: the value placed on the consequences of the behavior.
Emotional coping responses: strategies used to deal with emotional stimuli including
psychological defenses (denial, repression), cognitive techniques such as problem
restructuring, and stress management.
Enactive learning: learning from the consequences of one’s actions (versus
observational learning).
Rule learning: generating and regulating behavioral patterns, most often achieved
through vicarious processes and capabilities (versus direct experience).
Self-regulatory capability: much of behavior is motivated and regulated by internal
standards and self-evaluative reactions to their own actions.
3.5. Diffusion of Innovations
Diffusion of innovations is a theory that seeks to explain how, why, and at what rate
new ideas and technology spread through cultures. Diffusion of Innovations seeks to
explain how innovations are taken up in a population. An innovation is an idea,
behavior, or object that is perceived as new by its audience.
five stages (steps): awareness, interest, evaluation, trial, and adoption are integral to
this theory.
Knowledge: In this stage the individual is first exposed to an innovation but lacks
information about the innovation. During this stage of the process the individual has
not been inspired to find more information about the innovation.
Persuasion: In this stage the individual is interested in the innovation and actively
seeks information/detail about the innovation.
Implementation: In this stage the individual employs the innovation to a varying
degree depending on the situation. During this stage the individual determines the
usefulness of the innovation and may search for further information about it.
Confirmation: In this stage the individual finalizes his/her decision to continue
using the innovation.

Difference between diffusion and adoption

Adoption is an individual process detailing the series of stages one undergoes from
first hearing about a product to finally adopting it. The diffusion process, however,
signifies a group of phenomena, which suggests how an innovation spreads among
consumers.
Adopter categories
Innovators: Innovators are the first individuals to adopt an innovation. Innovators
are willing to take risks, have the highest Social class, have great financial liquidity,
are very social and have closest contact to scientific sources and interaction with
other innovators.
Early adopter: This is the second fastest category of individuals who adopt an
innovation. These individuals have the highest degree of opinion leadership among
the other adopter categories. Early adopters have a higher social status, have more
financial liquidity, advanced education, and are more socially forward than late
adopters.
Early Majority: Individuals in this category adopt an innovation after a varying
degree of time. This time of adoption is significantly longer than the innovators
and early adopters. Early Majority tend to be slower in the adoption process, have
above average social status…
Late Majority: Individuals in this category will adopt an innovation after the
average member of the society. These individuals approach an innovation with a
high degree of skepticism and after the majority of society has adopted the
innovation. Late Majority are typically skeptical about an innovation, have below
average social status, very little financial liquidity.
Laggards: Individuals in this category are the last to adopt an innovation. Unlike
some of the previous categories, individuals in this category show little to no
opinion leadership. These individuals typically have an aversion to change-agents.
Laggards typically tend to be focused on "traditions", likely to have lowest social
status, lowest financial liquidity, be oldest of all other adopters, in contact with only
family and close friends.
 Chapter Four
Segmentation in social marketing
4.1 Introduction
Audience segmentation is a process of dividing people into more similar subgroups
based upon defined criteria such as product usage, demographics, psychographics,
communication behaviors and media use.
Audience segmentation is widely accepted as a fundamental strategy in
communication campaigns to influence health and social change. Audience
segmentation makes campaign efforts more effective when messages are tailored to
the distinct subgroups and more efficient when the target audience is selected based
on their susceptibility and receptivity.
4.2 Segmentation criteria in social marketing
Commercial marketers typically segment according to three broad criteria:
personal characteristics, behavioral characteristics and benefits sought by
consumers all of which are relevant to social marketers.
Personal characteristics
The relevance of demographic segmentation to social marketing is widely accepted.
for many health and social problems, the main predictors of mortality, morbidity,
health behavior and health risk continue to be demographic.
Geodemographics
This is the classification of people on the basis of where they live. The geographical
distribution of much ill-health and the clustering of health and social problems in
certain areas, particularly urban areas of deprivation), suggest that this approach can
contribute usefully to social marketing.
Behavioral characteristics
In commercial marketing, behavioral characteristics may include volume of product
usage – heavy, medium, light users – transactional history (previous usage),
readiness to use, responsiveness, and attitudes towards usage.
The model was initially developed to explain smoking cessation behavior, but has
since been applied to smoking, alcohol and drug addiction, weight control and
eating disorders, safer sex behavior, exercise participation, mammography
screening, sunscreen use, and other health behaviors).
During pre-contemplation, individuals either do not want to change their behavior or
are unaware of its consequences for themselves or others. During contemplation,
they begin to think about the costs and benefits of changing their behavior. In
preparation, the individual is motivated to change, and makes initial mental and
practical preparations. During the action stage, the individual is in the process of
changing, following which he or she may proceed to either maintenance or relapse
to an earlier state.