Ride or be ridden.

May 31

Control diabetes or let it control you.  That’s a rallying cry for the “Red Riders” who cope with Type I and Type II diabetes and will be participating in the American Diabetes Association’sTour de Curethis weekend on June 3rd.

The group knows all too well the importance of exercise and staying in shape when dealing with this potentially deadly condition. They’re taking to the roads in Virginia with 1,500 other riders –including an Ogilvy Team!—to generate funding for diabetes research, advocacy, and information programs.

Last week, the news on diabetes could not have been more stunning.  A report published in the journal Pediatrics indicated that, in less than a decade, the numbers testing positive for diabetes or pre-diabetes jumped from nine percent to 23 percent of American teens. That’s nearly one in four.

The risks from diabetes are huge—kidney failure, vision loss, amputation, stroke, heart attack, and nerve damage.  It’s a heavy prospect for a person at any age.  But it’s particularly frightening to consider what such a large number of youth are facing so early in their lives.

The situation is one more resounding alarm for embracing a healthy lifestyle.  As a parent, it’s a reminder for me to be a good example to my kids; to get them to eat a vegetable by doing so myself; to lead from the front by dropping the bag of chips and jumping on the bike. Just like those Red Riders.

Is Your Life Glass Half-Empty or Half-Full?

May 24

Credit: NYimes, Yvetta Fedorova

Credit: Yvetta Fedorova

In both our personal and professional lives, we all encounter situations where the perception of our life glass is either half-full or half-empty. Our response to that age-old question helps to define us as individuals, as well as inform our personal outlook on life. I have been an optimist my entire life, for better (always seeing the good in people) or for worse (even when I shouldn’t), continually looking on the bright side of life (not to quote Monty Python). But, I never thought about the health benefits of my personality traits until now.

Earlier this week, Jane Brody, Personal Health and Wellness contributor to The New York Times, wrote a blog post on optimism and its various health benefits. While reading her blog, it made me think, “How can optimism actually make me healthier?”

In her blog post, Brody talks about “Breaking Murphy’s Law,” by Suzanne C. Segerstrom, a professor of psychology at the University of Kentucky, who explains that “optimism is not about being positive so much as it is about being motivated and persistent.” She adds that people can become more optimistic by simply acting as if they were more optimistic, providing some support for the notion of positive thinking.

An example of this persistence in the sports world is clear in a recent tweet on May 1 from Drew Brees, a spokesperson for Ogilvy Washington’s client, the President’s Council on Fitness, Sports & Nutrition (PCFSN): “Just enjoyed a lunch with Billie Jean King in DC between PCFSN meetings. Quote of the Day from her: Failure is not failure, its feedback.” I am sure that this positive perception on failure helped Ms. King overcome any challenges in her amazing tennis career.

The Mayo Clinic notes that “optimism is the belief that good things will happen to you and that negative events are temporary setbacks to be overcome.” In a study the Clinic released in May 2011 entitled, “Positive thinking: Reduce stress by eliminating negative self-talk,” the overwhelming physical and mental health benefits of positive thinking are discussed, including (but not limited to):

  • Increased life span
  • Lower rates of depression
  • Lower levels of distress
  • Better psychological and physical well-being
  • Reduced risk of death from cardiovascular disease
  • Better coping skills during hardships and times of stress

While the study is unclear as to why positive thinking provides these health benefits, it does theorize that perhaps a positive outlook allows individuals to better handle stressful situations and thus reduce the harmful effects of stress.

To help develop a more positive outlook on life (for those pessimists or realists out there), the Mayo Clinic identified six ways to lead a healthier lifestyle:

  • Identify areas to change
  • Check yourself
  • Be open to humor
  • Follow a healthy lifestyle
  • Surround yourself with positive people
  • Practice positive self-talk

As part of my resolution for 2012 (yes, I know, I am a little late), I will try to incorporate at least three ways to lead a healthier lifestyle (listed above) into my daily life. What will you do?

*For applications on Optimism and Social Marketing, check out Lisa Charnitski’s blog post from January 2012.

“Gamifying” Weight Loss and Behavior Change

May 21

We all know that weight loss is a simple equation – more calories expended than consumed. Eat healthy and increase physical activity. But if it was that easy to change behavior, break habits, and stave off cravings, then we would not be facing the problem of obesity among over one third of all adults in the U.S.

Last week, amidst all of the Weight of the Nation buzz, an article in The New York Times caught my eye. Nicole LaPorte’s article, “Dieting for Dollars (or Maybe a Movie Ticket),” presents a few important ideas:

  • “Gamification,” or applying techniques from games and psychology, can change real world behavior. The IBM engineers featured in the article wanted to make weight loss fun, so they took inspiration from their favorite video games to develop a program that helps with weight loss every step of the way.
  • Real time encouragement and feedback is key. The IBM program takes a card from the Honda Insight hybrid and gives immediate feedback on behavior – meaning someone is “scolded” when they eat a candy bar but praised when they opt for a salad.
  • Tangible rewards don’t hurt either. Beyond the encouragement, the program offers actual incentives like money and movie tickets as a reward for successful weight loss.
  • Workplace participation and support means success. IBM envisions the program being offered by health insurance providers through workplaces, meaning employees are encouraged to get up and take a 15 minute walk at lunchtime, or bike into the office. Institutionalizing healthy living and weight loss encourages actual lifestyle changes rather than fad diets.

Gaming is being applied more and more often in social marketing – and not just in the weight loss arena. For more posts about the use of games to change behavior, check out these previous posts: Using Games in Social Marketing and Modifying Behavior Through Video Games.

image from istockphoto.com

Effective Communication Strategies Can Help Reduce Non-Communicable Diseases

May 18

This blog was co-authored by Maria James and Carrie Dooher.

Chronic diseases, often referred to as “lifestyle” diseases, including heart disease, stroke, cancer, diabetes, and arthritis – are among the most common, costly, and preventable of all health problems in the U.S. and also the leading causes of death and disability. According to the Centers for Disease Control and Prevention (CDC), four modifiable health risk behaviors—lack of physical activity, poor nutrition, tobacco use, and excessive alcohol consumption—are responsible for much of the illness, suffering, and early death related to chronic diseases. Specifically with regards to obesity, just last week the CDC released a new report published in the American Journal of Preventive Medicine warning that 42 percent of the U.S. population will be obese by 2030 – while that may seem to be some time in the future, that’s actually just 18 years away.

But this is not just an issue that afflicts the U.S.; it is a global epidemic estimated to kill 36 million people a year and is so important and acute that in 2011 for only the second time in its history, the United Nations (UN) addressed the prevention of non-communicable diseases, or NCDs, at their General Assembly meeting to set a new international agenda on the prevention of NCDs. The first and only other time that the UN General Assembly met on a health issue was to discuss the world epidemic of AIDS.  World leaders joined Health and Development Ministers in the consensus adoption of a wide-ranging Political Declaration on the prevention and control of NCDs; this Declaration’s implementation will be evaluated in 2014. And progress is already beginning to be benchmarked against it – on May 16, the World Health Organization released new data highlighting increases in hypertension and diabetes incidence around the world in anticipation of the World Health Assembly, to be held in Geneva from 21 to 26 May 2012, which will consider progress made from last Septembers meetings. In addition, the World Health Assembly will continue discussions about developing a global monitoring framework and a set of voluntary targets for prevention and control of these diseases.

While there are many disciplines considering solutions to NCDs, one that should not be ignored is social marketing. As an effective health promotion strategy, social marketing can be, and has been, used to motivate people to use health information and change behavior in ways that promote and maintain good health. And a critical step in creating positive behavior change to impact health is simple, science-based, behavior-focused communication messages on nutrition and health.

On May 1st, the International Food Information Council (IFIC) Foundation announced the publication of the proceedings from its 2011 Global Diet and Physical Activity Communications Summit: “Insights to Motivate Healthful, Active Lifestyles,” in the May 2012 issue of the peer-reviewed journal Nutrition Reviews, stressing again the need for health communicators to be part of the solution in addressing NCDs. As U.S. Surgeon General Dr. Regina M. Benjamin stated in the keynote address at IFIC Foundation’s Global Summit in September 2011, there is an essential need for communicators of global health to provide clear, simple information based on the latest science, to stress prevention and to employ a comprehensive, holistic approach to combating non-communicable diseases or NCDs.

Along with the release of the Nutrition Reviews article, last week the IFIC Foundation also released a helpful one-page fact sheet entitled, “Communication Strategies to Help Reduce the Prevalence of Non-communicable Diseases.” The fact sheet combines the key findings from the Summit into 10 helpful tips for communicating health messages with consumers.

The top five tips include:
1.    Use easy to understand messages.
2.    Set realistic goals.
3.    Connect with children early in life on how they can succeed.
4.    Focus on “how to do it” instead of “what to do.”
5.    A key message should be “do something.”

When the UN measures progress in 2014, what are your thoughts on how far we will have come?

Skinny, Unscripted: Reality TV’s Effect on Body Image beyond the Small Screen

May 17

Full disclosure: I’m a bit addicted to “The Bachelor.” Every few months, a new season premieres on ABC and, every few months, I swear to myself that this will be the last season I watch. But before I realize that it’s happened, I’ve been sucked back down into the abyss of beautiful people, scripted drama, and saccharine love stories once again.

However, I am not alone. Millions of people are tuning in with me, many of whom are also 20-something women. So, what keeps us coming back for more, season after season? In a Huffington Post blog post titled “‘The Bachelor': Why Smart Women Watch (and Love) It,” Emma Gray tackles the question head-on, analyzing why so many viewers succumb to temptation every Monday night. She aptly compares watching the show with rubber-necking on the freeway; essentially we are unable to tear our eyes away from a “good train wreck.” She also credits the fake love on screen with making us grateful for the real thing in the real world.

What I believe is Ms. Gray’s most poignant argument, however, is that many viewers possess an innate need to pass judgment to relieve internal frustrations- with a bad day at work, a painful break-up, or simply their own inability to make it to the gym each night- in “safe” environments, such as their living rooms. In this way, the show acts as a cathartic kind of stress release.

Measuring one’s own worth through comparisons to others is a natural tendency, but unfortunately, watching programs such as “The Bachelor” provides viewers with a skewed representation of what “most people” look like and therefore an unrealistic contrast. It also reinforces the high standards of society and mainstream media’s definition of “attractive,” which, based solely on “The Bachelor’s” 10-year record of immaculately-groomed and perfectly-toned contestants, seems to be exclusive to sizes zero and two.

"The Bachelor" Cast: Season 14

In the 2006 paper, “The ‘Reality’ of Health: Reality Television and the Public Health,” the Kaiser Family Foundation expresses concern that the obsession with being physically attractive and sexually desirable as portrayed on shows like “The Bachelor” may contribute to the rise in eating disorders among young girls, since they are less likely than older generations to see the contrived nature of the shows and, therefore, more likely to take what they see at face value. This means that for the eight million Americans who suffer from eating disorders and the millions more with body image issues, shows like “The Bachelor” and “The Bachelorette” may only be adding fuel to the fire.

In a mainstream culture so saturated with superficiality, the effect of images portrayed as “normal” in reality TV programs on young women should be an important topic of study, since an eating disorder is as real as any other disease. Much emphasis and government funding is placed on solving the country’s obesity epidemic, as over 60% of American adults are carrying excess pounds, but it is important not to overlook those in need of gaining a few, or at least those who are in need of reassurance they do not need to be a size zero.

So what does this mean in the social marketing context? Although there is a plethora of coverage on eating disorders in the media, promotion of more general discussions about the pressure women feel to be “perfect” could go a long way. It seems the majority of existing anti-eating disorder campaigns is based in foreign countries such as the United Kingdom, Italy, and Israel, and most are entirely ad-focused, relying heavily on shock tactics to grab attention. In truth, the possibilities for campaign messaging and tonality are plentiful. Whether by taking a shock-and-awe approach or promoting female empowerment and acceptance of all body types, the initiative could undoubtedly be customized to fulfill various client needs (think: Dove’s 2004 “Real Beauty” campaign.) These initiatives could incorporate tactics such as television PSAs that air during the programs of greatest concern (like “The Bachelor”), thereby easily reaching the young, female target audience. Perhaps this is also an opportunity to challenge entertainment and casting companies to include women who represent a more “typical” body image within the reality TV sector.

In the meantime, as long as we “The Bachelor” addicts are careful to maintain some distance and understand that what we’re watching is pure entertainment and NOT normal life, ordinary people, standard scenarios, or typical relationships… it’s fairly harmless. Or so I will continue to tell myself, this season and (most likely) next.

Introducing OgilvyEngage

May 16

OgilvyExchange Logo

The Business of Behavior

Companies increasingly recognize that if societies falter, their business can’t succeed. Accordingly, many enterprises acknowledge that it is a business imperative to get people to change individual behaviors around such issues as driving safely, eating healthier, taking medications regularly, staying out of debt  and others.

Through corporate responsibility commitments, sustainability initiatives, philanthropic contributions, and more, companies are changing the way they do business and driving awareness of important social issues. But too many efforts stop there, and much more can be done. What’s often missing is the engagement of stakeholder audiences in changing their behaviors… to move people beyond awareness toward actions that make an impact.

This new frontier is discussed in the latest edition of Ogilvy & Mather’s Red Paper Series – From Cause to Change: The business of behavior.  It explores the ways in which companies across a broad range of industries can become agents of behavior change and contribute even more so to the well-being of individuals and society while improving business performance.  For companies, this can translate into market expansion opportunities, reduced costs, strengthened brand positioning, and an enhanced reputation and leadership profile.

Leveraging the science of behavior change is at the heart of social marketing, the application of marketing and communications to the promotion of ideas, issues, and practices that support personal and public health and safety, community benefits, and social change.  In effect, it’s to spark positive behavior change. Social marketing traditionally has had a rich and successful legacy in the public sector, something that our agency has been acquainted with for nearly three decades. We know how social marketing gets people to buckle up, get screened for colon cancer, purchase flood insurance, and more.  These are significant impacts and the results cannot be discounted.

What is OgilvyEngage?

OgilvyEngage is Ogilvy Public Relations’ new global behavioral science practice that helps companies drive socially-beneficial behavior change among consumers, employees, and other stakeholders to improve business performance while contributing to the well-being of individuals and society.  We use proven behavior change models, theories, tools, and techniques to help clients assess opportunities; better understand the motivations of their audiences; and design results-oriented messages, strategies, and programs.

This expertise is born out of our global social marketing practice.  For nearly 30 years, we have been a global leader in helping clients change minds, shift attitudes, redefine norms, and support sustained individual and community behavior change.  We design research-based and theory-informed integrated solutions that combine disciplines such as paid, earned, and owned media; partnership development and coalition building; special events; advertising; and direct marketing to help clients around the world make a difference in healthcare, wellness, safety, education, personal finance, and more.

At the heart of this specialty is our agency’s proprietary Dynamics of Change model, a tool designed to identify the specific change a company should invest in to bring about maximized outcomes for its business, individuals, and society, as well as to define the strategy and processes for implementing a change program.

The Benefit for Business

Global changes to the economy, to our environment, and to our social welfare are mandating new approaches to how we live.  Adding behavior change leadership from the private sector to that of government and public interest organizations will create a multi-faceted approach with exponential benefits.  For example, companies can:

  • Reap meaningful and measurable business performance and return on investment, ranging from market expansion opportunities and reduced costs to strengthened brand positioning and an enhanced reputation and leadership profile.
  • Advance and evolve their engagement in public good and expand the impact of many of their corporate responsibility initiatives.
  • Strengthen the increasingly important – and necessary – relationship among a thriving business enterprise, the well-being of stakeholders, and social change.

Examples in Action

On April 19, we hosted a panel discussion at Ogilvy Washington – Socially Responsible Behavior Change as a Business Imperative –  to share how some companies are already embracing the opportunity to build their business while fostering socially-responsible behavior change.   For example :

  • Opower works with utilities to help them meet their efficiency goals by getting their customers to use less energy.
  • Starbucks promotes composting by providing coffee grounds to consumers to take home for their composts.
  • Energizer prompts consumers to change their smoke detector batteries twice a year when they change their clocks for daylight savings time.
  • Allstate asks teens to pledge not to text and drive.
  • Clorox encourages consumers to regularly disinfect phones and other items in the home that are touched often to reduce the incidence of flu.

These companies are early adopters of what we see as a growing trend and a business imperative.  We are absolutely convinced that businesses that engage consumers and other stakeholders in socially-beneficial behavior change stand to enjoy meaningful benefits to their bottom lines.  And we believe that the engagement of the private sector is critical to helping individuals and societies across the globe tackle the many complex and difficult problems that we face – issues like obesity, water conservation, disease prevention, and financial literacy – that will only be addressed successfully by the cooperation and involvement of all sectors.

Download the Red Paper

We invite you to join the discussion and we welcome your reactions and responses to our Red Paper.  And I invite you to connect with me directly:

Jennifer.Wayman@ogilvy.com
@JenniferWayman

5 Links to Help You Navigate Government Social Media Guidelines

May 15

Navigating government social media guidelines can be tricky since there are so many different components to consider, so I wanted to share 5 links that help me advise my clients and comply with the guidelines.

1. Apps.gov- Apps.gov lists all the approved social media sites and tools that have Terms of Service agreements with the government.  This is a great place to start when looking to solve a communication problem with a social media tool since the site needs to have an approved TOS agreement in order for your client/agency to use it.   While you can use this site as a resource you still need to check with your clients/agency leadership as every agency has more specific guidance that may limit this list further.

2.Web2Access.org.uk-  This site has tested many of the most popular Web 2.0 sites for accessibility for those with disabilities.  You can use it to evaluate the strengths and weaknesses of a particular site in relation to 508 compliance.  They even give each site a score based on different types of disabilities.

3. Archives.gov Memo on FOIA Archiving- I get many questions about how and what to archive from government clients, but most of the advice on agency sites is vague and recommends talking with your agency’s FOIA officer or checking with archives.gov (which is still a good course of action).  However, a direct link to this archiving guidance is hard to find, so I dug it up on the archives.gov website.  The memo clearly outlines what needs to be archived in Social media and how you might go about doing that.

4. OMB Guidance on Information Collected through Social Media- As a best practice, we recommend our clients engage in social media by asking questions and involving their audience in a two-way dialogue.  However, there is always confusion about what government agencies are allowed to ask and what types of information they can collect from the public without OMB approval.  Luckily, OMB has guidance on this very issue online and available to the public in case you ever need a refresher.  As a little preview, open ended questions are OK, but surveys and polls are not without OMB clearance.  Read the memo for guidance on contests, e-mail address collection, rankings/ratings/votes and more.

5. HHS Center for New Media- Most of my clients fall under the HHS umbrella so this site is exceedingly helpful to me when I need to research a social media guidelines question.  It’s got a great section on Standards and Policies for HHS that is inclusive of everything you need to think about before embarking on a social media campaign for a HHS agency.   There are also many many resources and tools that can help you educate yourself and learn where to go for more information.

What links do you rely on to help you comply with government social media guidelines?  This is definitely not a comprehensive list, so please leave a few of your favorite resources in the comments.

Want to be smarter? Try dressing like a doctor.

May 10

As a preteen in the 80s, my demands for Guess jeans and Z Cavaricci shorts were met repeatedly with the same wise—but at the time, annoying—words from my mom: “It’s not what you wear. It’s what’s on the inside that counts.”

Even though she was doing it more in the “we’re not buying you those ridiculously expensive designer clothes” kind of way, the point was not lost on me.  We’d all like to think that what we wear doesn’t really impact how people perceive us – that people will be able to tell how smart or talented or kind we are by what we say and how we act.  But what about how we perceive ourselves?

We know that there are times when we want to “dress to impress,” whether for a job interview or to meet your boyfriend’s parents.  We know that people do pay attention to what we are wearing, whether consciously or not.  Studies have shown that women wearing masculine clothing in a job interview are more likely to be hired, and teaching assistants wearing more formal clothes are thought to be smarter.  Plus, maybe more importantly, what we wear can impact how we feel about ourselves.  I think many of us feel differently when we dress up for a special event or wear a suit to an important meeting.

But could what we wear actually influence our cognitive abilities?  Turns out the answer might be yes, and that wearing clothing that you associate with being smart can make you act smarter.  The New York Times recently reported on a study led by Northwestern University’s Kellogg School of Management (read study abstract) that showed that wearing a white coat that you believe to be a doctor’s coat—as opposed to a painter’s coat—will increase your ability to pay attention.  This is a phenomenon the authors call “enclothed cognition,” which posits that the clothing you wear systematically affects your psychological processes.  If you know the symbolic meaning of a piece of clothing (i.e., a doctor’s white coat), you may take on the traits you associate with it (i.e., being careful, rigorous) when you wear it.  It’s a play on “embodied cognition,” a growing scientific field focused on the interplay of how our physical experiences (e.g., position, posture) impact our psychological processes (e.g., make us feel more powerful).

Image from Mercy Hospital

The goal of the study was to determine if your clothes could affect how you approach and interact with the world.  Research participants who wore a white “doctor’s coat” performed better on a test of sustained attention than those wearing a white “painter’s coat,” a generic white coat, or street clothes.

The idea that what you wear could have a real impact on how you think or perform in the world is fascinating, bringing new meaning to the expression “dressing for success.”  What else could make us act smarter?  Wearing glasses?  Carrying a briefcase?

As a public health professional, the study results make me think: how can we use enclothed cognition to improve people’s health?  Is there something we can wear to help us make better/healthier choices?  Will putting on our exercise clothes really motivate us to go for that run or get to that exercise class?  And how can we facilitate access to these types of clothes for everyone, not just those who can afford them?  Beyond exercise, how can this effect be used to help us stick to our health resolutions or follow through on those behaviors that we know are better for us?

Pass First–On and Off the Court

May 08

North Carolina Tar Heels are super passionate about their college basketball team.  (Case and point: the season is over and I’m still talking about it.)  So when North Carolina point guard Kendall Marshall–the nation’s leading assist man–announced he had a fractured wrist shortly after his team’s advancement to the Sweet 16, many ardent fans–myself included–felt their championship dreams crushed, much like Marshall’s wrist.  But instead of wallowing in despair, one student decided to bring Carolina fans together and hold out hope for Marshall’s tournament return.  Turns out, it proved to be more than a gesture among friends as the idea quickly transformed into a movement.

The idea was simple: draw the number five on your right wrist, representing Marshall’s jersey number and the location of his fracture.  The creators—who have chosen to remain anonymous—coined it “PassFir5t,” citing Marshall’s pass-first basketball mentality.  They casually created a Twitter account and a Facebook page, and shared it with a few friends.

Five on Wrist

It didn’t take long for the Carolina community to catch on.  Within hours, hundreds of people had posted pictures of “5” wrists on their Facebook accounts and Twitter handles, showing silent solidarity for the injured guard.  Ten days later, there were more than 3,200 members on the PassFir5t Facebook page. Articles were written by ESPN.com, the News & Observer, and several blogs.  Even Kendall Marshall took notice.

K. Marshall Tweet

With the growing momentum, the creators began to ask themselves: what do you do with the attention of thousands of passionate people?  How can we make this about more than basketball?  Their answer: use the platform and its message to exemplify how people should live their lives—by putting others before themselves (or in Marshall’s case: pass first).   The creators wanted to inspire people to do good within their own community.   Leading by example, they set up a meeting with Basebald–a local organization dedicated to raising money for childhood cancer research–and established their first partnership.  News of the partnership spread quickly over their social media network and within 24 hours, PassFir5t and its supporters had raised $2,000 for Basebald.

The Tar Heels rallied past the University of Ohio in the Sweet 16 game before falling to the University of Kansas in the Elite Eight.  Kendall Marshall did not play in either game.  Wrists were washed, but the PassFir5t spirit lived on as the number of supporters grew and new partnerships formed with other organizations, including local chapters of Fighting Cancer Below the Belt and Uhuru Child.  As of April 12, 2012, PassFir5t had raised almost $4,000 for various charities.  The creators have stressed that PassFir5t is more than simply raising money.  It’s about sharing the message of selflessness with others and taking a more active role in the community through volunteerism or supporting local organizations.

As an early supporter of the PassFir5t movement, it’s been amazing to see how quickly an idea can spread over social media, how it evolves over time, and how one person’s passion can inspire an entire community to act.  This year, Carolina fans proved that their passion extends beyond the basketball court and into communities where their actions truly make a difference.  And that makes me proud to be a Tar Heel.

For more information about PassFir5t, visit:

Website: http://www.passfir5t.org/
Twitter: https://twitter.com/#!/PassFir5t
Facebook: https://www.facebook.com/PassFir5tCarolina

“China’s Evolving Social Health Initiative: A Metaphor for New China?”

May 01

*The views expressed on this blog are my own and do not necessarily reflect the views of my employer.*

World Health Organization (WHO) definition of health literacy: The cognitive and social skills which determine the motivation and ability of individuals to gain access to understand and use information in ways which promote and maintain good health.

As China is establishing itself as a more permanent global presence, efforts are being taken to shift how the government connects with and influences the general public on health related issues. When the People’s Republic of China was first established in 1949, the government’s concept of health education revolved mainly around increasing knowledge of the general public through heavy-handed, top down campaigns that provided little information. Recently, there has been a gradual shift toward measures that support the WHO’s definition of health literacy with campaign efforts using positive language to proactively maintain healthy habits.

The responsibility of health education in The People’s Republic of China has typically fallen to the Ministry of Health (MOH)’s Patriotic Health Campaign Committee (PHCC). This committee, established in 1950, heads the Patriotic Health Campaign, which works on a national and provincial level to inform the general public on actions to take to improve health.

In the past, the PHCC has presented health issues as enemies to be destroyed. Little information was provided and issues were oversimplified in an attempt to eradicate problems as quickly as possible, rather than educating the public to encourage healthier decisions. Dialogue about healthcare was typically one-way, with education curriculums developed at the national level and then taught throughout cities across the country regardless of local characteristics and needs.

In the 1950s and 1960s, to help control the schistosomiasis endemic, the PHCC identified snails as being responsible for the transmission of the disease. The government conducted a mass campaign to eliminate snails through poisonous drugs, an approach that had limited success eradicating the problem. This complemented Mao Zedongs’s war against “the four devils”—flies, mosquitoes, mice, and sparrows—that encouraged Chinese peasants to kill these pests to improve general health. Mao era propaganda targeted specific environmental factors as being the fastest and easiest way to “understand” and therefore eliminate a much more complex problem.

"The Four Pests" (image.baidu.com)

As recently as 2004, the Communist Party mobilized a campaign to remove civet cats, badgers, raccoon dogs, rats, and cockroaches in order to combat the SARS virus. Rather than informing the public of what SARS is and how it can be avoided, the government took a simplistic approach to the issue by identifying an enemy to defeat in order to solve the problem.  Both SARS and schistosomiasis are influenced by a number of environmental factors.  Furthermore, the mass killing of species can greatly influence the environment and cause new issues.  For these reasons, such tactics oversimplified the issues and did nothing to increase the education of the general public about these diseases. http://news.bbc.co.uk/2/hi/asia-pacific/3371659.stm

Another example of the Chinese government’s heavy-handed approach to an overly-simplified problem concerns the country’s on-going anti-smoking campaign. The MOH has a history of adopting a strong anti-smoking stance and in 2003 ratified the WHO’s Framework Convention on Tobacco Control. While there has been international support for this effort through the Bill and Melinda Gates Foundation, the MOH approach has intentionally presented a limited scope of information in their marketing tactics to intensify their discouraging of specific behaviors.  The campaign’s visual assets do not provide any information about why smoking is dangerous or the benefits of quitting other than associating smoking with death. Scare tactics such as these have been known to produce results, but do nothing to help increase the general public’s understanding of the underlying issues.

Chinese anti-smoking OOH (image.baidu.com)

Despite these current examples of propaganda-supported social marketing, the MOH and Chinese government have been showing increasing acceptance of other social marketing efforts. In the case of the schistosomiasis control-program mentioned before, recently China has been exploring a more informative approach by administering “a health education program aimed at changing behaviors of people living in the epidemic area. Three preventive healthy behaviors were proposed for the residents:  avoid contact with contaminated water; comply with treatment for prevention and infection; and properly dispose of excreta.  Knowledge about the dangers of unhealthy behaviors is provided and disseminated.” [Wang 272 http://www.bvsde.paho.org/bvsacd/cd26/promocion/v15n3/269.pdf]  This approach better informs the public of the exact means through which schistosomiasis is spread.  Possessing a more complete knowledge of this danger is an important element to developing the motivation to combat it.  Rather than strict control, a more well-rounded behavioral reform is the focus.  Good habits are encouraged and two of the three directives are encouraging healthy behavior rather than admonishing poor behavior.

Schistosomiasis OOH (mgcdc.cn)

As the government decentralizes and the power of local governments increases, there should be more opportunities to explore social marketing practices that encourage healthy behaviors. While challenges remain, it will be exciting to see what strategies are adopted to reach the various audiences of such a vast population. It is encouraging that there is already a shift away from overly-negative, overly-simplified messages and tactics toward more informational, audience-focused efforts. Additionally, the involvement of such organizations as the Gates Foundation and WHO in health education efforts indicates that the government is becoming more tolerant and flexible in how it reaches the general public.