Getting Them off the Fence! Developing a Social Marketing Campaign to Encourage Uptake of H1N1 Vaccine Among 18- to 24-Year-Olds in North Carolina

Background: Unlike other types of flu, adults 18 to 24 have been identified by the CDC as a high risk group for contracting the H1N1 virus. While children and adolescents are also susceptible to the virus, 18- to 24-year-olds may be more likely to reside away from previous caregivers and are making health decisions on their own. Eighteen to 24-year-olds are also one of the groups least likely to get vaccinated.

Program background: This research was conducted as part of a social marketing campaigns class working with the NC Division of Public Health.  The objectives of the research were 1) to uncover perceptions of the H1N1 vaccine among 18-24-year-olds in North Carolina and 2) to develop and test the effectiveness of promotional messages with members of the target audience.  The research was informed by the Health Belief Model and the Transtheoretical Model.

Evaluation Methods and Results: Phase I:  Intercept interviews (n=24) were conducted with 18- to 24-year-old students and non-students in three geographic locations in North Carolina. Participants were asked about their knowledge and perceptions of the H1N1 virus and vaccine, including perceived susceptibility and severity of getting the H1N1 virus, and perceived benefits and barriers to getting vaccinated.  Differences in perceptions were not found between students and non-students.  Key barriers included inconvenience and lack of perceived susceptibility or severity of H1N1 for their age group. Key benefits included the ability to protect oneself and other loved ones from contracting H1N1 and becoming ill. Based on findings, the target audience was segmented into three groups: (1) refusers, (2) seekers, and (3) fence-sitters; fence-sitters were selected as the target audience for the campaign. Phase II:  Three message concepts were developed and tested via an online survey.  Respondents (N = 135) were randomly assigned to one of four experimental groups (3 treatments + one control). Respondents were asked about sources of vaccination uncertainty and then the three treatment groups each were shown one of the ad concepts; the control group was not exposed to an ad. All groups were then asked about their vaccination intentions and preferred sources of health information.  The “I got mine” concept emerged as most appealing (48.1%). Vaccination intent was moderated by reasons for vaccination uncertainty; respondents in the treatment groups who were unsure about vaccination because they “didn’t have enough information” were significantly more likely to want to talk with friends or family members (p < .05) or to a doctor or other health care provider about getting the vaccine (p < .05).

Conclusions: The “I got mine” concept was adapted by the North Carolina Division of Public Health and is currently being used in a statewide H1N1 vaccine marketing campaign. The campaign materials and formative research results were also shared with the New York Department of Public Health.

Implications for research and/or practice: When communicating with 18-24 year-olds undecided about getting the H1N1 vaccine, practitioners should make the vaccine as convenient as possible, explicitly promote the fact that 18-24 year-olds are an at-risk group, and transform the benefit of vaccination beyond the prevention of contracting H1N1 oneself to protecting others whom they care about.