From Couch to Examination Table: Evidence-Based Marketing for Creating Behavior Change in High-Risk Populations

Background: In 2008, the DC Department of Health, HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA) partnered with Octane Public Relations and Advertising (Octane) to develop strategic social marketing campaigns targeting demographics at the highest risk for HIV in DC. In 2014, HASTA and Octane conducted a survey of DC residents to gauge the visibility and effectiveness of the DC Takes on HIV (HIV awareness), Ask for the Test (HIV testing) and Rubber Revolution (condom use) campaigns. The purpose of the study was to determine if campaigns were visible by and resonating with target demographics in the city’s eight wards, and if residents demonstrated the change in health behaviors promoted by the campaigns’ messaging.

Program background: The total number of study participants (citywide sample) consisted of 810 respondents with a fairly even representation of men (48%) and women (52%). Social marketing efforts targeted the demographics already being targeted by the HIV-prevention campaigns for survey recruitment. To ensure that targeted subpopulations were adequately represented in the survey, the study purposely recruited more, or oversampled, African Americans and gay men of all races. By oversampling, we were able to allow for more reliable estimates to be reported for these groups. 

Evaluation Methods and Results: The study found that the three campaigns assessed had high visiblity throughout the city, with 44% recalling DC Takes on HIV, 39% recalling Ask for the Test, and 14% recalling Rubber Revolution (the last campaign being the newest and marketed for under half the time span of the first two campaigns). Behaviors were positively influenced by the campaigns, with more than half (55%) of respondents reporting that the campaigns made them think about getting tested for HIV, and 27% reporting they got an HIV test as a direct result of the campaign. More than one in four respondents (28%) reported that they used condoms more frequently. In terms of tactics, transit and TV ads were the most recalled channels across all three campaigns, with approximately one-third of respondents recalling both Rubber Revolution and Ask for the Test TV commercials, and as much as 44% recalling transit ads (Ask for the Test).

Conclusions: Overall, we learned that transit ads and TV commercials are the most effective platforms for campaign messaging in terms of both reach and recall, and instigating behavior change. We also learned that residents are exponentially more likely to recall messaging from brick-and-mortar or TV platforms over digital platforms (websites and social media).

Implications for research and/or practice: These results are leading to responsive shifts in our social marketing strategies, including more frequent refreshes of TV and transit creative, and emphasizing social media tie-ins to events and ad campaigns. Overall, we know that we can and will ask DC residents to step up their efforts to prevent HIV on a personal level. When we ask residents to learn more about their risk for HIV, get tested, and use condoms, they rise to the challenge.