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Background
As noted by Kriznik et al. (2018), “the dominant epistemic assumption (i.e. the assumption about what constitutes admissible evidence to guide action) underpinning the implementation of public health and other behavioural change programmes is that human behaviour is a major determinant of health, and that behaviour is largely a matter of individual choice; individuals are therefore responsible for their own health and for making health-related behaviour changes”. Evolving from commercial marketing, social marketing first emerged as a discipline within health which aimed at changing individual behaviours to benefit both the individual and the society in which they live (Andreasen, 2002). In line with other behavioural change and public health practice recent social marketing reviews highlight the continued dominant focus of intervention efforts on the individual (Almestahiri et al., 2017), a focus that may overlook social and environmental behavioural determinants. It is acknowledged that an individual focus is frequently stigmatising and can lead to victim-blaming (Brennan et al., 2016).
In an individually (also referred to as downstream or micro) focussed programme, social marketing uses the tools and techniques of commercial marketing to influence the individual whose behaviour needs to change to benefit society more broadly. Andreasen explains that what sets social marketing apart from other behaviour change fields are three factors: first, behaviour (and not awareness raising) is at the core; second, social marketing is customer-driven; and perhaps most notably, social marketing creates attractive programmes into which individuals will willingly enter into exchange to achieve the desired behaviour (Andreasen, 2002). Social marketing’s core principle of exchange overcomes victim blaming and stigmatisation criticisms directed at behavioural change programmes, particularly when monetary exchange occurs and people willingly purchase a programme of their own volition.
Typically in social marketing, behavioural change is the desired ultimate goal. There are some settings where behaviour maintenance, and not behavioural change are required (Rundle-Thiele et al., 2015 who sought to maintain the non-alcohol drinkers while attempting to moderate binge drinkers). Measurement indicating that behavioural change has occurred following implementation would indicate to programme evaluators that the social marketing programme was a success. This suggests that in many cases, behaviour change is the variable of interest for social marketers, and not simply behaviour.
Although behaviour change is the end goal...