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Strategic social marketing campaigns must be deliberately planned with the desired results in mind, no matter how difficult or far in the future the intended behavior may be expected. Unfortunately, when tackling health-related behaviors, the outcome can sometimes mean life or death. In the case of the U.S. Department of Health and Human Services’ (HHS) We Can Do This campaign, many lives were at stake as Fors Marsh Group (FMG) sought to inform and persuade the “movable middle”—or roughly 80% of Americans—across an immense and ever-changing landscape, influencing: 

  • All socioeconomic groups, genders, ages, ideologies and value sets, health conditions, and many other differentiators;
  • About a novel virus that the mainstream population had not experienced before;
  • During what became a pandemic of unprecedented and controversial medical and economic proportions;
  • As quickly as possible, while science and medicine tried to get ahead of the spread.

FMG was tasked with the strategy and implementation of the national COVID-19 Public Education Campaign, or We Can Do This, in late August 2020. We have since received two follow-on contracts, all awarded by HHS’s Office of the Assistant Secretary for Public Affairs (ASPA). We rapidly assembled a best-in-class team, including population-specific and multicultural agencies to become embedded in our team, bringing along with them more than 700 national and community partners.  

FMG also sought out and engaged expert media-buying agencies skilled at negotiating and placing paid advertising at both the national and local levels. And by tapping more than seven different creative firms, including FMG’s in-house talent, we led myriad consumer and market research activities and strategy development to build a science-based, consumer-centric, flexible, and compassionate approach to influence COVID-19 vaccine uptake.  

FMG was awarded the first contract during the previous presidential administration. We collaborated with the transition team and are now working with a stable of public servants in the current administration. We became adept at providing the proper oversight of the contract and helped onboard new government staff and support HHS. The agency—and FMG—remain committed to controlling and ending the pandemic. 

Three Multifaceted Phases 

FMG designed the We Can Do This campaign with three phases of strategic marketing:  

1. Slow the Spread: When vaccines were still in development, FMG relied on paid and earned media to promote prevention, such as wearing masks, handwashing, and maintaining a safe distance. At the time, it was important not to create demand for the vaccines before they were released and readily available.

One of the biggest mistakes in marketing is to create demand when there is no or low supply, which can backfire and alienate your audience. In other words, when consumers “sample” your product, you must ensure that the experience is valuable to them, delivering on all the promised benefits. We knew that if we successfully motivated people—specifically older adults—to go out and seek the vaccine, we couldn’t subject them to long lines or a complicated experience.

2. Building Vaccine Confidence: FMG’s campaign mirrored the U.S. release of the vaccines in March 2021, targeting the 65+ age group, the immunocompromised, and health care workers. The phase of the campaign became one of frequent pivots based on access to the vaccine for younger age groups and the unique barriers of some audiences. Three sets of audiences and behaviors are balanced within this phase:

a.  Adult First-Dosers yet to receive the vaccine for the first time.
b.  Parents of children now authorized to receive the vaccine.
c.  Boosters for those eligible. 

Although all closely related, each of these audiences and behaviors must be explored independently to understand barriers and benefits among each group, as well as in subgroups. Once you start to sketch the matrix, you can see that we’ve implemented campaigns within campaigns, and along the way, produced more than 4,000 unique ads and resources in 17 different languages. 

3. Preparing the Nation: This phase of the campaign primarily used paid media to distribute information on new science, vaccine and test availability, and the course of the disease. Because COVID was new for literally everyone, this is one of the only health concerns we worked on where information and education was truly critical.  
 
From a “stages of change” model perspective, we knew that many members of our audiences were in contemplation—even pre-contemplation—and that’s where Preparing the Nation could provide support. We tapped into the questions that people were asking and provided new advertising on a consistent basis to answer those questions. We also sought to provide the most credible and accurate information to help address misinformation.  

Focus on the "Movable Middle"  

a bell curve graphic that illustrates the "movable middle"

With the bell curve in mind, we knew that we needed to focus on the “movable middle” for the greatest outcomes. This kept us true to our agreed-upon strategy while using innovative mediums—such as trusted messengers—to reach underserved populations. Flexibility was essential to balance scientific rigor with a mutating virus, treatments under development, and vaccines in approvals and production.  

When evaluating your audience in any marketing campaign, it’s important to assess likelihood of openness, ability, and access to the behavior you’re requesting from your audience, then focus efforts on the critical mass. We designed our overarching strategic approach to specifically meet the needs of audience segments at the middle of the curve rather than at the two ends. 

a.  Innovators needed no influence since they were ready to vaccinate.
b.  Early Adopters needed different types of communication than Late Majority
c.  Laggards, no matter how much your communication seeks to meet their needs, will rarely act; for example, those who may have a distrust of government, those who believe in natural immunity, and/or those who were not supportive of other vaccines and continue to be anti-vaxxers.

Individuals Change Behaviors Through a Series of Steps 

From there we were guided by fundamental behavior change theory to develop tailored vaccine messaging and targeted placements. The stages of change model, also known as the transtheoretical model (TTM), was designed in the 1970s to explain the stages of intentional change in smoking cessation. It outlines the cycle of developing healthy behaviors, from before change is even being considered to Preparation, Action, Maintenance (such as acceptance of boosters), and finally Termination, at which point the change is fully accepted. The model can be used at any point in a behavior change campaign to assess the stage of your audience(s), then influence a move to the next stage.   

Transtheoretical graphic showing the stages of intentional change in 6 stages

Why FMG? 

FMG has more than 20 years of experience in applying data-driven strategies to some of our nation’s biggest health concerns. We have the relationships to quickly assemble teams with diverse expertise in social marketing, communications, behavior change, technology, and program management. Learn more about FMG.

About the author

Ronne Ostby

Ronne Ostby

Ronne Ostby is an experienced social marketing and health communication professional with more than 19 years in the field. She has proven expertise in applying communication and marketing principles to consumer campaigns on a range of health concerns, including illicit drug and alcohol use, tobacco use, prescription drug misuse and abuse, suicide prevention, youth violence prevention, and adult immunization. Her skill set includes primary and secondary research, situational analyses, strategy development, creative planning and oversight, campaign execution, and project leadership.

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