Reality bytes: Lessons learned from a community-based social marketing intervention to promote colorectal cancer screening

Theoretical Background and research questions/hypothesis:

The Florida Prevention Research Center developed and implemented a community-based social marketing intervention to promote colorectal cancer screening (CRCS) within communities surrounding two federally qualified health center (FQHC) sites serving the greater Orlando area. We describe development, implementation, and evaluation of this pilot intervention. In this presentation we: 1) Describe the development and implementation of a community-based CRCS social marketing intervention; 2) Describe the extent to which intervention strategies were successful in motivating community residents to visit a local FQHC for CRCS; and 3) Identify factors that may help improve success of similar interventions in the future.

Methods:

We conducted brief surveys and intercept interviews (N = 148) in community locations near partnering FQHC sites to guide development of print-based CRCS promotional materials. Local businesses (e.g. beauty salons, pharmacies, laundromats,) within five miles of FQHC sites were asked to display “implementation packets” in their facilities from October 2018-April 2019. Each site was given CRC educational materials (e.g. brochures), document holders, and a 12”x18” poster directing clients to a nearby FQHC for CRCS. Posters also instructed individuals to share it on social media using a unique hashtag assigned to each business, allowing investigators to track where posters were viewed. Adults visiting the partnering FQHC during the intervention were surveyed to determine if intervention materials motivated them to come in.

Results:

Formative research participants (N = 148) were between ages 19-73 (M = 41.2); most were women (59.5%); 37% were Hispanic, 41% were Black/African American, and 28% were White/Caucasian. Almost 36% of participants reported having no health insurance coverage; 33% said they did not know where to find affordable healthcare in their community; and 66% said they had never heard of the partnering FQHC. Formative research also suggested: most participants and their friends/families used Facebook and Instagram; most participants would share CRCS materials via social media; and intervention materials would motivate individuals to seek CRCS or suggest CRCS to family/friends. As of February 2019, no study hashtags were posted to social media; and no patients reported seeing intervention materials in the community. Follow-up interviews are scheduled for March 2019 to explore the extent to which CRCS materials are noticed and understood by the community; how materials could be modified to generate more attention; and why people choose not to share materials on social media.

Conclusions:

Formative research indicated that community-based social marketing may be effective at increasing visibility and usage of local FQHCs for CRCS; however, evaluation findings suggest that other strategies are necessary to achieve intended goals. Consistent with previous research, social marketing campaigns require strong brand equity, which often requires a significant amount of time to build public trust. Additionally, social media was an ineffective way to assess engagement with our intervention.

Implications for research and/or practice:

Follow-up interview data will be incorporated into the final conference presentation, which will help explain why intervention strategies were unsuccessful, and help identify strategies to improve success of future community-based social marketing efforts.