Table 2 The eight social marketing elements in ‘Get Your Life Back’

Consumer orientation

Older adults from three regions were involved in various stages of the research from formative stages through to implementation and final evaluation. Researchers considered the health needs of the target audience, but more broadly concentrated on the determinants of quality of life in older adults. Formative research highlighted that being healthy to enjoy time with their grandchildren and family was highly valued, and could motivate older adults to take action and seek information.

Insight

It was important to gain insight into the asthma knowledge, perceptions, and health behaviours of older adults in our target communities. Over 4000 individuals from three regions responded to the initial large-scale formative research survey. The data demonstrated that almost half of the sample had recently experienced breathlessness, and that this experience was a predictor of lower mood and poorer health ratings [20]. Furthermore, this formative research gave insight into effective audience segmentation based on respiratory symptoms and asthma diagnosis. Subsequently, 34 older adults participated in focus groups to test campaign messages and materials [37]. This insight suggested that older adults respond best to positive and empowering health promotion materials that include individuals and everyday situations that they can personally relate to. Finally, more than 700 individuals from both intervention and control communities completed pre- and post-campaign surveys as part of the evaluation of the intervention.

Segmentation

The older adult population was segmented on the basis of two variables: recent experience of respiratory symptoms, and the presence of an asthma diagnosis. These variables created four segments: Wheezers, an asthma diagnosis and symptoms; Breathers, an asthma diagnosis, but no symptoms; Strugglers, no asthma diagnosis, but have symptoms; and Bloomers, no diagnosis and no symptoms. These segments had distinct differences in asthma knowledge and perceptions, general health ratings, and frequency of visits to the doctor. Due to their recent experience of respiratory symptoms, Wheezers and Strugglers were the main target of ‘Get Your Life Back’.

Marketing mix

Product. For individuals with respiratory symptoms, the product was the ability to undertake activities that would only be possible with improved respiratory health.

Price. The possibility of receiving a diagnosis could cause concern for Strugglers; there may also have been a monetary cost for both target segments for medications needed to manage their respiratory symptoms.

Place. Doctors and pharmacists, and the environments where they work, cafes, community and leisure centres, libraries, shopping centres frequently visited by older adults were the key places in this marketing mix.

Promotion. In addition to advertising on bus shelters and in public bathrooms, postcards were delivered throughout the region. Promotion events were held in local shopping centres, and the campaign gained media attention on local TV and radio.

Theory

The Health Belief Model was used in conjunction with the social marketing framework to better understand the asthma perceptions of older adults and to determine how the campaign would best encourage website visits, calls to the information line, and visits to the doctor to discuss respiratory symptoms.

Behaviour

‘Get Your Life Back’ encouraged older adults with uncontrolled respiratory symptoms to seek further information about asthma on the internet or by telephone, and promoted the discussion of their respiratory symptoms with their doctor. In the future, this may lead to the adoption of appropriate self-management behaviours.

Competition

All other local and national health promotion interventions conducted in the same timeframe competed for older adults’ time and attention. Commercial advertising also competed with asthma awareness promotion efforts. ‘Get Your Life Back’ attempted to stand out from the competition by incorporating local images into the campaign materials, and by ensuring the placement of campaign materials was in locations visited regularly and frequently by older adults.

Exchange

‘Get Your Life Back’ highlighted that respiratory symptoms are not normal and encouraged older adults to take control of their health. The primary benefit offered to older adults with respiratory symptoms was the ability to participate more fully in the activities they enjoy by controlling the symptoms that may hinder their choices. In return, individuals had to be willing to give up their time to seek information; incur potential costs to visit the doctor, and potentially experience psychological distress in the instance of being diagnosed with asthma or another condition.