Case studies presented at the Institute of Communication Agencies conference illustrate the challenge that ad agencies face in the arena of personal issues such as health, drinking and driving, and sexually transmitted diseases.
Yvette Thornley, manager for the communications branch of the Ontario Ministry of Health and Long-term Care, said partnerships between ad agencies and governments have resulted in great creative executions that have made a clear impact on human behaviour over time, although it is critical that marketers determine before the campaign begins what the biggest obstacles are standing in the way of people adopting different behaviour.
Advertising a free flu shot to Ontarians in 2000 saw an uptick in flu shots from 14% to 34% of the province's population in the first year of the program, and resulted in 30,000 fewer visits to emergency rooms as a result, Ms. Thornley said, but it is an ongoing challenge to get people out for a shot, even if they know they can get one. Now the average is about 35%, although 45% were innoculated last year when H1N1 warnings proliferated.
"Success [in such a campaign] is not defined by the amount of coverage it receives in the media," she said. "It is defined by changed behaviour."
In one of the examples cited, advertising helped ameliorate one of the biggest public health problems in Ontario: the overuse of hospital emergency rooms for non-emergencies. It led to a still-running awareness campaign in 2009 for the province's Ministry of Health and Long-Term Care from Narrative Advocacy Media, a division of Toronto ad agency Bensimon Byrne.
Agency brass knew that consumers were avid seekers of health information on the Web even though a good deal of it is incorrect, said David Rosenberg, chief creative officer at the Toronto agency. At the time the campaign started in early 2009, Ontarians were waiting an average of 9.4 hours in hospital ERs before being seen. The long wait times were happening because they were not going to emergency rooms for actual emergencies and were largely unaware of other health-care options in their area, such as urgent-care centres, medical drop-in clinics or whether or not their doctors belonged to a health network. At the time, 566,000 visits to ERs across the province every year were for non-emergencies.
The biggest hurdle with Ontario residents was the ongoing word-of-mouth horror stories about hospital ER care. "The question was 'How do we contain the horror?' " Mr. Rosenberg recalled, and promote the health-care system as trustworthy and efficient.
"Most people dreaded the thought of heading to an ER," said Amanda Alvaro, managing director at Bensimon Byrne's Narrative Advocacy Media. "So why did they go? Because they didn't think they had any other options."
A website with searchable information by postal code would also be an asset, the agency reasoned, and one that provided information such as average wait times for surgeries. Delivering options to Ontarians became the strategic and creative thrust of the campaign.
One unexpected stumbling block, however, was that the ministry itself lacked a comprehensive list of what health-care professionals offered in terms of services in various areas of the province, and at what hours.
Before they could build a comprehensive database of health-care providers in the province, Bensimon Byrne and the ministry had to do extensive research for reliable information. In the past, promotion of the non-ER options had been left to doctors, clinics and local health-care administrators, and was patchwork and inconsistent in its approach.
After the legwork, the resulting TV and Web campaign has seen the number of non-emergency visits to emergency rooms decline 13% since its inception; overall visits to the ER have declined 10%. Television ads were run heavily on the weekend; after waiting to check on the status of their family member's illness all weekend, people tended to overuse ERs as a default health-care option on Sunday afternoons and Monday mornings, Ms. Alvaro said.
The campaign drove 1.5 million people to the site and sparked more than a million searches -- the site received more hits than OHIP's site--a government first. Fifty-two per cent of people who visited the website reported accessing alternative services to ERs.
The overall average ER wait time declined to 8.6 hours from 9.4.
More recently, the campaign was awarded bronze this week at the Cassies Awards, the advertising competition that judges entries based on their ability to increase business or effect change.
While the Ontario ministry's campaign has been a success, one speaker at the conference said the major impediment to such campaigns is often resources, given that many of them are publicly funded.
"In the [United States] it is a constant struggle," said Les Pappas, founder and creative director of Better World Advertising, a San Franciscobased firm that focuses solely on social marketing. As such, social marketing work is frequently "done by amateurs and overly constrained by politicians," he said. "And in an economic recession, social marketing is the first to go."