One of our main areas of expertise is in health communications and behavior change campaigns. From addiction to sexual/reproductive health to COVID-19, Fraser has tackled the most important public health topics of our time. In recent years, Fraser has had the honor to work on several campaigns addressing substance use disorders; and through the process of creating these campaigns, we realized two important things: how vital evidence-based approaches are; and how conducting thoughtful research is crucial to developing campaigns that resonate with audiences to take action and actually change behavior.
In general, when messaging about substance use disorders, we are often asking people to do something they don’t want to do… something their addiction makes incredibly difficult: quit. An additional challenge often is the smaller budgets for these campaigns, compared to that of private sector companies. For these reasons, these campaigns must look and sound different and distinctive in order to “cut through the noise” of other advertising; and even with this in mind, a “one size fits all” approach must be set aside for a more targeted strategy. Fraser always has our finger on the pulse of health communications’ best practices and peer-reviewed literature, but we are using our own innovative research and approaches to evolve health comms and create thoughtful, effective campaigns for our clients.
In the field of tobacco control, there is a robust base of research and peer-review publications showing that “hard-hitting” media campaigns - those campaigns that show the negative impact that smoking has on health - in graphic or emotionally provocative ways, are most effective at motivating smokers to make a quit attempt. This communications strategy has been well-documented as contributing to reducing smoking rates all over the world, especially when it is paired with practical resources for cessation (such as no-cost nicotine replacement therapy, connecting to cessation counselor, etc.). The most impactful ads have been a unique combination of presenting risk and health impact in very realistic ways, while also suggesting the impact of illness and death on the people the smoker loves. In qualitative research sessions like focus groups and interviews with those who are addicted, these ads make smokers think and feel in ways that motivate them to quit with some urgency, ultimately resulting in effective campaigns.
In our approach to campaigns on opioids misuse prevention, we learned from this process and tested both hard-hitting and more positive concepts with users of prescription opioids. Just like tobacco prevention ads, the hard-hitting concepts that warned of negative health consequences and the toll of misuse on family members were strongest – during qualitative sessions, they created a great deal of introspection and risk calculation among respondents. Ultimately, this was the approach taken to create campaigns that made the audience think about their use of prescription pain killers, evoking an emotional response to their own risky behavior and how their use could potentially have a negative impact on the people they love.
In approaching the creation of a campaign to speak to both at-risk and regular users of methamphetamines, we started with what we knew worked, but quickly realized the tried-and-true approach for other public health campaigns about addictive substances must evolve in order to be even more effective.
The context of meth and the people who it is very different from tobacco and even opioids - both legal substances for which there are large industries to blame and a discourse of sympathy for users. Meth use carries with it a great deal of stigma, far more than that people struggling with dependence on tobacco or prescription drugs. Meth users are often among the most marginalized people in communities across the country; and prevention campaigns often add to this stigma, showing monstrous addicts behaving in violent ways.
Through interviews with experts in the field of meth use and recovery, from academics to members of outreach street teams, we learned that these campaigns were not backed by many evaluations on effectiveness and seemed to contribute to the problem by pushing people who are struggling with meth addiction further into the margins. We realized then, that reaching these audiences and “cutting through the noise” would require a very different approach – one that communicates compassion and empathy, a tone that people using meth don’t often experience. After doing in-depth interviews with current and former users of meth, it was clear that shame and stigma were major barriers in getting into recovery. Message testing with both at-risk and actively-using audiences showed that hard-hitting ads, while memorable, did not speak directly to the experience of the people who needed these messages most. The final campaign offered messages that showed empathy toward the struggles that lead people to use while demonstrating compassion and creating hope for the future. The results were stunning: our quantitative evaluation showed campaign exposure was associated with having more negative attitudes toward methamphetamine, calling a substance abuse service helpline, using methamphetamine fewer days, and considering quitting methamphetamine.
Fraser approaches every campaign, whether it be public health or a private sector client in the same way– we learn from others, expand on what we know and seek out information to better understand how campaigns and its audiences are unique in their behaviors and thinking. This thoughtful approach ultimately leads to nuanced strategy, creative communications and media planning that speaks to audiences both intellectually and emotionally, so they feel understood and motivated to change behavior.
You can see Fraser’s innovative public health campaigns on our YouTube channel.