Social Marketing: A Birds-Eye View

The field of marketing has evolved through interactive conceptualization, ideas, thoughts, and theoretical constructs, which were initially developed from the perspective of their respective fields such as economics, sociology, psychology, and other fields of social sciences (Khan, 2014). The field had transcended from the narrow perspective of commercial orientation to rethink social marketing taking the lead from the work of Hunt (2003) in their thought-provoking article titled, “Controversy in marketing theory, for realism, truth and objectivity” that help expand the dimension of marketing thinking and its actionable implications by targeting social causes. This new direction has triggered a new debate, whether marketing should only focus on commercial aspects or extends towards advancing the good of society through addressing social issues. This development was further advanced by several scholars as well as other institutions like an article by Anderson and Bushman (2018) also highlighted the debate on how various scholars explored the ways that how marketing help address social issues. Earlier in this regard, a valuable contribution by Lazer (1969) has highlighted that “marketing must serve not only business but also the goals of society; it must act for broad public interest” (p.3). Similarly, the article by Foote (1963) underscored that “In the future consumption and consuming activities will occur in a society suffering from obesity and not hunger; in society emerged from a state of chronic scarcity, one confronting problems of satiation, full stomachs, garbage’s, closets and houses” it is also important to mention that pioneering work by Wiebe (1951) who has questioned, “why can’t we market brotherhood like we sell soap” using marketing communications. The same debate was carried out by Satyavageeswaran and Kumar (2007) in their thought-provoking article entitled “social marketing and engagement: a systematic review”. They were of the view that social campaigns should have been supported by a different social mechanism rather barely dependent on advertising and trade, marketing, distribution tools that only suited to business products; a new approach in marketing was imperative to integrate society or desired target group, who need to be mobilized for pro-social behavior.

Broadening the concept of marketing had raised a pertinent issue of the time and Lazer, Murata, and Kosaka (1985) who were well sensitized to changing social and economic realities of the time and how marketing philosophy could have been a strategic tool as well as a fiscal stimulus to improve social indicators besides economic indicators. Finally, these developments and intellectual resistance were taken to the next level by Kotler and Zaltman (1971), who propounded the idea of social marketing to advance the body of knowledge of marketing. The authors have advocated the need for social marketing taking the lead from the work of Wiebe (1951) in their thought-provoking work titled Social marketing: An approach to planned social change. This had triggered the debate to expand the utility of marketing techniques to market social products. Social marketing also uses 4Ps of marketing (product, price, place, and promotion) like commercial marketing to create an exchange of benefits of a product between consumer and marketer.

In developing countries behavior like hand-washing and different products like oral rehydration treatment (ORT) can be promoted based on marketing approaches followed by other consumer brands (Evans et al 2014). Precisely marketing provides values to the customers and in return, it creates an exchange between buyer and seller. If a customer feels that a product offered by a marketer offers greater value, then he is most likely to purchase a product. The marketing firm's goal is to increase his market share and the company’s financial position by providing good value to its consumer. While on another hand the social marketer uses the same approach from a different angle; social marketing is not selling any product or service for the consumers but influences the target audience to adopt socially beneficial behavior (Hastings, 2007). A good body of knowledge indicates that marketing can be convincing to augment behavioral changes for good causes (Evans et al., 2008).

This research comprised four interrelated elements of fear appeals; risk perception, anticipatory emotions, anticipated emotions, and perceived severity.

Risk Perception

It refers to the perception of people in terms of their susceptibility towards risk. How people make opinions about becoming victim of a disease. The items comprise “how likely you become affected by a particular disease. Many studies on risk perception underpinned induced behavior changes (Popova et al., 2018). A few theories in the field of psychology have proved that risk perception tends to change behavior such as health belief model (Rosenstock, 1974), protection motivation theory (Maddux, Rogers, 1983), parallel process model (Leventhal, 1970), and psychometric paradigm (Slovic, 1987, 1992).

Anticipatory Emotions

Bandura’s social cognitive theory (1986) highlights behavior change may happen due to emotions that have significance in social science. Undesirable future events that may occur can threaten people. This study focused on negative affective reactions to fear appeals. People tend to perform certain actions subject to the fear they anticipate. Both anticipatory and anticipated emotions are future-oriented. The social researchers have convincingly argued about these two future-oriented emotions (Loewenstein et. al 2001). One may currently experience emotion due to the prospect of any undesirable event that may occur in future. These affective reactions are anticipatory emotions, because they are currently experienced due to something that could happen in the future. An abundance of research has drawn the attention of people towards these affective reactions based on anticipatory emotions (Janssen, van Osch, de Vries, & Lechner, 2011; Klein, Zajac, & Monin, 2009). These can be measured by worry or anxiety regarding fear or threat. For example, “The possibility of becoming ill in the future makes me feel anxious”; not at all to extremely). In this regard, there are models that are related to fear appeal like PPM, PMT, and the EPPM pointed out the impact of messages to arouse fear in the target audience.

This research implies risk perception with reference to the cognitive evaluation of a threat and, following Loewenstein et al., (2001) uses the term anticipatory emotions to capture negative, and affective components. Research posits that risk perceptions and anticipatory emotions such as fear and worry are modestly correlated (Linville et al., 1993; McCaul & Mullins, 2003). Recent research on anticipatory emotion highlights that emotions help to induce behavior change in an experimental setting (Zampetakis et al., 2017). Research on anticipatory emotions in social marketing showed impressive results to induce behavior change (Antonetti, Baines & Walker, 2015). Social marketers employ negative emotional appeals with to promote individually or collectively beneficial behavior because they believe these appeals to be highly persuasive (Andrews, Netemeyer, Kees, & Burton, 2014; Dillard & Peck, 2000; Stainback & Rogers, 1983). Guilt and fear appeals are common (Huhmann & Brotherton, 1997; Roberts, 2009) and have attracted significant attention from researchers (Antonetti & Baines, 2015; De Hoog, Stroebe, & De Wit, 2007; Witte & Allen, 2000).

Anticipated Emotions

Anticipated emotions are future oriented emotions. Anticipated emotions comprise imaginations, a person may visualize a certain disease to be developed in future. Such negative anticipated emotions are reflected in “regret”. These affective reactions to the hazard or threat of future events are called anticipated emotions. In this regard, Loewenstein et al. (2001) referred to the need that differentiates between different types of future oriented emotions related to affective reactions to potential hazards. They particularly explored and differentiated between two future oriented emotions i.e. anticipatory emotions and anticipated emotions. The emotions which measure worry are anticipatory emotions whereas emotions which measure the outcome of any decision are anticipated emotions which are expected to occur when one experience any outcome of decisions. The extensive research on anticipated emotions focused on guilt, regret and shame (Giner-Sorolla, 2001; Richard, van der Pligt, & de Vries, 1995). Anticipated emotions are measured by the items such as “I would feel regretful/ashamed if I feel ill in future”. A study conducted in Belgium and Hungary indicated that anticipated emotions have a positive impact both on consumer intentions and their actual behavior (De Pelsmaeker et al., 2017).

Perceived Severity

The models like Health Belief Model and Protection Motivation explored another fear variable called perceived severity of the threat. Perceived severity determines the severity of the beliefs held by people about the seriousness of the negative consequences of any disease or other hazards. It is measured by the items like “The consequences of effecting with disease in coming days would be serious not at all– extremely serious.”

Research on risk severity highlights that perceived severity reinforced the change in intention and behavior. A study conducted by Janz and Becker (1984) found that there is a significant correlation between perceived severity and behavior. Findings reveal that perception, perceived severity, anticipatory emotion, and anticipated emotion are independent but have interrelationship as explored through factor analysis (Karayurt & Dramal, 2007; Cadarette, Beaton, & Hawker, 2004; Harris, Linn, Skyler, & Sandifer, 1987). Pennington et al., (2016) conducted a study on transferring the data utilization by healthcare providers indicates that perceived severity of illness has significantly increased. Generally, this research aimed to test the impact of fear appeals on exercise intention and physical activity behavior by using explanatory power of social norms and systematic interaction to induce behavior change. Following hypotheses were developed using these grounds:

Use of fear Appeals in Social Marketing and Lesson Learnt

In marketing as well as in social marketing communication, fear appeals have been used as persuasive tools to influence behavior change and has extensively been used for various behavioral change programs; for example, antismoking campaigns, use of seat belts while driving, reproductive health, efficient use of energy, campaigns to improve nutrition, prevention of drug abuse and alcohol intake and other social issues (Fox & Kotler, 1980). Various studies have shown that fear appeals have been associated both with intention and predictive behavior (Sheeran & Taylor, 1999; Brewer et al., 2007). In a meta-analysis conducted by Sandberg and Conner (2008) underscored that fear appeals are significantly correlated with behavior. Another study by Janz and Becker (1984) established that there was a significant association between perceived severity and behavior. We use experience and exposure to different kinds of messages through media and non-media channels that influence our attitudes and behavior. Sometimes these messages form conflicting attitudes if the messages are not filtered through psycho-social realities of the society. This may tend to create a dissonance that may create problems to achieve development-related goals. Fear appeals have extensively been employed by social marketing to augment behavior changes. The emotional angle of fear appeals has shown greater success to bring about desired behavior changes (Antonetti & Baines, 2015).

Many scholars have argued that threatening communication in social marketing leads to achieving desired behavior change and can help to off-load bad norms from society (Donovan & Hanley, 1997). In this regard research, has empirically tested the influence of guilt and fear appeals to achieve social and behavior change goals (Antonetti & Baines, 2015). Sheeran, Harris, and Epton (2014) have argued that fear appeals tend to augment behavior change especially those interventions that suggest recommendations about off-loading some unwanted behavior. This, therefore, does not merely help to create awareness in the targeted communities but also transcend from some degree of preventive measures to keep them away from a potential threat. Most of the past researches have studied the impact of fear appeals on behavior in laboratory settings in different contexts to see the impact of intervention of a variety of behavior like anti-smoking, use of seat belts while driving, and physical activity behavior (Witte & Allen, 2000). Ruiter, Abraham and Kok (2001) have empirically found that fear appeals helped to provoke fears in target audience that tend to augment behavior changes and helped to achieve many of development related goals of the target communities. They have argued that the message frame in threatening communication help to modify behavior e.g. obesity is dangerous to develop heart disease and at the same time when they have also recommended and advised measures like “do exercise regularly” (Loewenstein, Weber, Hsee, & Welch, 2001). The growing tendency of Obesity and overweight in the USA and world at large is a matter of great concerns for policymakers, health and community professionals, marketers and community members to tackle such problems. This kind of growing social and health issues and problems are barely being addressed through conventional tools and knowledge. For this broad-based knowledge is required to be built that help develop better tools and techniques to address such problems. In this context, one of the leading social change scholars, Novelli (2007, p.) had advocated that:

“Obesity - it’s hard for people individually to change their eating behavior because the world they swim in is full of normative behavior around eating and being overweight.”

The USA still has the highest obesity rate among high-income nations (NCD Risk Factor Collaboration, 2016). Although various organizations in the USA like government organizations and other civil sector organizations trying their hard to address issues related to obesity and overweight through social marketing campaigns and using various emotional appeals but they cannot achieve the results. The issue remains persistent over the period and any perceptible improvement has not yet been observed. Various developed countries bearing huge advertising and promotional cost to run a campaign to create awareness and fighting obesity. The process through which consumer’s act because of social marketing campaigns is of utmost importance (Krishen & Bui, 2014). Moreover, various social marketing and health promotion campaigns based on elements of fear appeals showed a better result to augment behavior change as compared to hope to yield some results from benefit appeals. The threat that has been produced by fear appeals motivates people to process information and takes necessary action against bad habits or questionable acts (Chang 2007; Kuvaas & Selart 2004; Sobh, 2011).

Messages based on fear appeal tend to influence the target audience to take some measures recommended by fear-based messages to augment desired behavior change (Keller & Lehmann, 2008). In this regard, a very influential model developed by Maddux and Rogers (1983) called Protection Motivation Model (PMM) has been extensively used by many scholars in the field of consumer behavior, marketing, and social marketing (Pechmann, Zhao, Goldberg, & Reibling, 2003). This model has explored different variables to assess the target audience. The model of protection motivation has identified four variables namely “threat severity”, “threat susceptibility”, “self-efficacy” and “response efficacy”. These variables proposed and recommended to bring about desired behavior change. Past literature, however, found a weaker link between perceived severity, intention, and behavior change (Milne, Sheeran, & Orbell, 2000). Although, impressive results have been achieved by this model, however, this has failed to bring sustained behavior change as it was mainly focusing on one-way communication.

People are quite indifferent to health-seeking behavior promotion mechanisms aim to induce fear appeals that tend to induce pro-social behavior and refrain from those activities for that are a cause of dreaded diseases. Social marketing using fear appeals through one-way communication, persuasive techniques, or intra-individual processing to bring about planned behavior change has extensively been deployed. It has, however, been reported that such techniques barely succeeded or even change is barely sustained (Khan, 2005, 2014). This resulted in a lack of association and ownership by the target audience and other stakeholders. In the Pakistan polio campaigns, unfortunately, have met quite a resistance. The billions of rupees of advertising campaigns did not come to fruition. The literature, therefore, bears a strategic gap that has made many social marketing programs quite ineffective to bring about perceptible changes and sustenance of desired results. The participatory paradigm focusing on group discussion has shown better results but has not been extensively used in the domain of fear appeals theory. The past research techniques have focused on individual cognitive process and widely ignored social contexts where people interact with others. In other words, the realization of social problems and modalities to resolve these problems can better be approached through a social mechanism like group dynamics and its associated theories. The past research in the domain of social marketing focusing on social marketing has questioned how to bring sustained behavior changes to improve the health and wellbeing goals of the target communities (Ahmad, Khan, & Hassan, 2018).

People are quite indifferent to health-seeking behavior promotion mechanisms aim to induce fear appeals that tend to induce pro-social behavior and refrain from those activities for that are a cause of dreaded diseases. Social marketing using fear appeals through one-way communication, persuasive techniques, or intra-individual processing to bring about planned behavior change has extensively been deployed. It has, however, been reported that such techniques barely succeeded or even change is barely sustained (Khan, 2005, 2014). This resulted in a lack of association and ownership by the target audience and other stakeholders. In the Pakistan polio campaigns, unfortunately, have met quite a resistance. The billions of rupees of advertising campaigns did not come to fruition. The literature, therefore, bears a strategic gap that has made many social marketing programs quite ineffective to bring about perceptible changes and sustenance of desired results. The participatory paradigm focusing on group discussion has shown better results but has not been extensively used in the domain of fear appeals theory. The past research techniques have focused on individual cognitive process and widely ignored social contexts where people interact with others. In other words, the realization of social problems and modalities to resolve these problems can better be approached through a social mechanism like group dynamics and its associated theories. The past research in the domain of social marketing focusing on social marketing has questioned how to bring sustained behavior changes to improve the health and wellbeing goals of the target communities (Ahmad, Khan, & Hassan, 2018).

From the above discussion, when people interact in-group members generate new ideas and thoughts and insights that help members to realize the importance of new behavior, and this realization transforms into meaningful activities (Ahmad, Khan, & Hassan, 2018). The activities will further make them realize the benefits of behavioral and social change activities and help to compare their state of alertness and good feeling compare to the previous state of sense of diffidence and lethargy. Behavior is a function of the cognitive expansion of the attitude that reinforces the intention to bring changes in behavior. This experience helps to expand the cognitive dimension of the attitude and reduce the state of anxiety and evasiveness towards healthy activities. Unlike the conventional method of social marketing based on fear appeals that merely create a sense of awareness that hardly transform into meaningful sustainable healthy activists. Whereas, group-centered approaches as a strategic tool for social marketing not only generate requisite dynamism that transforms group members to act and transform and engage other members and let them realize the importance of this collective activities and wellbeing (Ahmad, Khan, & Hassan, 2018). The group centered approaches, however, likely to bring about the perceptible impact on behavior changes when target audiences realize the importance of meaningful activities that improve their quality of lives once they experience the efficacy of pro-social behavior activities. The knowledge of the outcomes further reinforces the process using a theory based on group dynamics. It is through this process they tend to offload their biases and preconceived apprehensions about the program since it is filtered through their value system and social norms because of continuous interactions. In this process, potential biases are offloaded and members get new understanding and insights. This, in turn, creates value to perform a certain behavior which is imperative to improve the quality of life of the people. In other words, fear appeals reinforce the desired behavior to perform as a function of new understanding and insights, internalization (change within rather without). The knowledge of the outcomes induces reinforcement of the norms. In social marketing, the explanatory power of interactive participatory paradigm, a progeny of group dynamics, focusing meaningful and purposeful interaction has shown better results to augment behavior change. However, fear appeals theory has never been discussed in the context of systematic interaction and social norms to induce sustained behavior change.

Fear appeals could better be explained through group-centered approaches focusing group as a unit of analysis unlike conventional approaches used in social marketing. This, in turn, better delineates the relationship between fear appeals and behavioral modification. Interaction and dialogue among the group members generate the desired level of dynamism for meaningful actions. Although social marketing has used fear appeals extensively in earlier researches, however, the efficacy group-centered approaches in the context of fear appeals have not been explored. In group-centered approaches where people could speak freely to address their social issues without social prejudices, can not only strengthen fear appeals and behavior change relationship but, it can put society on a path to sustained progress by offloading bad norms. This suggestion is in line with the study takes the lead from the pioneering work of Kurt Lewin followed by various scholars using group-centered approaches (Burnes & Bargal, 2017). The appeal if promoted through an interactive process, in turn, induces behavior changes. In other words, any kind of dosage of fear appeals may prevent them from actions. Whereas interactive process makes them perceive fear appeals positively and this, in turn, leads to actions and enhance the value of fear appeals that tend to make their confidence and intention to make changes in their current behavior. The group centered approached focuses on the incremental value of systematic interaction where the fear appeal is used to bring about prosocial behavior or unhealthy behavior in the interaction process. A though-provoking work of many leading scholars has also proved this that group-centered approaches are more useful to bring sustained behavior changes as compared to conventional approaches used in social marketing and fear appeals (Khan, 2005).

Fear appeals in social marketing have got attention from many eminent research scholars in developing word like Pakistan. However, fear appeals in social marketing programs in Pakistan have hardly brought sustained behavior changes. On the other hands' question about, how to bring sustained behavior changes? This could hardly be answered with conventional wisdom. Previous research has suggested initiating measures for workplace wellness promotion for a greater wellbeing of employees (Qaisar & Malik, 2015; Qaisar, Mariam, & Ahmad, 2018). We suggest future research to examine the role of fear appeals in effectiveness of such wellness programs in organizations. There is also a need to bring have a fresh look on the significance of group-centered approaches for long term attitudinal and behavioral reconstruction. Future scholars may focus group centered approaches as a strategic thrust towards enhancing the value of fear appeals for large scale holistic wellness.