INTRODUCTION
Social marketing seems to be a relatively new area of marketing that uses the methods and techniques of commercial marketing but differs from it in terms of the subject of interest, which is creating social behavior rather than selling a particular product. However, the oldest and most frequently used term of social marketing is the definition by Kotler and Zaltman [1], according to whom social marketing means design, implementation and monitoring of programs that are designed to influence the admissibility of social ideas and involve the issues of product planning, pricing, communication, distribution and marketing research. Over the years, many new or modified definitions of social marketing have emerged, but the essence of these definitions has remained constant: changing negative behaviors in society. A basic element of social marketing is the social campaign. It represents a primary approach to health issues, because its design makes the target group think and change behavior, and it encourages them to explore the subject of a given campaign.
Social marketing used in health care aims to improve society’s health and habits. The problems of modern society, including health, social and economic problems, have contributed to a new approach to marketing. Traditional marketing focuses on particular products, while social marketing sells ideas.
Gynecological cancer refers to diseases, such as vulvar cancer, vaginal cancer, cervical, endometrial cancer, and ovarian cancer. The best way (both in terms of population health and economy) to combat these diseases is prevention and early diagnosis. Although mortality from gynecological cancers worldwide is relatively moderate and constant, they are still a major epidemiological problem. A strong downward trend can only be observed in ovarian cancers (from 9.5 in 1992 to 6.0 in 2019) [2]. Mortality from cervical cancers has increased in recent years, even though there is certain improvement in Poland, since approximately 30–40% of the sub-population are covered by preventive programs. Oncological morbidity and mortality are affected by many different socio-economic, behavioral, and other environmental factors, including poverty, race, access to health care, health care quality, education, obesity, nutrition and stimulants [3]. Prevention, which is aimed at counteracting deviations from health, requires considerable effort and commitment in creating and implementing health programs. Marketing, public relations, and social advertising are only some of the tools that are used to minimize the effort put into disease prevention [4]. Prevention in Poland is comparatively limited and requires constant improvement. This can be illustrated by the fact that only 2.3% of the expenditures on health care in 2018 were spent on prevention and public health, whereas as much as 62.5% were spent on treatment and rehabilitation services [5]. Increasing funding for prevention could result in a reduction in expenditure on the treatment and medicinal products. A disease itself is economically less viable, both for the state and society, than the disease prevention. Therefore, it is important to constantly implement and improve health promotion, an important element of which is marketing and social campaigns. This topic seems to be of key importance particularly nowadays when the COVID-19 pandemic is indicated by a reduced epidemiological threat and society is exposed to its severe long-term effects.
Objectives
The aim of the study was to analyze the use of social marketing in gynecological cancers prevention in Poland and the United States, and to compare the achievements of these countries in this respect. The perspective after COVID-19 pandemic was presented.
MATERIAL AND METHODS
The research methodology was based on a review of the literature on PubMed, ScienceDirect, Google databases and the reference list of key papers were searched to retrieve research literature. We used terms: ‘social marketing’, ‘gynecological cancers’, ‘Poland, USA’, ‘prevention’. Searches were limited to the period 2016–2021 and English language. We included full-text articles of any study design. We excluded articles when the full text was not available.
The case study was conducted based on an analysis of five social campaigns in Poland and five social campaigns in the United States, which were dedicated to the gynecological cancer prevention. The analysis included the following criteria:
- basic goals;
- slogans used in the campaign;
- messages for the society;
- use of statistical data or medical facts;
- faces of the campaigns;
- creative methods;
- means of communication;
- use of social media.
All the elements presented above made it possible to perform an effective analysis, as a result of which certain aspects of the campaign were distinguished that could impact the effectiveness of the enforcement of a campaign, and which allowed for a comparison between Poland and the United States regarding the use of social marketing in the prevention of gynecological cancers.
RESULTS
The analysis of the Polish and American campaigns aimed at showing the social marketing features in the prevention of gynecological cancers, including the main goals of the campaigns, the nature of transmitted messages and the means of communication. The summary of the results is presented in Table 1 and descripted below.
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Table 1. Description of Polish and American social marketing campaigns |
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Name of the campaign; main interest |
Main goals |
Nature of transmitted messages |
Means of communication |
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Polish campaigns |
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„She’s beautiful because she’s healthy” cervical cancer |
Education, raising awareness of the importance of preventive gynaecological examinations. Men commitment to fight this cancer |
Evoking positive emotions, motivating to take action |
Internet Press Advertising spot App Stationary event |
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„Coalition for Life” ovarian cancer |
Multiple network collaboration to create a patient-centered system. 3 requirements: molecular diagnostics for each person with ovarian cancer, improving the quality and accessibility of treatment, and applying early-stage treatment methods in line with EU standards |
Causing anxiety, fear, motivating to expand knowledge and take action by increasing interest in the health of the individual |
Internet Movies Press and scientific conferences Webinars |
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„For Her. We can do more” ovarian cancer |
Supporting women suffering from gynecological cancers and their relatives. Taming the fear of gynecological cancer diagnostics |
Evoking positive emotions, involving personally and close people to take action |
Internet Advertising spot Guidance materials |
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„Do a checkup and live” cervical cancer |
Convincing women to preventive examinations and expanding knowledge |
Evoking positive emotions, educating through humorous messages, motivating to action, addressing the individual directly |
Internet Stationary event Advertising spot Educational film Promotional posters |
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„Diagnostics of the ovary” ovarian cancer |
Consideration of the importance of regular gynaecological visits for the prevention and early detection of gynaecological diseases |
Generating negative emotions, fear of the health of the individual, motivates to reflection and take action |
Internet Advertising spot Opening conference |
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American campaigns |
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„Our Way Forward” ovarian cancer |
Call for action on ovarian cancer to encourage patients, their families and health care workers to rethink their thinking and talk about the cancer through education and support. |
Evoking positive emotions, calm messages, motivate action through education and patient stories. |
Internet Stationary events Invitations to clinical trials Promotional videos |
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„Inside Knowledge: Get the Facts About Gynecologic Cancer” 5 types of gynecologic cancer |
Awareness raising about 5 gynaecological cancers: cervical, ovarian, uterine, vaginal, and vulvar. Encouraging women to take care of their bodies so they can see warning signs and seek medical help |
Positive messages that focus on the general public by clarifying and presenting health statistics |
Television Radio Internet Printed materials Public transportation, public places in major US cities Promotional videos |
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„It is Time to End Cervical Cancer” cervical cancer |
Informing the public, including women and girls about ways to prevent cervical cancer through health information. Raising awareness for the early detection of this cancer |
Direct messages to individuals that motivate them to take care of their health and improve it. Generate positive emotions by using animated commercials |
Internet Printed materials Stationary events Promotional videos Involvement of public institutions |
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„GO Teal and White” cervical cancer |
Raising awareness of cervical cancer prevention. Calling on women in Alabama to continue regular screening for cervical cancer. Highlighting the fact that during the COVID-19 pandemic it is equally important to prevent this disease and save lives through vaccinations, pap tests, and follow-up examinations |
Raising concern through direct messages. Motivating to become active and to take an interest in one’s own health |
Internet Printed materials Television Stationary events Podcast Promotional videos |
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„Move The Message” 5 types of gynecologic cancer |
Call on people from all over the country to join a social movement to raise awareness of five gynaecological cancers: cervical, ovarian, uterine, vaginal, and vulvar |
Positive messages that motivate people to act and spread knowledge through exercise (5 minutes for exercising and social media posting #MoveTheMessage) |
Internet Printed materials Stationary events Promotional videos |
As part of the study, Polish and American social marketing campaigns mentioned below were analyzed. The first Polish campaign subject to analysis was a campaign focusing on cervical cancer that was carried out by the Kwiat Kobiecości Foundation in 2019 in the framework of the 10th edition of the nationwide social campaign “She’s beautiful because she’s healthy” [6]. Due to the difficulties in finding social campaigns matching the subject of the analysis, two campaigns of the Kwiat Kobiecości Foundation were included in the study. The other one focused on ovarian cancer, “Diagnostics of the ovary”. Another campaign was the “Coalition for Life” carried out by the Polish Amazons Social Movement in 2020, and the first edition of this campaign focused on ovarian cancer [7]. In January 2022, the Medistica medical group launched a campaign “Do a checkup and live!” as part of the project co-financed by the European Union from the Regional Program of the Lesser Poland Voivodeship [8]. The last Polish campaign subject to analysis was the 2013 campaign carried out by a coalition of several organizations “For Her. We can do more”, which focused on ovarian cancer [9]. Regarding the American resources, the first campaign was the 2021 campaign “Our Way Forward” created by one of the biggest pharmaceutical companies GlaxoSmithKline (GSK) in cooperation with the National Ovarian Cancer Coalition (NOCC) and the Ovarian Cancer Research Alliance (OCRA) [10]. Another campaign was conducted by Centers for Disease Control and Prevention (CDC) in 2012, “Inside Knowledge: Get the Facts About Gynecologic Cancer” and it covered five types of gynecological cancers [11]. In 2018, Pan American Health Organization (PAHO), in cooperation with WHO, launched a campaign to prevent cervical cancer, “It is Time to End Cervical Cancer” [12]. Yet another campaign was launched in 2018 by the US Health Mitchell Cancer Institute, “GO Teal and White” [13]. The last campaign subject to analysis was “Move The Message” carried out in 2021 by the Foundation for Women’s Cancer on the occasion of the month of gynecological cancers, and it focused on five gynecological cancers: cervix, ovary, endometrium, vagina and vulva cancer [14].
Online resources offer many more opportunities to find information about campaigns carried out in the United States than in Poland. Campaigns in Poland focused on single types of cancer: 3 out of 5 campaigns focused on ovarian cancer, and 2 out of 5 were dedicated to cervical cancer. Some US campaigns focused on all types of gynecological cancer (2 out of 5 campaigns), one campaign focused on ovarian cancer, and one was dedicated to cervical cancer.
The aim of most of the analyzed campaigns was widely understood prevention, encouraging the society to think about their health and educating society about gynecological cancers. Both Polish and American campaigns used direct messages which addressed an individual recipient. The goal of the message usually was to evoke positive emotions (3 out of 5 Polish campaigns, and 4 out of 5 American campaigns), and encourage women to participate in preventive examinations and increase their knowledge about gynecological cancers. Two out of five Polish campaigns and one American campaign were characterized by a negative overtone and included messages created to cause anxiety and lead to emotions such as fear. The goal of such campaigns is to encourage the rejection of negative behaviors, such as avoiding cytological examinations among young women.
Each of the analyzed Polish and American campaigns had its own website. Two Polish campaigns offered free medical tests and vaccinations, and only one campaign in the USA promoted an event with free vaccinations. Creative methods that were frequently used were educational films and short advertising spots. Two American campaigns involved charity runs for women and their relatives. Most of the USA campaigns were based on printed materials in the form of informational and educational leaflets or promotional posters. Unlike in the USA, public figures, such as actors and artists, appeared as the faces of two campaigns in Poland, which offered a great opportunity for promotion due to the huge number of their followers and the possibility of using social media to promote the campaigns. Faces of the campaign were frequently women who were patients or who had managed to win over a gynecological cancer (2 out of 5 Polish campaigns, and 3 out of 5 American campaigns). Promotional spots and other films created for the campaigns featured also doctors and specialists, who have authority among the campaign recipients due to their knowledge and experience. Two out of five USA campaigns did not have the face of the campaign.
The most frequently used means of communication, both in Polish and American campaigns, were the Internet, advertising spots and educational films. Four campaigns in Poland and four campaigns in the USA involved stationary events (campaign inaugurations, charity runs). Two of the Polish campaigns used the press and printed materials for promotion. Contrary to Polish campaigns, 2 out of 5 American campaigns used television and radio as the means of communication. The following social media platforms were used in the analyzed campaigns: Instagram, Facebook, Twitter and YouTube. Facebook was the most frequently chosen social media platform among Internet users and campaign organizers. A total of 62.4% of all persons following the profiles of social campaigns in the USA and 78.9% of all persons following the campaigns in Poland had a Facebook account. Regarding the posted content, Facebook was the most popular, too, with about 270 posts uploaded by American organizations and about 210 posts uploaded by Polish organizations. Over 8.5 million (2.6% of the US population) people in the United States and almost 25 thousand (0.07% of the Polish population) people in Poland followed social media profiles of the campaigns that were subject to analysis in this study.
DISCUSSION
Most social campaigns are organized by non-governmental organizations and few of them are dedicated to gynecological cancers. Polish governmental organizations should follow the example of the United States and start to participate in the organization of creative social campaigns in order to target as many people as possible and stop the downward trend in patients’ participation in preventive programs.
Social media make it possible for their users and social campaign organizers to quickly spread information with “one click” and “share” buttons. It is worth improving this means of communication as almost everyone has a smartphone these days, and social media are likely to be used more and more frequently by the whole society.
Taking into consideration the fact that that social marketing is a new field in Poland, there is no other study on social campaigns dedicated to gynecological cancer prevention. The structure of the analysis of social campaigns was inspired by the division presented in the book “Social campaigns on health issues - analysis of the content and forms of communication” [15]. Joanna Sułkowska and Robert Seliga [16] discussed the implementation of social marketing in health prevention in their study “Social marketing in health prevention”, which is a case study based on three social campaigns on health issues and includes an analysis of the campaigns’ main goals, ranges, organizers, and the media used.
The main conclusion of the study is that social marketing improves the effectiveness of health prevention activities. The effectiveness of social marketing was also proved in “Putting social marketing into practice” by Gerard Hastings and Laura McDermott [17], who focused on a television social campaign designed to increase oncological awareness. This campaign resulted in a significant increase in the number of patients reporting to medical facilities, and thus an increase in the detection of cancer cases. The authors proved the effectiveness of using social marketing tools in health care and the increased interest in this marketing tool in their country [17].
It should be emphasized that numerous difficulties were encountered in finding social campaigns in the narrow field of gynecological cancer prevention. Only a small number of social campaigns in the relevant area have been registered in Poland and in the USA. This creates a wide variety of opportunities for future research and discussions on the importance of health prevention and ways of promoting. This study leads to a reflection on the current state of social marketing and future possibilities to ameliorate its implementation in gynecological cancer prevention.
CONCLUSIONS
Social marketing tools are underutilized in gynecologic cancer prevention in both Poland and the United States, leaving ample room for future improvement in its use. It is problematic to find Polish social campaigns dedicated to gynecological cancer prevention, which might be related to the fact that gynecologic oncology is a relatively new field in Poland, and it is continuously modified. The analysis showed that American state organizations are more strongly involved in social campaigns than their Polish counterparts and they show a more modern approach to the gynecological cancer prevention. It is worth noticing that neither of the countries can fully use the potential of social media. More than 60% of the Internet users in Poland have their accounts on social media platforms. This offers a great opportunity to reach to the whole society at a small expense, and it can be of a substantial benefit to non-governmental organizations, which usually have a limited budget. It can be observed that the number of new social campaigns in Poland that are dedicated to the specialist field of gynecological cancers prevention is still small. As opposed to the United States, Poland has not yet created a campaign covering all types of gynecological cancers.
The main problem in Poland is the lack of access to free preventive medical examinations. In addition, population surveillance technologies are outdated and there is no universal database or integration with software that is used by medical professionals. For the implementation of preventive activities based on social marketing, it is of key importance to convince decisive persons and doctors to use preventive activities, and to teach patients about the idea of cancer prevention and its benefits.
A general assessment of the use of social marketing in the prevention of gynecological cancer seems to show that the social marketing tools are more effectively used in the United States than in Poland. There are more foundations, governmental and non-governmental organizations that undertake preventive activities in the USA. Due to the lack of study materials, two campaigns organized by the same foundation were included in the analysis of the Polish campaigns. Many more American campaigns can be found online, which can be related to the fact that the history of social marketing in the USA is much longer than in Poland.
Article information and declarations
Author contributions
All authors should have made substantial contributions to all of the following: 1) the concept and design of the study, or acquisition of data, or analysis and interpretation of data, 2) drafting the article or revising it critically for important intellectual content, 3) final approval of the version to be submitted.
Funding
None declared.
Acknowledgments
None declared.
Conflict of interest
None declared.
