Firestone Rebecca, Rowe Cassandra J, Modi Shilpa N, Sievers Dana
Population Services International, 1120 19th Street NW, Suite 600, Washington, DC 20036, USA
North Carolina Coalition Against Domestic Violence.
Health Policy Plan. 2017 Feb;32(1):110-124. doi: 10.1093/heapol/czw088. Epub 2016 Jul 31.
Social marketing is a commonly used strategy in global health. Social marketing programmes may sell subsidized products through commercial sector outlets, distribute appropriately priced products, deliver health services through social franchises and promote behaviours not dependent upon a product or service. We aimed to review evidence of the effectiveness of social marketing in low- and middle-income countries, focusing on major areas of investment in global health: HIV, reproductive health, child survival, malaria and tuberculosis. We searched PubMed, PsycInfo and ProQuest, using search terms linking social marketing and health outcomes for studies published from 1995 to 2013. Eligible studies used experimental or quasi-experimental designs to measure outcomes of behavioural factors, health behaviours and/or health outcomes in each health area. Studies were analysed by effect estimates and for application of social marketing benchmark criteria. After reviewing 18 974 records, 125 studies met inclusion criteria. Across health areas, 81 studies reported on changes in behavioural factors, 97 studies reported on changes in behaviour and 42 studies reported on health outcomes. The greatest number of studies focused on HIV outcomes (n = 45) and took place in sub-Saharan Africa (n = 67). Most studies used quasi-experimental designs and reported mixed results. Child survival had proportionately the greatest number of studies using experimental designs, reporting health outcomes, and reporting positive, statistically significant results. Most programmes used a range of methods to promote behaviour change. Programmes with positive, statistically significant findings were more likely to apply audience insights and cost-benefit analyses to motivate behaviour change. Key evidence gaps were found in voluntary medical male circumcision and childhood pneumonia. Social marketing can influence health behaviours and health outcomes in global health; however evaluations assessing health outcomes remain comparatively limited. Global health investments are needed to (i) fill evidence gaps, (ii) strengthen evaluation rigour and (iii) expand effective social marketing approaches.
社会营销是全球卫生领域常用的策略。社会营销项目可通过商业部门网点销售补贴产品、分发定价合理的产品、通过社会特许经营提供卫生服务，以及推广不依赖于产品或服务的行为。我们旨在综述社会营销在低收入和中等收入国家有效性的证据，重点关注全球卫生的主要投资领域：艾滋病毒、生殖健康、儿童生存、疟疾和结核病。我们检索了PubMed、PsycInfo和ProQuest数据库，使用将社会营销与健康结果相联系的检索词，查找1995年至2013年发表的研究。符合条件的研究采用实验性或准实验性设计，以测量每个卫生领域行为因素、健康行为和/或健康结果的指标。通过效应估计以及社会营销基准标准的应用对研究进行分析。在查阅了18974条记录后，125项研究符合纳入标准。在各个卫生领域，81项研究报告了行为因素的变化，97项研究报告了行为的变化，42项研究报告了健康结果。研究数量最多的是关注艾滋病毒结果的研究（n = 45），且大多在撒哈拉以南非洲开展（n = 67）。大多数研究采用准实验性设计，结果不一。儿童生存领域采用实验性设计、报告健康结果且报告有统计学意义的积极结果的研究比例最高。大多数项目采用一系列方法来促进行为改变。有统计学意义的积极结果的项目更有可能运用受众洞察和成本效益分析来推动行为改变。在自愿男性包皮环切术和儿童肺炎方面发现了关键的证据空白。社会营销可影响全球卫生中的健康行为和健康结果；然而评估健康结果的研究仍然相对有限。需要进行全球卫生投资，以（i）填补证据空白，（ii）加强评估的严谨性，以及（iii）扩大有效的社会营销方法。
