1. Utilizing Social Marketing for TB Education with the Navajo Nation Diana Fortune RN BSN Program Manager New Mexico DOH

2. Objective Describe social marketing strategies utilized on the Navajo Nation to provide community TB education

3. What is Social Marketing? “…….the use of marketing principles to influence human behavior in order to improve health or benefit society.” CDC: Gateway to Health Communication & Social Marketing”

4. Types of Social Media High Tech: Technology available to person Ability to use technology Low Tech: More passive on client’s part

5. Types of Social Media High Tech Internet Twitter YouTube Facebook Low Tech Posters Movie Ad Television Billboards Radio

6. When has social marketing exacted changes in behavior?

7. When has social media exacted changes in behavior?

8. When has social marketing exacted changes in behavior?

10. Health Communication Basics How Do I Do It? Describe the problem Perform Market Research Define Market Strategy Develop Interventions Evaluate your plan Implement your plan

11. How Do I Do It? Careful thought & knowledge of problem Public health surveillance – disease burden Needed Policy changes CDCynergy modelhttp://www.orau.gov/cdcynergy/soc2w eb/default.htm

12. Health Communication Basics How Do I Do It? Describe the problem Perform Market Research Define Market Strategy Develop Interventions Evaluate your plan Implement your plan

13. Describe the problem TB Mortality Study from 2007 – 2009 16% Mortality rate in NM Populations Impacted Native American – (40%) Hispanics born in Mexico – (40%) Reasons Delay in patient seeking treatment Delay in clinician diagnosis

14. Health Communication Basics How Do I Do It? Describe the problem Perform Market Research Define Market Strategy Develop Interventions Evaluate your plan Implement your plan

15. Perform Market Research Enhance understanding of your target audience’s characteristics NM DOH TB Program met with: Navajo Nation TB Program Indian Health Services Appropriate Media Poor access to internet Good portion of Navajo – do not have electricity Cell phone reception is poor in many areas High Tech Media – not an option

16. Health Communication Basics How Do I Do It? Describe the problem Perform Market Research Define Market Strategy Develop Interventions Evaluate your plan Implement your plan

17. Define Market Strategy Plan of action- entire marketing program Target audience Desired behavior change Benefits Interventions to support change Researched “products” already developed Washington State, Canada

18. Health Communication Basics Describe the problem Perform Market Research Define Market Strategy Develop Interventions Evaluate your plan Implement your plan

19. Develop Interventions Patient education: Posters, billboards, movie ads, radio ads Documentary of TB on Navajo Nation Utilized in waiting rooms in IHS facilities Clinician Education Four Corners TB/HIV Conference UNIDOS Conference

20. Navajo Nation Posters

22. Billboard on Navajo Nation

26. Billboard: Between Las Cruces, NM & El Paso, TX & Mexico

27. Health Communication Basics Describe the problem Perform Market Research Define Market Strategy Develop Interventions Evaluate your plan Implement your plan

28. Evaluate Your Plan Ultimate Goal Decrease in TB related deaths May take years to see decrease How to measure…..change in behaviors Survey outside of Movie Theatre (not viable) Survey outside Casino (not viable) Billboards display close to Casino Utilize Census Block Groups 30 random groups – survey 7-10 household

29. Health Communication Basics Describe the problem Perform Market Research Define Market Strategy Develop Interventions Evaluate your plan Implement your plan

30. Implement Your Plan January 2011: Posters printed Reprinted Nov 2011 NM DOH Website – available to reprint March 2011: Billboard at (2) locations Gallup & Farmington Relocated one billboard – better site Third location added: Nov 2011 Stay in place until Jan 31, 2012 or later……. October 2011: Movie Theatre Ads initiated Radio Ad Script developed and recorded Not on radio yet……

31. Cost of Implementation Posters: $200/approx for 300+ posters Billboards: $4,900/3 billboards for 1 yr + Movie Theatre Ads 15 seconds; $6078 for 12 months/2 theaters 510,000 people annual attendance Radio Ads No cost; recorded at Four Directions Studio Shiprock, NM (HIS facility)

32. Funding for Implementation Media Campaign: CDC Carry over $$ Clinician Educational Conferences Four Corners HIV/TB Collaborative Effort – NM, AZ, UT, CO, NN UNIDOS: Mini-grant CDC Posters/Billboards – NM Office of Border Health

33. How to adapt to your area…..? Utilize tools already developed Adapt to your audience State printers Think outside the box Don’t even admit there is a box See what resources are available Native American Population IHS – media department Universities & other schools MPH students Don’t be discouraged: Genius is just inflamed enthusiasm

34. TB ETN Award: Sept 2012 Social Marketing for TB Education

35. Go Forward With Courage When you are in doubt, be still, and wait; when doubt no longer exists for you, then go forward with courage. So long as mists envelop you, be still; be still until the sunlight pours through and dispels the mists -- as it surely will. Then act with courage. PONCA CHIEF WHITE EAGLE