In Search of a Value Proposition for COVID-19 Testing in the Work Environment: A Social Marketing Analysis
Abstract
:1. Introduction
Commercial Marketing and Social Marketing
- Product. The first step in any form of marketing is recognizing a problem that potential consumers can articulate (e.g., need to clean teeth), or that taps into a more latent desire (e.g., be attractive to others). The second step is to then create a product that solves this problem. Third, the product needs to be distributed and promoted so that potential customers can find it if not by a brand (e.g., “Crest”) then by a category (e.g., toothpaste). The product identity is comprised of a name or brand, its inherent attributes (e.g., flavor, fluoride, whitening ability in toothpaste), as well as its potential benefits to consumers (e.g., taste, cavity protection, whiter teeth). The marketer must also be aware of the competition (other brands in category) or substitutions (other product categories) that potential consumers might choose to solve the perceived problem. In social marketing the “product” is often a behavior change [30]. For example, naming a designated driver has been a socially marketed behavior change to reduce driving under the influence. The “product” is the benefits perceived for performing this behavior, which in the case of the designated driver, is social approval by peers. A COVID-19 example is wearing a face covering correctly. The “product” would include the mask attributes (its material, construction, fit); the behavior of wearing it; and the perceived benefits, which have been debated (protecting self; protecting others).
- Price. This is anything given in exchange for the product, which in commercial marketing is almost always money, but in social marketing more often includes time, energy, a sacrifice of comfort or pleasure (as in the examples above) or going against social norms when a negative behavior is normative [31]. A COVID-19 example would be having to endure mocking from peers for wearing a face mask correctly when social norms have shifted to not wearing face coverings.
- Place. The location to acquire a product or service, or where a behavior will be performed. The goal is to make the offering easy to find and access [32].
- Promotion. This is the communication strategy used to support the full intervention [33]. In commercial marketing, promotion may include incentives such as cents off coupons or gifts with purchase.
2. Materials and Methods
2.1. Parent Study
2.2. Participant Recruitment and Eligibility Criteria
2.3. In-Depth Interviews
2.4. Initial Phase One Data Analysis
2.5. Analysis for Social Marketing Themes
3. Results
3.1. Product
3.1.1. Product Identity
(Healthcare 6) “The return-to-work policy changed over time. Initially, it was test based and then, as we realized that you could test positive for a really long time and still not really be sick. We flexed to a time-based strategy based on the CDC guidelines.”(Transportation 17) “It’s self-reporting as far as coming to work. They are asked if they are sick not to come into work and they have to self-report if they’re not feeling well.”(Healthcare 2) “Definitely self-reported, and then … nursing supervisors check temperatures at a certain location.”
3.1.2. Product Attributes
(Manufacturing 8) “They wanted to do the … rapid test but because of my research and what I had read online and had discussed with my own rheumatologist … there was too many false positive and too many false negatives [with the rapid test].”(Coal Mining 14) “It went from timely results for tests at one point we were waiting a week to get results. To honestly, … I just didn’t trust the testing at all. And employees didn’t trust it. And an employee, just case in point, there was tested three times and couldn’t get a consistent result. That becomes a major frustration.”(Retail 10) “The testing is no fun. I mean nobody really wants to go get that shoved up their nose …”
3.1.3. Product Benefits
3.2. Price
(Manufacturing 16): “Costs are a factor, because we are a small company … And I mean I would get some of the new stuff that comes out the ‘home testing kits’ … That might be feasible depending on the CPPs (costs per person).”(Retail 7): “For 2100 employees there’s a pretty significant cost. We spent pretty significant dollars on setting up all the protocols within the store and labor.”(Healthcare 6): “We can’t do mass testing of our employees. We don’t have supply enough to do screening of employees, we only have enough to do testing of symptomatic people.”(Education 12): “In the beginning, there was some apprehension with the testing process. [If employees] tested positive what would happen to confidentiality? Or would [testing] be [performed during] … work-time or personal-time?”(Coal Mining 14): “I fear that [testing] would be price gouging.”
Associated Costs of Testing
(Manufacturing 8): “So, waiting for those test results to come back it’s difficult to find replacements … We … had guys that had worked 18–19 days straight, while the other guys were in quarantine … that’s one reason we couldn’t do random [testing] on our shift people, [like] we could do on the salary people.”
(Transportation 17): “We’re one of the organizations with the emergency paid sick leave was able to be implemented. So, employees that weren’t feeling well they were able to … use up to those 80 h and they didn’t have to use their accrued sick leave.”
(Construction 20): “The major thing with the employees has been you know, ‘Am I going to be paid?’ … most of our field staff are hourly, so once that happens to them that that is their main issue. Our office staff not as much because they are on salary and as long as they make a phone call a day you know we have to pay them their full salary.”
(Construction 20): For example, I could have an employee that would [say] “hey I get 80 h paid COVID pay no matter what”, so they could take a test and then tell me, “oh I don’t have the results back, I don’t have the results back and so on,’ and then almost two weeks later to the day they amazingly get [the results] back. And to be honest, I can’t judge that because I myself was one of those that I took one and, after two weeks, I still haven’t gotten the results back. Come to find out that the company messed up. So, you know I don’t want to say that my employees are trying to deceive us.
(Manufacturing 8): “It was just you have to follow the rules … because some people tried to sneak in, and so they felt uncomfortable having to tattle tale on their employees that … they’re sick and they’re not telling you the truth.”
(Seafood processing 19): “We have put that personal responsibility on those who feel that they need a test can go get one … If I would try to test my workers, they would quit. So, I’m not mandating testing.”
3.3. Place
(Manufacturing 11): “Having our business in multiple locations [meant] … we had to follow state guidelines for each of those areas, sometimes even county guidelines, and that was a little of difficult.”
3.3.1. The Convenience of Testing
(Retail 10): “We don’t do [testing] at our store … because I don’t know how we would do that from a medical capacity …. There’s an urgent care near us that does walk in rapid test and then also through local health care provider.”(Public Safety 4): “So when we had the free testing … that was given to us by the state … in which all they had to do was drive up, and it was an oral test, and so they would not even leave the vehicle. We would hand them the test and demonstrate out in front of the windshield what they needed to do. They would all do the test themselves and then hand it back to us in a box and label it and we will move on down the road.”(Manufacturing 8): “We eventually found a local clinic that did testing [for us] only and you didn’t have to have symptoms … The laboratory just happens to be right in their backyard, so it went straight to the lab.”(Manufacturing 5): “The smaller size sites that we have all over the states, it was not that easy … We depended on the [named national pharmacy chain]; we depended on the [named commercial lab company]; we depended on the urgent cares. We provided coverage at all these locations, so we advised our employees, you can go to your place of choice, and the nurses in most of my locations would follow until we got the results.”
3.3.2. Access to Employees to Be Tested
(Manufacturing 16): “A bit tough given [how] spread out we are.”(Retail 7): “I’m not sure how … our employees work three shifts, they’re coming and going off all times of the day and night. Some are seasonal, one day a week, and some are five days a week, they’re full time. So … Unless somebody was actually sitting in that location, all the time, how we would catch everybody?”
3.4. Promotion
3.4.1. Audience Segmentation
- Group 1
(Healthcare 6): “As healthcare organization and given the prevalence of COVID 19 in our community and the presence of asymptomatic spread, there are pretty significant risks here, depending on where they work and what kind of work they do.”(Healthcare 2): “We find you can talk to people and just continue to have positive tests for very long periods of time. And since we are in central workforce, we didn’t feel like we have the ability to just have that many people out waiting for a negative test.”
- Group 2
(Public Safety13): “They all utilize shared computers, telephones, desk spaces, so there was concern about the sanitization or cleaning of the workstation prior to another person coming on. And similar with patrol officers, they don’t have assigned patrol cars, they share patrol cars.”(Retail 7): “Initially it was talking people off the ledge. You know, a lot of concerns, a lot of fear. I think then our employees saw that … we can work safe. Within all of our stores, there was only one department in one store that ended up taking out seven people (due to COVID exposure) … and then I found out they weren’t following protocols.”(Transportation 17): “Of course, they were concerned about the public. But then the mask mandate went off, so we were doing everything we could to ensure that they knew all the safety protocols and that we were doing taking extra measures to sanitize the buses, the facilities, things of that nature.”
- Group 3
(Construction 20): “Our field staff is just, you know, scared. They are and honestly, they’re the largest population that we had [that also was at high risk for COVID].”(Manufacturing-oil 8): “… We have a control room [for] the refinery … they’re enclosed in that room for 12 h or longer. They don’t leave that seat. And, then our outside crew when they’re not in the unit they’re in a blast resistant building, we call it a BRB, and so … there’s not much space there.”(Coal mining 14): “At first, there was a lot of concern in regards to contact tracing and whether … they should be notified if there was a positive result and whether or not it was the company’s responsibility to notify the employees.”(Coal mining 15): “Probably one of our biggest issues was being able to get people together for training purposes, not being [able] to [have] bigger groups and things like that, so that created some issues that’s one of the things we had to change up a little bit.”
- Group 4
(Agriculture 3): “I mean … our “outside guys” naturally social distance just because of the nature of our business. It’s not like we have 50 people packed in the office.”(Seafood processing 19): “For the most part, my workers, to be honest with you, think this is a farce, politically. That’s been the conversation around our dock. Those who have gotten sick with anything have just stayed home at that point and waited until they were feeling better.”
3.4.2. Promotional Strategies
(Retail 7): “I developed a little flow chart, so the managers and employees kind of knew what to do. We don’t like paper, but we did mail one to every home, because we thought it was that important, so everybody knows that the protocols are for that.”
(Coal mining 14): “I also personally have a huge concern with an employer walking in and saying this is mandatory … Immunizations or vaccinations or something like that or even testing is mandatory. We don’t require you to bring your vaccination card for anything else for employment with the company, and so I personally don’t agree with that.”(Public Safety 4): “They would have to be convinced that it’s necessary, I have a lot of a type A personality personnel who try to make up their own mind about things, and when it’s not absolutely mandatory that they have to do it, you’re going to get some rejection… I think the main challenge is mental. I think convincing them that it is necessary for them to all protect each other by getting tested is key. But that campaign hasn’t worked in our department as much.”
4. Discussion
- Physical touching required (e.g., patient care, salon services, EMS)
- Public Facing (e.g., teaching, retail sales, commuter transportation)
- Non-Public Facing/Close interaction (e.g., manufacturing, food processing)
- Non-Public Facing/Outdoors, distanced, Working from anywhere (Fishing, agriculture, financial management).
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Disclaimer
References
- Rothschild, M.L. Carrots, Sticks, and Promises: A Conceptual Framework for the Management of Public Health and Social Issue Behaviors. J. Mark. 1999, 63, 24–37. [Google Scholar] [CrossRef]
- Thaler, R.H.; Sunstein, C.R. Nudge: Improving Decisions About Health, Wealth, and Happiness; Penguin Books: London, UK, 2009. [Google Scholar]
- Kahneman, D.; Tversky, A. Prospect Theory: An Analysis of Decision under Risk. Econometrica 1979, 47, 263–291. [Google Scholar] [CrossRef]
- Guide to Community Preventive Services. Health Communication and Social Marketing: Campaigns That Include Mass Media and Health-Related Product Distribution. Systematic Review 2021 September 30. Available online: https://www.thecommunityguide.org/findings/health-communication-and-social-marketing-campaigns-include-mass-media-and-health-related (accessed on 4 May 2021).
- Doustmohammadian, A.; Bazhan, M. Social marketing-based interventions to promote healthy nutrition behaviors: A systematic review protocol. Syst. Rev. 2021, 10, 75. [Google Scholar] [CrossRef] [PubMed]
- Kubacki, K.; Rundle-Thiele, S.; Pang, B.; Buyucek, N. Minimizing alcohol harm: A systematic social marketing review (2000–2014). J. Bus. Res. 2015, 68, 2214–2222. [Google Scholar] [CrossRef]
- Olawepo, J.O.; Pharr, J.R.; Kachen, A. The use of social marketing campaigns to increase HIV testing uptake: A systematic review. AIDS Care 2019, 31, 153–162. [Google Scholar] [CrossRef]
- Robinson, M.N.; Tansil, K.A.; Elder, R.W.; Soler, R.E.; Labre, M.P.; Mercer, S.L.; Eroglu, D.; Baur, C.; Lyon-Daniel, K.; Fridinger, F.; et al. Mass Media Health Communication Campaigns Combined with Health-Related Product Distribution: A Community Guide Systematic Review. Am. J. Prev. Med. 2014, 47, 360–371. [Google Scholar] [CrossRef]
- Sublet, V.H.; Lum, M.R. Use of Health Communication and Social Marketing Principles in Planning Occupational Safety and Health Interventions. Soc. Mark. Q. 2008, 14, 45–70. [Google Scholar] [CrossRef]
- Chapman, L.J.; Brunette, C.M.; Karsh, B.-T.; Taveira, A.D.; Josefsson, K.G. A 4-year intervention to increase adoption of safer dairy farming work practices. Am. J. Ind. Med. 2011, 54, 232–243. [Google Scholar] [CrossRef]
- Elise, A.L.; Stacy, H.; David, G.; John, R. A Case Study: The Development of Safety Tip Sheets for ATV Use in Ranching. Safety 2015, 1, 84. [Google Scholar] [CrossRef]
- Tovar-Aguilar, J.A.; Monaghan, P.F.; Bryant, C.A.; Esposito, A.; Wade, M.; Ruiz, O.; McDermott, R.J. Improving eye safety in citrus harvest crews through the acceptance of personal protective equipment, community-based participatory research, social marketing, and community health workers. J Agromed. 2014, 19, 107–116. [Google Scholar] [CrossRef]
- Macario, E.; Hannon, S.W.; Baker, R.; Branche, C.M.; Trahan, C. Preventing falls in residential construction: Effectiveness of engaging partners for a national social marketing campaign. Am. J. Ind. Med. 2015, 58, 809–823. [Google Scholar] [CrossRef] [PubMed]
- Menzel, N.N.; Shrestha, P.P. Social marketing to plan a fall prevention program for Latino construction workers. Am. J. Ind. Med. 2012, 55, 729–735. [Google Scholar] [CrossRef] [PubMed]
- Abdin, S.; Welch, R.; Byron-Daniel, J.; Meyrick, J. The effectiveness of physical activity interventions in improving well-being across office-based workplace settings: A systematic review. Public Health 2018, 160, 70–76. [Google Scholar] [CrossRef]
- Kaveh, M.H.; Layeghiasl, M.; Nazari, M.; Ghahremani, L.; Karimi, M. What Are the Determinants of a Workplace Health Promotion? Application of a Social Marketing Model in Identifying Determinants of Physical Activity in the Workplace (a Qualitative Study). Front. Public Health 2020, 8, 614631. [Google Scholar] [CrossRef]
- Feltner, C.; Peterson, K.; Weber, R.P.; Cluff, L.; Coker-Schwimmer, E.; Viswanathan, M.; Lohr, K.N.; Palmieri Weber, R. The Effectiveness of Total Worker Health Interventions: A Systematic Review for a National Institutes of Health Pathways to Prevention Workshop. Ann. Intern. Med. 2016, 165, 262–269. [Google Scholar] [CrossRef] [PubMed]
- Caban-Martinez, A.J.; Parvanta, C.; Cabral, N.; Ball, C.K.; Eastlake, A.; Levin, J.L.; Moore, K.; Nessim, D.; Stracener, E.; Thiese, M.S.; et al. Barriers to SARS-CoV-2 Testing among U.S. Employers in the COVID-19 Pandemic: A Qualitative Analysis Conducted January through April 2021. Int. J. Environ. Res. Public Health 2022, 19, 11805. [Google Scholar] [CrossRef]
- Parvanta, C. Social Marketing and Social Media: Friends with Benefits. Am. Med. Writ. Assoc. J. 2019, 34, 188–190. [Google Scholar]
- Andreasen, A.R. Marketing Social Marketing in the Social Change Marketplace. J. Public Policy Mark. 2002, 21, 3–13. [Google Scholar] [CrossRef]
- Manoff, R.K.; Cooke, T.M. Whose Milk Shall We Market? J. Trop. Pediatrics 1980, 26, 43. [Google Scholar] [CrossRef]
- Novelli, W.D. Social marketing: Issues for consideration. Soc Mark Update 1983, 3, 3. [Google Scholar]
- Smith, W. Social Marketing: What’s the Big Idea? Soc. Mark. Q. 1998, 4, 5–17. [Google Scholar] [CrossRef]
- Lefebvre, C.R.; Flora, J.A. Social Marketing and Public Health Intervention. Health Educ. Q. 1988, 15, 299–315. [Google Scholar] [CrossRef] [PubMed]
- Kotler, P.; Zaltman, G. Social Marketing: An Approach to Planned Social Change. J. Mark. 1971, 35, 3. [Google Scholar] [CrossRef] [PubMed]
- Andreasen, A. Social Marketing: Its definition and domain. J. Public Policy Mark. 1994, 13, 108–114. [Google Scholar] [CrossRef]
- Bryant, C.A.; Forthofer, M.S.; Brown, K.R.M.; Landis, D.C.; McDermott, R.J. Community-based prevention marketing: The next steps in disseminating behavior change. Am. J. Health Behav. 2000, 24, 61–68. [Google Scholar] [CrossRef]
- Deshpande, S. Social Marketing’s Strengths, Weaknesses, Opportunities, and Threats (SWOT): A Commentary. Soc. Mark. Q. 2019, 25, 231–242. [Google Scholar] [CrossRef]
- French, J.; Russell-Bennett, R. A hierarchical model of social marketing. J Soc Mark. 2015, 5, 139–159. [Google Scholar] [CrossRef]
- Luca, N.; Suggs, L.S. Strategies for the Social Marketing Mix: A Systematic Review. Soc. Mark. Q. 2010, 16, 122–149. [Google Scholar] [CrossRef]
- Creswell, J.W.; Creswell, J.D. Research Design: Qualitative, Quantitative, and Mixed Methods Approaches, 5th ed.; SAGE Publications, Inc.: Los Angeles, CA, USA, 2018; p. 304. [Google Scholar]
- Centers for Disease Control and Prevention (CDC). National Occupational Research Agenda (NORA). Available online: https://www.cdc.gov/nora/councils/default.html (accessed on 29 January 2022).
- Archibald MM, M.M.; Ambagtsheer, R.C.; Casey, M.G.; Lawless, M.J. Using zoom videoconferencing for qualitative data collection: Perceptions and experiences of researchers and participants. Int. J. Qual. Methods. 2019, 18, 1609406919874596. [Google Scholar] [CrossRef]
- VERBI Software. MAXQDA 2020, version 20.4.1; VERBI Software: Berlin, Germany, 2019.
- Kuckartz, U. Qualitative Text Analysis: A Systematic Approach. In Compendium for Early Career Researchers in Mathematics Education; Kaiser, G., Presmeg, N., Eds.; Springer International Publishing: Cham, Switzerland, 2019; pp. 181–197. [Google Scholar] [CrossRef]
- Glaser, B.; Strauss, A.L. The Discovery of Grounded Theory; Aldine: Chicago, IL, USA, 1967. [Google Scholar]
- Charmaz, K. Constructing Grounded Theory, 2nd ed.; SAGE Publications Ltd.: Thousand Oaks, CA, USA, 2014; p. 416. [Google Scholar]
- Saldaña, J. The Coding Manual for Qualitative Researchers, 3rd ed.; SAGE Publications Ltd.: Thousand Oaks, CA, USA; Amazon Digital Services LLC: Seattle, WA, USA, 2015; p. 366. [Google Scholar]
- Prochaska, J.O.; DiClemente, C.C. Stages and processes of self-change of smoking: Toward an integrative model of change. J. Consult. Clin. Psychol. 1983, 51, 390. [Google Scholar] [CrossRef]
- Velema, E.; Vyth, E.L.; Steenhuis, I.H. Using nudging and social marketing techniques to create healthy worksite cafeterias in the Netherlands: Intervention development and study design. BMC Public Health 2017, 17, 63. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Elliot, D.L.; Kuehl, K.S.; Goldberg, L.; DeFrancesco, C.A.; Moe, E.L. Worksite Health Promotion in Six Varied US Sites: Beta Testing as a Needed Translational Step. J. Environ. Public Health 2011, 2011, 797646. [Google Scholar] [CrossRef] [PubMed]
- Lavack, A.M.; Magnuson, S.L.; Deshpande, S.; Basil, D.Z.; Basil, M.D.; Mintz, J.H. Enhancing occupational health and safety in young workers: The role of social marketing. Int. J. Nonprofit Volunt. Sect. Mark. 2008, 13, 193–204. [Google Scholar] [CrossRef]
- Akbar, M.B.; Ndupu, L.B.; French, J.; Lawson, A. Social marketing: Advancing a new planning framework to guide programmes. RAUSP Manag. J. 2021, 56, 266–281. [Google Scholar] [CrossRef]
- Rogers, E.M. Diffusion of Innovations, 5th ed.; Simon & Schuster, Inc.: New York, NY, USA, 2003. [Google Scholar]
- Petty, R.E.; Cacioppo, J.T. The Elaboration Likelihood Model of Persuasion. In Advances in Experimental Social Psychology; Berkowitz, L., Ed.; Academic Press: New York, NY, USA, 1986; Volume 19, pp. 123–205. [Google Scholar]
The Test (What test?) | What attributes or features are sought in a COVID-19 test? [saliva based, instant read, 24-h turnaround in lab, pre-packaged, disposable without sharps or other special containers, etc.]. What is the price point you think the sector can pay per test application? What is the normal quantity that a typical organization in this sector would need, and how often to do adequate testing? |
Testing | What are the ‘benefits’ of testing for your sector? [safety of public, safety of other workers, etc.] What “place” do you think will be the most effective/efficient for reaching your sector? What do they need to ‘exchange’ to get testing done in a satisfactory manner? [loss of production, time off, days out, cost of tests, etc.] How can barriers to testing be lowered for this sector? |
Competition | What are organizations within your sector doing/what did they do/ instead of using testing to return employees safely to work? |
Audience Segment Group | Label | Examples of Specific Occupations |
---|---|---|
1 | Physical contact with public required | Patient care, EMS, salon services |
2 | Public interaction (face-to-face) required | Teaching, Transportation, Retail, Janitorial |
3 | No public interaction, close inter-personal working conditions | Food processing, warehouse, apparel manufacturing, mining |
4 | Outside, distanced, or working from anywhere | Fishing, farming, financial management |
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Share and Cite
Parvanta, C.; Caban-Martinez, A.J.; Cabral, N.; Ball, C.K.; Moore, K.G.; Eastlake, A.; Levin, J.L.; Nessim, D.E.; Thiese, M.S.; Schulte, P.A. In Search of a Value Proposition for COVID-19 Testing in the Work Environment: A Social Marketing Analysis. Int. J. Environ. Res. Public Health 2022, 19, 12496. https://doi.org/10.3390/ijerph191912496
Parvanta C, Caban-Martinez AJ, Cabral N, Ball CK, Moore KG, Eastlake A, Levin JL, Nessim DE, Thiese MS, Schulte PA. In Search of a Value Proposition for COVID-19 Testing in the Work Environment: A Social Marketing Analysis. International Journal of Environmental Research and Public Health. 2022; 19(19):12496. https://doi.org/10.3390/ijerph191912496
Chicago/Turabian StyleParvanta, Claudia, Alberto J. Caban-Martinez, Naciely Cabral, Cynthia K. Ball, Kevin G. Moore, Adrienne Eastlake, Jeffrey L. Levin, Dalia E. Nessim, Matthew S. Thiese, and Paul A. Schulte. 2022. "In Search of a Value Proposition for COVID-19 Testing in the Work Environment: A Social Marketing Analysis" International Journal of Environmental Research and Public Health 19, no. 19: 12496. https://doi.org/10.3390/ijerph191912496