Recipe for success with Change4Life

Social marketing is complex and sophisticated and can be very effective. For example, the public sector behavioural-change campaign Change4Life, launched in January 2009, was a huge success and has lessons for the private sector. Alison Hardy and Jane Asscher explain

In late 2007, the Department of Health assembled a team of marketers charged with developing a social marketing strategy to combat the rise in childhood obesity. This would be the first and most ambitious national campaign on this issue to launch anywhere in the world. We were fortunate enough to be among the first recruits to that team.

The group blended civil servants with commercial sector marketing, advertising and research experts. The planning and development took more than a year and involved ten specialist marketing and communications agencies, including media planning, advertising, direct and relationship marketing, partnership marketing, database marketing and digital communications.

The team members achieved a tremendous amount. We created a customer segmentation, to allow resources to be targeted to those families who most need help; we gleaned insight into why those families behaved as they did; created a new brand identity; provided ‘products’ (handbooks, questionnaires, wall charts, ‘snack swappers’) that families could use to change their behaviours; signposted them to services (ie dance classes, accompanied walks and free swimming); and brought together an unprecedented coalition of local, non-governmental and commercial sector organisations to help families change their behaviours.

Nearly two years, a change of Government and an economic crisis later, Change4Life continues. The campaign has won 15 industry awards original remit (children aged five to 11) to include early years (under the Start4Life sister brand) and middle-aged adults. Multiple sub-brands (Cook4Life, Walk4Life, Swim4Life, Moreactive4Life, Muckin4Life, Bike4Life, Smallsteps4Life to name a few) have been launched, some by the department, others in partnership with other government departments and agencies and by commercial partners.

Stopping children from gaining too much weight requires fundamental changes for families – including the food they buy, how they prepare it, when and how much they eat, how they travel and how they spend their leisure time. For families to trial and sustain lifestyle changes they need powerful motivation, coupled with access to services and support. A traditional government information campaign could not do this.

Instead, we used marketing resources to inspire a societal movement, through which community leaders, teachers, health professionals, charities, leisure centres, retailers and food manufacturers could play a part in helping families change.

Recognising the Challenge Obesity is in the news every day. We knew from the research that, although parents were exposed to this coverage, they made no link between what they saw and their own children’s weight gain.

Academic research reveals that only 17% of obese parents whose children are obese recognise that their child has a weight problem.

The role for marketing was not to tell people obesity was a problem, it was to reframe the whole debate, so that people recognised it is a problem for them and for their children. Most children reach puberty at a healthy weight; the issue is that they are already exhibiting the behaviours (poor eating habits and sedentary lifestyles) that could make them overweight or obese in adulthood. Changing behaviours that are ingrained through decades of habit is difficult. Therefore, we set out to create a programme that would change behaviours in childhood, and, in the case of babies, establish positive behaviours from birth.

Our work was driven by a substantial body of research, both academic and consumer, collected during the 18 months before the campaign launched.

In particular, five insights drove the development of the campaign:

1. People know obesity is an issue (93% of UK parents agree that ‘childhood obesity is an issue of national importance’) > but do not realise that it is their issue (only 5% of all parents believe that their child is overweight or obese).

2. Parents routinely underestimate the amount of food that they and their children eat and overestimate the amount of activity that they do.

3. A host of behaviours that are thought of as unhealthy (eg long periods of watching television) are not perceived by parents as a risk.

4. Healthy living is perceived as a middle-class aspiration.

5. Parents prioritise their children’s immediate happiness over their long-term health (the link between poor diet and sedentary behaviour today and future health outcomes is not understood).

Behavioural Solution As long as these barriers persist, any conversation that a health professional, or anyone else, instigates about ‘obesity’ becomes a criticism of how a child looks rather than a concern about their health. As we attempted to tackle these barriers, we focused our efforts on those families with children under the age of 11, whose attitudes and behaviours suggested that their children were at greater risk of excessive weight gain.

Segmentation highlighted that there were approximately three million of these families in England. For some of the families, this would be the first time that they attempted to follow a diet or healthy eating programme.

When providing people with advice and information it therefore needed to be universal and easy to follow.

A panel of experts devised the eight behaviours that parents should encourage their children to adopt to avoid excessive weight gain. We promoted the behaviours, using people’s own language and simple rules of thumb – five a day, 60 active minutes, ‘me’-size meals – with tips to support people along the journey towards behaviour change.

We designed our programme specifically to create preconditions, identified by academic advisers as necessary triggers to drive behavioural change, to make people:

• be dissatisfied with the present and concerned that weight gain has health consequences;
• recognise that their families are at risk and take responsibility for reducing that risk with a positive image of the future;
• subject to positive environmental pressures via the campaign messaging (normalisation), know what they need to including the Marketing Society’s Award for Excellence 2010, for best new brand. Change4Life has expanded beyond its do to change, ie know the behaviours and be able to relate them to their lives; and

believe that change is possible, believe that others around them are changing and know help is available for them to change.

Behaviour change is a long and complex journey and success depends in part on the services that people encounter in their local areas. We therefore started our programme with six months of engagement with local communities and local service providers. This included writing to every general practitioner and practice nurse, engaging with schools, with voluntary organisations and with local service providers.

We then set out to assemble a cross-societal coalition of workforces, government departments, nongovernment organisations, local activists and commercial brands, so that as our target audiences attempted to change their families’ behaviours they would feel that everyone around them – the people, institutions and brands they trust – are supporting them.

The Change4Life brand and its sub-brands were made available to local and national partners, so that they could market their own products and services (ie accompanied walks, free swimming, gym sessions, dance classes, new play facilities, healthy school meals, recipe books and cooking classes) within the movement. Families were invited to join Change4Life. They received a questionnaire that asked about a typical day in the life of each child. This enabled Change4Life to send them a personalised action plan with advice for each child.

Some 200,000 of the most at-risk families were enrolled in a customer relationship management programme which provided additional continued support. New products and offers were developed to prompt behaviour change:

250,000 ‘snack swapper’ wheels were distributed to help parents negotiate with their children about healthier snacking, and seven million free swims were provided by local authorities.

Positive Results

The campaign exceeded all published targets, with brand awareness topping 90%. It helped parents make the link between the behaviours that cause excess weight gain and poor health outcomes. For example:

• 85% of mothers agreed that the Change4Life advertising campaign ‘made me think about my children’s health in the long term’;
• 81% agreed it ‘made me think about the link between eating healthily and disease’; and
• 83% agreed that it ‘made me think about the link between physical activity and disease’.1

Brand metrics are strong, most especially being clear, trusted, relevant, adaptable to lifestyles and supportive – not judgemental.

Change4Life galvanised activity across communities. For example:

• 50,000 community leaders joined Change4Life as local supporters and used Change4Life materials to start conversations with more than a million people about their lifestyles2;
• 44% of primary schools, children’s centres, hospitals, GP surgeries, town halls, leisure centres and libraries displayed Change4Life materials3; and l NHS staff ordered more than eight million leaflets and posters to distribute to the public.4

More than 200 national organisations (including Asda, Tesco, Unilever, PepsiCo, Kellogg’s, Nintendo and the Fitness Industry Association) supported the movement by, for example, selling bikes at cost, providing money-off fruit and vegetables and funding free exercise sessions. Other government departments synchronised their activity and created new activity under Change4Life subbrands (such as Swim4Life, Play4Life and MuckIn4Life).

Three of the main health charities (Cancer Research UK, Diabetes UK and the British Heart Foundation) ran the own campaign in support of Change4Life, and other non-governmental organisations, such as Natural England and Sustrans, also supported the campaign.

Early results indicate that families are already changing their behaviours. In our tracking study, 30% of mothers who saw the advertising (equating to more than one million mothers) are claiming to have changed at least one thing in their children’s diets or activity levels as a direct result of Change4Life.

Actual purchases were analysed by dunn-humby (using the Tesco Clubcard database) of 10,000 of the families who were most engaged with Change4Life5 and compared these to a demographically compatible control group. The analysis found a significant difference in the purchasing behaviour of the intervention group. Specifically, Change4Life families bought more low-sugar drinks, more low-fat milk, more fruit and vegetables, more dried pasta and fewer cakes.

The Department of Health has committed significant funds to Change4Life. In addition to the not-yet quantified free activity provided by local authorities, the NHS and community groups, the Change4Life movement has attracted significant support and in kind funding from partners. For example:

• £1.5m from other government departments;
• £9m spent by national partners;
• £12.5m in free media space for the launch6;
• £500,000 in free media around the sponsorship of Channel 4’s The Simpsons7; and
• £200m in future commitments by Business4Life consortium.
• Collectively, these give an ROI of £2.98 for every £1 spent.

What are the key lessons from the programme? Reviewing the programme, we realise that there are some things that have been crucial to the success and provide useful learnings for marketers across both the private and public sectors.

l Put corporate social responsibility activity at the heart of an organisation’s marketing efforts. With Change4Life, embedding the campaign within the broader policy context was crucial. This helped to bind the policy together and explain it to the public.

l Mobilise a network of national partners, across the commercial sector, non-governmental organisations and, if relevant, other government departments.

The coalition of partners, as an embedded team, is the engine that delivers the campaign. With Change4Life the team opened a new range of money-can’t-buy communications channels and, as the trusted voice, helped to change behaviour at the all-important points of influence, purchase or consumption.

• Engage at a grass-roots level via trusted local partners – in this case the NHS, schools, community groups and businesses.
• Consider engaging a number of specialist agency partners capable of working well together. Base a campaign on the latest evidence and behavioural insight, share the evidence base widely and seek external expert opinion to guide decisions where evidence is limited.
• Consider a big brand idea (rather than an advertising idea). The Change4Life brand idea, created by M&C Saatchi, captured the imagination of the public and made it possible to land some hard-hitting messages in an engaging and charming way. It also provided a rallying call for those already working in the area and inspired others, including marketing partners, to create great engaging content, tools and products.

1. BMRB tracking study, Q1 2009. 2. Source: Continental Research survey of local supporters, December 2009. 3. Source: BMRB observational survey of community venues, 2009. 4. Source: COI/Prolog. 5. ‘Most engaged’ was defined as having joined Change4Life and responded to at least one of the CRM packs. 6. Source: Freud Communications. 7. Source: Freud Communications. Jane Asscher is founder and chairman of 23red. www.23red.com Alison Harding is behaviour change specialist, Communications Directorate, at The Department of Health.

 Early results indicate that families are already changing their behaviours; 30% of mothers who saw the advertising claim to have changed at least one thing in their children’s diets or activity levels as a direct result of Change4Life

 The marketing role was not to tell people obesity was a problem, it was to reframe the debate