Txt 4 Safe Sex. Samantha Smith 1 & Madryn Sanderson*



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Txt 4 Safe Sex Samantha Smith 1 & Madryn Sanderson* Managing Director Pinnacle Communications c/o GPO Box 1124, Melbourne, Vic 3001, Australia Email: sam@pinnaclecommunications.com.au Ph: +61 418 576 129 *Marketing Manager Marie Stopes International c/o GPO Box 1635, Melbourne Vic 3001, Australia Email: madryn.sanderson@mariestopes.com.au Ph: +61 3 9658 7507 1 Samantha Smith is an experienced communications, marketing and public relations practitioner who has been working with Marie Stopes International since 2003. Marie Stopes International is a not-for-profit sexual and reproductive healthcare provider, with centres in the ACT, Victoria, Queensland, New South Wales and Western Australia. A key part of MSI s service offering is community-based health promotion and education, and Samantha works closely with the MSI team on creating and delivering high-impact campaigns. Academically, Samantha has obtained a Bachelor of Business majoring in Marketing, and a Masters in Communications and Media Studies. In 2008 Samantha was accepted as a doctoral candidate at Monash University, and is currently researching communicating social marketing messages to Generation Y.

Project overview Marie Stopes International developed the Txt 4 Free Condomz social marketing initiative with the aim of: encouraging condom usage and address rising STI rates; overcoming the embarrassment and cost issue of buying condoms; and promoting a safe sex message using a medium and language that resonates with youth. The campaign was launched in 2007 with mobile phone users sent two free condoms in plain packaging when they text messaged their name and address details to 19 SEXTXT (19 739898). Text message costs were 55c. The campaign was repeated in 2008 and extended to target all sexually active Australians in 2009. Background and policy context Chlamydia notifications have hit an all time high in Australia, with the annual total for 2009 exceeding 60,000 (National Notifiable Diseases Surveillance System, 2010). Over half of these notifications were in the 15-24 year old age group. Research has found that although 61% of teens rate their knowledge of sexual health issues as good/excellent, nearly half (45%) were not aware that they could be infected with Chlamydia but have no symptoms (Marie Stopes International, 2008). In addition, youth have admitted that they don t use condoms every time they have sex, with 43% of sexually active students reporting that they only used condoms sometimes when they had sex (Smith et. al, 2008). In fact, approximately 1 in 10 sexually active students reported using the withdrawal method at the last sexual encounter (Smith et. al, 2009). When it comes to purchasing condoms, Marie Stopes International s client feedback has indicated that a number of young people are embarrassed to go to the supermarket, convenience store or chemist, or they simply don t have the money to do so. On the communications front, an estimated 83% of Australian teenagers own a mobile phone (Haddo Research, 2009) and they send an average of 5 messages per day, using SMS as one of their main forms of communication (Patterson, 2007). The average age for under-18s to begin using mobile phones is 13, and the reason for text messaging s popularity is that it is direct and immediate, discreet, less confrontational and usually cheaper than a phone call. From a marketing perspective, the group referred to as Generation Y is savvy and informed, having grown up online (Heaney, 2007; Cui et. al. 2003). As consumers, they have a particular preference for marketing strategies that require short attention spans, showcase core brand values and utilise a soft sell (Bartlett, 2004, Morton, 2002). The 8 Social Marketing Criteria Behavioural Goals "Aims to change people s actual behaviour: identifies baselines and sets clear behavioural goals, which, where possible, are measurable and time-bound." Behavioural analysis utilising Marie Stopes International and La Trobe University (2003) research, in addition to published journal articles (Rissel et. al., 2003; Dunne et. al., 1994; Lindsay et. al., 1999; Agius et. al., 2006) was conducted to gain a picture of current behavioural patterns and trends, for both the problem behaviour and the desired behaviour.

Specific behavioural goals for the campaign were established, being to: 1. establish an understanding of the importance of condom usage; 2. reinforcing the behaviour of using condoms; and 3. ultimately achieving a changed behaviour of ongoing condom usage. Customer Orientation "Puts the customer at the centre, seeking to fully understand the target audience and the presenting issue by using a mix of quantitative and qualitative research." In developing the campaign, analysis of existing research conducted by both Marie Stopes International and La Trobe University (2003) was used to develop an understanding of the customer. Online surveys hosted on Marie Stopes International s sexual health websites www.likeitis.org.au and www.sextxt.org.au and one-on-one discussions with clients in the target audience were also conducted at a centre and call centre level to gain an insight into their characteristics and needs. Insight, Exchange and Competition Insight "Uses research to identify actionable insights - key pieces of understanding that will underpin programme development." Exchange "Considers both the benefits and the costs of adopting a new behaviour; aims to maximise the benefits and minimise the costs to create an attractive exchange." Competition "Seeks to understand what competes for the audience s time, attention, and inclination to change, and to work with or learn from the competition." Online surveys on Marie Stopes International s sexual health websites www.likeitis.org.au and www.sextxt.org.au and one-on-one discussions with clients in the target audience were conducted to help guide the campaign development. In conducting this research, a clear analysis of the full cost to the consumer in taking up the offer and achieving the proposed benefit was completed. In addition, marketing journal articles and research focused predominantly on media consumption were reviewed to gain an insight into what competes for the time and attention of the audience. Theory "Uses behavioural theories to understand human behaviour, and to build programmes around this understanding." The Health Belief Model was used to inform and guide development of the campaign (Hochbaum, 1958). The model rests on the theory that personal belief influences health behaviour. It also suggests that a person s willingness to change their behaviour is based on perceived susceptibility, perceived benefits, perceived barriers, perceived seriousness, cues to action, self efficacy and any personal factors that may affect whether the new behaviour is adopted. Segmentation and Marketing Mix

Segmentation "Avoids a one size fits all approach: identifies audience segments, which have common characteristics, then tailors interventions appropriately." Marketing Mix"Uses a mix of methods to prompt and facilitate behaviour change, including education, support, control and design techniques. Does not rely solely on raising awareness." In an effort to reach as many youth as possible with the vital safe sex message, males and females aged 15 24 nationally were broadly targeted in the marketing effort. The campaign was launched to coincide with Schoolies week and the low budget methods used to target the group included direct marketing via a postcard drop, SMS marketing, online marketing, Schoolies event promotion and public relations. Evaluation, Results and Lessons Learned In Year 1 of the campaign (2007), 1,036 youth text messaged for free condoms. A positive response was received from youth, and messages of support for the service from parents. Extensive media coverage was generated for the campaign. In Year 2 of the campaign (2008), 1,595 youth text messaged for free condoms. In 2009, based on the success and feedback of previous years, it was decided to expand the campaign to target all sexually active Australians in an effort to encourage condom usage as part of Sexual Health Week. The key lesson gained from the campaign was the role media coverage plays in impacting campaign awareness levels. Positive and negative media coverage was received for the campaign and both increased awareness. Timing the campaign to coincide with Schoolies Week was also crucial to ensure a relevant media hook and to take advantage of the promotional opportunities available. It is vital that for campaigns of this nature the communications clearly state that the mobile phone bill payer must give permission for the request to be sent. It is also important that text messaging costs are kept at a minimum so as not to deter requests.

References Agius P., Dyson S., Pitts MK., Mitchell A., Smith AM., 2006. Two steps forward and one step back? Australian secondary students sexual health knowledge and behaviors 1992-2002. Journal of Adolescent Health 38(3), 247-252. Agius P., Pitts MK., Dyson S., Mitchell AM., Smith AM., 2006. Pregnancy and contraceptive use in a national representative sample of Australian secondary school students. Australian New Zealand Journal of Public Health. 30(6), 555-557. Bartlett, M., 2004. Analyst: understanding what shapes generations can help the CU market to that generation. Credit Union Journal 8(21), 14-15. Communicable Diseases Network Australia (CDNA), 2010. National Notifiable Diseases Surveillance System. Available from http://www.health.gov.au/internet/main/publishing.nsf/content/cda-cdna-index.htm, accessed 20 January 2010. Cui, Y., Trent, E., Sullivan, P., and Matiru, G., 2003. Cause-related marketing: how generation Y responds. International Journal of Retail and Distribution Management 31(6), 310-320. Dunne MP., Donald M., Lucke J., Nilsson R., Ballard R., Raphael B., 1994. Age-related increase in sexual behaviours and decrease in regular condom use among adolescents in Australia. International Journal of STD and AIDS 5(1), 41-47. Habbo, 2009. New Research: The Financially Responsible Generation with an Appetite for Credit. Available from http://www.vedaadvantage.com/news-and-media/article.dot?id=507294, accessed 20 December, 2009. Heaney, J., 2007. Generation X and Y s internet banking usage in Australia. Journal of Financial Services Marketing 11(3), 196-210. Hochbaum, GM., 1958. Public Participation in Medical Screening Programs: A Sociopsychological Study. Public Health Service Publication No. 575. Kaiser Family Foundation, 2010. Generation M2: Media in the Lives of 8- to 18-Year-Olds. Available from http://kff.org, accessed 20 January, 2010. Lindsay J., Smith AM., Rosenthal DA., 1999. Conflicting advice? Australian adolescents use of condoms or the pill. Family Planning Perspectives. 31(4),190-194. Lindsay J., Smith AM., Rosenthal DA., 1999. Uncertain knowledge: a national survey of high school students knowledge and beliefs about hepatitis C. Australian and New Zealand Journal of Public Health 23(2),135-139. Marie Stopes International, 2008. Sex telling it like it is: a parent and teen insight, Marie Stopes International/ Quantum Market Research. Available from www.mariestopes.com.au, accessed January 2010. Morton, L., 2002. Targeting Gen Y. Public Relations Quarterly 47(2), 46-48.

Patterson, B, 2007. Generation TXT. Herald Sun. Available from http://www.heraldsun.com.au/news/national/generation-txt/story-e6frf7l6-1111113617012, accessed 20 June 2007. Rissel CE., Richters J, Grulich AE., de Visser RO., Smith AM., 2003, Sex in Australia: first experiences of vaginal intercourse and oral sex among a representative sample of adults. Australian and New Zealand Journal of Public Health 27(2), 131-137. Smith A., Agius P., Dyson S., Mitchell A., Pitts M., 2003. Secondary Students and Sexual Health 2002. Australian Research Centre in Sex, Health & Society, La Trobe University. Monograph Series No.47. Smith A., Agius P., Mitchell A., Barrett C., Pitts M., 2009. Secondary Students and Sexual Health 2008. Australian Research Centre in Sex, Health & Society, La Trobe University. Monograph Series No. 70.