Creating and measuring social change
Stay home — stay safe.
Get tested.
Staying apart — keeps us together.
These are just some of the messages many of us have been receiving in various forms over the past few months. Some are crisp and simple, some are emotive, some are instructive. Common to all is that they are visible. They can be found on highways, on the sides of buildings, on our televisions, in our newspapers, in our inboxes, on our news feeds. For many of us they are impossible to miss, hard to misinterpret, and difficult to ignore. And because they reach us, wherever we are and whoever we are, they have the potential to create something shared among us. Maybe it’s a common goal, a common enemy, a shared belief, or a quiet agreement to do something together, and for each other.
Campaigns have a long history in public health, and aim to “persuade a defined public to engage in behaviours that improve health or refrain from behaviours that are unhealthy” (Springston J, 2013). Public health campaigns adhere to four elements: (1) they are organized and strategic; (2) they are focused on specific outcomes; (3) they target a large number of individuals; and (4) they are time bound with clear beginnings and endings.
All of us are likely to recall at least one campaign — be it about staying safe in a pandemic, wearing seatbelts, winning an Olympic bid, not smoking cigarettes, gaining marriage equality, or washing our hands. Rainbow laces, Drinkwise, the long running TAC campaigns, and more recently This Girl Can (implemented in Australia by VicHealth) — are good examples of high-profile campaigns that have captured our interest and that target a range of social issues.
The pathways by which these and other campaigns have contributed to change can be short or long, with the more complex types of changes likely to require more sustained investment. And investment in a range of efforts that reach a diversity of audiences, and challenge long-held or hard to shift beliefs, opinions, attitudes, norms and cultures.
Understandably, evaluating these types of activities and their effects is difficult. There’s the perennial challenge of complex causal relationships (attribution vs contribution); the long-time horizons required for change; and the scale at which such campaigns are deployed. In our own work, we tend to gravitate to three inter-linked and complementary evaluative perspectives to inform the design of our evaluations — and these perspectives essentially relate to ‘what’ is being evaluated: campaign evaluation; advocacy evaluation; and social movements.
Evaluations of complex campaigns
Complex communications campaigns include multiple elements, delivered via a range of channels, to a variety of audiences, and with multiple intended effects. Guides for evaluating complex campaigns, such as those from the WHO, provide structured design features — built around the core elements of the campaign, their intended effects on awareness, knowledge and behaviour, and their quality of implementation. Scholars of public health campaign evaluations highlight that the most effective campaigns are those that target change that is ‘one-off or episodic’ (e.g. vaccination, screening) rather than more habitual change (e.g. making better food choices, increasing physical activity) (Wakefield et al. 2014).
Advocacy Evaluation
Campaigns often form part of larger advocacy efforts — activities designed to sway public opinion, build support, and encourage policy change (see Innovation Network for some useful resources). Evaluating advocacy efforts is made challenging by a range of factors, including: the often long time frames associated with desired change; complex causal relationships between advocacy activities and their effects; and the need for proximal or interim markers of progress to document success and course correct. Consistent with other evaluation approaches, advocacy evaluation is built around a theory of change, agreed measures of progress and success, efficient methods for collecting data, and ways of using data to inform ongoing adjustment and adaptation of advocacy activities.
Evaluation of Social Movements
Social Movements are “sustained groupings that develop a frame or narrative based on shared values, that maintain a link with a real and broad base in the community, and that build for a long-term transformation in power” (Pastor and Ortiz, 2009, 7). Within social movements may be specific advocacy activities and campaigns, with social movements providing the broader umbrella for these features. The theory and practice of evaluating social movements has advanced since the 1960s and 70s, in recognition by movements themselves, donors and funders that evidence of their effects is important and useful to capture. Yet like advocacy efforts, documenting these effects is challenging.
Pastor, Ito and Rosner note two key elements that appear important to capture in relation to social movements, and which are consistent with both campaigns and advocacy: transactions and transformations. Transactions are considered to be quantifiable markers including amounts of funding secured, number of members, number of policies enacted or passed, number of voters etc. Transactions are relatively simple to account for. In contrast, transformations show how “people, organizations, and movements have been altered through the collective efforts”. Measures of transformation can reveal how the attitudes, beliefs, values and views of people, groups and even whole societies have changed. Often, measures of transformation are qualitative in nature.
These approaches aren’t how-to guides or recipes for success, rather they offer ways of understanding the world and changes that are taking place within it. Importantly, we draw from each in shaping our own evaluations, and suggest others may do so also.
The times that we are living through, and the contexts we are living in — shared and apart — offer us unique vantage points to experience public health campaigns. We can imagine these campaigns, and indeed evaluate them in all sorts of ways; these three approaches offering a starting point, perhaps.
We find that they help us when thinking about campaigns in times of complexity: in how we develop evaluation questions (and what the questions are); in what we choose to measure and how we measure it; in where we source data; in how insights are analysed and made sense of; and how the evaluation is used. Ultimately, they help us design and implement evaluations that support accountability, learning and improvement.
References
· Springston JK. Public Health Campaign, In Encyclopedia of Public Relations. Edited by Heath RL. 2013
· Wakefield MA, Loken B, Hornik RC. Use of mass media campaigns to change health behaviour. Lancet. 2010;376(9748):1261–1271. doi:10.1016/S0140–6736(10)60809–4
· Pastor M, Ortiz R. Making change: How social movements work — and how to support them. Program for Environmental and Regional Equity. University of Southern California. 2009.
