Communication And Marketing As Climate Change-Intervention .

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See discussions, stats, and author profiles for this publication at: ommunication and Marketing As ClimateChange-Intervention Assets. A Public HealthPerspectiveARTICLE in AMERICAN JOURNAL OF PREVENTIVE MEDICINE · DECEMBER 2008Impact Factor: 4.53 · DOI: 10.1016/j.amepre.2008.08.016 · Source: PubMedCITATIONSREADS903163 AUTHORS, INCLUDING:Edward W MaibachConnie Roser-RenoufGeorge Mason UniversityGeorge Mason University160 PUBLICATIONS 4,907 CITATIONS42 PUBLICATIONS 970 CITATIONSSEE PROFILESEE PROFILEAvailable from: Connie Roser-RenoufRetrieved on: 16 February 2016

Communication and Marketing As ClimateChange–Intervention AssetsA Public Health PerspectiveEdward W. Maibach, PhD, Connie Roser-Renouf, PhD, Anthony Leiserowitz, PhDAbstract:The understanding that global climate change represents a profound threat to the healthand well-being of human and nonhuman species worldwide is growing. This articleexamines the potential of communication and marketing interventions to influencepopulation behavior in ways consistent with climate change prevention and adaptationobjectives. Specifically, using a framework based on an ecologic model of public health, thepaper examines: (1) the potential of communication and marketing interventions toinfluence population behaviors of concern, including support for appropriate publicpolicies; (2) potential target audiences for such programs; and (3) the attributes ofeffective climate change messages. Communication and marketing interventions appear tohave considerable potential to promote important population behavior change objectives,but there is an urgent need for additional translational research to effectively harvest thispotential to combat climate change.(Am J Prev Med 2008;35(5):488 –500) 2008 American Journal of Preventive MedicineIntroductionEither we will achieve an awareness of our place inthe living and life-giving organism of our planet,or we will face the threat that our evolutionaryjourney may be set back thousands or even millions of years. That is why we must see this issue asa challenge to behave responsibly and not as aharbinger of the end of the world.– Vaclav Havelformer president of the Czech Republic1The potential health effects of climate changehave been reviewed extensively.2–7 Earth systemchanges, including rising temperatures, increasing climate variability, increased rainfall in some areasand drought in others, and more frequent severeweather events, have considerable potential to affecthuman health. Severe weather events may result ininjuries and fatalities, and heatwaves can cause directeffects such as dehydration, heat asthenia, heat exhaustion, and heat stroke; excess deaths during heatwavesresult primarily from underlying cardiovascular andrespiratory diseases. Ecosystem changes can increaseFrom the Center for Climate Change Communication, GeorgeMason University (Maibach, Roser-Renouf), Fairfax, Virginia; and theSchool of Forestry and Environmental Studies, Yale University (Leiserowitz), New Haven, ConnecticutAddress correspondence and reprint requests to: Edward W.Maibach, PhD, Center for Climate Change Communication, GeorgeMason University, 4400 University Drive, MS 6A8, Fairfax VA 22030.E-mail: emaibach@gmu.edu.488the range, seasonality, and infectivity of some vectorborne diseases. Heavy rainfalls and related factors areassociated with waterborne disease outbreaks, andthese may increase the risk of foodborne illness. Higherlevels of carbon dioxide and heat may promote production of allergens (e.g., pollen) by such plants as ragweed, and warmer weather may promote the formationof ground-level ozone. Humidity combined with heatfacilitates fungal growth and transmission.Potential indirect effects—for which data are lessavailable and uncertainties are greater—include mental health consequences, population dislocation, andcivil conflict. In addition, changes in the patterns ofpests, parasites, and pathogens affecting wildlife, livestock, agriculture, forests, and coastal marine organisms can alter ecosystem composition and functions,and changes in these life-support systems carry implications for human health.8 The burden of theseconditions is expected to increase as climate changeadvances.Successfully addressing climate change as a publichealth threat will require both mitigation and adaptation strategies, or, in more common public healthterms, primary and secondary prevention strategies.Primary prevention requires aggressive efforts to reduce atmospheric levels of greenhouse gases, both byreducing emissions and by sequestering gases already inthe atmosphere (e.g., through reforestation). Secondary prevention requires efforts to adapt to a changingclimate in ways that protect population health andAm J Prev Med 2008;35(5) 2008 American Journal of Preventive Medicine Published by Elsevier Inc.0749-3797/08/ –see front matterdoi:10.1016/j.amepre.2008.08.016

well-being. Examples of adaptation include reinforcinglevees in coastal areas, implementing heatwave preparedness plans in urban areas, and reforestation.There is an urgent need to influence people’s behavior— on a large scale or population basis—to helpprevent and reduce the burden of climate change onhuman and other populations. Social and behavioralscience intervention methods offer important tools tothis end. Here, two broad sets of tools— communicationand social marketing—are examined as assets formounting a public health response to climate change.Communication is defined as the production and exchange of information to inform, influence, or motivate individual, institutional, and public audiences, andsocial marketing as the development and distribution ofproducts or services to influence behavior on a largescale for the purpose of societal benefit rather thancommercial profit.First, a summary is presented of what is known aboutthe drivers of population behavior, along with a framework that organizes these influences. Current knowledge is then reviewed about (1) the potential of communication and social marketing to influence populationbehavior, (2) general public audiences for climate changeinterventions, and (3) effective message strategies toinfluence these audiences. It is important to note thatthe majority of the research cited here was conductedwith people in the U.S., and that recommendations aremade primarily for the current American context.Many of the general points, however, likely have relevance to other developed nations and even to developing nations.Influencing Population Behavior: Understandingthe ChallengeThe public health community, like many others, wasslow to recognize the threat of climate change. Thethemes of World Health Day 2008 (Protecting HealthAgainst Climate Change) and National Public HealthWeek 2008 (Climate Change: Our Health in the Balance) make clear that the threat is now recognized. Theneed for the public health community to mobilize itsassets against that threat is now obvious.Fortunately, the public health community has muchto offer. Perhaps most notably, this community hasboth breadth and depth of experience in understanding and responding to population behavior-changechallenges (see Text Box for an example).Historically, when people fail to behave in ways thatare in their own or society’s best interest—as judged bypublic health professionals, environmental scientists,and other similar experts—the tendency has been toassume that the cause must be either a lack of relevantknowledge on their part (i.e., an information deficit)and/or misguided attitudes. The prescription that hasNovember 2008Text BoxChronic disease prevention provides an example of thetype of challenges that climate change poses. Over thepast several decades, the public health community hasfocused on understanding and preventing chronic diseases through population-based intervention strategies.9,10 Many of the underlying behavioral and economic factors that make chronic diseases sochallenging to control in the modern era appear tohave direct relevance to climate change control. Forexample: People have a strong innate tendency to value immediate benefits more than future benefits.11 Althoughmany of the costs—including monetary (e.g., retrofitting buildings with energy-efficient devices), time andeffort (e.g., using active or mass transit optionsrather than driving in one’s car), and social (e.g.,challenging people’s preferences about whetherdinner should include meat or not)—associatedwith prevention and adaptation are necessarilyborne in the present, many of the associated benefitsdon’t accrue for months (e.g., reduced utility bills,reduced BMI), years, or even decades into the future(e.g., reduced global warming, heart diseaseaverted).People have a tendency to consume resources inproportion to how available and affordable theresources are.12 In societies where resources arereadily available and affordable (such as the U.S.),this tendency can lead to excess consumption, thatis, consumption levels that exceed the individual’s— or society’s— best long-term interests. Welldocumented examples of such excess consumptioninclude calories and electronic media content.13Production, distribution, and consumption of suchresources are typically dependent on fossil fuels atpresent.People have a tendency to conserve physical effortexpenditures.14 This innate human tendency hasbeen greatly enabled in the developed world by theproliferation of labor-saving devices (e.g., cars,home appliances, power tools). Like other resources, the production, distribution, and use ofthese devices currently depends on fossil fuels.tended to follow this diagnosis is: to change people’sbehavior, we must provide them with the knowledgethey lack and/or persuade them to change theirattitudes.15In the public health community over the past severaldecades, this “information deficit” view of populationbehavior—although appealing in its simplicity and apparent face validity— has been largely supplanted byecologic views of population behavior. The “people andplaces” framework (Figure 1) is one example of anecologic model.16,17 The framework describes population health—and environmental outcomes—as beingAm J Prev Med 2008;35(5)489

Figure 1. A “people and places” frameworkdetermined primarily by population behavior, which, inturn, is determined by people-related and place-relatedfactors. The people-related factors that influence population behavior are organized into three levels ofanalysis: individual-level factors (such as beliefs andskills), social network-level factors (such as behavioralmodeling and social reinforcement), and group-, community- or population-level factors (such as socialnorms and collective efficacy). The place-related factors—as identified by Farley and Cohen18—are described in broad terms as the availability and cost ofproducts and services, the attributes of physical structures, social structures (i.e., laws and policies), and thecultural and media messages in our communities.These place-related factors manifest at two levels ofanalysis: the local level and the distal level. Local-levelfactors describe people’s immediate environment—their homes, schools, workplaces, and neighborhoodshops—and influence population behavior only in agiven locale. Distal-level factors originate furtherafield—in state, national, and multinational capitals,and in the headquarters of multinational corporations—and exert influence on population behaviorover wider geographic areas. The framework also acknowledges that place-related factors—for example,harmful environmental exposures— can exert directinfluence on population health and environmentaloutcomes, but the framework intentionally emphasizes490the role of human agency in causing or preventingthose environmental exposures.The potential of communication and social marketingas means to influence population health and environmental outcomes becomes clear in the context of thisframework. Specifically, most of the people- and placebased drivers of population behavior potentially can beinfluenced through communication and/or socialmarketing.The Potential of Communication and Marketing toInfluence the Drivers of Climate Change–RelatedBehaviorRemarkably little progress has been made in understanding how best to influence climate change–relatedbehaviors on a population basis, especially given thelikelihood of severe negative consequences that mayarise—including health, environmental, and economicimpacts.19 The research literature on individual climatechange–mitigation behaviors has focused primarily onfour broad categories: household energy use, recycling,surface transportation behavior, and purchase of“green” products.20 The research literature on individual-level adaptation has focused primarily on issuesrelated to increasing household preparedness againstnatural disasters, such as hurricanes.21American Journal of Preventive Medicine, Volume 35, Number 5www.ajpm-online.net

Influencing Individual-Level Drivers ofPopulation BehaviorThe intervention studies conducted to date have primarilyattempted to influence population behavior by targetingindividual-level factors. The large majority of 38 recentlyreviewed household energy conservation interventions,for example, used communication to influence individual-level drivers of population behavior.22 In this and otherreviews, several modes of communication have shownpromising ability to reduce energy use23: (e.g., specifying who is at risk, how severe and howcertain the risk is, and what can be done to reduce therisk or diminish losses), repeated often (e.g., through avariety of interpersonal and media channels, electronically and in print), by a variety of trusted sources (e.g.,scientists, community leaders, journalists).Marketing interventions—in which improvements aremade to products or services, their prices and availability,and how they are promoted (to enhance their perceivedvalue to potential customers)— have also shown promiseas tools for population behavior management with avariety of climate change–relevant behaviors:The provision of tailored or customized recommendations— based on home energy audits— has been Financial incentives to install energy-efficient applishown in some (but not all) studies to reduce energyances can substantially increase homeowners’ puruse in the range of 4% to 21%.24 –27chase of such appliances, especially if the offers areThe provision of feedback (i.e., specific informationaggressively promoted (i.e., communicated).38about the amount of energy being used)— especially Green energy programs—in which utility companieswhen the feedback is frequent or continuous— hasoffer their residential customers energy from renewbeen shown to reduce energy use in the range of 5%able sources at a premium price— have a growingto 13%.28 –32presence in the marketplace. Programs withEncouraging people to set an energymore aggressive marketing features—lowreduction goal—especially if they areminimum purchase requirements, shortgiven feedback about their progressListen tocontract lengths, and aggressive promotoward the goal— has been shown torelated Podcasttion— have higher customer participaappreciably reduce household energyat www.ajpmtion and total energy purchases.39consumption.33,34online.net. Travel demand management programs—Using mass media to model behaviors ofwhich use a variety of marketing methods—interest has long been known to be anhave been shown to substantially ineffective population behavior-change35crease use of public transportationstrategy ; regrettably, only a single(20%–33%) and active transport modesstudy that has tested this approach to influence(including walking [16%] and cyclingclimate change–relevant behavior was found. In that[6%–91%]), and to reduce the numberstudy, TV was used to model ways to reduce houseof car trips taken (10%) and distancehold electricity use. The programming led to a 10%traveled by car (17%).40reduction in household electricity use, although thereduction was not apparent a year later.36Eco-labeling programs have been shown to influInfluencing Social Network–Level Driversence population behavior—at least some people’sof Population Behaviorbehavior under certain conditions.37 People whoRelatively few studies have attempted to influencehold pro-environmental attitudes are most likely topopulation behavior through social network–level inbe influenced. Moreover, to be effective, peopleterventions. One important exception is a series ofmust understand the label, must believe that thestudies in which block leaders were recruited in neigh“green-designated” product offers meaningful enviborhoods to model household recycling behavior andronmental benefits, and must trust the organizationexhort and assist neighbors to recycle. The approachthat has given the designation (with governmentresulted in significant neighborhood-wide increases indesignations being more trusted than industry desrecycling.41– 43 Opinion-leader interventions of this typeignations).23 The effectiveness of eco-labeling prodeserve considerable additional research attention begrams tends to increase over time as consumerscause of their potential to influence a wide range ofdevelop trust in the labeling system.climate change–mitigation and adaptation behaviors.44A number of communication campaigns promotinghousehold disaster preparedness have been evaluated.Influencing Community-Level DriversTheir behavioral impact has ranged from no behaviorof Population Behaviorchange at all to a relatively great deal of public and21household change. The more successful campaignsCommunication interventions that influence people’stypically used what are now commonly accepted asnormative beliefs—that is, people’s beliefs about thegood campaign design practices: simple clear messagesbehavior of others— have been shown to promote aNovember 2008Am J Prev Med 2008;35(5)491

range of relevant behaviors including recycling,45 reduced household electrical use,46 and reduced hoteltowel use (which has direct water-use implications).47Recent advances in understanding how to use theseinexpensive methods to manage population behaviorhave readied them for widespread application.48 And,given the rapidly growing literature suggesting thatcommunity-level variables can be far more powerfulthan individual-level variables in shaping populationbehavior,49 there is a pressing need for interventionresearch on other community-level drivers of population behavior.Influencing Place-Based Drivers of PopulationBehaviorDespite the importance of the attributes of place, littleintervention research has been conducted to test strategies for influencing these attributes. Some illustrativereal-world examples, however, include: The limited availability and higher up-front costs ofcompact fluorescent lighting (CFL) have, until recently, depressed demand for the product.50 Prior to2007, retail shelf space and marketing promotion forCFLs was severely limited, and prices were exorbitantly high by comparison.51 Each of these factorshas improved recently, in part due to retailing giantWalMart’s successful initiative to sell one millionCFLs in 2007.52Sidewalks and certain other physical attributes makesome communities more walkable than others. Residents in walkable neighborhoods get more physicalactivity and do more of their errands on foot, thando residents in less walkable neighborhoods.53 Asmall but growing number of campaigns are advocating neighborhood/city reconfigurations to makethem more supportive of active living.54Low gasoline taxation in the U.S. fosters higherconsumption. It is estimated that increasing thegasoline tax to 2/gallon would reduce short-termconsumption by ⱖ15% and long-term consumptionby ⱖ60%. Similarly, federal subsidies on a range ofproducts—including oil production and large sportutility vehicles—lower their price to encourage consumption, thereby creating taxpayer-su

Change–Intervention Assets A Public Health Perspective Edward W. Maibach, PhD, Connie Roser-Renouf, PhD, Anthony Leiserowitz, PhD Abstract: The understanding that global climate change represents a profound threat to the health and well-being of human and nonhuman species worldwide is growing. This article

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