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A report of field trials of social marketing interventions for early detection of lung cancer in men Communication

Introduction Avon, Somerset and Wiltshire Cancer Services and Bristol PCT, with funding from the National Awareness and Early Detection Initiative, commissioned the Bristol Social Marketing Centre to run a field trial to determine the most effective way to increase early detection of lung cancer. A review of the literatures on cancer detection and behaviour change theory allied to learning from social marketing case studies suggested a number of emotional and practical barriers, as well as the opportunity to capitalise on social influences and strong community ties. For clarity, a simple message was chosen: “3 week cough? Get it checked�.

Following two pieces of qualitative research among the target market to:

a. Gain insight on

attitudes and behaviour surrounding detection of lung cancer

A marketing communications campaign was conceived in collaboration with a creative and media planner. Six concepts were tested in focus groups; the best was developed into a multi-media campaign that appeared on posters, buses and bus shelters, local press, pub media and a leaflet through the door.

b. Test several

intervention concepts, different approaches were trialled in four deprived areas. Selected GP practices in every area received a set of materials developed in collaboration with Secondary Care professionals informing them of our initiative and reinforcing the importance of referral for chest x-ray. Area 1 received the GP awareness materials only, thus functioning as a control for the social marketing interventions. Co-creation

GP Awareness Area 1




GP Awareness

GP Awareness

GP Awareness

Area 2

Area 3

Area 4

Co-creation A collaborative process facilitated by agency Uscreates brought together community volunteers, members of the target audience and many other stakeholders including nurses, health trainers and smoking cessation advisors. Because different teams of community volunteers worked in Areas 2 and 4, the interventions themselves were different:

Recognise Yours? creatives

Area 2 Volunteers told us that social networks and

word-of-mouth were the most effective ways to spread informavtion. So, we supported them in organising a community Fun Day, men’s health table at local BBQ, beer mats and features on local radio and newsletters.

Area 4 A small number of volunteers developed

the idea of a Big Push: a range of awareness raising methods (posters, t-shirts, balloons) were distributed throughout the day by volunteers who spoke to members of the target audience on the street.


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A District Nurse was available at the Fun Day and Big Push events to offer advice and refer worried men to their GP. The trials were evaluated using the Lung Cancer Awareness Measure (LCAM) survey and by comparing chest X-ray referral data for the period of the trial compared to the same time period in 2009. Two LCAM surveys were carried out; one prior to the trial period and one after. 200 men in the target audience were interviewed face-to-face; quotas were set to ensure appropriate age and geographic distribution.


Recall local advertisements about coughing? The co-creation in Area 2 achieved high levels of spontaneous recall.

Co-creation workshop

Big Push event

Spontaneous mention of coughing as a warning sign of lung cancer? The ‘cough’ message has had an impact (especially in areas 2 and 4) and has been linked with lung cancer.

Confident can recognise a symptom of lung cancer? Co-creation has proved very effective in increasing people’s confidence that they would recognise a sign of lung cancer.

GP Awareness



35 25

Pre-trial % 10 Area 1

Conclusions - Overall, the social

marketing interventions were successful in raising awareness of the message about coughing.

- Co-creation (particularly in Area 2) has been the most effective in raising awareness and increasing knowledge; it was also the most cost-effective.

4 2 2

- Combining

24 8 0 3












Post-trial % for each area







2 4

communications and co-creation results in greater recall of the communications, but was less effective at increasing awareness and knowledge than the co-created intervention in Area 2.

Area 1


- We await the chest X-ray

data to discover if the intervention has also stimulated behaviour change and which methods have been most successful in achieving this.

Area 1



- We are planning


further qualitative work in Areas 2 and 4 to investigate why the intervention in Area 2 was more successful in communicating the message.

Cough Cough Cough case study  

Case study detailing a project to increase the early detection of lung cancer in Bristol.