摘要：Objectives. We present a social marketing conceptual framework for Experience Corps Baltimore City (EC) in which the desired health outcome is not the promoted product or behavior. We also demonstrate the feasibility of a social marketing–based recruitment campaign for the first year of the Baltimore Experience Corps Trial (BECT), a randomized, controlled trial of the health benefits of EC participation for older adults. Methods. We recruited older adults from the Baltimore, MD, area. Participants randomized to the intervention were placed in public schools in volunteer roles designed to increase healthy behaviors. We examined the effectiveness of a recruitment message that appealed to generativity (i.e., to make a difference for the next generation), rather than potential health benefits. Results. Among the 155 participants recruited in the first year of the BECT, the average age was 69 years; 87% were women and 85% were African American. Participants reported primarily generative motives as their reason for interest in the BECT. Conclusions. Public health interventions embedded in civic engagement have the potential to engage older adults who might not respond to a direct appeal to improve their health. All that's required on your part is a willingness to make a difference. That is, after all, the beauty of service. Anyone can do it. President Barack Obama, upon signing the Edward M. Kennedy Serve America Act, April 21, 2009 1 Social marketing uses marketing principles to promote interventions that enhance a social good. Social marketing–based public health interventions could be particularly useful in addressing health behaviors such as physical inactivity, where health education alone may not be effective. 2 Social marketing differs from traditional health education in that the health promotion outcome may not be identical to the product or behavior being promoted. 3 An example of this is the VERB campaign, which increased free-time physical activity among children aged 9 to 13 years by marketing “fun” and “cool” activities, rather than focusing primarily on health benefits or health risks. 4 Similarly, in Baltimore, Maryland, Experience Corps Baltimore City (EC) was designed to increase physical, cognitive, and social activity among seniors through specially designed volunteer roles in public elementary schools. 5 , 6 In 2006, the National Institute on Aging funded the Baltimore Experience Corps Trial (BECT), a randomized controlled trial designed to determine the model's potential to compress the morbidity associated with aging. 7 In addition to the primary outcomes of mobility-associated disability, the BECT analyzes the effect of the model on self-reported falls, self-efficacy, memory, health expenditures, and physical activity. The recruitment for the BECT represents a model for future social marketing interventions that could promote health through an appeal to the participation of older adults in national and community service. EC has been described in medical literature as a social model for health promotion that describes the “win-win” potential of the program from society's perspective. 5 It has yet to be described within the theoretical framework of social marketing, which takes the perspective of the potential volunteer ( Figure 1 ). However, EC, as originally designed, 5 is remarkably consistent with social marketing principles. The “4 P's” of social marketing are product, price, place, and promotion. 8 , 9 Product is the desired behavior, or the goods or services that support the desired behavior change. For EC, the product is increased physical, cognitive, and social activity. Price reflects the cost or barriers to adopting the product and must include a consideration of the competing products or behaviors, which for EC would be inactivity. Place represents the location where the target audience will perform the desired behavior; in EC, older adults volunteer in public schools. Promotion reflects the messages and strategies used to reach the audience. In EC, we theorized that older adults would be attracted by generative motives (i.e., desire to make a difference for the next generation). The 4 P's of social marketing provide a conceptual framework for future interventions modeled after EC. Open in a separate window FIGURE 1 Social marketing conceptual framework for Experience Corps Baltimore City, Maryland. The development and implementation of the first year of recruitment for the BECT demonstrate how this social marketing conceptual framework could serve as a template for future public health interventions. Using the 4 P's of social marketing, we describe the design of a promotion campaign that appeals to generative motives in older adults. Prior recruitment for a previously published pilot trial was limited to word of mouth, community outreach, and limited direct mailing. 5 , 10 We present promotion campaign results and mass marketing data from the first year of recruitment for the BECT (2006 through 2007 school year). We also demonstrate the feasibility of recruiting older adults through a social marketing campaign using multiple strategies. Finally, we demonstrate how social marketing could be used to guide (1) the development of volunteer programs designed to serve as public health interventions and (2) future research.
