Social Marketing Health Scotland by 1q981Zt


									            Learning from the
    ‘KCND’ communications campaign

                 Ann Kerr, Team Head
      Kenny McDonald, Communications Manager
Ali MacDonald, Health Improvement Programme Manager

                NHS Health Scotland

What the campaign was trying to do
How the evaluation assessed the campaign
Implications for the new HEAT target
Aims of campaign

The campaign supported the Keeping Childbirth
Natural and Dynamic (KCND) programme. It ran in
3 phases from winter 2009 through to spring 2011.
The activity aimed to raise awareness of the
changes among both those supporting the delivery
of care and people using services in order to
enhance uptake.
This evaluation followed pre-testing and aimed to
assess what was understood by the key
messages, was it successful in reaching target
groups, and how was the information used and
acted upon.
Evaluation methodology and sample;
1. Public

• Face-to-face interviews with:
    Pregnant women;
    Women with a new baby;
    Socio-demographic ABC1C2DE;
    Aged 16–45;
    Urban and rural locations (3 HB areas)
    Including BME and hard to reach groups.

• Mini groups:
    Pre-family women of child-bearing age;
    Family women of child-bearing age (with children
     1-3 years).
Evaluation methodology and sample
2: Professional ‘Gatekeepers’

• Depth interviews:
    community pharmacists;
    sexual health staff.

• Mini groups:
    GP practice managers;
    GP practice receptionists.
How do women find out they are pregnant?

The majority of women in the sample undertaking
pregnancy testing at home, purchased mainly in
supermarkets or Pound Shops (C2DE
teenage/younger women), with some in

Most sought ‘official’ confirmation from GP.

A few had confirmed their pregnancy via a
pharmacist, sexual health clinic or GP in the first
What do women know about contacting

There was little awareness:
 •   That confirmation of pregnancy by GP not necessary
 •   Of the benefit or existence of the new pathway
 •   About the role of the midwife
 •   When to make initial contact with health services

General perception that ‘nothing happens before scan’ (in
context of midwife interaction).
     Women in specific groups
     Who to contact is strongly patterned by age,
      ethnicity and deprivation:
   Young women & lower socio-economic groups -
    check out with peers and family
   Older/more affluent women- GP
   Gypsy travellers- NHS 24/GP
   Chinese community-GP
   South Asian-midwife accepted
 What is behind choice of contact?

• Driven by word of mouth
• Choice of who and who to contact also affected by past
  experience and peer/family information
• Health professionals and gatekeepers in primary care
  are key
• Some indication that, when seen, the campaign added
  weight to peer reports of the pathway
• General feeling that it is important to involve GP
  Campaign awareness- public
 Awareness when prompted
 Message only relevant to women in early
 Message interpreted as ‘tell a
  midwife/doctor/someone if you’re pregnant’
Impact on knowledge- getting in early

• Benefits of early access not understood by all
• Widely viewed as a secondary message
• Often seen simply as a gentle means of
  encouragement rather than an important component
  of antenatal care
What does ‘Get in early’ mean?

• Some assumed it meant as soon as you know;
• Others assuming 10-11 weeks into the pregnancy
  (just prior to the first scan taking place);
• Some simply reading as ‘sooner rather than later’.
Campaign awareness:
Practice managers and receptionists

• Recall mainly limited to the public facing
• Most of the GP practice gatekeepers in
  Grampian and Lanarkshire recalled receipt of
  the posters and ‘credit cards’
• Recall of this campaign in Lothian was unclear
  (awareness related primarily to the materials
  produced by NHS Lothian)
Campaign awareness: Community pharmacists
and sexual health staff and nurses

• Not aware of the changes to antenatal access
• Still automatically referring to GP (practice),
  believing practice receptionists will signpost
• Some awareness of variation in first point of
  contact - not attributable to a change in pathway
• Assumption being this is focused on individual
  need or local protocols
Campaign awareness: Professionals

Across all of the gatekeeper and professional
sample, only one individual recalled the information

  • No practice managers or receptionists
    remembered receiving the briefing note;
  • Majority felt it would have been very valuable.
Campaign awareness : professionals

“We get lots of information that comes in
that kind of format.”
Practice manager, Lanarkshire

“It just looks like one of those letters you’re always
getting; you know, ‘dear colleague…’. Immediately it’s
not a letter to you, it’s a general circular letter. If you’ve
got time you’ll read it, but most of the time you skim to
see whether there’s something you need to do…”
Practice manager, Lothian
         Implications for HEAT
 Women’s pathways to care are complex and socially
 There is a very narrow timeframe to get the message
  across to women
 The benefits of ‘getting in early’ are not clearly
 Health professionals and their ‘gatekeepers’ are critical
  in providing this information
 Professional communication is enhanced by back up
 Mass media (posters etc) are not the best way to get the
  message across
Implications for HEAT

Critical role of GP needs to be recognised
Methods of communicating information to
 ‘gatekeepers’ need to be tested
Key messages about the benefits of ‘getting in early’
 for the public need to be explored and tested
Ways of getting the messages across in a range of
 communities need to be developed
 Next Steps at Health Scotland
  Health Scotland will be developing social marketing
  approaches for the new target
  Please get in touch if you would like to be involved in
  planning this, or in any testing or pilot work


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