Defining our audiences: Creating culturally relevant social marketing materials in English and Spanish for a folic acid campaign in North Carolina

Background: Despite increasing public awareness about folic acid, only one-third of women of childbearing age in the United States take a multivitamin regularly. North Carolina launched a social marketing campaign to promote multivitamins focusing on two audience segments: 18-24 year-old English-speaking women and 18-35 year-old Spanish-speaking women. Methods: Qualitative research was completed using focus groups with women from both of the target audiences (total n = 61). Women viewed and discussed a variety of existing and proposed folic acid materials. Materials and messages were then developed by national advertising agencies and pre-tested with consumers of both target audiences. Results: English-speakers preferred images of young, healthy women who looked like them, and suggested that materials and messages portray images depicting energy, nutrition, healthy weight, exercise and vibrancy. Spanish-speakers emphasized the need to define birth defects, neural tube defects, and folic acid. They preferred the use of images of men, women and families in materials. Despite these significant differences, members of both target audiences agreed that the following elements are important: use of photographs, illustrations, simple language, and vibrant colors. Conclusions: Qualitative research highlighted the need to develop materials that reflected the cultural values and preferences of the target population. Using social marketing principles, this study transformed a broad traditional public health message into consumer-friendly and culturally-relevant messages. This research also highlights an important health communication principle: direct translations of educational materials from English into other languages may not always be effective.