Working across boundaries: Leveraging local knowledge in the co-design of social marketing messages

Background: The Community Health Improvement for Milwaukee's Children: Save Lives-Immunize! (CHIMC) project is a community-based participatory research (CBPR) aimed at eliminating immunization disparities in Milwaukee's neighborhoods. One aim of the project is to influence immunization completion in underserved neighborhoods through pro-immunization messaging. Over the years, the use of social marketing in community-level public health promotion has increased significantly. Typically, social marketing messages for health promotion campaigns are created through traditional, expert-driven processes. By contrast, community-based health interventions integrate community perspectives more fully in creating, implementing, and evaluating these messages. Method: Social marketing campaign messages with pro immunization concepts and images were co-designed through a partnership of CHIMC project partners and the Children's Health and Hospital Systems and disseminated using billboards, flyers, etc. in select Milwaukee communities. The messages were developed, informed, and implemented using focus groups of study participants and CHIMC workgroup discussions and deliberations. Results: Responses from a random sample of 202 individual intercept interviews in the community showed that over 58% recalled the message, 40% were motivated to get their child immunized and 30% were prompted to review their child's immunization records. Conclusion: By working across boundaries that normally separate academic research and institutional systems from study participants, effective health communication campaigns that reflect subtle, yet important cultural differences and promote pro-immunization health behavior can be achieved.