ARTICLE INFO

Article Type

Analytic Review

Authors

Ranaei   V. (1)
Dadipoor   S. (1)
Davoodi   S.H. (2)
Aghamolaei   T. (*3)
Pilevar   Z. (4)






(*3) Cardiovascular Research Center, Hormozgan University of Medical Sciences, Hormozgan , Iran
(1) Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
(2) Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
(4) Food Sciences & Technology Department, Nutrition Sciences and Food Technology Faculty, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence

Address: Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Phone: +98 (71) 33337192
Fax: +98 (71) 33337192
teaghamolaei@gmail.com

Article History

Received:  January  27, 2020
Accepted:  March 7, 2020
ePublished:  June 20, 2020

BRIEF TEXT


Social marketing is one of the approaches that are effective in promoting healthy eating behaviors by affecting different levels of target audience behaviors.

… [1-14]. Social marketing was developed in 1971 as a discipline and as a method to solve social problems, including health and the environment. In 1994, Andreasen identified social marketing as "the application of commercial marketing technologies in the analysis, planning, implementation, and evaluation of designed programs to affect the voluntary behavior of targeted audience defined for improving their personal well-being and their community" [16]. … [17-25].

The purpose of the present study was to determine the effectiveness of interventions based on social marketing theory in promoting healthy eating behaviors.

This research was a review.

The present study was based on the PRISMA checklist (reporting items for systematic reviews and meta-analyses) [26]. Initially, Persian and English databases, including Google Scholar, Scopus, ScienceDirect, Web of Science, PubMed, SID, and IranMedex were reviewed from June to July 2019 to identify interventions. Manual research of the journals, conference abstracts, seminars, and dissertations (gray literature) was also conducted. To search the databases, "and" and "or" were used to obtain consistent and different studies.



An initial search was performed by the author and then duplicate articles were excluded. In the next step, more limited searches were performed to remove irrelevant studies. After reviewing the title, abstract, and then the text of the articles and according to the inclusion criteria, the eligible articles were identified. It should be noted that there were no restrictions when searching the electronic databases in terms of publishing language, study time, duration of intervention, type of participants, and place of study. To evaluate the quality of articles, the Jadad standard score was used. According to PICO [28], the following studies were selected: 1) Providing sufficient and clear information for at least one of the social marketing criteria (issue). 2) Promoting healthy eating behaviors as a key issue in the study (issue). 3) The distinct study population. 4) Quasi-experimental studies (intervention and comparison). 5) A clear outcome of the intervention (consequence). 6) The available full-text. Qualitative studies and reviews, studies that combined social marketing with other educational programs, and studies, in which changing in the healthy eating behavior was not the main objective were excluded. Case studies, short articles, cross-sectional and descriptive-analytical studies, letters to the editor, and narratives and systematic reviews were also removed.

Searching databases and other sources yielded 371 articles. In the next step, because the articles were searched from several databases, duplicate articles were deleted and 273 articles remained. Besides, 170 articles considering their titles and due to their subjects irrelevant to the present study, such as studying variables, such as drug use or physical activity, and also 80 articles after studying their abstracts and because of different objectives compared with the purpose of the present study, for example, having a qualitative method or being a review and combining social marketing with other information or other educational programs were deleted. The remaining 23 articles were reviewed by both authors and based on the Jadad scale, and to reach a consensus, the third person finalized the articles.Most studies had been conducted in the United States [22, 29-42], followed by Iran [43], China [44], the United Kingdom [45], Switzerland [46], the Netherlands [47], Tanzania [48], Vietnam [49] and a study had been conducted in three countries: the Philippines, Bangladesh, and Indonesia [50] (Table 1). Review of Andreasen Assessment Criteria: Of the 23 studies, 12 interventions [30-34, 36, 44, 46-48] included all social marketing criteria. In all interventions, a behavioral goal had been reported. In all interventions, customer orientation and his needs and values had been considered. All interventions considered what motivated people to change (exchange), and also in all interventions, the target population was specifically sectioned and the mixture of the methods had been used. However, the use of the marketing mix in all studies was not consistent. Some studies had focused on some of them [35, 51], whereas others had focused on others, such as changing policies and stakeholder cooperation [44]. In the included study, paying to participate in the study [29, 31, 34], competition design [48], play and painting [45, 46] and tasting healthy food [29, 45] were some of the processes of increasing motivation in the targeted customers. Competition was also observed in 12 interventions [29-36, 44, 46-48]. Changing Healthy Eating Behavior: In all studies, some positive changes in healthy eating behavior had been reported. However, in one study, the majority of students did not achieve the minimum amount of fruit consumption (2 times a day) [34]. In another study, a social marketing-based program had no effect on vegetable consumption [45]. In addition, some interventions led to the acceptance of policies and other environmental changes [32, 37, 43, 47].

Some of the internal competitive strategies involved in the present study included educating parents and caregivers to manage emotions and conflicts [29, 46] and coping skills [35]. External competitive strategies also included changing and strict adherence to the school rules regarding the access of unhealthy foods to children and adolescents [22], accessibility of healthy foods [48], and organizing healthier eating conditions [37, 43, 47]. In Carins and Rundle-Thiele [21] study, 10 out of 34 studies and in the Luecking et al. research [18], 6 out of the 77 interventions had considered competition, which their findings are consistent with the present study.

It is suggested that future studies provide more comprehensive and effective interventions for behavioral changes using all criteria of social marketing, as well as the application of the all components of the social marketing mix.

We did not consider the Kappa statistic, which is one of the limitations of this study.

The social marketing approach can promote healthy eating behaviors.

We would like to thank all those who helped us with this study at Hormozgan University of Medical Sciences.

None to declare.

This study was approved by the Hormozgan University of Medical Sciences (IR.HUMS.REC.1398.360).

The present study is sponsored by the Hormozgan University of Medical Sciences.

TABLES and CHARTS

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