This article criticizes the predominant use of fear appeals in social marketing. Laboratory studies, which have been the basis for most of the research on fear appeals and which generally suggest that high fear works, have limitations that include forced exposure, short-term measurement, and an overdependence on student samples. Although, unfortunately, field research evaluations of fear appeals are few, they usually reveal that fear has both weaker effects and unintended deleterious effects in real-world social marketing campaigns. Ethical concerns about fear appeals include maladaptive responses such as chronic heightened anxiety among those most at risk and, paradoxically, complacency among those not directly targeted, and increased social inequity between those who respond to fear campaigns, who tend to be better off, and those who do not, who tend to be the less educated and poorer members of society. Alternatives to fear appeals are the use of positive reinforcement appeals aimed at the good behavior, the use of humor, and, for younger audiences, the use of postmodern irony

Methodology/Approach: Review of systematic reviews and primary studies using prespecified search and inclusion criteria. Social marketing interventions were defined as those which adopted specified social marketing principles in their development and implementation.Findings: A total of 54 interventions met the inclusion criteria. There was evidence that interventions adopting social marketing principles could be effective across a range of behaviours, with a range of target groups, in different settings, and can influence policy and professional practice as well as individuals.Research limitations/implications: As this was a systematic review, the quality of included studies was reasonable and many were RCTs. However, many of the multi-component studies reported overall results only and research designs did not allow for the efficacy of different components to be compared. When reviewing social marketing effectiveness it is 3 important not to rely solely on the 'label' as social marketing is often misrepresented; there is a need for social marketers to clearly define their approach.Practical implications: The review shows that social marketing can form an effective framework for behaviour change interventions and can provide a useful 'toolkit' for organisations that are trying to change health behaviours.Originality/Value: The research described in this paper represents one of the few systematic examinations of social marketing effectiveness and is based on a clear definition of 'social marketing'. It highlights both social marketing's potential to achieve change in different behavioural contexts and its ability to work at individual, environmental and wider policy levels.

Methodology/Approach: Review of systematic reviews and primary studies using prespecified search and inclusion criteria. Social marketing interventions were defined as those which adopted specified social marketing principles in their development and implementation.Findings: A total of 54 interventions met the inclusion criteria. There was evidence that interventions adopting social marketing principles could be effective across a range of behaviours, with a range of target groups, in different settings, and can influence policy and professional practice as well as individuals.Research limitations/implications: As this was a systematic review, the quality of included studies was reasonable and many were RCTs. However, many of the multi-component studies reported overall results only and research designs did not allow for the efficacy of different components to be compared. When reviewing social marketing effectiveness it is 3 important not to rely solely on the 'label' as social marketing is often misrepresented; there is a need for social marketers to clearly define their approach.Practical implications: The review shows that social marketing can form an effective framework for behaviour change interventions and can provide a useful 'toolkit' for organisations that are trying to change health behaviours.Originality/Value: The research described in this paper represents one of the few systematic examinations of social marketing effectiveness and is based on a clear definition of 'social marketing'. It highlights both social marketing's potential to achieve change in different behavioural contexts and its ability to work at individual, environmental and wider policy levels.

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Objective: To evaluate the feasibility of undertaking a food skills intervention study in areas of social deprivation aimed at altering cooking confidence, food preparation methods and dietary choices. Design: A standardised skills programme was implemented in community-based settings. Pre-(T1) and post-intervention (T2) and 6-month follow-up (T3) measures (7-day diaries and self-administered questionnaires) were undertaken in intervention and comparison groups. Setting: Eight urban communities in Scotland. Subjects: One hundred and thirteen adults living in areas of social deprivation. Results: It was clear that many subjects led fragmented lives and found commitment to intervention classes problematic. Sixty-three subjects completed the final (T3) assessments. The response to each component varied due to inability to attend sessions, illness, study requirements, employment, moving out of the area, change in circumstances, loss of interest and loss of postal questionnaires. At baseline, reported consumption of fruit and vegetables was low (mean frequency 8.1^4.78 times per week). Fruit intake increased significantly (P, 0.05) between T1 and T2 in the intervention group (1.7^2.36 to 2.7^3.28 times per week) only. Between T1 and T3, there was a significant increase (P , 0.05) in intervention subjects who reported confidence in following a recipe (67 -90%,).Conclusions: This exploratory trial shows that a food skills intervention is likely to have a small but positive effect on food choice and confidence in food preparation. A full-scale randomised controlled trial in this hard-to-reach group would require a range of flexible approaches rather than a fully defined intervention, and presents challenges for trial design.

Objective: To assess the impact of a school-based nutrition education intervention aimed at increasing the consumption of fruits and vegetables. Design: The intervention programme increased the provision of fruits and vegetables in schools and provided a range of point-of-purchase marketing materials, newsletters for children and parents, and teacher information. Curriculum materials at age 6-7 and 10 -11 years were also developed and utilised. Evaluation was undertaken with groups of younger (aged 6-7 years) and older (aged 10-11 years) children. Methods included 3-day dietary records with interview and cognitive and attitudinal measures at baseline, with follow-up at 9 months, in intervention and control schools. Setting: The work was undertaken in primary schools in Dundee, Scotland. Subjects: Subjects comprised 511 children in two intervention schools with a further 464 children from two schools acting as controls. Results: Children (n ¼ 64) in the intervention schools had an average increase in fruit intake (133^1.9 to 183^17.0 g day 21 ) that was significantly (P , 0.05) greater than the increase (100^11.7 to 107^14.2 g day 21 ) estimated in children (n ¼ 65) in control schools. No other changes in food or nutrient intake were detected. Increases in scores for variables relating to knowledge about fruits and vegetables and subjective norms were also greater in the intervention than in the control group, although taste preferences for fruits and vegetables were unchanged. Conclusions: It is concluded that a whole school approach to increasing intakes of fruits and vegetables has a modest but significant effect on cognitive and attitudinal variables and on fruit intake.

Purpose – Value co-creation thinking is reshaping the understanding of markets and marketing and presents a significant opportunity to develop the theory and practice of social marketing. However, whilst value co-creation offers thought-provoking new directions for the field, applying this theory and its core concepts in social marketing is not without significant challenges. The paper aims to discuss these issues. Design/methodology/approach – This is a conceptual paper that seeks to integrate lessons from social marketing practice with the value co-creation discourse from commercial marketing. Drawing upon two projects that have applied principles of collaboration and co-design, the paper provides a critical perspective on the adoption of value co-creation in social marketing. Findings – The collaborative and emancipatory ambitions of co-creation seem highly compatible with social marketing. However, the paper notes some significant conceptual, ethical and practical obstacles in the path of a workable theory of value co-creation for social marketing. Originality/value – While representation of value co-creation and other collaborative approaches is increasing in the social marketing literature, this is the first attempt to provide an integrated and critical review of their compatibility with social marketing at a conceptual, ethical and theoretical level. The analysis shows that value co-creation theory can simultaneously offer opportunities and present obstacles for social marketing.