poster
“Flirting is Not Consent. Ask Everyone, Every Time”
Designing, Implementing, and Evaluating a Health
Communication Campaign to Prevent Sexual Violence
CASESin PUBLIC HEALTHCOMMUNICATION & MARKETING
Peer-Reviewed Case Study
Suggested citation: Haas, E.J.; Mattson, M.; Wilkinson, K. “Flirting is Not Consent. Ask Everyone, Every Time”: Designing, Implementing, and Evaluating a Health Communication Campaign to Prevent Sexual Violence. Cases in Public Health Communication & Marketing. 2011;5:47-74. Available from: www.casesjournal.org/volume5.
Volume V, Winter 2011
Emily Joy Haas, MA 1 Marifran Mattson, PhD 2
Kathlyn Wilkinson, MPH 3
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1 Purdue University, Indiana Campus Sexual Assault Primary Prevention Project and Brian Lamb School of Communication 2 Purdue University, Brian Lamb School of Communication 3 Purdue University, Student Health Center
Corresponding Author: Emily Joy Haas, Purdue University Student Health Center, 601 Stadium Mall Drive, West Lafayette, IN 47907-2052. Email: ejhaas@purdue.edu
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Abstract
Research shows that sexual assault is one of the most pervasive problems on college and university campuses. Some research also indicates that sexual assault is the most common violent crime committed in campus communities. This case study describes and analyzes the development, implementation and evaluation of a social marketing campaign for a university committed to the pri- mary prevention of sexual violence. The Health Communication Campaign Framework provided theoretical and practical guidance for the working group during all phases of the campaign process. Campaign messages were designed to educate students about what consent is and to increase their comfort level in obtaining verbal, sober consent before having sex. The campaign also is critically analyzed with recommendations for how to address a sensitive is- sue, such as sexual violence, in messages displayed throughout a campus community.
Key Words: Social Marketing, Health Communication Campaign Framework, Sexual Violence, Primary Prevention, Message Design
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Introduction
Sexual violence is one of the most pervasive problems on college and university cam- puses,1 and the most common violent crime committed in campus communities.2 Sexual violence encompasses a range of offenses that are perpetrated against someone’s will, including a completed, nonconsensual sex act; an attempted nonconsensual sex act; and an abusive sexual contact.3 Every two minutes someone is raped in the United States (U.S.) and the chances of being raped are four times greater for a female college student than any other individual.4 Re- search suggests that 3% of college women are raped during a nine month academic period and 20-25% of women experience a completed or attempted rape during their four to five years spent in college.5 Also, a study of experiences among college stu- dents found that 27% of females reported unwanted sexual attention and 5% reported unwanted sexual contact in their lifetime.6 Often, campus sexual violence is associated with high-risk drinking and other drug use.7
The “Clery Act,” originally known as the Campus Security Act, requires that Insti- tutions of Higher Education (IHE) disclose information about crime on and around their campuses.8 However, since these sex offenses are underreported,9 the issue sometimes is not warranted as problematic. The following survey data provides a more specific, localized indication of this problem. In spring 2006, 13 campuses in Indiana participated in the Core Survey (n=6,000).10 In the results, 5.2% of the respondents re- ported forced sexual touching, 3% unwanted sex, and 1.9% both forced sexual touching
and unwanted sex. In another survey in- volving eight Indiana campuses (n=7,530),11 7.3% of respondents reported being sexu- ally touched without their consent while enrolled as a student on their campus; 2.8% an attempted or completed sexual penetra- tion without their consent; and 4.2% report- ed being taken advantage of sexually while drinking or using drugs. These surveys render consistent results regarding sexual offenses within IHE in the state.
Recently, IHE were encouraged to adopt policies and other prevention efforts to end sexual violence.5,9 To help address violence comprehensively, Centers for Disease Con- trol and Prevention (CDC), in partnership with the state’s health department, provides funding in the form of a Rape Prevention and Education (RPE) grant to prevent the occurrence of sexual violence on cam- puses.12 Recognizing that beliefs and atti- tudes regarding sexual violence are formed early,12 CDC encourages a focus on promot- ing healthy relationships and non-violent norms. Besides federal funding to support sexual violence prevention, a modification to current legislation, the Campus SaVE Act, was introduced in April 2011.13 If passed, this legislation will mandate that IHE cre- ate and implement a comprehensive strat- egy to both prevent and respond to sexual violence.13 The Act is calling for awareness campaigns as a best practice to prevent sexual violence,13 indicating the timeliness of this case study.
This case study demonstrates how health communication provides a foundation for primary prevention campaigns by discuss-
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ing the development, implementation, and initial evaluation of a campus-based social marketing campaign to prevent sexual violence. Primary prevention efforts aim to prevent first-time perpetration and vic- timization.3,9,12 In accordance with CDC philosophy, more health campaigns are emphasizing primary prevention strate- gies instead of secondary and tertiary prevention approaches.12 Social marketing
campaigns are one method to create large, behavior-changing initiatives on cam- puses.14 Social marketing and media cam- paigns have been used as prevention tools for a variety of health behaviors including bystander intervention14 and motorcycle safety.15 Social marketing campaigns work particularly well on campuses because they are designed to reach large numbers of people with targeted messages.16-17
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Background: Framing a Sexual Violence Primary Prevention Campaign
The Sexual Violence Primary Prevention Campaign (SVPPC), which targets college students, is framed by an adapted version of the Health Communication Campaign Framework (HCCF) shown in Figure 1 (next page).18-19 The objectives of this case study include: analysis of the SVPPC campaign as it progressed from initial steps in forma- tive research, to reveal a primary problem
contributing to sexual violence on campus, into developing its strategic plan to address the problem, through the message develop- ment and implementation of the campaign, culminating with initial evaluation and lessons learned. Following is a summary of the HCCF’s four phases which are further addressed with respect to the SVPPC.
Health Communication Campaign Framework
The SVPPC was framed by an extension of Mattson and Basu’s18-19 Message Develop- ment Tool (MDT) which utilizes messag- ing elements derived from communication theory and is consistent with social market- ing.20 The first phase includes convening a working group and strategy development, which sets the foundation for the cam- paign.14,18-19 The second phase consists of a needs assessment followed by developing and testing of messages and materials for proven messaging elements including be- ing stimulating, motivational, contextually and culturally consistent, and concordant with the constraints of organizational
resources.18-24 The third phase involves implementing the campaign to the target audience through appropriate communica- tion channels and events. The final phase is to evaluate the campaign’s effectiveness, and if necessary, make corrective or mid- course changes, at relevant points in the campaign’s lifecycle, usually by measuring audience knowledge, attitudes, and behav- iors. Now that the theoretical framework has been summarized, we illustrate how it was applied in practice to design, imple- ment, and initially evaluate the SVPPC at a university.
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Figure 1. Health Communication Campaign Framework (Adapted from the Message Design Tool by Mattson & Basu; 2010a, 2010b)18-19
Phase 3 – Implementation & Evaluation (Re)Implement Strategy/Disseminate Campaign Messages
Process Evaluation-tracking system to assess program deliv- ery and utilization
Outcome Evaluation-comprehensive assessment of campaign effectiveness • Pre-test/Post-test surveys
Phase 4 – Correction Loop
“Correct” Campaign based on Process and Outcome evaluation and cycle back through Phases 2 and 3.
Phase 1 – Convene Working Group/Committee Who? • Health Issue Experts • Public Health/Communication Specialists • Community Partners • Funding Sources
What? • Create Problem Statement
Correction loop
Phase 2 – Strategic Planning from Formative Research Needs Assessment • Research • Statistics • Target Audience(s) -Pre-test-existing knowledge, attitudes, and behaviors
Messaging Process • Develop/revise campaign messages taking into account proven messaging elements including: • Stimulating - attention-getting, salient • Motivational - risks, susceptibility, fear • Contextually Consistent - response efficacy and self-efficacy, subjective norms, costs/benefits • Culturally Consistent - values, traditions, roles, rules, power structure • Resource-Dependent - quality, reach • Pre-test DRAFT messages using focus groups with target audience • Revise messages according to feedback
Marketing Mix • Product • Price • Placement • Promotion
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Methods
Phase One: SVPPC Working Group
Phase 1 of the HCCF involved convening a working group that was concerned about or had an interest in the issue being ad- dressed. The SVPPC working group con- tained several people from the university and surrounding community. The group consisted of the project director, the leader of the group, who recruited relevant part- ners on campus including representatives from the university’s Student Wellness Of- fice (SWO), Women’s Resource Office, Cam- pus Safety, Residence Life, the community’s Rape Crisis Center, and students. Their first task was to write a problem statement that would guide the group to develop a campaign after which a needs assessment was conducted to inform the problem and target audience.14,18-19,25
Needs Assessment Before finalizing a targeted, accurate prob- lem statement, needs assessment research was conducted. The needs assessment gath- ered specific University and state data to better understand sexual violence locally, including who the problem affected and what behavior changes were needed.26 The working group examined University data from the Student Wellness Survey,27 campus safety data, and solicited student input in several diverse classes. Results of the Stu- dent Wellness Survey,27 implemented online to the University student population, in- cluded questions about violence experienced on campus. Of the participants (n=4,264), 1.9% experienced a sexual assault on cam- pus within the past 12 months and more
than 15% were forced to have sexual contact within the past 12 months. National data discussed previously indicated the preva- lence of sexual violence in the U.S., and although higher than the local data gath- ered, both signify that sexual violence is common on college campuses.7,28-29 Further, the campus’s safety data revealed that the majority of reports from students regarding rape were acquaintance rapes. Discussions with students after sexual health presenta- tions, requested by instructors and residence life staff, indicated that alcohol contributed to the lack of consent exchanged before sex, and that alcohol was involved in almost all of the assaults reported.
The needs assessment revealed that stu- dents on campus support a date rape cul- ture, i.e., an environment that fosters rape attitudes and increase risk factors for sexual violence.30 Date rape cultures form as a result of rape myths, which are preva- lent on many campuses. The perpetuation of rape myths foster victim blaming and minimization of injuries experienced by vic- tims.31 Examples of rape myths perpetuated on college campuses include: the type of clothing people wear suggests how willing they are to have sex; when someone is raped it often is because the way they said “no” was unclear; if a woman engages in kiss- ing or lets things get out of hand, she wants to have sex; and someone who is sexually assaulted while drunk is somewhat re- sponsible.32 Some of these rape myths were assessed in Indiana’s College Relationship
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Survey (n=7,530),11 which found that 42.4% of participants agreed or strongly agreed that someone who is sexually assaulted while drunk is somewhat responsible and 28.7% agreed or strongly agreed that the type of clothing people wear suggests how willing they are to have sex. This assess- ment supported the need to focus on rape myths, specifically the concept of consent, to prevent acquaintance rapes and assaults that occur on campus. The working group gathered, reviewed, and analyzed enough relevant information to formulate the fol- lowing problem statement:
A majority of students on campus do not ask for consent before engaging in sexual activity. They do not ask for consent because they are either embarrassed to ask, or do not know what consent is and is not. The lack of obtaining consent is contributing to a portion of acquaintance sexual assaults on campus. In response, it is necessary that students on campus become more familiar with what con- sent is, and become more comfortable obtaining and communicating verbal, sober consent before proceeding to sex.
Focusing on consent among the target audi- ence has also been a method used among speakers and other campaigns to prevent sexual violence, such as The Date Safe Project33 and The Consensual Project.34 In addition, sexual activity among late ado- lescents without clear consent is an aspect of violence that needs to be addressed on campuses.35 Often sexual activity is never
clearly given or verbally stated and instead, implied.35-36 Therefore, the working group’s problem statement aligned with current practices to prevent sexual violence by focusing on strengthening the communica- tion between two people before engaging in sexual activity.
Strategic Planning Based on the problem statement, the work- ing group created a strategic plan to guide their activities. After consulting University data and talking with students after the presentations referenced above, the working group realized that the SVPPC needed to target the entire undergraduate population on campus. Representatives of the student population, i.e., first-year students through fifth-year students, student-athletes, fra- ternity and sorority members, and health- related majors, provided consistent feedback and stories about their friends’ experiences regarding sexual violence on campus, fur- ther confirming the need to target everyone.
Strategic planning was enhanced by us- ing CDCynergy,37 an online tool that in- cludes a step-by-step process of creating social marketing campaigns starting with a detailed timeline. The timeline for the SVPPC spread across a calendar year, with deadlines corresponding to each phase of the HCCF. First, the project director, who was awarded the grant, participated in a social marketing and focus group train- ing provided by a RPE grant coordinator. The training allowed the project director to develop a timeline, with deadlines sensitive to the academic calendar. After the fall 2009 training, the remainder of the semester was
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spent conducting the formative research and needs assessment previously discussed. Dur- ing the spring 2010 semester, the working group drafted messages, tested those mes- sages in focus groups, revised the messages, and tested them again. During the summer, the messages were finalized, the visual im- ages desired by students were purchased, and proofs were requested from the printing company. Because students are most suscep- tible to sexual assaults in the first six weeks of the academic year,38-40 it was imperative to have the campaign implemented when students arrived on campus in August 2010. Finally, initial evaluations of the campaign were conducted at the end of both the fall 2010 and spring 2011 semesters.
A precise budget for campaign activities was developed by using the marketing mix, i.e., product, price, placement, and promo- tion.20 Although the promotional aspect of the marketing mix expanded during campaign implementation, other aspects of the marketing mix were determined early during strategic planning. For example, the working group decided what products and mediums would be used to disseminate the campaign message, within the $2,000 budget provided. Additional aspects of the marketing mix are discussed during the implementation section.
Phase Two: Drafting and Testing Messages
The messaging process within Phase 2 of the HCCF consisted of three stages. First, the working group drafted messages based on the needs assessment and the message effectiveness elements. Second, the drafted messages were tested in focus groups with the target audience. Third, based on itera- tive feedback, messages and promotional items were revised and finalized.
Stage One In the first stage of the messaging process, the working group drafted 12 messages that not only were aligned with the problem statement, but were also in keeping with effective messaging elements in that they were stimulating, motivational, consistent with the context and environment, and
culturally appropriate.21-24 When drafting messages, the working group paid attention to the recommendations of the HCCF by making the messages stimulating in order to break through the clutter of messages students receive. Forming a message that attracted attention may motivate students to change their behavior and begin asking for consent.
In terms of the cultural consistency of the messages, the working group drafted mes- sages that might appeal to both men and women on campus. It was important not to put all of the pressure to obtain consent on one gender within the interaction. Besides being an equal responsibility, the working group did not want to depict men as being
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in a position of greater power. Instead, a goal of the campaign messages was to put men and women on a level playing field, be- ing able to respectfully communicate with each other.
Stage Two After a variety of messages were drafted based on effective messaging elements, they were tested. Two focus groups41 were con- ducted to test the written messages without images. The working group did not want to contaminate student’s initial viewpoints of the written messages by biasing them with images. However, feedback was requested from participants regarding what images might resonate with students and comple- ment the written messages.
Students were recruited to participate in one-hour focus groups via the University’s electronic flier board system, the Univer- sity television network, and by members of the working group personally recruiting students. One focus group of communica- tion majors was offered extra credit by their instructor for their participation. The other focus group was provided dinner for their participation and were student members of the campus safety department. The focus groups occurred between March 31 and April 4, 2010, with 8-15 students participat- ing in each discussion which is a typical number of participants.41 The first focus group was facilitated by the grant coordina- tor so that the project director could observe the facilitation process and lead subsequent discussions. The note taker for each focus group was a graduate assistant in SWO who
was in the SVPPC working group. Student participants were asked a series of ques- tions about each of the 12 draft messages, e.g., “Would the message stand out on cam- pus?”; “What do you like/dislike about the message?”; “Who does the message target?”; “Will the message change personal behav- ior?”; and, “How can we make the message more clear?”. Since the second focus group provided similar feedback to the first focus group and was a different student demo- graphic, the working group felt confident to move forward with revising the messages.
Stage Three The third stage of the messaging process was iterative and involved taking the focus group feedback and revising draft messag- es. To illustrate this process, examples are provided in the following sections. Draft Message 1. The working group draft- ed the message, “Consent? W@? Flirting is not consent. We ALL have the right to say yes,” using text message lingo. Some mem- bers of the working group thought that uti- lizing text messaging language would appeal to students and attract attention over other messages. To their surprise, focus group participants said that the text language was difficult to understand. Specifically, they thought the “Consent? W@?” was confusing. Some working group members were sur- prised while others thought the message was confusing, but because they did not text, did not comment on the initial draft. However, participants communicated that the last part of the message was powerful and should be used without the first part of the message.
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Draft Message 2. Because the needs assess- ment found that students often are embar- rassed to ask for consent, the working group thought that infusing the messages with hu- mor may help ease the tension in situations where consent is necessary. So, a series of messages were drafted which played off the concept of Global Positioning Systems (GPS). One draft message was, “There’s no GPS for sex. Ask for consent every step of the way.” This message was perceived as too silly. Participants commented that it would become a joke on campus. Others expressed that the message had a connota- tion of getting lost, which is not an enjoy- able experience. Participants expressed dislike for linking sex with getting or need- ing directions. Although some participants thought the message could be modified to resonate better with students, the risk of consent being laughed at instead of taken seriously prompted the working group to table these messages. Because these drafts required extensive modifications, they could not be utilized during this grant period and campaign. However, the working group liked this series of messages and based on some positive student feedback, stored these drafts for potential modification, testing, and future use.
Draft Message 3. The needs assessment revealed that students often interpret other signs or nonverbal cues, such as flirting, as consent. With this in mind, several drafts targeted these behaviors as not being consent. Many draft messages con- tained phrases such as, “Flirting is not consent,” and “Not sure if he/she’s into it? Ask!” Participants unanimously liked the
message “Flirting is not consent” stating it was strong, simple, direct, accurate, and a powerful statement. They also appreciated that this shorter message could be read as they frequented campus buildings. Working group members also appreciated the suc- cinctness of this message.
Draft Message Slogan Development of the campaign slogan serves as another example of the messaging pro- cess. The draft slogan was, “Everybody, Every time, Everywhere” indicating the im- portance of always asking for consent, even if consent was previously gained. Partici- pants liked the concept of this message but felt that it lacked a call to action and was too long. After revisions and feedback from the second focus group, the final campaign slogan informed by students became “Ask everyone, every time.” This message was shorter and had a blatant call to action that students could remember.
Unanticipated Message Barriers The working group encountered construc- tive feedback that had to be addressed. For example, an unanticipated barrier to developing and testing these messages was that several of the original drafts were interpreted as promoting sex, as well as promoting consent. The working group did not initially notice this contradiction until alerted by focus group participants. When testing phrases such as, “It may not be easy but it’s worth it! Get consent.” and “Nothing gets things started like getting consent,” participants stated that these messages im- plied people would eventually say yes to sex. After noticing this aspect, messages that
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were interpreted this way were not used in the final message testing since others tested much better and were not perceived as promoting sex. The working group was cognizant of this issue during the remain- der of the messaging process.
Images After the text was finalized, images were needed. The first two focus groups recom- mended that two people, i.e., a couple, were needed to clearly depict the consent mes- sage. Participants insisted that the concept of consent becomes confusing when alcohol is involved in the scenario, so a bar-like setting with alcohol needed to be present in at least one image. Because the needs as- sessment also showed that alcohol impairs the ability to obtain and provide consent, the working group agreed. However, par- ticipants also said that images of couples talking and playfully flirting would assist in depicting the message. Images without alcohol also were necessary because half of the target population is under age 21 and not legally allowed to drink alcohol.
Based on this feedback, images were found on istockphoto.com and tested with a new focus group of eight participants recruited and facilitated through the same methods described previously. These participants provided feedback, including: the couples
appeared to be too old or too young; it was not evident if they were flirting; they ap- peared to be too far into the physical in- teraction and consent already should have been obtained; the image complemented the message and reflected the students on campus.
Final Message Towards the end of the third stage of the messaging process, participants approved several messages and images. However, the working group decided to implement one, consistent message. One call to action was deemed appropriate to change this specific behavior and also tied the campaign togeth- er. The SVPPC message became, “Flirting is not consent. Ask everyone, every time.” To resonate with the entire target audience, students recommended depicting a variety of couples to represent the main demo- graphic groups on campus. The three rep- resentative istockphoto images chosen for the campaign, coupled with the same mes- sage included a Caucasian couple flirting at a bar (Figure 2), an African American couple flirting (Figure 3), and a homosexual couple flirting (Figure 4). Drafting, test- ing, revising, and finalizing messages was a time-consuming process but the iterative feedback from students assisted in creat- ing campaign messages specifically for the target audience.
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Figure 2. Flirting is Not Consent Message with Bar Couple
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Figure 3. Flirting is Not Consent Message with African American Couple
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Figure 4. Flirting is Not Consent Message with Homosexual Couple
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Campaign Implementation
After the messages were completed, the working group consulted the budget and decided how they could implement the campaign. Before classes began in August 2010, 750 campaign posters were ordered from printing services for $436.00 and dis- seminated to every residence hall, sorority, fraternity, campus building, athletic locker rooms, community apartments, and city bars. The distribution of these posters was carefully considered. Consistent with the concept of audience segmentation empha- sized in the HCCF18-19 and CDCynergy,37 the working group targeted which campaign posters would be delivered to each building. For example, the African American frater- nity only received the poster with the Afri- can American couple and the homosexual fraternity only received the poster with the homosexual couple. The bars surrounding campus received posters of the couple at a bar. Working group members placed posters in their respective buildings and monitored their exposure. To the group’s knowledge, no posters were vandalized. However, one 11x17 poster was stolen from a board in the health center and replaced. All of the uni- versity’s electronic advertising systems were used to disseminate the posters, including exposure before movies for three months at the University’s Union for $60.
The messages also were advertised during October 2010 within the city’s public trans- portation bus system. Three tail signs were purchased for the back of busses that navi-
gated the campus and surrounding commu- nity for $705. Also, 120 interior bus signs were displayed in all 60 busses of the public transportation company for $773. Univer- sity students use these busses frequently as they travel throughout the campus and to and from their apartments and houses. The final cost to print and disseminate the mes- sages totaled $1,974.00.
The working group determined it was es- sential not only to post messages around campus, but to also be available to discuss the campaign face-to-face with students. The project director stayed alert for events occurring around campus during which distributing campaign posters would be ap- propriate and attended these events. Collab- oration increased the campaign’s exposure and the direct communication with students provided outlets to discuss the campaign’s message and answer questions. Venues where the campaign message was present included Take Back the Night, National Preparedness Safety Day, Pan-Hellenic Council meetings, Campus/Community Bar Retail Coalition Meetings, and YWCA com- munity events. Through all these methods of implementation and message distribution, the scope of the campaign continued to have considerable breadth and depth. The cam- paign continued for the remainder of the academic year knowing that a target audi- ence member must recognize a message up to three times before they keep it in mind.42
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Initial Evaluation
Campaign evaluations typically measure the effectiveness of the campaign and provide feedback for making mid-course corrections to the campaign.18-19,26 This case study highlights two initial campaign evaluations; a survey that was conducted 12 weeks after the SVPPC was implemented in December 2010 and then again in April 2011. The purpose of these surveys was to fulfill requirements of the granting agency, which included a report discussing satura- tion and any potential behavior change 12 weeks after implementation and again dur- ing the spring semester. The project direc- tor used one student worker and one student volunteer from SWO to survey their peers. The working group avoided conducting the evaluations in order to prevent social desir- ability bias among the respondents.
The volunteers randomly surveyed students they did not know who were walking alone on campus in various locations, e.g., resi- dence halls, academic buildings, fraternity/ sorority houses, athletic locker rooms, and agreed to be surveyed. Although not sys- tematic, this approach of surveying students who were alone was selected to avoid any potential social desirability biases associ- ated with asking questions among a group of friends and to minimize any pressures or time constraints while answering questions. Students were surveyed on four separate occasions during each one-month evaluation period.
In December 2010, 117 students were randomly intercepted and if available, answered questions while the volunteers checked off their peer’s responses on an Ex-
cel tracking sheet. The number of students originally approached was not recorded. However, the surveyors did not experience resistance from students to participate in the survey. Each participant was shown the series of messages and asked if they saw the messages. If the participants had not seen the messages prior to the survey, they were done with the survey. If participants had seen the message, the following questions were asked: “Where did you see the mes- sage?”, “Did you read the message when you saw it?”, “What is the message about?”, and “Will this message contribute to behavior change of students on campus?” Each par- ticipant’s year in school and gender were also requested, which demonstrated a wide range of students, i.e., 45% males, 55% fe- males, 24% first-year, 23% sophomore, 32% junior, and 21% senior. Students reported seeing the messages in a variety of places including the student health center, movie ads, residence halls, fraternity houses, the bus, campus events, and staff offices. The diversity of outlets for this message was successful in reaching students, illustrating the importance of planning the marketing mix.
Of the 117 students surveyed, 76% (n=89) both saw and read the campaign message, indicating a broad reach. Further, 81% (n=72) of those 89 students who saw and read the message answered “yes” to the question, “Do you think this campaign will contribute to behavior change on campus?” Although the measure of behavior change only is a prediction among students, the campaign message was viewed as accurate in addressing a campus health issue and
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persuasive enough to alter students’ behav- ior. Although 117 is not a large sample (un- der 1% of the total student population), this initial evaluation encouraged the continua- tion of the campaign.
Short, qualitative responses to the evalua- tion question “Briefly, what is the message about?” indicated comprehension of the campaign message. Students’ responses con- sisted of a few words and therefore, could easily be coded into themes by the project director and grant director and then quan- tified. Thirty-four percent (n=40) stated the message is about asking for sex; 14% (n=16) stated it is about being aware and protecting yourself; 14% (n=16) stated don’t interpret flirting as “yes”; 8% (n=9) stated it is about communicating consent; 4% (n=5) stated it is about safer sex; and 3% (n=3) said it is about being careful when drinking alcohol.
In April 2011, the same student volunteers assessed the comprehension of the message again through the exact intercept meth- ods described above. Of the participants (n=113), 28% were males, 72% females, 16% first-year, 13% sophomore, 41% junior, 27% senior, and 3% were graduate status. Of the 113 students, 48% (n=54) both saw and read the campaign message. Further, 27% (n=16) of those 54 students who saw and read the message answered “yes” to the question, “Did this message change your behavior?” This question was an assessment of behav- ior change whereas the initial evaluation in December inquired if the students thought the message would change behavior. The lower number of students who saw the mes-
sage was not surprising, since the budget for the campaign allowed for three months of advertising, which ended in December 2010. During the spring 2011 semester, only the posters were displayed in print and elec- tronically as described previously.
Of the 113 participants, 91 (80%) answered the question, “Briefly, what is this mes- sage about?” These short responses were again coded. Forty percent (n=36) stated the message was about rape or rape awareness; 31% (n=28) stated don’t interpret flirting as “yes”; 18% (n=16) stated it is about commu- nicating consent; 7% (n=6) stated it is about alcohol and sex; 2% (n=2) said it is about sex at parties; 1% (n=1) said safer sex; one said it is about respecting boundaries, and one said sexual harassment.
These qualitative responses during both evaluations indicated a general understand- ing of the campaign message, providing additional support for the HCCF strategy of thoroughly testing messages for clarity before implementation. The campaign will be re-implemented through new media out- lets in Fall 2011, and in Spring 2012, will undergo an impact evaluation.
In addition to the initial evaluations con- ducted, a relevant event occurred on cam- pus that merits mention. At the beginning of the semester during which the SVPPC was implemented, a sex position of the week cartoon was printed in the campus newspa- per titled The Prestige. The cartoon showed a couple having sex doggy-style, when the man sneaks out and, without the woman’s knowledge, is replaced by another man.
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This cartoon promoted non-consensual sex which, by definition, is rape. Many students expressed being appalled to see this car- toon in the newspaper. The editor stated in an apology the following week that she received and responded to multiple angry e-mails and phone calls regarding the car- toon.43 In addition, students sent editorials in response to the cartoon, of which over a dozen were published. For example, one student wrote the following: “…This comic essentially portrays sexual assault; engag- ing in intercourse with someone who is for
whatever reason not able to consent (intoxi- cated, or in this situation, not able to see) is sexual assault...”.44 Another student wrote, “This week’s sex position is in all actuality, sexual assault. If two people are having sex and one of those people switches out with someone else, without the other’s consent, that is rape…”.44 All editorials had a simi- lar theme. Although we cannot be certain, it is possible that the campaign message about consent cued students to act on and com- plain about the printing of the cartoon.
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Lessons Learned for Campaign Practice
After progressing through the HCCF to de- velop, implement, and initially evaluate the SVPPC, there are three recommendations for campus health practitioners and working groups to consider during their own cam- paign processes. The first recommendation is to apply the HCCF as a systematic process to develop a health campaign in order to avoid and/or address unanticipated barriers. Ap- plying this framework may help proactively address an issue before it becomes a problem. A systematic framework, such as the HCCF, may also provide credibility when responding to administration concerns, which is ad- dressed in the next recommendation.
The second recommendation concerns the ability to effectively address a sensitive campus health issue through messaging. Addressing sexual violence can be challeng- ing. The reason for this often is two-fold. First, when using prevention messages that specifically state the words “rape” or “sexual assault” students may tune-out be- cause the message may not seem applicable to them. For example, a message that says, “Sexual assault- not understanding no” is persuading students to obtain consent, much like the SVPPC messages. However, using the term sexual assault might cause students to ignore the message, thinking that it does not apply to them, particularly if they never assaulted anyone or were sexually assaulted. Second, even if students responded to these types of messages, it is possible to experience backlash from cam- pus administration who may not perceive sexual violence to be a significant issue on campus. Although this type of feedback did not occur on this campus, the work-
ing group was prepared with current data collected during the needs assessment to demonstrate that sexual violence occurs.
In response to the challenges that can occur when attempting to design and implement a sexual violence campaign, softer language may initially be used to create messages and images that appropriately address the problem. For example, instead of referring to negative aspects of relationships, such as not committing a sexual assault, mes- sages can focus on positive aspects of rela- tionships, such as communicating about or respecting relationship boundaries. Rein- forcing these positive behaviors through messaging may help frame sexual violence as an issue that can be talked about and prevented in campus communities. Students and administration may be more receptive to messages that encourage keeping com- munication lines open, maintaining healthy relationships, and being aware of their actions. Even though the vocabulary in the messages may differ, the same behaviors are targeted as messages that use more con- troversial terms, such as rape. For working groups that are similarly trying to combat a negative health behavior that may be sensi- tive to address, thinking creatively in terms of messaging is recommended.
The final recommendation is to take advan- tage of any opportunity to promote the cam- paign whenever and wherever appropriate. For example, after the newspaper printed the cartoon described above, the project director contacted the newspaper, framing this situation as a teachable moment. The newspaper accepted the invitation to print
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a cover story about the SVPPC, discussing the connection between consent and sexual assault. Relevant incidents and events such as the one just described may occur on campus during campaign implementation.
It is the responsibility of the working group to remain vigilant and consider ways to collaborate with others to further reinforce and promote campaign messages.
Limitations We are aware that steps can be taken to improve the campaign and ensure the mes- sage is truly having an impact on behavior. First, the selection of focus group partici- pants was not random nor representative of the entire campus body; a convenience sample of students from one communica- tion course and a campus safety department participated. The importance of identify- ing ways to ensure broader representation in future formative research is recognized. Second, the survey format was not an ideal evaluation method and could have obtained biased feedback about the effectiveness of the messages. For example, although the student volunteers who conducted the initial evalua- tions were instructed to select students who were walking alone at random, it is possible that they approached students more selec- tively, for example, based upon an assess- ment of a students’ potential receptivity. It is also possible that although the intercept interviews were anonymous, and the students who participated did not know the surveyors, their responses may have been biased either by wanting to provide a socially desirable response, or potentially by the interviewers. Lastly, asking students who were exposed to a campaign message whether it will or did change behavior is not a true evaluation of the effectiveness of the campaign messages.
These are acknowledged limitations that will be improved upon in a more formal impact evaluation planned for April 2012. As cur- rently envisioned the impact evaluation will utilize an online survey and focus groups to more formally evaluate the visibility and effectiveness of the SVPPC and if necessary, engage in the correction loop of the HCCF.
Finally, future modifications of the cam- paign will include formative research about the gender differences present in sexual violence experiences, including the issue of power and control in relationships. Previous research on sexual violence shows that gen- der-related norms and power and control in relationships are influential factors in de- termining sexual violence perpetration.45-46 Power and dominance are more common in intimate partner relationships and stranger rapes.46-47 However, since in the college population acquaintance assaults are more likely to occur, mainly because of the pres- ence of alcohol7 and implied consent,35-36 this campaign focused on these aspects of prevention. In the future, attention to gen- der and power may result in an expanded campaign that additionally targets couples or students in longer term intimate partner relationships, thus, reaching out to prevent sexual violence in another campus audience.
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Conclusions
This case study serves several objectives from a pragmatic perspective, while being grounded in communication theory. The HCCF guided the working group through the necessary phases to design, implement, and initially evaluate a health communi- cation campaign by highlighting crucial steps, such as needs assessment and mes-
sage testing. As this case study illustrates, even those who are social marketing novices can come together and learn how to prog- ress through a theoretical model to help ensure a targeted and effective campaign that addresses a pervasive health issue for students.
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Acknowledgements
This social marketing campaign was funded by the Indiana Cam- pus Sexual Assault Primary Prevention Project and the Indiana State Department of Health through a CDC cooperative agreement. The authors wish to thank Dr. Nancy Maylath, the Director for the Indiana Campus Sexual Assault Primary Prevention Project, for her assistance in this campaign.
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Author Information
Emily Haas is a PhD candidate studying health communication at Purdue University and a coordinator for the Indiana Campus Sexual Assault Primary Prevention Project. Emily contributed to the conceptual design of the social marketing campaign, as well as guided and provided technical assistance during each phase of the HCCF, particularly the analysis of data collected, and manuscript writing.
Marifran Mattson is a professor of communication at Purdue Uni- versity. Marifran contributed to the conceptual design of the social marketing campaign, offering expertise in how the HCCF can guide the creation of a social marketing campaign, and manuscript writ- ing.
Kathlyn Wilkinson is the Sexual Health Educator at Purdue Uni- versity and the project director for the Sexual Violence Primary Prevention Campaign. Kathlyn progressed through and guided the campaign working group through the HCCF, which included gath- ering local data, drafting, testing, and finalizing messages, and eventually implementing the campaign on campus. She served as the campaign practitioner and was the point of contact if anyone had questions about the campaign.