Drama Downunder (DDU) is one of Australia’s most successful and longest continually running sexual health campaigns. Commissioned by AFAO (Australian Federation of Aids Organisations) and produced by VAC (Victorian Aids Council), the Drama Down Under campaign has been globally recognized as an innovative and effective social marketing campaign.
The campaign launched in Victoria in Feb 2008 and was subsequently adopted by other state health organisations to become a national campaign. Throughout this post there are a selection of campaign images and advertisements. Starting from the launch of the campaign in Feb 2008, they continue up to the most recent, including the new “Spring” execution, heralding the start of the 2015 campaign to be launched in Oct 2015. All the feature the main talent of Frank Bonnici.
Critical Success Factors
I recently had the opportunity to interview Adam Hynes, Health Educator at VAC and ask him about some of the factors which have contributed to the ongoing campaign success. These cover: The campaign addressing a specific issue and need, a creative strategy based on real consumer insights, setting clear measurable objectives & regularly measuring against those, targeting different sub groups with different media/messaging, and refreshing the message & creative material to maintain cut through and impact.
His answers are detailed below.
1. What are the specific objectives of the campaign. It it as primarily a campaign about changing behaviour? Rationale for the campaign and the creative strategy?
The objectives of the DDU campaign when it was first created included:
• To improve knowledge and understanding of STIs and HIV;
• To increase testing, treatment and care of STIs and HIV; and
• To minimise the transmission and morbidity of STIs and HIV in gay and other homosexually active gay men
These objectives have expanded over time and at the latest iteration include:
• Increase awareness of STIs and HIV;
• Increase access to diagnosis, treatment and care of STIs and HIV;
• Increase the notification of sexual partners potentially exposed to STIs;
• Increase the proportion of gay men who report being tested for STIs and HIV (in line with STIGMA guidelines); and
• Minimise the transmission and morbidity of STIs and HIV in gay and other homosexually active gay men
Whilst the overall goal of the DDU campaign is to reduce the burden of disease resulting from STIs and HIV amongst the target population, we are aware of the limitations of using social marketing strategies to change individual behaviours as they are influenced by a range of factors. Education and awareness are the foremost concepts behind the main objectives (which despite being specific, are overarching broader objectives), and whilst these do relate to attitudes and beliefs, the ability of social marketing strategies to dramatically change these varies from person to person.
However, through the light hearted tone of messaging combined with the humorous nature of the campaign imagery, the DDU campaign attempts to de-stigmatise sexual health testing experiences and thus indirectly attempts to influence attitudes and beliefs, thus potentially resulting in behavioural changes.
The campaign was developed by the Victorian AIDS Council (VAC) by request from the Australian Federation of AIDS Organisations (AFAO) in 2006-2007 as a result of increasing STI rates nationally and various research reports indicating that gay and other homosexually active men were not testing as frequently as STIGMA guidelines recommended. These guidelines suggest that all men who have had any type of sex with another man in the previous year should get tested at least once, and for all men who have sex with other men who have engaged in any of the following; any unprotected anal sex; more than 10 partners in six months; participate in group sex; use recreational drug use during sex; or are HIV positive, should be tested up to four times a year.
The creative strategy, as mentioned above, was to de-stigmatise the process of having a sexual health check up by reiterating that it is easy, simple and pain free, hence the constant message of; get tested, get treated, no drama! This was done through the use of light hearted messaging and visual imagery to emphasise that the process was not as daunting as some people may think.
2. As Australia’s longest continuously running sexual health campaign how are you measuring the success of the campaign against the above objectives? and how have the results changed since the start of the campaign?
The success of the campaign whilst not measured specifically against the main objectives is judged by the recall and recognition rates of external evaluations, conducted by both the Burnet Research Institute and through independent evaluation consultants. As a range of factors influence decision making processes, it is hard to establish a causal relationship between seeing an advertisement and then direct changes in behaviour. However in the evaluations conducted on the DDU campaign behavioural change questions are asked, but these are not used as markers for continuous behavioural change or as a benchmark for campaign implementation success.
Some of the main findings from one of the first evaluations conducted in 2010 include:
• 85-87 per cent recall among the target audience
• 67-87 per cent of survey respondents able to recall at least one campaign message
• 32-34 per cent of respondents reported that the campaign prompted them to discuss HIV/STI transmission with their peers or friends
• 19-23 per cent of respondents reported that campaign prompted them to discuss HIV/STI transmission and testing with their doctor
• 55 per cent of Burnet survey respondents indicated that the campaign prompted them to be more conscious of using condoms and lube
• 26-31 per cent of respondents indicated that the campaign prompted them to visit a sexual health clinic
• 20-29 per cent of respondents reported that the campaign prompted them to visit a GP clinics
• 34-35 per cent of respondents reported that the campaign prompted them to request a STI test from their doctor
• 23-45 per cent of survey respondents indicated that they had visited the campaign website for further information
From the latest DDU evaluation, conducted in 2015, some of the main findings include:
• 58% recall this specific iteration, but overall 83% recall the campaign itself (i.e., meaning a previous iteration)
• 86% of respondents correctly identified the sexual health message of the campaign
• 21% said the advertisements very effectively communicated this message and 51% said it was effective
• 39% of respondents reported that they are more likely or somewhat more likely to consider having a sexual health check
• Over 50% of all respondents indicated that these advertisements made them feel more positive or somewhat more positive about sexual health checks
• 39% of respondents indicated thought that these advertisements were useful reminders to get regularly tested. 36% of respondents thought they were somewhat useful reminders to get regularly tested.
• 46% of respondents thought the advertisements compared a lot better or a little better to other HIV advertisements they had seen
• 20% of respondents had visited the Drama Downunder website
However it is also important to point out that some of the sample were frequent testers and as such they may not need to test more frequently than they currently are. There are several other sources of data that are used to indicate that the campaign may potentially be influencing health outcomes, such as sentinel surveillance data, which indicates that there have been increasing rates of the target audience being tested for STIs and HIV since the campaign has been implemented – but again it is hard to attribute this increase to the implementation of the campaign.
3. Your primary target audience is sexually active gay men, aged 18+?. What media are you using to reach them? Have the channels and mediums used to reach them changed since the start of the campaign? If so, how? Has the media budget changed significantly during that time?
VAC has used a range of media to reach the target population including outdoor, online and in print media. The use of these modalities to implement the campaign have not changed over time, however the continued use of each one is informed by the ongoing evaluation research on the project to indicate where the target population are encountering the campaign. Furthermore we have also used engagement activities such as GLBTI festivals, university open days and community forums to disseminate campaign collateral. The media budget for the campaign has remained relatively stable since the campaigns inception.
4. Tell me about the role of digital specifically in the campaign?. What digital channels are you using in the 2015 campaign ? Is digital being used to target a specific segment of your primary target audience or everybody? How are you measuring the success of the digital component of your campaign?
Digital marketing of the campaign is a highly effective tool to engage with the target population and allows the campaign to disseminate campaign messaging through a variety of ways. We utilise online social networking sites such as Manhunt, Grindr, Squirt and Aussiemen; online GLBTI news outlets such as Star Observer, Gay News Network and Same Same; and other sites such as Facebook, the VAC website and other social media platforms. Whilst messaging and imagery remain the same across the iteration, with slight alterations (i.e., ‘remind to get tested’ or ‘STIs don’t always show symptoms’ etc) particular social networking sites such as Squirt attract less gay community attached men, and as such provide an opportunity to engage with a segment of the target population that may not encounter the advertisements online.
The majority of recall and recognition is done through outdoor advertising which is allocated the largest proportion of the budget for campaign implementation and is determined through evaluation results indicating the need to do so. Alterations to which social networking sites we advertise on is done through a combination of Google Analytics tracking and evaluation results. Some people may see the advertisement on a particular site but may not click on it. Certain websites offer the ability to message or email members as well, which again provides an opportunity to engage with the target population, or particular segments (i.e., under 30, HIV positive etc) with specific messaging which provides a strategic advantage in engagement.
5. Objectives for the 2015 campaign and where does the campaign go from here? Are you concerned about the campaign wearing out or losing cut through over time?
The objectives of the campaign for 2015 remain the same as those outlined above, however the focus of latest iteration (the seasons) is to reinforce the importance of regular (three monthly) testing. However as mentioned previously, the degree to which individuals need to get tested is dependent upon their lived situational context (i.e., number of partners, monogamous relationship etc).
The campaign will continue to grow with a new iteration currently being planned. It is important to refresh the campaign to keep constant engagement, both with the messaging and with the visual creative imagery. By constantly refreshing the campaign imagery and slightly shifting the messaging we are not concerned that the campaign will lose cut through over time – as evidenced by the recall and recognition rates from the last evaluation being similar to those found in one of the initial evaluations.
Other Contributing Factors – Talent
The choice of talent, Frank Bonnici is also a big factor in the success of the campaign Here is a link to a radio interview with Colin Batrouney, VAC’s Director of Health Promotion, Policy and Communications by Joy94.9FM where he talks about the broad appeal of Frank to a range of different target audiences. (Warning: It’s only 7 minutes long!). The interview coincided with a recent retrospective exhibition at OKLA Gallery in Melbourne held to celebrate the campaign and help launch the 2015 campaign material.
by Konrad Markham
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