Since March of 2020, the COVID pandemic has drastically shifted lifestyles around the globe. In the early days, the astonishing health effects, the death toll, the lack of treatment created uncertainty that disrupted supply chains, shut down industries and disconnected us from our colleagues, friends and family. Even before vaccines were created, public health practitioners knew that driving vaccine acceptance would be critical to ‘returning to normal’ or moving on to whatever we define as the new normal. CARE, in partnership with Meta, set out to test social media platforms, principally Facebook and Instagram, as scalable tools for social and behavioral change communications (SBCC). SBCC, in the context of public health, is the strategic use of communication to promote positive health outcomes, such as changing personal habits and attitudes, based on proven theories and models of behavior change. Increasingly, SBCC is being used for disease prevention, especially in low- and middle-income countries. Often this communication is 1:1 or 1:few and can be quite costly. CARE and Meta wondered if behavior change models could be executed at scale via social media. Specifically, could we drive positive change in individual attitudes towards COVID vaccines using behavioral change messaging on Facebook and Instagram? That is what we set out to do.
From February – December 2021, CARE ran social and behavioral change communications campaigns to reduce vaccine hesitancy in 20 countries. (Bangladesh; Benin/Togo; Burundi; Cambodia; Czech Republic; Ghana; Guatemala; Haiti; India; Iraq; Mali; Nigeria; Pakistan; Palestine/West Bank/ Gaza; Philippines; Sierra Leone; Somalia; Turkey; United States; and Yemen). Campaign plans for each country were locally developed. Each country office researched vaccine hesitancy in the local context, identified hesitant audience demographics, researched what prevented that population from vaccine adoption and what might motivate a shift in their attitude, knowledge and/or behavior towards the vaccine. Messaging, design and ad development was unique for each campaign in each country, responding very specifically to the needs of the target audiences identified. Each of the more than 45 campaigns CARE launched ran for 3 weeks and were followed by a brand lift study. Using Facebook’s brand lift tool, CARE surveyed exposed and unexposed audiences to measure success.
Collectively, CARE’s SBCC Campaigns reached more than 250 million people in 20 countries and, compared to the control group, people who saw the campaigns were 4 percentage points more likely to express positive knowledge, attitudes and behaviors about COVID vaccines, representing a change in almost 10M individuals. Audiences with high hesitancy shifted in the following ways: 2.4M believed getting vaccinated was important; 2.3M believed the vaccines were safe; and 1.7M indicated they were more likely to wear a mask. Overall, 9.4M people who saw our campaign ads reported positive knowledge, attitudes and behaviors related to the vaccines compared to the control group. The best practices and lessons learned from these campaigns will be published in a journal article in the spring/summer of 2022 and have inspired CARE, in continued partnership with Meta to continue to explore social media as a scaling tool for social and behavioral change communications for public health outcomes.