Table 3 Social marketing approach to effecting behavior change in Veterans Health Administration market segments.

Knowledge: "I know I should"

Provide target audience with knowledge about the desired course of action:

• Manager: Support the new depression care program;

• Manager; "I know I should support this program."

• Provider: "I know I should refer my depressed patients to this program."

• Veteran: Seek treatment for depression.

• Veteran: "I know I should get treated if I'm depressed."

Desire: "I want to"

Create desire by presenting image of benefits of new behavior:

• Manager: Better patient outcomes and potential for additional funding;

• Manager: "I want to enhance my facility's reputation and obtain additional funding."

• Provider: "I want my patients to have improved mood."

• Veteran: What life could look like after depression is treated.

• Veteran: "I want to enjoy my life more fully."

Skills and resources: "I can"

Provide skill set, tools, and resources to enable implementation of desired course of action:

• Manager: Resources to implement the depression care program;

• Manager; "I know how to implement this program."

• Provider: "I know how to refer my patients to this program."

• Veteran: Facilitated access to the program.

• Veteran: "I know how to get treatment if I'm depressed."

Optimism:"It's worthwhile"

Demonstrate real or potential outcomes related to desired course of action:

• Manager: Depression care program improves outcomes for a reasonable cost;

• Manager: "The program's quality or financial benefits are worth the cost."

• Provider: "My depressed patients are getting better."

• Veteran: Quality of life improves.

• Veteran: "I feel better."

Facilitation: "It's easy"

Demonstrate the desired behavior is feasible

• All segments: Enhance self-efficacy for implementing, utilizing, or accessing the program (e.g. through social modeling); and testimonials from similar others about their positive experiences.

• All segments: "I am like you, and this depression care program works for me. It can work for you."

Stimulation: "I'm joining in"

Use stimuli to create action, i.e., adopt new behavior:

• Manager: Primary care clinics are beginning to refer patients to the program;

• Manager: "We're seeing benefits from this program."

• Provider: "I'm learning how to utilize the program."

• Veteran: Small steps toward improved mood.

• Veteran: "I haven't felt really down in a week."

Reinforcement:

Show that positive outcome will help individuals form new personal habits

• All segments: Personal mastery experiences accumulate; and feedback from managers, providers, and veterans regarding their progress.

• Manager: "We're making the depression care program work."

• Provider: "I routinely refer my depressed patients to this program."

• • Veteran: "I'm not letting depression control my life."