Using Social Norm Marketing Tactics for Effective Health Communications

Date: 2018-10-11

In a world filled with misinformation, it’s tempting to design health campaigns that correct false beliefs. Many educational campaigns attempt to do so by first stating and then debunking the common myth. For example, a typical ad campaign might say:

“The flu vaccine causes the flu. FALSE! Thousands of studies have proven that you cannot get the flu from the flu vaccine.”

Unfortunately, research shows that these myth-correcting strategies don’t actually work. In today’s blog post, we’ll explain why you should avoid myth-busting in your health campaigns and use a social norms approach instead.

Myth-busting is not effective and can backfire.

Numerous studies have shown that debunking common myths can actually backfire. For example, after being told that the flu vaccine cannot cause the flu, people who were highly concerned about vaccine side effects actually became less likely to vaccinate.[1] When individuals are exposed to information that disconfirms strongly-held beliefs, particularly beliefs tied to their identities, they are motivated to cling to their original beliefs due to consistency bias. As a result, they dismiss the new information as irrelevant, thereby further reinforcing their existing belief.

In another study to test myth-busting effectiveness, participants were presented with four true statements paired with supporting evidence, along with four false statements paired with a correction and supporting evidence.[2] When surveyed a few days later, participants tended to incorrectly remember one of the four false statements as true. The more false statements someone misremembered as true, the more their attitudes shifted to align with the false statements. “Myth-busting” thus not only damaged recall, but also shifted initially neutral attitudes towards false beliefs!

Try social norms instead!

If you’ve stayed in a hotel recently, you may have noticed a card in your room asking you to reuse your towels. Perhaps they tried bribing you with a credit at the coffee shop or guilting you about the environmental impact. We’re susceptible to both caffeine and guilt trips, but there’s an even more effective route: telling people about the behaviors of others. As social creatures, we want to fit in, and one of the best ways to fit in is to do what everyone else is doing. (Sorry, Mom, if everyone is doing it, over the cliff it is!) People rely on group norms to guide their behavior; changing perceptions of norms can nudge people toward new, desirable behaviors.

Researchers[3] partnered with a hotel to test whether changing the message on the towel card could increase towel reuse. Rooms were randomly assigned to receive a neutral message, simply asking people to reuse their towels to help the environment, or they were asked to join their fellow guests in reusing towels to save the environment. The standard message resulted in about one-third of guests reusing towels, while the message establishing a group norm resulted in about half of guests reusing their towels. Follow-up work in this domain has found smaller but reliable effects,[4] and an energy efficiency company, Opower, has applied this finding to increase conservation among their users.[5]

Social norms can also be deployed in a health context. For example, colleges are a hotbed of health social norms campaigns, trying to give students accurate information about the way their peers study, eat, drink and exercise. In our research partnership with Envolve and Centene Corporation, we tested the concept of social norms and their impact on our members as it pertains to flu vaccination-seeking behavior. The new flu vaccination campaigns found that a social norms framing increased the percentage of Centene members who said that they were likely to get a flu shot after viewing the campaign (46 percent) when compared to the percentage who viewed a myth-busting frame (41percent). Based on this research, Centene is implementing its flu vaccine campaign for health plan members in the 2018-2019 flu season using social norms.

Social norm campaigns seem to be most effective when the message is:

  • Relevant: College students want to know the drinking norms of their peers, not their parents!
  • Relatively specific: “Hotel guests in this room” may be stronger than “hotel guests” at large.
  • Doable: Don’t ask people to give up electricity altogether!

With these guidelines in mind, you can build stronger, more effective campaigns no matter the target behavior.


About the Authors

Lindsay Juarez is a senior behavioral scientist in the Center for Advanced Hindsight at Duke University. She has a Ph.D. in social psychology and specializes in goal pursuit and self-control. She works with the Envolve Center’s Behavioral Economics (BE) team, which incorporates BE and social science into health-related behavioral modification programs.

Rachel Kahn is a behavioral researcher on the Better Living and Health Group at the Center for Advanced Hindsight at Duke University. She has a BS in biomedical engineering and a strong background in social psychology. She works with the Envolve Center’s Behavioral Economics (BE) team, which incorporates BE and social science into health-related behavioral modification programs.


About the Envolve Center for Health Behavior Change™

The Envolve Center for Health Behavior Change™ is a partnership between the Brown School at Washington University in St. Louis, The Center for Advanced Hindsight at Duke University and Centene Corporation. The Envolve Center advances life-centric health research to improve lives so that communities can thrive.



[1] Nyhan, B., Reifler, J., & Ubel, P. A. (2013). The hazards of correcting myths about health care reform. Medical care, 51(2), 127-132.

[2] Peter, C., & Koch, T. (2016). When Debunking Scientific Myths Fails (and When It Does Not) The Backfire Effect in the Context of Journalistic Coverage and Immediate Judgments as Prevention Strategy. Science Communication, 38(1), 3-25.

[3] Goldstein, N. J., Cialdini, R. B., & Griskevicius, V. (2008). A room with a viewpoint: Using social norms to motivate environmental conservation in hotels. Journal of Consumer Research, 35(3), 472-482.

[4] Scheibehenne, B., Jamil, T., & Wagenmakers, E. J. (2016). Bayesian evidence synthesis can reconcile seemingly inconsistent results: The case of hotel towel reuse. Psychological Science, 27(7), 1043-1046.

[5] Allcott, H., & Rogers, T. (2014). The short-run and long-run effects of behavioral interventions: Experimental evidence from energy conservation. American Economic Review, 104(10), 3003-37.