Abstract / Summary
Abstract Background Promotional activities, such as social marketing approaches, are important for raising cancer awareness and increasing breast cancer screening participation. Such interventions are designed to facilitate change and maintain positive health behaviors at both the community and society level. With the growing use of these promotional activities in public health, it is pertinent to map available studies to inform future evaluations and the development of effective interventions. Objective This study aimed to review existing studies on how social marketing interventions have been used to promote breast cancer screening and early diagnosis. The specific objectives were to assess the characteristics of social marketing interventions aimed at promoting breast cancer screening, identify the methodological approaches used in evaluating the interventions, identify the outcomes used to measure the impact of social marketing interventions for breast cancer screening, and assess the impacts of social marketing interventions when promoting breast cancer screening. Methods A comprehensive literature search was performed in 6 electronic databases to identify qualitative and quantitative evaluations of social marketing interventions targeting breast cancer screening and early diagnosis. Titles and abstracts were reviewed independently by two reviewers, followed by data extraction and verification. The methodological quality was evaluated using the Cochrane Handbook for Systematic Reviews of Interventions. Outcomes were categorized using an adapted version of key performance indicators and metrics related to social media use in health promotion. Results Overall, 15 research articles were eligible and analyzed. The 4 types of social marketing interventions identified were health professional and educational strategies, social media or mass media campaigns, community outreach campaigns, and video-based marketing. The predominant intervention source was public health government bodies, followed by regional health services, cancer charities, and educational institutions. Most interventions were designed to influence breast cancer screening behaviors by raising awareness through advertisements, educational interventions, and fundraising activities. Most interventions reached a large audience (>500 people), but participants had mixed awareness and perceptions toward social marketing strategies, and the outcomes were shaped by demographic factors such as cultural backgrounds, age, education, marital status, and occupation. Knowledge gaps, cost concerns, and the lack of physician recommendations also constituted key barriers to screening uptake. Behavior change outcomes were sparingly assessed in most interventions, thereby contributing to limited understanding of mechanisms affecting screening uptake. Conclusions Available evidence suggests that social marketing interventions may enhance breast cancer screening and early diagnosis. However, robust evaluations of these interventions and assessment of behavior change outcomes could be performed in future research by using well-established evaluation frameworks and reporting guidelines. Developers and funders of these campaigns should also consider using an evaluation plan before conducting the actual campaign.