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NINDS: Stroke Proceedings: Levy

Proceedings of a National Symposium on Rapid Identification and Treatment of Acute Stroke
December 12-13, 1996

How Do We Get From Here to There?
The Message, the Audience, and the Medium

Norman A. Levy, M.S. 
Procter & Gamble, Cincinnati, Ohio

Advertising plays a strong role in the marketing of many products--coffee, cosmetics, peanut butter, toothpaste. It creates and maintains awareness of these products and continually communicates and reinforces an understanding of the benefits the manufacturers promise and deliver. Familiar statements about these products are focused, memorable, and capable of visualization in the medium of television:

Pampers--For drier, happier babies

Choosy moms choose Jif

If it's gotta be clean it's gotta be Tide

Pantene--For hair so healthy it shines

Bounty--The quicker picker upper

The success of product campaigns is by no means assured by vast expenditures of money. The world of communications is littered with advertising campaigns that do not work (in the sense of creating behavior change) despite flashy and expensive execution. While it is natural to think about advertising in terms of execution--the film effects, the personalities, the drama, the music--it is the quality of strategic thinking preceding the executional work that plays the fundamental role in the ultimate success of an advertising campaign. For example, the underlying factor in the success of the Folgers coffee campaign was the importance that the phrase "the first cup of coffee in the morning" had for coffee drinkers. That piece of consumer understanding and insight preceded(and guided) creative work that eventually produced the highly memorable campaign "the best part of wakin' up is Folgers in your cup."

Many people are surprised to learn about the scope and quality of consumer research and analysis that forms the basis for creative advertising efforts. Summarized simply:

Strategy Precedes Execution

The following example demonstrates the "translation" process from strategy to execution. Let us assume for a moment that after reviewing the research on acute stroke and applying our best judgment, we agree that the following represents the most focused expression of the message content we want to communicate:

Upon first experiencing stroke symptoms (or observing them in others), I can save life or serious disability by getting to a hospital for treatment very quickly.

This is the "business-speak" of strategy. We are not attempting to be creative but rather to focus on message content. Translating business-speak into the language of advertising might produce a mantra such as:

When stroke strikes don't delay -- Call 911 right away

This is a slogan or summary line. Note that it is unlikely that such a summary line could carry all the information required. For example, calling out specific stroke symptoms would be a necessary part of the total message in a 30-second commercial but would not fit into a summary message.


The point is that the better the strategic thinking, the more likely it is that the advertising messages created for television, print, radio, or the World Wide Web will gain awareness and promote behavioral change. This basic strategic work involves conducting and analyzing research on target consumers to help us understand present attitudes, habits and practices, satisfactions and dissatisfactions, expectations, the hierarchy of benefits desired (both tangible and emotional), and any other relevant information that will give us true insights into the way people think and act with respect to the product or service offered.

This kind of strategic information is finally expressed in summary form in a document generally referred to as a "creative brief." These are the kinds of headings used in such a document (which varies from organization to organization but revolves around essentially the same subject matter):

Creative Brief

• Target audience

• Desired action

• Current consumer beliefs, understanding, and barriers

• Copy strategy

--Major benefit

--Reason to believe

--Brand character

With the acquisition of this information it is possible to move confidently into the executional phase where writers, producers, film makers, and art directors translate the business-speak of the creative brief into actual advertising--the television commercial or print ad. Ideally, additional research is conducted during the creative development phase to assure that our executions are understood by and motivating to the target audience.

I have been very impressed with the empirical information gathered to date on issues such as public perception of stroke warning signs, the reasons for delay in seeking treatment, and reports of public and professional educational programs aimed at populations at risk for stroke and myocardial infarction. This says to me that we have a head start on the information required to write a useful creative brief. It is very important that our new initiative respects and learns from the experiences of previous communications efforts with regard to both stroke and myocardial infarction. We must build on the pioneering work of others.

Tempering this optimism is the need for patience in any effort attempting to effect behavioral change in large population groups. Changes that can be measured are often the result of consistent efforts over many years; good examples include the positive results of massive campaigns aimed at modifying nutritional habits, sexual practices, and substance abuse.

To move ahead on a deliberate basis, these are the steps that are required:

· Appointment of a core client group. This should be a relatively small number of individuals, representing the appropriate mix of involved organizations. This group is invested with the power to make decisions on behalf of the coalition.

· The appointment of a volunteer advertising agency charged with working with the core client group on the creative brief and the subsequent creation of actual executions for the appropriate media. Either as part of the advertising agency commitment or as a separate effort it is important that this initiative have professional public relations input. In the early stages of the emergency stroke treatment campaign it is likely that this kind of information will be welcomed by journalists and radio and TV commentators.

Another critical function of the core client group and the advertising agency is coordination with other constituencies and organizations that will participate in the total emergency stroke treatment initiative. Maximum impact will result from an integrated effort--a total marketing and educational program that creates synergy and an awareness of the message and the product. One of the key objectives of this monograph is to create the resolve, the infrastructure, and the vision to allow this integration to happen.



Even if the strategy and executional work we produce is of the highest quality it will have no effect unless we can deliver the messages consistently and at high enough levels to our intended audiences. The hard fact is that it is never easy for nonprofit initiatives to secure a ready source of funds for advertising and promotion. For many national public service efforts, organizations like the Advertising Council have been key facilitators in acquiring volunteer services from both advertising agencies and the media. Long-term efforts on behalf of the American Red Cross and prevention campaigns targeting child abuse, crime, forest fires, and drug abuse are ones with which we are all familiar. The Advertising Council has a long list of worthy groups seeking their cooperation, and the emergency stroke treatment campaign needs to be among these groups. However, there are other constituencies that will benefit from successful emergency stroke treatment efforts--pharmaceutical companies, private industry, managed care organizations, and governmental units all have a stake in the success of these efforts. And all of these constituencies are potential sources of funding and resources. All must be approached to create recognition of their enlightened self-interest for supporting the emergency stroke treatment campaign.

Beyond the use of the media there is clearly a continuing role for innovative patient education materials. It is realistic to hypothesize that long after the initial surge of media support for even the best emergency stroke treatment advertising we will need to rely on innovative educational materials directed at the at-risk population, caregivers, and family members. These materials require the same application of focused thinking and creative and innovative execution. For many at-risk people the ready availability of stroke-related information in the home, in the wallet or pocketbook, or on the refrigerator door may be the key to promoting appropriate action and saving lives.

In summary, what I have attempted to describe is the basic process by which advertising and promotion campaigns are developed on behalf of both commercial and public service efforts. Given the potential of the emergency stroke treatment campaign to save lives and improve the quality of life, I'm confident that talented professionals can be recruited, enthusiasm maintained, and resources enlisted to achieve our goals.


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National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

Last Modified May 17, 2011