G r i f f i t h U n i v e r s i t y B u s i n e s s s c h o o l 2 0 . M a y . 2 0 1 4

“Sun Shield” social

campaign

---The insight towards to Queensland, Australian skin

cancer health issue

S 2879108 :Meixia Gao

Skin cancer problem in Australia

1 Executive Summary

When skin cells are damaged due to over-exposure to

ultra-violet (UV) radiation it is known as skin cancer

(Cancer Council Australia 2014). Sinclair and Foley

(2009) reported that Australia is ranked the highest in

the world for the incidence of skin cancer. It is two to

three times the rates in Canada, the US and the UK

(Cancer Council Australia 2014). The factors causing skin

cancer is sun exposure (UV Index) and sunbeds (HOPE,

Cancer Council NSW 2014). According to Australian

Government Department of Environment, the ozone layer

depletion in the mid-latitude over Australia continent

had resulted to more UV radiation reaching the earth.

Other environmental factors contributed to skin cancer

are geographical factors, social norms, lifestyles and

outdoor cultures of Australian. Melanoma cancer is

Australia’s forth most common disease. (HOPE, Cancer

Council NSW 2014).

2

In the past ten years, Australian government, states,

territories and social community have started a set of

campaign to enforce the social awareness for preventing

sunburn and diminishing skin cancer incidences.

The SUN SHIELD project optimize integrative social

theories to influence its target audience. Through PEST

analysis and driven behavior observation to find out

teenagers group as the key target audience. The SUN

SHIELD project aims to conduct a series of campaign in

order to achieve consistent social influence.

Table of Contents

1 Executive Summary 2

3 Health issues specification 5

3.1 Definition of the health issue: skin cancer 5

3.2 Contribute factors to the skin cancer 5

3.3 Initiative expectation 6

4 Target audience analysis 7

3

4.1 Criteria for selection 7

4.2Risk factors towards segmentation 10

4.3 Primary segmentation 10

4.4 Identify key potential target audience 12

5. Behavior drivers and Competition analysis 13

5.1 Attitudes and motivation of the target audience 13

5.2 The competitors 14

6 Environmental analyses 15

6.1 PEST analysis 15

6.2 What environmental factors need to be changed 16

7 The implication of theories and models 16

7.1 The Elaboration Likelihood Model 17

7.2 Health Belief Theory 17

8 Project objectives and recommendations 18

Reference 20

Appendix 22

Figure

Graph1 Melanoma incidence rate in Australia

6

4

Graph2: skin cancer of females in Queensland during

2007-2011 8

Graph 3: skin cancer of males in Queensland during 2007-

2011 9

TABLE 1: Primary Segmentation

10

TABLE2: PEST Analysis

15

5

3 Health issues specification

3.1 Definition of the health issue: skin cancer

Australian Government Department of Health indicated

three key statistics of skin cancer problem in Australia.

Australia has the highest skin cancer incidence

proportion in the world.

The risk of getting skin cancer is higher than the

other forms of cancer by four times in Australia.

Before 70 years old, about 65% Australians will be

diagnosed with skin cancer.

According to the calculation of the UV radiation from

1959 to 2009, the deviation levels demonstrated that

clear-sky UV is on the rise over the 50 years period in

Australia. ( Sinclair & Foley,2009 ) Skin cancer is a

life-threatening metastatic disease triggered by the

sunburn under high UV level. Cancer Council of NSW

categorized skin cancer into three main types: Basal

cell carcinoma (BCC), Squamous cell carcinoma (SCC) and

Melanoma.

6

The state of Queensland has the highest recorded melanoma

incidence. The researcher estimated that around 6% men

and 4% women under the life risk of getting skin cancer.

( Aitken, Janda, Lowe, Elwoo. el, 2004) In 2008,

Australian Institute of Health and Welfare forecasted

that approximately 450,000 people get skin cancer every

year. (Sinclair & Foley, 2009 )

3.2 Contribute factors to the skin cancer Geographic: Australia recorded with the highest UV

level over the world caused by the stratospheric

ozone level decrease. In Queensland, only stand

under cloud-free daytime for 11 minutes, the UV

level is strong enough to cause sunburn.

Gender: In Australia, the skin cancer rates rank in

the first among the males aged from 0-49. Due to

the outdoor workers, especially the male workers,

long time exposure under the peak hours of highest

UV radiation.

Age: The children, teenager and adult aged from 20-

49 is in the highest risk in getting skin cancer

reported from Queensland Cancer Statistics.

Demographic: In Australia, almost 14% of adults, 24%of teenagers and 8% of children get sunburn in the

weekend of summer. (Cancer Council Australia)

7

Race: The race with fair skin color and light eye

color is more likely to absorbing UV radiation and

getting sunburn.

Gene: The minority of skin cancer incidence Is

caused by genetic mutation.

Lifestyle: Australian outdoor-oriented lifestyle

such as seaside activities, BBQ, sportive

activities, cricket, rugby, tennis etc provides the

environmental factors and social factors which

contributes to skin cancer.

Misconception about tanning: Actually, by exposing

face, arms and hands or equivalent areas to contact

with UVR in few minutes everyday during summer time

or 1-2 hours during winter is enough to produce

daily needs of vitamin D for human being.

Ignorance of putting sun block: Lack of the

encouragement and supervise by the peers and social

force. The awareness of skin safety message is still

very weak in the Australian society.

Attitude towards sun protection: For Australian

people, as common sense, to get a big sun through

tanning or sunbed is very normal and prevalent.

Tanning skin is considered as the healthy colour.

3.3 Initiative expectationPurpose:

1. Increasing the social awareness of sun prevention

measurement.

8

2. Increasing the pubic attention in the severity of

the skin cancer disease.

3. Increasing the cooperation between social community

and SUN SHIELD organization.

4. Increasing the self-efficacy from target audience

and trigger spontaneous behavior exchange and

regular skin check-ups.

Focus:

1. Decreasing the skin cancer incidence in the State of

Queensland.

2. Decreasing the indifference of sun safety message.

3. Decreasing the misconception about tanning skin

color is the symbol of health.

4. Decreasing the bias about applying sunscreen is

unessential and annoying.

4 Target audience analysis

4.1 Criteria for selection

9

Graph1 Melanoma incidence rate in AustraliaSource: Australian Institute of Health and Welfare,

Canberra.

Graph2: Average number of most common skin cancer diagnosed per year by age group among females in Queensland during 2007-2011 Sources from Queensland Cancer Statistics

10

These statistics are based on the rates of cancer

diagnosed among female group in the state of Queensland

from 2007 to 2011. These bar charts show that in the aged

group from 0-34 years old, the risk of getting melanoma

account for the highest rate than the other kind of

cancer. Even though in the group aged from 35-79, the

seriousness of getting melanoma get less than the breast

cancer and colorectal cancer within female, but the

diagnose number of skin cancer is keeping on increasing.

Graph 3 : Average number of most common skin cancer diagnosed per year by age group among males in Queenslandduring 2007-2011Sources from Queensland Cancer Statistics

The information of this graph is related to the most

common cancer diagnosed by male age group in Queensland

11

from 2007-2011. It appears the similar situation that

males aged from 0-49 are more likely to getting melanoma

skin cancer than getting the other types of cancer.

Further observation shows that, compared with females in

the same age group from 35-49, males are in higher risk

of getting skin cancer. This statistics clearly show that

the length and intensity of daytime outdoor working

attributing to the males is the predominant segmentation

accounting for the diagnosed skin cancer population.

Primary selection of Target audience: The State of

Queensland, people aged from 0-49 years old both females

and males.

4.2 Risk factors towards segmentation

Group 1: Children, aged from 0-12 Because of the school

time during the peak of UNR from 10am to 2 pm, the

strongest UV radiation will directly contact with

students while the outdoor sports activity. (Cancer

Council Queensland 2014).

Group 2: Teenagers 13-18 The sun exposure before 15 years

old contributes more potentiality of being attacked by

skin cancer. (Armstrong, B. K.,1997)

Group 3: 1,360 cases of workforces compensation within

total $38.4 million was claim from 2000-2009, which is

12

related to sunburn and skin disease. (Cancer Council

Western Australia)

Group 4: Outdoor player aged from18-30 Footballers,

cricketers, golfers, swimmers, surfers, musical festival

engager etc.

TIPS: Group 5: From 2006, Australian government and each

state government promulgate the law for banning tanning

bed. Now there are only less than 15 solarium bed club in

Queensland. So we will not take this group into

consideration in the next TA segmentation analysis.

4.3 Primary segmentationTABLE 1:

Segmentati

on

categories

Seg1

Children

3-12

Seg2

Teenagers

13-18

Seg3

Outdoor

workers

18-49

Seg4

Adults

18-49

Demographi

cs

About 13.3% About 8% About 15% unknown

Gender Male and

females

Males and

females

Males Males and

femalesGeographic State of

Queensland, AustraliaBehavior Lack of

awareness of

“slap, slop,

The teenager,

especially

those who

Some workers are not willing to apply

The adults

who forget

applying

13

slides”

measurement and

knowledge of

sun safety.

Need to be

supervisor

under adults

for applying

sun protection

methods.

prefer outdoor

activities

like surfing,

seaside

swimming,

soccer, rugby,

at higher risk

in get sunburn

and

potentially

develop into

skin cancer in

the future.

They don’t

realize the

severity of

sunburn and

don’t foster

habit of

applying

sunscreen.

sunscreen cause feel not“cool” and only old people and fair skin willget sun burn.

sunscreen

have several

main reasons.

1. Don’t

reapply

sunscreen

when having

entertainment

. 2.Not

convenient

for bringing

the

sunscreen. 3

tanning skin

is very

attractive

Accessibil

ity to

exchange

Ability

Not accessible

to change the

willing or

behavior by

social campaign

but more rely

on school

School

teenager is in

the

cornerstone of

fostering life

habit and

common sense.

Legal

obligation

requires

stakeholder

take

measurement in

preventing

Through

educating

about the

damage of

skin caner to

adult,

offering the

14

education and

parents’

control. Not

easy to change

their behavior

and perception

due to the age

limitation.

To educate

them in terms

of integrating

the social

power, school

education and

family up

bring will

make a

profound

influence in

social norms

and behaviors.

workforce from

getting skin

cancer and

sunburned

during outdoor

work.

sunscreen

sample in the

festival or

event to

reminding

young people

the take

precaution of

skin cancer.

Cooperating

with

sunscreen

producer to

facilitate

the package.

Unable to

estimate

The population percentage in the TABLE 1 is calculated

from Australian Bureau of Statistics

Based on the primary analysis of the four types of target

segmentation, the schooling teenagers aged from 13-18,

and adults aged from 19-48 (especially for outdoor

workers) will be the potential target audience. To

further select the key potential target audience, I will

use the methodology based on attitudes and motivation to

select the most potentially achievable TA.

15

4.4 Identify key potential target audience

Health Belief Model in changing teenagers’ behavior

As it can be seen, the adult keeps more attention on

their appearance than their health. To persuade them, the

evidence should contain two basic factors: happiness and

beauty. That means the interventions will need to

optimize the social norms to maximize the necessary of

sun safety precaution. The school education and social

support from skin cancer community, government health

department, peers, parents will be the critical factors

which influence the achievement of the initiative.

Schoolings are also playing the connective role to

transfer social norms to their families. Particularly,

for those teenagers’ parents who work outdoor, if the

intervention starts in education, the children will bring

the information to the family. They are the target

audiences, meanwhile, they will become the desired

behavior delivers. This phenomenon will forms as a

virtuous cycle.

Key potential TA:

Teenagers aged from 13-18

Secondary Audience:

Adults aged from 18-49 ( especially for outdoor workers)

16

5. Behavior drivers and Competition analysis

5.1 Attitudes and motivation of the target audience:

Attitudes from schooling teenager’s perspective:Optimism:

“Applying sunscreen is time-wasting, I don’t think

I will get skin disease.”

“Even though get sunburn, it wouldn’t be so serious

as to get skin cancer.”

Good looking:

“Fair skin looks not healthy, I prefer to getting

dark tanning skin color.”

‘’ I didn’t see my friends or peers applying sun

screen before outdoor sports activities. Only girls

like applying something on the skin.”

Misconception:

“ I use sun screen before outdoor activities once a

time. Who will think about applying sunscreen when

the game is going on?”

“ I don’t know the effect of sunscreen only lasts

for limited hours? There also have water resistant

sunscreen? “

Motivation

I often forget applying sunscreen, if the package

will be smaller for me to easily carry out.

Free sample? Of course I will accept and use it!

The picture of skin cancer is really disgusting….I

will start to applying it from now on.

17

Attitudes and motivation from outdoor worker’s

perspective:

Attitude

Optimism:

“I am young and strong. It’s impossible to get skin

cancer.”

“During winter or when the cloudy weather, if your

skin doesn’t feel burned, that will be no necessary

to apply sunscreen.”

Obeying:

“We all work under high UVR exposure, that’s one

part of my life.”

“ I can control the sun light, this is my job.”

Misconception:

“ I reckon it’s too late for me to do skin

protection since I get sun burned when I was a kid.

“The sun light is too strong, applying sun block

doesn’t make any effects.”

Motivation:

“If the doctors tell me it’s really useful to take

fully skin protection, I am willing to do it.”

“My patron ask us to do skin check per half year,

and the fees was covered by insurance. That’s good.”

“There is temporary shade in one side of the

construction site. And also free sun block offered

there.”

“I hope I will be always healthy and take care of my

family.”

18

“My children bring the skin prevention brochure back

home, they tell me they love me and tell me the

importance of applying sunscreen, that’s so sweet.”

5.2 The competitors

1. The stakeholders who sell the products in

association with surfing, fishing, boating etc. And

the solarium bed club.

2. Insufficient awareness of skin protection. Apathy

group that who purposely ignore persuasive message,

instead of choosing exposure under UVR for intensity

outdoors activities.

3. The past national skin cancer campaigns.

4. Similar intervention ( seen in appendix ): The

campaign processed by Queensland’s Sun Smart, Sun

Safety, SafeWork Australia, Cancer Council

Australia, Cancer Council Queensland etc.

5. Involuntary disinclination: the group who are

reluctant and unwilling to change habitual behavior

( ie: not apply sunscreen regularly).

6. The shortfall of funding and support from government

and social communities.

19

6 Environmental analyses

The table below identifies the environmental drivers that influence the current behaviors of the target group in regards to the risk of skin cancer and protection against the risk of skin cancer in Queensland.

6.1 PEST analysis

Table 2Teenagers Outdoor workers

Political

-Legislation

-Regulatory

-Lobbying

Activity

It is lack of legal

obligations to protect

children and teenagers, and

the government is responsible

for providing policy in order

to avoid injury, disease and

death caused by high UV

damage among teenagers.

According to the Australian

Occupational Health and Safety

(OHS) legislation (Loudoun,

Mcphail, & Wilkinson, 2009):

1 outdoor worker could ask for

tax deduction in the cost of sun

protection goods like sunglasses,

hats and sunscreen. (PPE)

2 Stakeholders have duty to

prevent injury, disease and death

occurring in the workforce, and

also provide fully equipment for

protecting worker from any kind

of incidences.

Environmenta

l

-Climate

-

Geographical

The commute hours and

schooling time is in the peak

UV level period. It increase

the time that under the

sunlight exposure. There is

Mostly outdoor workers work under

the UV level peak hours from 10am

to 3pm and directly expose under

sunlight.

20

-Natural no spacious shed in the bus

stop, open-air playground

also increase the dangerous

of getting sunburn.Social

-Cultural

-Lifestyle

-Demographic

Despite a set of social

interventions make efforts in

reinforcing social awareness

and delivering message of the

sun safety measurement, it

still exists ignorance of the

severity of sun prevention

from some social communities.

Some schools are still under

process in deciding whether

conducting sun safety

education because of lacking

financial support and

government support.

The outdoor workers such as

construction workers, postal and

courier workers, military

personnel who are recruited by

government have the guarantee

legal compensation.

But gardeners, farm workers,

people working on fishing boats

for private stakeholder could not

be 100% guaranteed by the

protection of the legislation.

Technologica

l

But lack of exclusive

detection product which is

cheap and use-friendly for

teenagers. The traditional

sun protection product is

long shirts, sunglasses, hats

and sunscreen. For satisfying

and matching the market, the

innovation of the package,

material and components is

The existing skin cancer-

screening APP has been launched

to the market. But the target

market is still very limited.

21

very necessary.

6.2 What environmental factors need to be changed?

Social awareness: The sun protection of teenagers

group is lack of the policy and legislation support

from government, the funding and endorsement from

skin cancer organization.

Finance: By contrast, the publicity in Queensland is

more interested in sustainable development recently.

After the 2010, there is no novel skin cancer

prevention campaign due to lack of funding. This

phenomenon urgently required an up to date social

campaign for provoking public awareness about skin

safety message again.

Innovative technology: The treatment and medicine of

curing melanoma skin cancer is under pilot testing.

Marketing strategy: To utilize the mass media and

social media for promoting the campaign.

7 The implication of theories and models

7.1 The Elaboration Likelihood Model

The peripheral cues like public presentation through

social media or advertisement by credible spokesmen may

22

attributes to the deliberation of behavior exchange.

( Eagle and Dahl, Social Marketing, 2013) This model is

especially suitable for the people who underestimated the

risk of the phenomenon. ( Eagle and Dahl, Social

Marketing, 2013)

According to the inspiration from this model, the

implication of the celebrity and spokesman in the public

announcement is critical for changing the behavior of

teenager and apathy group of outdoor workers.

Implication: Celebrity. School seminar. Printing

materials.

7.2 Health Belief Theory

Threats

Involuntary of the behaviors

exchanges

Ignorance of the risk

information

Benefits

Increasing the standard of health

life and longevity

Decreasing government expenditure

on this health issueSeverity

The growth of young people

suffer skin cancer

Australia has the highest skin

cancer incidence in the world

Barriers

The bias of changing habitual

behavior and accept new behavior

The misconception of Vitamin D and

Tan Skin

Repeat the information of skin cancer Influence the target audience

23

Influence the peers, families and social

network

Repeated information trigger self-reported behavior

As the teenagers are more likely to be affecting by the

education, peers, authority figures and social norms,

thus they are figured out as the first level of behavior

which belongs to obedience level. The Sun Shied aims to

exert the sun safety information through bus stops,

school education, celebrity endorsement, seminars and

delivery the free sample of sunscreen to keep repeating

the sun safety message and appropriate sun protection

behavior.

8 Social marketing project objectives and recommendations

Project name: Sun Shield

Project location: Queensland

Project target audience: Teenagers

Project second key audience: outdoor workers

24

SUN SHIELD project aims to enhancing teenagers’ awareness

of sun protection.

o Mission 1: SUN SHIELD social initiative is

encouraging students to applying sunscreen regularly

under the peak UV level hours while they are

commuting between school to home and exercising in

the outdoor place.

o Mission 2: To change teenagers’ negative attitude in

sun prevention, and help them to shift behavior

proactively through celebrity promotion, tour

reference in Queensland high school, free sunscreen

sample delivery in the teenagers’ outdoor events or

festivals.

o Mission 3: To send out brochure, flyer, leaflets,

posters that fully demonstrate the information of

skin cancer. Teenagers will be influenced by the

message and bring back to the families, especially

for those parents who work in outdoor sites. Use the

“family oriented” strategy to touch the parents’

heart, and change the whole families’ sun protection

habit.

o Mission 4: Our potentially future goal is to

establish the “Queensland Teenagers Sun Protection Alliance”,

25

which will cooperate with related social

communities.

o Mission 5: Through our campaign to push the policy

making process in association with the prevention of

skin cancer from teenagers.

Partner

o Celebrity Effect. “Werewolf” Hugh Jackman is the

well-known Hollywood Star from Australia, he also

was attacked by nose skin cancer in 2013 and under

the second stage treatment. He publicly blamed the

laziness is the reason causing the health problem,

and hope people frequently get “proper check-up.”

(News.com.au)

o Commercial community: To collaborate with

pharmacy, shopping mall, recommendation these

communities to give clear instruction of how to

alternate the sunscreen product, long shirt, hats

and sunglasses, and give discount for the students

buyers. The discount stickers are given by the

Queensland Teenagers Sun Protection Alliance.

o Membership: As anyone join in the Sun Protection

Alliance, they will get the discount stickers

booklets once yearly, or the students who attends

any activities, lecture or workshops held by

26

Queensland Teenagers Sun Protection Alliance, they

will also get the same benefits.

o Recreation sites: To build temporary shed, tent,

and sunscreen sample box along the seaside. To set

up temporary skin scanner and skin problem experts

near the beach for providing skin checking for

seaside players. Delivery free sunscreen sample to

the in the beach, theme park, music festival,

market day, those place which is the most possible

to engage outdoor players.

Reference1. Shih ST, Carter R, Sinclair C, Mihalopoulos C, Vos

T. Economic evaluation of skin cancer prevention in

Australia. Preventive Medicine 2009; 49 (5): 449-

453.

2. Aitken, J. F., Janda, M., Lowe, J. B., Elwood, M., &

al, e. (2004). Prevalence of whole-body skin self-

examination in a population at high risk for skin

cancer (Australia). Cancer Causes & Control,15(5),453-63.

3. Retrieved from

http://search.proquest.com.libraryproxy.griffith.edu

.au/docview/213065040?accountid=14543

4. Lemus-deschamps, L., & Makin, J. K. (2012). Fifty

years of changes in UV index and implications for

skin cancer in Australia. International Journal of

27

Biometeorology, 56(4), 727-35.

doi:http://dx.doi.org/10.1007/s00484-011-0474-x

5. Australian Bureau of Statistics

(http://www.censusdata.abs.gov.au/census_services/

getproduct/census/2011/quickstat/3

6. Rebecca Loundoun, Ruth McPhail & Adrian Wikison 2009

INTRODUCTION TO EMPLOYMENT RELATIONS 2ED,Pearson in

Australia , pp258.

7. Cancer Council Western Australia. Occupational

exposure to ultraviolet (UV) radiation: Workers’

compensation claims paid in Australia 2000-2009.

Monograph Series 2011. 2011

8. News.com.au. skin-cancer-scare/story-fn907478-

1226765704700

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http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/

4338.0main+features162011-13

http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/

3303.0Chapter42011

10. Bell J, McCredie M, Coates MS & Armstrong BK 1997. Trends in colorectal cancer incidence and mortality in New South Wales 1973–1992. Medical Journal of Australia 166:178–1.

11. Australia Government Department of Health

28

http://www.health.gov.au/

12. Cancer Council Australia

http://www.cancer.org.au/about-cancer/types-of-

cancer/skin-cancer.html

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figures. Retrieved March 2009 from

www.cancer.org.au/cancersmartlifestyle/SunSmart/Skin

cancerfactsandfigures.htm.

14. Cancer Council Queensland

http://www.cancerqld.org.au/icms_docs/

61890_Skin_cancer_fact_sheet.pdf

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http://hope.cancercouncil.com.au/?

gclid=CPqSl4D7lL4CFQ9vvAodK0UA1g

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http://www.cancersa.org.au.

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http://www.who.int/en/

29

19. Lynne Eagle, Stephan Dahl, Susie Hill, Sara

Bird, Fiona Spotswood and Alan Tapp 2013 . Social

Marketing . Pearson Education Limited.

AppendixThe history of sun protection campaign in

Australia

1 SLIP,SLOP,SLAP Launched in 1981, Cancer Council Victoria, Australia

“ slip, slop, slap”: Slip ,slop slap, seek, slide The

health slogan encourages people to follow the sun

protection regime: “Slip on a shirt, slop sunscreen with

SPF30+, slap on your sunglasses. Seek a shed. Slide on

sunglasses.”

2 SUN SMART Funded in 1988 , Victoria ,Australia

“Sun smart” is a non-profit social marketing program.

This social promotion was one of the most cost-effective

interventions by the Victorian Department of Treasury.

(Shih, Carter, Sinclair, Mihalopoulos&Vos, 2009)

3 NATIONAL SKIN CANCER AWARENESS CAMPAIGN , 2006-2010, Australia

Australian Government Department of Health reported that from

2006 to 2010, This campaign exclusively aims at allowing

30

young people aging from 16-25 years old to raise

awareness and prevent from being diagnosed with Melanoma

cancer.

31