Cancer Research UK Generic Campaign
Presentation of Research Findings May 2012
Prepared for: Cancer Research UK
Prepared by: Research Works Ltd, Regency House, 219a, Hatfield Road, St Albans, Herts. AL1 4TB (01727 893159)
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Research objectives, method and sample
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Research objectives
Main campaign pre & post activity:
Recall of cancer communications in past month
Recall of the campaign amongst the target group
Direct Mail campaign: to establish:
Readership amongst the target group
Initial reactions/reactions e.g. appropriateness
Both campaigns:
Establish awareness of the campaign messages
Impact on awareness of the improvements in cancer outcomes
Impact on awareness of the benefits of early detection/diagnosis
Impact on intentions to visit the GP with an unusual or persistent change
Impact on confidence in talking to the GP
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Research approach
The evaluation assess the impact of the campaign overall and a more in-depth assessment of the impact of the Direct Mail activity
Main campaign pre & post stage research comprising:
Quantitative survey in-street Warrington pre & post activity
508 interviews pre stage & 499 interviews post stage
Inner and outer campaign areas (time pressure and change in location precluded
‘control’ and ‘test’ areas)
Observation – 2 days Cancer Research Awareness Roadshow & iVAN with film footage
Direct Mailing
Using the Direct Mail contact lists, 70 telephone interviews completed
All respondents aged 50+, C2DE and recalled receiving the mailing
In addition, 12 face-to-face follow up depth interviews
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Sample Pre & Post: overview
508 interviews completed pre: 275 inner v’s 233 outer
499 interviews completed post: 260 inner v’s 239 outer
Matched quota sampling in both the inner and outer campaign areas to ensure comparability pre and post:
Gender
Aged specified
Socio economic group
Only difference between the inner and outer samples is the % of DE respondents:
Inner area (60% pre and 62% post)
Outer area (53% pre and 61% post)
No other significant differences in the pre and post samples were
identified
9Sample Direct Mail
Significantly more women and DE respondents in the direct mail sample reflects deprived nature of inner campaign area and women’s role in maintaining the health of the household
70 telephone interviews with those who recalled receiving the Direct Mail
567 people were telephoned and 12% agreed to be interviewed
52% did not remember getting the leaflet and letter
11% remembered getting the leaflet and letter but didn't read it
25% refused to take part/not interested
Gender 100
20 30 40 5060 70 80
Male Fe-male
0 Age 10 20 30 40 50 60
50-70 71+
0 SEG 20 40 60 80 100
C2 DE
Base: (70) 12
29%
71%
44%
56%
77%
23%
Campaign and evaluation dates
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Research task Dates
Be Clear on Cancer
Campaign Activity 30th January to 19th March
including TV, radio, press and poster activity Pre-stage quantitative 1st – 6th March
Observational visits CRUK Roadshow 14th March
iVan at Warrington Hospital 22nd March Campaign from 19th March – 13th April
Direct Mail sent 28th – 29th March
Direct Mail qualitative interviews 10th and 11th April Direct Mail quantitative interviews 3rd – 13th April
Post-stage quantitative 12th – 17th April
Overall approach to sampling, weighting and statistics
Data not weighted – statistical analysis shows that sampling approach achieved matched samples (which was the key requirement)
Therefore, we can be confident that any significant changes pre to post are due to differences in attitude, not differences in sample profile
Statistical testing was carried out to assess whether differences between pre and post and inner and outer samples were statistically significant (using a confidence interval of 95%)
Figures marked ‘*’ denote a significant difference at 95% pre v’s post
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Main Findings
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Recall of cancer communications
Have you seen or heard any advertising or received any communication which talked about cancer in the past month?
8%* rise in recall pre v’s post
There was higher recall across the whole sample (i.e. both inner and outer areas) amongst:
Women (strong role in maintaining health of the household)
50-70 year olds (the younger end of the campaign audience)
C2 group
those living in the inner campaign area
Base: all pre (508) post (499) * significant difference at 95% pre v’s post
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Total Inner Outer
Pre 60% 59% 63%
Post 68*% 68% 68%
Recall of activity – (unprompted + prompted) Can you tell me where you have seen, read or heard it?
Post Pre Post Pre Post Pre
Post 66%
TV DM Radio National Newspaper
Local Press Poster /Billboard
72% 77%
60%
10% 17%
16%* 20%*
6% 16%
3% 8%
6%
12%*
11%
21%*
GP
3%
8%*
5%
20%*
3%12%* 20%*
6%
3% 13%
17%
* NET
unprompted + prompted
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Base: all recalled pre (303) post (341) * significant difference at 95% pre v’s post
The influence of the ‘Be Clear On Cancer’ campaign is clearly
indicated by high recall of TV activity
However, there are significant increases in recall of direct mail, local press, and poster/billboard activity post-campaign which seem more likely to be the result of CRUK activity
3%
Recall of activity – (unprompted + prompted) Can you tell me where you have seen, read or heard it? (2)
Post Pre Post Pre Post Pre Post
Less than 1%
Magazine Phone kiosk Leaflets
handed out in street
Ivan Hospital /
pharmacy/d entist
Cancer Awareness Roadshow Local Event
3% 7%
3%
8%
2%1%
1%
2% 4%
3% 5%
2%
2%
9%
1%1% 2%
1% 2%
1%
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Base: all recalled pre (303) post (341)
* NET
unprompted + prompted
2%
0%
1%
1%
* 1%
Less than 1%
Campaign activity – Roadshow observations
Although the Roadshow and Ivan may not feature in the quantitative results, their effect on individuals must not be overlooked
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“I read this leaflet, so where should I go to get something
checked out? Would it be a nurse or a doctor?”
Conversation between an older man sitting with his family and a
vicar in Warrington Hospital, discussing the leaflet and how
much more hope there was of surviving cancer now than 40
years ago.
Campaign activity – Roadshow observations (2)
Reactions to the Gill and Eric leaflet
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“It’s a useful piece of information to read. You can never know enough about cancer. I know
we have to catch it quick to stand a chance.”
“It’s useful. I will probably keep it handy in case I’m worried
about anything.”
“I’ll read this and pass it on to my friend.”
“It’s nice to see the people looking so well and enjoying life
again. It makes you a bit more hopeful doesn’t it?”
“I shall read this when I get home with my cup of tea.”
Communication – (unprompted)
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What do you remember about the communication? Pre Post
About bowel cancer 38% 17%*
Tells you symptoms of bowel cancer 12% Less than 1%
Go to see the GP 10% 13%
Check yourself/Be aware 7% 9%
About Breast Cancer 7% 4%
About Prostate Cancer 5% 6%
Information on symptoms 2% 6%*
Check for blood in poo 7% 5%
Early detection 5% 5%
Life stories about cancer 1% 5%
Base: All recalled Pre (303) Post (341) * significant difference at 95% pre v’s post
What do you remember about the communication? Pre Post
Go to see the GP 32% 25%
Early detection 17% 20%
Check yourself/Be aware 10% 13%
Do not ignore symptoms 7% 10%
Cancer is treatable if caught early 4% 7%
Be more aware 9% 5%
In our experience, the wide range of spontaneous messages indicates a degree of engagement with the topic - cancer
Communication – (prompted)
What were the key messages you saw, heard or read?
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What were the key messages you saw,
heard or read? Pre Post
Awareness of bowel cancer 71% 46%*
Importance of early detection 43% 54%*
Visit GP if unusual/persistent change 31% 40%*
Cancer screening 19% 24%
Lifestyle and cancer risk 14% 20%
Improvement of survival rates 14% 21%*
Signs of other cancers
Base: All recalled Pre (303) Post (341) * significant difference at 95% pre v’s post
The observable increase in recall of improved survival rates seems likely to have been driven by the prominent CRUK campaign headline:
‘You’re more than twice as likely to survive cancer than 40 years ago’
Source of cancer communication (prompted)
Do you recall the name of the main organisations behind what you saw, heard or read?
Post Pre Post Pre Post Pre Post Pre Post CRUK Pre
PCT
Macmillan
Marie Curie
Don’t Know
Base: all who recalled pre (303) post (341) 24
Pre Post
Inner 30% 28%
Outer 23% 21%
27%
25%
18%
13%
8%
10%
5%
3%
46%
51%
The results reflect the crowded marketplace for cancer
communications. It is clearly difficult for the general public to attribute
messages to particular organisations
Direct Mail findings
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Posters – Jill and Eric
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Awareness and impact of key campaign elements Post campaign – Poster
Have you seen this
communication before?
Please rate how much agree or disagree with the following
statement? ‘After seeing this poster, l would be more likely to seek advice if I had a
persistent or unusual change to my body’
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46% recalled seeing the poster
Recall higher in the inner
campaign area 52%* vs. 39%
outer area
82% agree
Nearly half recalled the poster, with higher recall in the inner campaign area where the poster sites were located
Base: all post (499) * significant difference at 95% pre v’s post
Press – Jill and Eric
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Awareness and impact of key campaign elements Post campaign – Press
Have you seen this
communication before?
Please rate how much you agree or disagree with the following statement? ‘After seeing this leaflet, I would be more likely to seek advice if I had a persistent or unusual change to my body’
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44% recalled seeing the press advert
Recall higher in the inner
campaign area 51%* vs. 37%
outer area
81% agree
Two fifths recalled the press advert, with recall in the inner campaign area increasing to almost half
Base: all post (499) * significant difference at 95% pre v’s post
Direct Mail – leaflet
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Awareness and impact of key campaign elements Post campaign – Leaflet
Have you seen this
communication before?
Please rate how much agree or disagree with the following
statement? ‘After seeing this leaflet, I would be more likely to seek advice if I had a
persistent or unusual change to my body’
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21% recalled seeing the leaflet
Recall higher in the inner
campaign area 28%* vs. 12%
outer area
79% agree
One fifth recalled the leaflet, with recall higher in the inner campaign area a result of the targeting of the direct mail campaign
Base: all post (499) * significant difference at 95% pre v’s post
Campaign materials message take-out – (prompted)
What were the key messages of the communications I have just shown you?
Signs of Other Cancers Lifestyle and Cancer Risk Go Cancer Screening Signs of Bowel Cancer Improvement in Survival Rates Visit GP if Persistent /Unusual Changes Importance of Early Detection
Base: all post (499)
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53%
46%
34%
24%
21%
19%
14%
When prompted, around half selected the key campaign messages:
the importance of early detection and encouragement to visit the GP. A third also selected the headline message about an improvement in
survival rates
No statistically significant differences between inner or outer areas
44% read all or most of DM
37% read some
19% glanced through it
Engagement with Direct Mail – (unprompted) Why did you read this leaflet and letter on cancer?
Base: all who recalled Direct Mail (70) 33
Top 5 reasons for engagement
‘It is important’ 33%
‘Interesting’ 17%
‘Wanted to read it’ 16%
‘Cancer in my family’ 13%
‘To learn’ 11%
Two fifths read most or all of the Direct Mail. A third chose to do so because they felt it was important
In RWL’s evaluation experience , a higher degree of engagement for an older 50 + audience is indication of success
Message take out from Direct Mail – (Unprompted) Can you describe what this mailing on cancer was about?
Survivors' stories Better Survival if Early Diagnosis Importance of Early Diagnosis Go to Doctors Be Aware of Symptoms/Know What to Look For
Base: all who recalled Direct Mail (70) *All other responses less than 10%
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60%
26%
23%
17%
10%
Three fifths spontaneously identified one of the key campaign
message communicated by the Direct Mail: be aware of symptoms. A quarter identified ‘go to the doctor’ and the importance of early
diagnosis as campaign messages
Message take out from Direct Mail – (Prompted) What were the key messages of the direct mailing on cancer that you received?
Bowel Cancer Survival rates Cancer Screening Visit GP if Persistent/Unusual Changes Importance of Early Detection
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100%
100%
97%
37%
7%
Prompted recall of the campaign messages about the importance of early detection and the need to visit the GP rose to 100%
Base: all who recalled Direct Mail (70)
Direct Mail – qualitative feedback
The Direct Mail was an
extremely effective way of communicating with an older, C2DE audience. It was positively rated as ‘personal’, ‘engaging’ and
‘informative’
Eric and Gill were clear strengths: ‘localness’ was a
significant factor, as was the use of an identifiable ‘peer’
Respondents recalled Eric and Gill from the outdoor and press
elements of the campaign
36“If it’s come to your door, with your name on it, then it’s meant
for you.”
“I opened it and thought, ‘Oh, it’s the Warrington woman.”
“It really brings it home because it’s someone local.”
Direct Mail – qualitative feedback (2)
The positive tone of the creative was very much appreciated
The ‘good news story’ about survival rates increasing also achieved impact
“She looks really well and happy with life. It looks like she has a rucksack on her back, so she could be going walking, so it shows you
can be fit afterwards.”
“This really hit me [the headline]. It’s just over 40 years ago my dad died of cancer. Maybe if he had got it now he might have survived it. It
was quite a personal message for me here.”
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Direct Mail – qualitative feedback (3)
Qualitative evidence suggests that the campaign messages were clearly understood
“It gives you the spirit to see your GP if you are worried about
any of the symptoms.”
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“It’s telling you to get to the doctors. The earlier you go, the
better it is to catch it.”
“I don’t spend my time thinking about looking for signs of cancer, so to receive this in the
post is a good reminder – a nudge that maybe I should be
getting something looked at.”
“Eric is telling the men that they need to go to the doctor. Some men just think they are immune to it. He is pointing out that you are not on your own when you
get it – there are people out there to help you.”
Direct Mail – qualitative and quantitative
There was evidence that the leaflet was being shared amongst family and kept
“We [husband and wife] got our letters on the same day so we
read them together.”
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“I have put my leaflet in the drawer – it looks like a handy bit of information and I may want to
refer to it again.”
“I showed it to my daughter and she thought it was good too. It
was the bit about finding out early that we talked about because then you have more
chance of survival.”
What did you do with the leaflet and letter on cancer?
79% kept it for themselves
21% threw it away
Did you speak to anyone about this leaflet and letter on cancer?
66% spoke to family and friends
34% did not speak to anyone Base: all who recalled Direct Mail (70)
Attitudinal findings from pre and post data
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Call to action: if you had a persistent or unusual change, how likely would you be to visit your GP?
A significant shift in propensity to visit GP post stage
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Pre stage – all very likely Post stage – all very likely
85% total 91%* total
83% inner 89%* inner
88% outer 92% outer
Base: All pre: (508) post: (499) * significant difference at 95% pre v’s post
Perceived barriers to help-seeking Emotional Barriers – Yes
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Emotional barriers Pre Post CAM
Whole Inner Whole Inner
Worried 33% 31% 39%* 40%* 37.1%
Scared 21% 21% 16%* 17% 23.2%
Embarrassed 12% 13% 8%* 9% 17.4%
Lack of confidence 7% 6% 7% 7% 9.6%
Base whole: All Pre (508) Post (499) * significant difference at 95% pre v’s post Base inner: All live in inner campaign area Pre (275) Post (260)
An increase in worry as a barrier to help-seeking likely to be the result of encouraging personal thought, but there was a notable
drop across the whole campaign area in feeling scared and embarrassed
Perceived barriers to help-seeking Service Barriers – Yes
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Service barriers Pre Post CAM
Whole Inner Whole Inner
Difficult to make an
appointment 25% 25% 30% 36% 36.5%
Wasting time 11% 12% 9% 7%* 26.1%
Difficult to talk to 5% 4% 6% 5% 13.9%
Base whole: All Pre (508) Post (499) * significant difference at 95% pre v’s post Base inner: All live in inner campaign area Pre (275) Post (260)
There is an observable increase in the difficulty of making an appointment being a barrier to help-seeking, particularly in the inner area where the extent of the barrier reflects the national data
Decrease in those saying that wasting time was a barrier significant in the inner campaign region
Perceived barriers to help-seeking Practical Barriers – Yes
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Practical barriers Pre Post CAM
Whole Inner Whole Inner
Too busy 4% 5% 2% 2%* 21.1%
Other priorities 8% 10% 4%* 4%* 17.5%
Transport 6% 9% 5% 5% 5.1%
Base whole: All Pre (508) Post (499) * significant difference at 95% pre v’s post Base inner: All live in inner campaign area Pre (275) Post (260)
Decrease in those saying that having ‘other priorities’ was a practical barrier significant across the campaign area as well as in
the inner campaign region only
Decrease in those saying that being ‘too busy’ was a barrier significant in the inner campaign region only
Attitudes to cancer – strongly agree
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Attitudes to cancer Pre Post
Whole Inner Whole Inner
More likely to survive cancer
now than 40 years ago 75% 70% 84%* 83%*
Cancer diagnosis early is more likely to be treatable
72% 71% 80%* 76%
People who’ve had cancer can expect to continue a normal
life
50% 45% 51% 47%
Cancer diagnosis is a death sentence
5% 6% 3% 3%
Going to the GP early makes no difference to changes of
surviving
4% 5% 2% 1%*
Cancer diagnosed early makes no difference to
chances of surviving
3% 4% 3% 3%
Base whole: All Pre (508) Post (499) * significant difference at 95% pre v’s post Base inner: All live in inner campaign area Pre (275) Post (260)
Conclusions
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Conclusions
Overall, disaggregating spontaneous recall of specific BCOC and CRUK campaign activity is difficult, given that the two campaigns were running very closely together and the general public’s difficulty in
attributing the provenance of specific cancer communications
However, there are significant post-campaign increases in recall of local press and DM activity which seem more likely to be the result of CRUK activity, particularly given than recall of BCOC TV and radio activity is decreasing post-campaign
The significant increase in recall of improved survival rates seems likely to have been driven by the prominent CRUK campaign
headline: ‘You’re more than twice as likely to survive cancer than 40 years ago’
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Conclusions (2)
Prompted awareness of the CRUK campaign materials provide greater understanding of the success of the campaign:
Half recalled the poster, with higher recall in the inner campaign area where the poster sites were located
Two fifths recalled the press advert, with recall in the inner campaign area increasing to half
One fifth recalled the leaflet, with recall higher in the inner campaign area a result of the targeting of the direct mail campaign
When prompted, half selected key campaign messages: the importance of early detection and encouragement to visit the GP. A third also
selected the headline message about an improvement in survival rates
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Conclusions (3)
Quantitative and qualitative findings from the Direct Mail activity demonstrate that this was a key component of the campaign
Two fifths of those who recalled the Direct Mail activity read most or all of the Direct Mail
A third of those who recalled the Direct Mail activity chose to read the Direct Mail because they felt it was important
Three fifths of those who recalled the Direct Mail spontaneously identified one of the key campaign messages: to be aware of
symptoms. A quarter identified ‘go to the doctor’ and the importance of early diagnosis as campaign messages
Qualitative feedback suggests that the Direct Mail channel as well as the positive tone of the creative and choice of a local peer to deliver the messages were key ingredients in the success of the mailing 49
Conclusions (4)
Statistically significant changes in attitudes towards cancer have been identified:
Decrease in those saying ‘wasting time’ was a barrier to help seeking in the inner campaign area
Decrease in those saying that being ‘too busy’ was a barrier in the inner campaign area
Decrease in those saying that having ‘other priorities’ was a barrier across the campaign area, as well as the inner area
Increase in those agreeing that one is ‘more likely to survive cancer now than 40 years ago’ across the campaign area, as well as the inner area
Increase in those agreeing that cancer diagnosis early makes it more likely to be treatable across the campaign area,
Decrease in those strongly agreeing that going to the GP makes no difference
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Recommendations
The ‘localness’ of the campaign is a key ingredient in its success:
The local, human interest case study approach engaged
The survival angle hooked the audience
The communication approach successful for a older DE audience
And the media planning ensured repeat exposure to the campaign
Although the campaign has a generic message (in that it is not cancer specific), it is specific in terms of localness
The choice of media was appropriate for the target audience, local press reinforced by the direct mail
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