Andy OwenAndy Owen

Changing behavior is difficult. It’s something that health communicators face every day in situations that demand diplomacy. If our efforts are too forceful—or worse, disrespectful—we risk losing our audience. But if we aren’t compelling, we risk losing the whole effort.

The stakes are high. A quick survey of the COVID aftermath shows that false narratives, both malicious and merely misinformed, are rampant—and even the most educated have trouble deciphering what to believe. The situation has become so fraught that, in 2021, U.S. Surgeon General Vivek Murthy released a report titled “Confronting Health Misinformation.”

We’re often reminded that scare tactics are rarely successful in addressing misconceptions. Even if they were, negativity isn’t ideal. What we need instead are ways to change behavior through trust and confidence. Enter social norming, which uses examples set by peers to encourage positive behaviors.

What is social norming?

The social norms approach is credited to researchers H.W. Perkins and A.D. Berkowitz, who developed it when studying the alcohol consumption habits of college students in the ’80s. A tenant of the approach is that perceptions of norms are often drastically different than the actual norms.

This article is featured in O'Dwyer's Oct. '22 Healthcare & Medical PR Magazine
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By acknowledging this principle, health communicators can use demonstrations of positive normative behavior to correct misperceptions and show audiences that, in reality, most people have chosen the healthy path. Your grandmother might have called this phenomenon leading by example. You might call it keeping up with the Joneses. You respect—and maybe even envy—the Joneses, so you want to emulate their behaviors.

How does it work?

Social norming can be particularly effective in situations where unhealthy behaviors tend to be perpetuated by an audience’s belief that those behaviors are common and therefore okay. This concept is called “false consensus,” which the American Psychological Association defines as “the tendency to assume that one’s own opinions, beliefs, attributes or behaviors are more widely shared than is actually the case.” For health communicators, social norming involves illustrating situations where reality—i.e., a norm—runs firmly counter to an unhealthy false consensus.

Where is it used?

Perkins’s and Berkowitz’s research was focused on college students’ justification of their own heavy drinking because they believed that all other college students drank heavily. By presenting students with the truth about their peers’ actual drinking patterns, problem behaviors like binging could be put into context and more easily understood for what they are.

Colleges and other institutions use the social norms approach to limit risky drinking behaviors among a variety of audiences. The resulting campaigns often show how drinking less can help individuals achieve healthy milestones that are, in fact, normal for most people. These campaigns tend to use straightforward messaging and clear statistics to tackle the misperception that a group engages in heavy drinking. The simple act of demonstrating a proper serving size of alcohol is a time-honored technique. Comparing a 1.5 oz. shot of 80-proof vodka to a pint glass filled mostly with liquor is a powerful way to help a heavy drinker understand that their idealized, “glass is always full” behavior isn’t actually normal or healthy.

Another place where the use of social norming has potential is in the current world of vaccine communications. The enormous amount of misinformation in post-COVID life can easily lead one to believe that most parents are hesitant to vaccinate their children. But, the truth is most parents do choose to vaccinate their children, and most children are up-to-date on vaccines. However, that doesn’t mean all children have the vaccines they need, so communicators are being called upon to help—because even a slight drop in vaccination rates can help diseases spread more quickly.

In pointing out the false consensus that childhood vaccination isn’t a priority for parents, we can also show our audiences that the opposite is true. With social norming, we demonstrate that most families are up to date with vaccines. In the process, we can encourage parents and healthcare providers with questions to look past rampant misinformation and seek trustworthy answers.

Where do social norming campaigns start?

Like any other communications activity, social norming requires a firm understanding of key audiences and easily understood messaging.

Research: Start by doing the research needed to understand how your audience compares to the peers who represent the healthy ideal. The more data you can find to support both the misconceptions that are affecting your audience and the normative behaviors that you’re encouraging, the easier it will be for you to refine your targeting and messaging.

Create: Once you understand the data, develop your content. Here, even more than in other situations, it’s important for messaging to be succinct and crisp. Remember that you’re using reality to encourage behavior change—and reality should be self-explanatory. Lengthy explanations will threaten your campaign’s plausibility.

Deploy: Social media may be the perfect tool for advancing social norms. It doesn’t take a sociologist to realize that all of us who share on social media are, in effect, engaged in norming our own preferences. And while the tendency of social media to promote outward comparisons can sometimes be harmful, there also are plenty of constructive ways to harness its power by remaining considerate of tone. A little bit of healthy virtue signaling rarely hurt anyone.

Of course, by creating sharable content, health communicators can take advantage of virality. Spreading information that encourages audiences to follow the lead set by peers they respect goes hand-in-hand with the idea of norming.

Reinforce: Old-school PR tactics have a place in social norming as well. Using expert, aspirational spokespeople for a campaign always helps to promote credibility. For a social norming campaign, it’s ideal to find individuals who are widely known to demonstrate the normative qualities that you want to exemplify. These individuals should be a mix of both respected peers and respected experts. Having credible and likable spokespeople will also make it that much easier to create content that’s ripe to go viral.

When a social norming campaign is well executed, it connects directly with its audiences as it educates them. In doing so, it finds a balance between diplomacy and a compelling message that will help win the day. After all, keeping up with the Joneses is always easier when the Joneses are grounded in reality.


Andy Owen is a Vice President in the Health Practice at Hager Sharp.