Social Marketing and Health Communication: A Case Study at the Brazilian Federal Senate

Abstract

This chapter aims to show how a breast cancer campaign can be successfully planned and how the expected results can be achieved, in accordance with the best practices of health communication under the social marketing paradigm. The case study is the Pink October (month dedicated to women’s health) at the Brazilian Federal Senate, in 2017, result of interdepartmental (Top Management, Health, Human Resources and Social Communication areas) and interinstitutional (Federal Senate, Government of the Federal District and health-related institutions) partnership efforts. Social marketing, internal marketing and endobranding concepts are explored, as well as the breast cancer issue, in order to provide a better understanding among interested readers. While results are positive, some challenges and concerns are brought to light, which point to the need for improvements in the Pink October program for the coming years. The case study involved literature review, analysis of media articles and focused interviews.

1. Introduction

It is well known that in every society, the behavior of some individuals is not in line with the long-term interests of society as a whole [1]. Examples range from the lack of contraceptive use in countries with overpopulation, excessive production of hazardous waste and even careless driving. In this context, the importance of social marketing arises, and it can be defined as the use of marketing tools to promote planned social change [2]. However, the assessment of effectiveness of social marketing programs still presents a great challenge [3, 4]. This chapter aims to help readers understand some of the dimensions that can be used to assess the effectiveness of a given health program—in this case, the Pink October at the Brazilian Federal Senate. Additionally, although there is literature to corroborate the idea of social marketing as the use of marketing theory, skills and practices to achieve social change, especially through the use of online social media, we believe this should be treated simply as marketing on social media. We focus on this at the end of this chapter, with a practical approach on how this concept is used by the Brazilian legislative house. To start with, we shall go over the main concepts of social marketing and its internal use in institutions, especially regarding the employees and their families.

The case study involved literature review, analysis of internal and external media articles and focused interviews with the organizers and partners to create a short overview of the initiative and its future potential improvements.

2. Social marketing and health communication on breast cancer prevention in a public institution

This section aims to discuss the present status of breast cancer cases in Brazil, the basic definition of social marketing and its relation to health communication, as well as the field’s best practices. Another main goal here is to bring up a discussion on internal marketing as a powerful tool to achieve an effective health communication, which may influence behaviors and attitudes toward other potential health issues, and finally, to present the Pink October case in detail.

2.1. Breast cancer

According to the Brazilian Ministry of Health, breast cancer is the type of cancer that mostly affects women countrywide, accounting for about 25% of the new cases each year. It is the second leading cause of cancer-related death in developed countries, falling only behind lung cancer [5]. The National Cancer Institute (Inca) reported that there are about 60,000 new breast cancer cases per year in Brazil, of which 15,000 lead to death.

According to the gynecologist Doctor Daniele Carvalho Mendes, the causes of the disease are varied, ranging from genetic mutations that might occur during a person’s own lifetime up to certain changes to genes that control the way our cells function, especially how they grow and divide. Also, it can be caused by the habits that are proper of a social and/or cultural environment. Examples of such causes include alcohol abuse, overweight and a sedentary lifestyle. Doctor Mendes points out that clinical examination of the breasts should be performed annually by a gynecologist for women from the age of 25. Mammography should be done periodically after the woman reaches 40 years old. When necessary, the doctor may refer the patient to a mastologist for detailed examinations. As Doctor Mendes sees it, the possibility of having cancer is not cause for panic, since the treatment evolved to be increasingly individualized and based on the genetic profile of the tumor.

2.2. Understanding social marketing, internal marketing and branding

For a better understanding of the term endobranding or internal branding, it is important to conduct a brief review of the internal marketing and branding concepts in order to see that branding, in this case, can be both a marketing tool—the so-called “internal branding”—and also an applicable tool in the internal communication of social marketing campaigns [7, 37, 38]. It is worthwhile, as well, to go through the definition of social marketing and how it is connected to the two previous concepts.

2.2.1. Social marketing

A well-established definition of social marketing, is “[…] the use of marketing principles and techniques to influence a target audience to voluntarily accept, reject, modify or abandon a behavior for the benefit of individuals, groups or society as a whole” [8]. For Wilkie and Moore, social marketing originally developed itself as an area that would focus on “the work of nonprofitable groups and government agencies that dealt with effective intervention in areas of social problems,” especially in public health programs as seen in Ling, Franklin, Lindsteadt and Gearon [9, 10].

This perspective of social marketing as a tool to encourage planned social change has been successfully used in different programs [11]. Nevertheless, although social marketing aimed at greater social welfare, the agents of such social change (governments, institutions, public policy makers) face complex ethical challenges [12, 13]. For Brenkert, the point goes beyond the moral issues faced by other forms of marketing such as accusations of manipulation and dishonesty and issues of intrusiveness [14].

The implementation of social marketing initiatives implies several challenges, as seen by Kotler and Lee, such as asking citizens to give up a pleasure (such as having to bathe more quickly), to be in a situation of eventual discomfort (such as wearing a seatbelt on buses and cars), resisting peer pressure (not starting to smoke), embarrassing situations (prostate examination), coping with sensitive situations (testing for AIDS),—challenges that may be added to asking citizens to reflect on issues that, at first, are difficult to grasp of are far from their immediate reality, such as the conservation of the oceans, among many others [15, 16]. For example, Peters et al. have demonstrated the low effectiveness of private sector initiatives in sexual and reproductive health campaigns in emerging countries for a number of difficulties [17]. Concerning health communication itself, Haider also enumerates several difficulties to face, for instance, the evaluation issue [18].

Hastings advocates that social marketing can take advantage of both external relationships among the stakeholders, and internal relationships such as the “domestic partnerships” of employees and functional departments of the organization [19]. In this context, we would have something that could be called a “social endomarketing” that could benefit from generic branding strategies, as referenced earlier. As the saying goes, “There is no better means of promoting another person’s change of heart than allowing our own heart to be changed.” (C. Terry Warner) [20]. In social marketing, that assumption remains true.

2.2.2. Internal marketing

The internal audience of an institution is important, be it as the selected target audience of a given social marketing campaign, or as a sample of a pre-stage testing for external campaigns. In the first case, one can use branding strategies, as advocated by Evans and Hastings in 2008, in the book “Public Health Branding: Applying Marketing for Social Change,” a book that emphasizes the benefits of using branding strategies to social marketing, confirming what had been said by Keller in 1998 and consolidated in the work edited by Evans [21, 22, 23].

According to Gronroos, internal marketing is “a philosophy to manage the staff and a systematic way for developing and performing a service culture,” a definition that moves into the quality of the service provided by the employees [24]. Nevertheless, we can see a broader approach in newer practices, social marketing included. Thus, just as there is B2B, business-to-business, and B2C, or business-to-consumer, we have the B2E, or business-to-employee, the marketing effort from the institution to its employees, as explained by Kotler and Keller. One example is the Disney Institute seminars on “Disney Style,” intended for their own employees, but also for employees from other organizations around the world who participate in these meetings [25].

Kotler and Keller also clarify that internal marketing describes the process of training and motivating employees so that they meet the customers’ needs. He states that “the greatest contribution that can be given by the marketing department is to be exceptionally skilled at inducing other parts of the organization to do marketing.” In the words of Costa [26]:

“The internal marketing and internal communication (although, in practice, they are often accepted as synonyms, internal communication is in fact part of the compound internal marketing) have a decisive role not only in the identification of this demand, but also in building the sense of belonging to the organization and satisfaction of the employees’ desires. Besides the tangible attributes of the relationship between the organization and the employee, you also must to know how to communicate subjective values. Before satisfying the external public, the organization needs to meet its workforce.”

Internal marketing aims to strengthen the internal relations of the organization with the mission of integrating the notions of customer and internal supplier; it intends to forge a shared view of the institution’s business among the employees, including of themes such as management, goals, results, products, services and markets in which it operates, but it also seeks to “convince” employees of a given social cause, as seen in the example presented later in this chapter.

The view and the concept of internal marketing, in the strategic levels of the organization, are key points that are in the core of the process. An initial diagnosis, followed by an implementation plan that takes into account the reality of the company is another key factor to ensure the desired results of the process. Among other factors that should be considered are the visual impact of instruments and the most appropriate branding strategy for internal messages in order to guarantee their success.

2.2.3. Internal branding

Brand management, or branding, “is a basic decision in an organization where it uses a name, a slogan, a design, symbols or a combination of all these to identify its products or the institution itself,” according to Kerin et al. [27].

It is also important to see that the organization’s brand must be related to “people,” to the way they attribute meaning to this brand, and this is a two-way street: it must focus on “endorsers,” that is, people who will defend the brand in different situations, and to the “employees” who must also learn to connect the brand with the company and grasp their values and meaning from it [6].

Strategic brand management starts with decisions regarding a particular brand identity that the organization wishes to have toward the market (as it wants to be seen), and then goes to the management to ensure, as far as possible, that brand image (how it is in fact perceived) in accordance with the intended identity [9].

Carvajal also brings up this matter [28]:

“All companies have the ability to radiate its own image, both outside and inside. Thus, we can think of an internal identity and external identity. The internal identity is generated into the organization and constitutes the cultural heritage (nonmonetary capital), or the corporate culture of a company, which is expressed in environmental values like order, cleanliness, good manners, goodwill at work, compliance with tasks and duties, etc. But there is a parallel external identity, i.e., the way in which ones’ company is perceived by the outsider. It would be correct to conclude that the external and internal identity will depend on one another, and that the object of study of corporate image is the administration of all forms of identity.”

When developing such inner identity, branding can play a very important role. Kotler and Keller define internal branding as the “activities and processes that help inform and inspire employees” [25]. As the branding per se is related to the management process of giving a brand to an idea or product, internal branding or endobranding is, for instance, the brand management of a social or motivational internal program. The brand helps in the understanding and it makes something tangible so it can be better perceived, understood and valued internally by employees of an organization.

Within the public sector, this need is also an issue. According to Dias [29]:

“Motivated mainly by the movement of deploying strategic planning, the public sector has been developing an ever-closer look at some essential practices to achieve overall better results, and, consequently, on the internal communication and internal marketing strategy.”

For Evans [23], the branding of social and health behaviors has become widespread and is now a central approach in social marketing. Thus, adequate branding, in social marketing programs, can enable a great deal of success, as it is also shown in Evans et al., when they examined a drug abuse campaign, which targeted young people. The same rationale could be used for internal campaigns, within organizations [30].

2.3. Social media: the new frontier for health communication

A report on the digital economy recently released (3) by the United Nations Conference on Trade and Development (UNCTAD) puts Brazil in fourth place in the world ranking of Internet users. With 120 million people connected, Brazil lags behind only the United States (242 million), India (333 million) and China (705 million). After Brazil, there are Japan (118 million), Russia (104 million), Nigeria (87 million), Germany (72 million), Mexico (72 million) and the United Kingdom (59 million) [31].

Regarding social media, their use in Brazil is also highlighted. More than 260 million people in Latin America, 42% of the total population, regularly access social networks. According to a survey by the eMarketer agency, 86.5% of users use smartphones to connect to networks. Brazil is the country with the most users of the continent, with a total of 93.2 million by the end of the 2017. In Mexico, there are 56 million, followed by Argentina with 21.7 million [32].

This growing expansion of social networks did not go unnoticed by the Brazilian Senate, which organized a seminar to better understand how different social networks have impacted both the politics itself and the logic of e-government and citizen participation [33]. Experts affirm that networks like Facebook, Twitter, YouTube and Instagram allow the public, which previously only received messages, to now produce content and intensify the impact that information and opinions can have, including regarding politics and the public image of institutions.

According to the Inter-Parliamentary Union (IPU)¹, as published in its guidelines for the use of social media by parliament members, “social networks” (also known as “Web 2.0”) are a wide-ranging set of web-based tools that allow individuals to access, participate and interact with third parties (whether being individuals, companies or public-sector entities), when and how they wish [34].

2.4. The institutional social media of the Brazilian Senate

Social networks, or social media, have become systematically part of the Senate’s everyday institutional life since 2010, initially as new media for the dissemination of facts and legislative news, but which evolved into interactivity with citizens and society in 2011 and have been increasingly used for corporate communication since 2013, with a more intensified work by the Coordination of Advertising and Marketing. Since then, it has been an important tool to foster closer, more effective and efficient relationships between the Senate and different target audiences. This basically reinforces the line of action advocated by Schellong regarding the employment of CRM—Citizen Relationship Management systems—which bring technology, people and business processes together, and was conceived to be used by the public sector, as a business tool for developing closer ties between citizens and government institutions [35, 36, 37, 38].

The Senate’s profiles on the social media are divided basically into four categories: Institutional, Journalistic, Segmented and Public Service.

The institutional profiles (not journalistic or hard news, but institutional in nature) are as follows:

• Facebook: Senado Federal do Brasil

• Twitter: @senadofederal

• Google Plus: Senado Federal do Brasil

• Flickr: Você no Senado

• YouTube: SenadoBR

The information produced by the Senate has been reaching an increasingly higher number of people through social networks. In January 2016, the homepage on Facebook had 240,000 followers. In April 2017, it reached 1.7 million, a growth of almost 600% in the period.

The growth in the number of people reached by the messages is also high. In the same period, Facebook posts were shared 4.6 million times, received 15.5 million likes and generated 23.6 million comments. In recent months, the Senate’s profile on Facebook has been the one with the world’s largest engagement records among government websites, surpassing that of NASA and the White House, according to Quintly (www.quintly.com), a social media analysis site. The Quintly ranking considers the total number of followers of the Facebook profile and the number of people interacting with the posts, which is measured by the number of shares, likes and comments. The position in the ranking changes constantly, since it depends on the daily activity of the pages [54].

The Senate’s social networks, as a whole, now have more than 3.5 million followers among Facebook, Twitter and Instagram, and are commonly referred to as benchmarks by other public institutions [39].

2.5. Social marketing programs of the Brazilian Senate

In 1997, the Senate created its Special Projects SubSecretariat—nowadays called Coordination of Advertising and Marketing—which was founded with the purpose of paying particular attention to promotional and institutional activities of the Senate. This new service, part of the Secretariat of Social Communication, would dedicate time and efforts to the institutional marketing of all areas of the Senate. With the mission of planning and developing internal and external campaigns, this sector was created to organize and take over dispersed tasks as well as the advertising creation of audiovisual products that were scattered throughout the legislative house [35]. In social media, advertising campaigns are disseminated primarily on institutional profiles in Facebook, Google Plus and Twitter networks. These campaigns can be divided into “institutional,” “public utility” and “corporate,” according to their main purpose. From 2015 on, the General Director of the Senate has gathered a small group of staff who responds directly to her in order to get a closer coordination of the internal communication initiatives, and that was the case of the Pink October 2017 edition.

3. Pink October case

Advances in coping with breast cancer and women’s empowerment were the main focus of the Pink October campaign of 2017. The pink ribbon symbolizes the fight against the disease and the movement aims to stimulate the participation of the population, of businesses and of institutions and to warn women about prevention.

The Federal Senate has released the Pink October Campaign as part of its 2015 Commitment Letter, which arouse from the concern regarding the health and the quality of life of its servers, ratified by the 2017–2018 Strategic Objectives document, in which this concern is again mentioned, obtaining the full support of the institution. Since the Senate has the institutional motivation, the resources and the health statistics to corroborate the importance of this initiative, the project was thoroughly carried out by all the participants.

The release of the “Outubro Rosa” campaign against Breast Cancer was held on October 3, 2017, with the pink lighting act of the National Congress. The Procuradoria Especial da Mulher (Women’s Special Attorneyship) and the Secretaria da Mulher da Câmara dos Deputados (Women’s Secretariat of the House of Representatives), in partnership with the General Board and other sectors of the two Houses, came together once again to organize various events during the month.

In the 2017 program, significant actions were conducted, such as the special moment for the outsourced collaborators of the House who, in addition to taking part in the activities proposed for the day, obtained medical referral for a mammography examination with a professional follow-up.

There was also a close chat with mastologists, geneticists and gynecologists, during which the female staff were able to ask questions about breast cancer and other issues. The initiative was provided free of charge by a specialized institution [40].

According to Doctor Daniele Mendes, “everyone has a beloved wife, a sister, a mother, a friend, a co-worker.” The main message today is to face the disease, knowing that medicine offers a wide range of effective treatments, especially for breast cancer. It is worth investing and insisting on the early diagnosis. She claims that campaigns such as the Pink October are important since, the more this relevant information is disseminated, the less fear will be faced by women when learning about a diagnosis. Knowledge is a powerful tool because it lowers the stigma that breast cancer is incurable. A well-informed woman can remain alert to her body and is more likely to discover an early-stage nodule with full healing possibilities [41].

3.1. Planning

An initial briefing took place in March 2017, in which the General Director of the Senate presented the initial ideas on the possibility of deepening and expanding the activities of the Pink October, traditionally carried out every year, aiming to extend the benefits to the outsourced employees of the Federal Senate. At the meeting, two mastologists from the Federal Senate, Doctor Daniele Carvalho Calvano Mendes and Doctor Martinho Cândido de Albuquerque dos Santos, constructively shared views and ideas consistent with the Director-General’s initiative of deciding to offer breast cancer exams—mammograms—over the public health services network to outsourced employees. In order to achieve this goal, the Directors of the Senate contacted the Health Secretary of the Federal District Government and consolidated the partnership, without any direct costs for this economically disadvantaged public.

Contacts were also made with the Internal Communication team of the Social Communication Secretariat of the Senate, so that a wide dissemination network could be formed. In a technical meeting with the area, other Secretariat teams were convened, so that an internal communication effort could be made in order to have available all the communication means of the institution, such as social media, web portal, newspaper, TV and radio of the Federal Senate, whose scope is relevant in terms of reaching out to the public.

The Department of Quality of Life at Work has been assigned as well to collaborate in the process.

In the case of the Pink October, the brand development for such an endobranding initiative has been created by an art director who works for the General Director staff, Mr. Thomas Cortes, responsible for creating other internal campaigns as well. The brand shows the silhouette of the National Congress (Federal Senate + House of Representatives) inside a rose (Figure 1).

Figure 1.

Pink October brand.

3.2. Execution

The release of the Pink October campaign on breast cancer occurred on the night of October 3, with the lighting act of the National Congress. The Procuradoria Especial da Mulher (Women’s Special Attorneyship) and the Secretaria da Mulher da Câmara dos Deputados (Women’s Secretariat of the House of Representatives), in partnership with other sectors of the two Houses, came together once again to organize various events during the month in order to warn society about the importance of prevention of this disease which is among the main causes of death amid women aged 30–69 (Figure 2).

Figure 2.

Special lighting of the National Congress (photo by Pillar Pedreira, Senado Federal).

On October 9, the outsourced collaborators started being forwarded to the place where the mammography exam would be conducted. This was an initiative of the Integrated Health System, as part of the actions of the Pink October, in partnership with the General Directorate and the Procuradoria Especial da Mulher (Women’s Special Attorneyship). There were 150 openings, and they were quickly taken. Women aged 40 or over were selected for consults with doctors from the Senate and with Doctor Carlos Marino, from the Brazilian Society of Mastology, all assisted by the Regional Hospital of Asa Norte in order to investigate the possibility of breast cancer (Figure 4).

The hall of the Medical Service building was decorated with pink balloons to receive the collaborators. They were then invited for a nice breakfast, which was only made possible from the donations of the Senate’s Civil Servants. They also counted on the support of the Occupational Health Service and the Quality of Life at Work department to do labor gymnastics. Late in the morning, the Senate Choir gave a presentation at the venue of the event (Figure 3).

Figure 3.

Choral presentation at the Pink October event (photo by Stumpf F, Senado Federal).

Figure 4.

Toward a specific target (photo by Stumpf F, Senado Federal).

The following events took place throughout the month of October (Figure 5):

• October Rosa against Breast Cancer—Ceremony of lighting of the National Congress.

• Artistic presentation of the Etude Seasons Ballet School with “Sleeping Beauty” by Tchaikovsky.

• Seminar to discuss the implementation of Law 12.732 / 2012, which determines a period of up to 60 days from the diagnosis for cancer patients to start treatment.

• “Talk Show” of the Oncovida Institute on Breast Cancer Prevention.

• Glamorous Parade from the “Roses of the Cerrado” (Victorious Women of Brasilia Against Breast Cancer)

• Consultation for outsourced women employees to undergo mammography at the Regional Hospital of Asa Norte.

• Women’s Health Workshop: Autonomy in the Body and in Life

• Human Pink Tie for Life

• Performative act of parliamentarians and leaders for the prevention of breast cancer.

• Public Hearing: “Advances in coping with breast cancer in Brazil: health promotion, prevention, detection and availability of treatment.”

• Women’s Agenda: “II National Conference on Women’s Health - Results and Challenges.”

Figure 5.

Pink October full program.

3.3. Media and assessment

In order to maximize the range and reach of the Pink October 2017 Program, the Federal Senate concatenated several complementary media, such as the Intranet, the Federal Senate’s newspaper, television channel, radio station, web agency, Instagram, Facebook, Twitter and Tumblr, along with electronic mail and printed banners.

Two specific posts were published on the Senate’s official Facebook page in October 2017 (Figures 6 and 7).

Figure 6.

Tips on breast self-examination—505,726 people reached; 3077 shares; 4310 likes (Legend: Federal Senate/ October 7, 2017/ #OutubroRosa).

Figure 7.

Rights of cancer patients—417,000 people reached; 3953 shares; 5016 likes. [Legend: “The right to health is a right for everybody and the duty of the state.” This means that everyone affected by any disease, including cancer, is entitled to treatment by the health care agencies maintained by the Union, the States and the municipalities. Brazilian legislation ensures special rights to people who have malignant neoplasms, such as cancer and other serious diseases. Learn more: http://bit.ly/pacientesdecancer].

In the Senate, the bill 5/2016 which obliges the free breast reconstruction in cases of mutilation arising from cancer treatment is currently in progress. The innovation of this project in relation to the law in force is that the plastic surgery should be done on both breasts, even if the tumor manifests only in one, so that the symmetry between the two breasts is guaranteed.

Learn more: http://bit.ly/2xR7cVU /Give your opinion: http://bit.ly/PLC05-2016

Do you have any questions about breast cancer and its treatment? Type your question in the comments. On Monday, October 6th, the Mastologist Doctor Daniele Carvalho will answer the main questions live, here on the page.

What to look for in the self-exam?

Most breast cancers are discovered by women themselves.

The main symptoms are:

A nodule (lump), hardened and usually painless.

Changes in the appearance of the nipple, such as sudden nipple reversal.

Spontaneous discharge of nipple or formation of scabs or wounds.

Reddish breast skin. Retracted or similar to orange peel.

Small nodules in the region under the arms (armpits) or neck.

Inward dimpling of the breast tissue, as if there was an indentation).

In addition, Facebook and Twitter avatars (profile images) as well as the covers were temporarily changed.

The Senate also produced a series of videos on the importance of breast cancer prevention and control. In all, seven internal programs were presented by the mastologists Doctor Daniele Calvano and Doctor Martinho Cândido on topics such as heredity, risk factors and forms of treatment. The material was produced by TV Senado and by the General Coordination of Health, in connection with the Secretary of Human Resources.

The choice of the topics covered was based on the patients’ main doubts, and the contents were defined by mastologists who work at the institution. The subjects that generate the most curiosity among the patients were then chosen.

In the doctors’ point of view, knowledge is the first tool to prevent and fight the disease. If people know about the disease, they will not be afraid of the diagnosis, nor fear the treatment and are more likely to ask for help. In the case of breast cancer, early treatment guarantees a good chance of cure.

The Secretariat of Social Communication, responsible for the campaign videos, had the goal to offer citizens direct and attractive material. Therefore, the average duration of each interprogram was 30 s. The idea was to get a quick, informative message that could come in between TV shows.

The Procuradoria Especial da Mulher (Women’s Special Attorneyship) also promoted initiatives both inside and outside the Federal Senate, supporting that its intention was to draw the population’s attention to the fact that women must have access to the cancer diagnosis and treatment. Its main goal was to make everyone aware that the campaign had reached as many people as possible, through the use of social media.

The videos are available on YouTube and on the Senate portal.

https://www12.senado.leg.br/noticias/videos/2017/10/quais-os-fatores-de-risco-para-o-cancer-de-mama

https://www.youtube.com/watch?v=BIHvRurHahE&list=PLLLnytnGoqiYLAsjeepfk312REkzb1iE9

The link for the playlist page of Pink October on YouTube is

https://www.youtube.com/playlist?list=PLLLnytnGoqiYLAsjeepfk312REkzb1iE9

The seven videos on YouTube reached the following number of people:

1. How to prevent breast cancer = 391

2. Is all breast cancer hereditary? = 181

3. What are the genetic factors of breast cancer? = 101

4. What are the risk factors for breast cancer? = 337

5. Forms of treatment for breast cancer = 33

6. Breast reconstruction guaranteed by law = 27

7. How many new cancer cases occur in Brazil? = 23

A series of articles and news were published online on the Senate’s Intranet. The titles and the reading access number are as follows:

• Outubro Rosa: vídeos produzidos pelo Senado auxiliam na prevenção ao câncer de mama (Pink October: Videos produced by the Senate help in preventing breast cancer): 19 views

• Outubro Rosa alerta para necessidade do diagnóstico precoce do câncer (Pink October alert to the need for early diagnosis of cancer): 781 views

• Outubro Rosa é aberto com alerta sobre importância da prevenção contra o câncer (Pink October opening with warning about the importance of cancer prevention): 418 views

• Terceirizadas passam por triagem no SIS para fazer mamografia gratuitamente (Outsourcers undergo triage in SIS for free mammography): 393 views

• Estilo de vida e herança genética podem causar câncer, afirmam especialistas (Lifestyle and genetic inheritance can cause cancer, experts say): 327 views

• Talk show com médicos, nesta quinta, discute a prevenção do câncer de mama (Talk show with doctors, this Thursday, discusses breast cancer prevention): 71 views

• Senado promove nesta quarta conversa pelo Facebook sobre câncer de mama (This coming Wednesday, the Senate promotes conversation by Facebook about breast cancer): 48 views

With a much broader target, the Senate’s homepage on the Internet reached results as shown below for the following news:

Title	Type	Total access (through social media and search engines)
Outubro Rosa conscientiza sobre prevenção do câncer de mama; (Pink October raises awareness on breast cancer prevention)	Special TV Show Cidadania.; 10/03/2017	1738
Senado promove nesta terça conversa pelo Facebook sobre câncer de mama; (This coming Thursday, the Senate promotes conversation by Facebook about breast cancer)	News Article; 10/10/2017	272
Outubro Rosa visa desmistificar o câncer de mama, afirma médica; (Pink October aims to demystify breast cancer, says doctor)	Video; 10/13/2017	88
Como prevenir o câncer de mama?; (How to prevent breast cancer?)	Video; 10/04/2017	157
Todo câncer de mama é hereditário?; (Is every breast cancer case hereditary?)	Video; 10/09/2017	261
Quais os fatores de risco para o câncer de mama?; (What are the risk factors for breast cancer?)	Video; 10/16/2017	123
Aberta campanha Outubro Rosa no Congresso Nacional; (Pink October Campaign is released in the National Congress)	News article; 10/03/2017	500

Although the target audience of the campaign has been the outsourced employees of the Senate, in terms of information and clarification, the campaign has reached a much broader internal and external audience, as shown by the visualization metrics of the activities.

When examining the campaign from the point of view of the 7 Ps of social marketing, according to Fine, and quoted by Bates [43], we have answers for the following questions:

1. (a) Who is the Producer, the source of the promotional message?

The Senate as well as expert partners were the message producers.

1. (b) Who makes up the potential Purchasers that we must address, and what needs and desires do these people have?

An immediate audience, composed of the outsourced employees without access to resources for medical tests, a wider audience composed of all the internal audience (other female servers in the Senate), and the general public, reached by the message, which is all the women who are part of the audience outside the Senate, who were reached either by social media, or by more traditional communication vehicles such as the radio, TV and newspaper.

1. (c) What Products can be identified specifically to meet those needs?

Basically the detailed information about breast cancer and its prevention, and the clinical and hospital tests and doctors consultations carried out.

1. (d) What is the Price the consumers will sacrifice to acquire the product?

In short, the price is the time available for the allocation of cognitive resources to get in contact, assimilate and share information, and also to face the fight against the fear; the fear of submitting oneself to medical tests, and to be prepared to eventually receive bad news regarding one’s health in case of a positive diagnosis.

1. (e) How can we communicate with our markets (Promote)?

Social media and other communication vehicles in the traditional media of the Federal Senate were used, as well as its internal information network, such as the Intranet, corporate emails and banners spread throughout the institution, in addition to events and artistic performances.

1. (f) Which institutions are involved in the process of making the product available at the best time and Place, for the buyer?

The internal infrastructure of the health service of the Federal Senate was provided, in partnership with the infrastructure of public health, at the time of the tests.

1. (g) How can we Probe and evaluate the campaign and how can feedback from the public be obtained?

Metrics for disclosure, visualization, and reviews of materials and postings were evaluated, as well as spontaneous manifestations of participants.

4. Conclusion

According to Mowen and Minor, research can benefit society. “Finding ways to influence people to act more responsibly […] and applying research findings to develop treatment methods and preventive actions” is paramount, and the natural way to do this is through the research into social marketing best practices [42].

Considering the campaign analyzed in this chapter, besides the health communication informing about breast cancer, several other actions took place. A major effort was made in order to reach Brazilian citizens through the Senate’s social media, as well as with an actual person-to-person contact, all these to try to make more people aware of the disease. For that, a close-targeted initiative was developed throughout the month of October: the outsourced female collaborators were invited to undergo an on-site medical consultation with the Senate mastologist doctors, and if the case required, the patient would be referred to a mammography exam carried out by the Public Health System (as a result of the partnership between the Senate and the Federal District Government). A total of 150 mammograms were performed. A disturbing fact is that most of the women who were reached by the initiative had never undergone a mammography before, which is an important exam to prevent breast cancer.

From the 150 patients assisted, 15 had an altered mammography result, and 4 of them had a diagnosis of breast cancer and were referred to a public hospital for treatment.

Although 150 people is a limited audience, the tests and the mammograms were just part of the campaign, which aimed to achieve, through advertising and journalistic information, the awareness of a wider audience, and the numbers registered show the campaign was extremely successful.

The high point of the initiative was being able to have the full support of the Public Health System to conduct the exams. It was a very important strategic partnership for the 2017 campaign, one that must be cherished and nurtured. Nevertheless, some mammograms were not performed within the expected period, due to problems commonly found in public hospitals nationwide, such as lack of personnel and equipment availability. This issue should be carefully addressed in the future editions of the Pink October campaign, for a more precise logistics and service for the women targeted in the program.

Other public and private institutions can take advantage of the strategies—and, literally, of all the informational materials produced –, although adjustments on the brand are needed, specially due to the fact that the October Rosa brand in the Senate has used the silhouette of the building of the National Congress.

Acknowledgments

The authors would like to thank Mr. Mikhail Lopes and Mr. Eduardo Leão, from the Secretariat of Social Communication of the Federal Senate, for their valuable assistance in gathering metrics from the Senate’s social media and from Intranet news, and of the Certified Translator Elisângela Tarouco for the context and grammar review.