In 2015, the Victorian Department of Health and Human Services (DHHS) conducted a major review of Victoria’s ambulance services.
Among the issues identified was the fact that there had been a huge rise in the number of non-emergency calls to 000 and that these calls were diverting up to 10 ambulances a day away from urgent cases.
To raise awareness of this and help the community better understand the role that ambulances play in our community, DHHS engaged BehaviourWorks Australia (BWA) partner, The Shannon Company (TSC), to develop a mass media campaign illustrating the types of medical emergencies requiring an ambulance, and who else to turn to for help.
What did we do?
To gather insights for the campaign, TSC and BWA convened a Facilitated Dialogue with stakeholders from DHHS, Ambulance Victoria, the Emergency Services Telecommunications Authority and marketing firms.
Prior to the dialogue, BWA researchers conducted a Rapid Review on the topic, looking at best practice approaches around the world.
After considering the review, other materials and the advice of the experts in the room, participants decided that the best way to talk to the community about the issue was by personalising it.
The Save Lives Save 000 for Emergencies campaign harnessed the Theory of Planned Behaviour, which posits that behavioural intentions are influenced by attitudes (toward the behaviour), subjective norms (perceived social pressure to engage in the behaviour) and perceived behavioural control (apparent ease or difficulty of engaging in the behaviour).
The first TSC advertisement focused on Will, a young boy whose life was saved by Intensive Care Ambulance paramedics (because they were not tied up with non-emergencies). A powerful and emotional video (right) tells the story of Will’s survival.
After evaluating the outcomes of the first phase, a second tranche of the campaign was produced in 2018. Entitled Meet the Team, it introduced viewers to a team of (typical) non-emergency health care professionals, including a General Practitioner, Pharmacist and Registered Nurse, who are available to people with non-life-threatening health issues.
Both campaigns involved mainstream and targeted media and were run over a period of months.
Apart from being involved in the formative research, BWA was heavily involved in monitoring and evaluating the campaign. In fact, the team, led by Kim Borg, conducted what is believed to be the most comprehensive known evaluation of a community-wide mass-media behaviour change campaign.
With A/Prof Peter Bragge, and co-authors from TSC, DHHS and AV, in 2019 Kim published the results of the formative research and the first round of assessments.
It showed that the short-term effects of the campaign were successful in shifting attitudes towards using ambulances. Then, in January 2020, the team published a second paper which focused on the longer-term behavioural outcomes. It showed that daily calls to 000 decreased after Will’s story was aired and that the campaign had indeed influenced health-seeking behaviours among the Victorian community.
An increase in calls to NURSE-ON-CALL coincided with a decrease in calls to 000 during the three months after Meet the Team advertisement was aired, compared to the same time in previous years.
This short-term change did not translate into a decrease in behavioural trends for any of the services included in the study. Rather than shifting from 000 to another specific healthcare service, it is likely that those who would have previously called 000 in a non-emergency sought advice or treatment from a number of different healthcare services, essentially dispersing among the Victorian healthcare system.
The findings from this research demonstrate the merits of sensitising the market (Will’s Story) before moving to a specific call to action (Meet the Team).
The team emphasised the importance of multi-sector engagement in the planning and execution of this campaign and from a policy and practice perspective.
The results illustrate the utility of taking an evidence-based approach to designing a state-wide campaign, along with implementing a robust monitoring and evaluation framework.
Based on the outcomes of this project, consideration will be given to applying this model to future applicable behaviour change campaigns within DHHS.
Borg K, Wright B, Sannen L, Dumas D, Walker T, Bragge P. (2019). Ambulances are for emergencies: shifting attitudes through a research-informed behaviour change campaign. Health Research Policy Systems; 17(31).
Borg, K, Dumas, D, Andrew, E, Smith, K, Walker, T, Haworth, M, & Bragge, P. (2020). Ambulances are for emergencies: shifting behaviour through a research-informed behaviour change campaign. Health Research Policy and Systems; 18(9).