24 August 2011

Good Intentions Gone Wrong: Part 1 - Breast Cancer Awareness

One of the things that I try to point out here is that some of the best conceived plans can lead to unintended consequences.  Even when the work has been done to prepare for all conceivable outcomes and hurdles things can still go wrong.  It is why I am such an unabashed fan of improving evaluations, supporting donor education, and call for a healthy dose of conservatism when starting new initiatives and ideas.

The goal is not to shut people out or to discourage innovation.  Innovation should take place and be encouraged, but let's not confuse redundancy with innovation.  Making the same mistakes over and over is troubling.  Improving evaluations coupled with better transparency will help to lead to a better informed public and sector.

This brings me to two recent studies which reveal the unintended consequences of an advocacy campaign and a health program.  In the first case, the color pink being used by breast cancer advocates may in fact harm their efforts to raise money.  The second example will be of the long term impact of insecticide treated bed nets in Senegal.  A decrease in malaria rates has not sustained and rates are not higher than they were at the beginning of the distribution of nets 2.5 years ago.

Turned off by Pink

On Mother's Day, you will see David Ortiz, the giant teddy bear of a DH for the Boston Red Sox, holding what looks like a pink toothpick between his massive frame. After striking out (Yankees fan, what can I say?), Derek Jeter steps to the plate, much smaller than Ortiz, with a bat of a similar pink hue. The bases upon which he runs after hitting a single off Josh Beckett are also pink as are the batting gloves he takes on while at first base and even the armband that wipes the sweat from his brow. The explosion of the color pink on the day is raise awareness about mother's day and one of the most deadly diseases affecting women: breast cancer.

There was once a time when gender norms determined that boys would wear pink and girls blue. After being flipped in the 1940's the color pink has been attached to women and preppy twenty-somethings who pop their collar. Using the color that is associated with women to advocate for a diseases that overwhelmingly affects women seems to have made perfect sense; or so it seems.

A group of researchers decided to take a look at attitudes associated with the color and the campaign and have published their findings in the Journal of Marketing Research (PDF).

The Society Pages blog summarizes the findings:
Stefano Puntoni and his colleagues found that when women were exposed to gender cues, like the color pink, they were less likely than women who had not been primed with a gender cue to think that they might someday get breast cancer and to say that they’d be willing to donate to the cause. Pink, in other words, decreased both their willingness to fund research and the seriousness with which women took the disease.

Puntoni explains this finding with a common psychological tendency. When people are faced with a personal threat, they tend to subconsciously go on the defensive. In this case, when women are exposed to information about breast cancer at the same time that they are reminded that they, specifically, are vulnerable to it, they subconsciously try to push away the idea that they’re vulnerable and that breast cancer is something that they, or anyone, needs to worry about it.
Given the ubiquity of pink ribbon's, it is likely that a significant amount of women are aware of the campaign and are being negatively affected by the way that it is presented. With the goal to raise awareness and get checked more frequently, it is possible that it is causing more damage than good.

What we do now know is that what seemed to be the obvious choice may be wrong. If research, like this study, was done prior to the campaign it may have lead to a different approach. So what is next? It is not likely that the color pink will be abandoned because of a single study. Who knows. Maybe next season the bases on the ball field will remain white all year long and arm bands will correspond to the uniform of the player's team.

Intention to do good undone by the use of the color pink. Use to show why it is important to do research before and that unintended consequences come in many different forms.

In part 2, tomorrow, I will discuss the recent malaria study from Senegal.