Using evaluation to enhance a pre-exposure prophylaxis (PrEP) social marketing campaign in real time in Los Angeles County, California

Objective To describe the application of a formative evaluation conducted concurrently with implementation of a public health social marketing campaign to allow for substantive changes to the campaign messaging to subsequently improve acceptability. Method A serial cross-sectional survey was used to evaluate the acceptability of two campaign messages among Black and Latino men who have sex with men (MSM) and transgender persons (TGP) in Los Angeles County from 2016 to 2018 through an online survey. Theinitial message, which presented the PrEP Protectors, a trio of superheroes embodying the power, knowledge, and protection pre-exposure prophylaxis (PrEP) can provide, was revised based on respondent feedback collected in the survey to increase specificity and clarity. An adjusted regression model tested whether the revised campaign message, (the initial campaign plus revised imagery and streamlined language) was predictive of increased campaign acceptability compared to the initial message alone. Results A total of 911 eligible respondents were surveyed, most were MSM (83 %), <age 30 (62 %) and reported PrEP awareness (76 %). Compared to respondents shown theinitial campaign, those exposed to revised campaign were significantly more likely to report campaign acceptability (adjusted odds ratio (aOR) = 2.56; 95 % CI: 1.64-3.94). Conclusion Conducting an evaluation concurrently with campaign implementation to test campaign acceptability facilitated responsive modifications to improve campaign which in turn enhanced clarity of campaign messaging and acceptability to the priority populations.