Fernando Fischmann

Even Life-Saving Innovations Don’t Sell Themselves

20 February, 2017 / Articles

Most businesses wouldn’t survive without driving demand for their products or services, either through marketing and advertising or through involving users so deeply in the design of the product that word of mouth spurs adoption. The same is true for social innovators. However, unlike many business leaders, it is easy for social innovators to overlook making an intentional effort to drive demand because the need for their innovation is so great. But even the most needed innovation does not sell itself.

Consider that 86 million U.S. adults were at risk of developing type 2 diabetes in 2015. That’s one in three people. At the same time, some 1,000 nonprofits and community-based organizations were offering a drug-free solution to help avoid developing diabetes, but they weren’t sufficiently publicizing it or engaging users to sell the service. Even though these programs were covered by insurance, making them essentially free, only 20,000 adults took advantage, or less than 1/1000th of 1% of the at-risk population.

Great need doesn’t necessarily equal great demand. When pharmaceutical companies launch a life-saving drug, they regularly spend twice as much on marketing as on the drug development. While nonprofits, often starved for general operating funds, can’t match pharma’s marketing budgets, a recent Bridgespan study argues that it’s time they and their funders heed business findings on increasing noise in the marketplace and the need to make any new offering, even a life-saving one, stand out. In other words, they need to pay what it takes to actively drive demand.

Among nonprofits we surveyed last year, 70% reported shortfalls in program participation currently, and half said they were struggling with participation now more than five years ago. As one leader said, “We have scaled up a (youth job-training) program we are very proud of, but people are not coming through the doors.”

Yet others are succeeding by using a number of methods to drive demand, or “diffuse innovation,” as academic researcher Everett Rogers called it. He sought to explain how, why, and at what rate innovations spread, and a wide range of for-profit companies continue to draw on Rogers’s theories. The takeaways from Rogers’s work for nonprofits include three principles:

Design your service or program for “spreadability,” not just effectiveness.

Narrow in on a subgroup most likely to participate rather than identifying a broad group of potential beneficiaries.

Develop and fund a sales and marketing capability from the outset.

Let’s look at each of these.

Spreadability encompasses not only increasing awareness but also simplifying adoption.

In diabetes prevention, Omada Health, a for-profit organization, essentially offered the same program as the YMCA and others, but it lowered the initial time commitment. It served close to 4,000 people in 2014, its first full year in the market, and expected enrollment to top 100,000 in 2016, five times the number enrolled by all other diabetes prevention program (DPP) providers combined in 2015. How?

Omada markets its DPP as short and intense — just 16 weeks. Only when someone has nearly completed the program does Omada offer six to eight months of maintenance sessions. Compare this with the tougher sell of yearlong classroom participation required by other DPP providers. Omada also provides free online demos, wireless weigh-ins, and online profiles so participants can track and share their progress, increasing the likelihood that prospective participants will learn about the program by seeing others using it.

Omada demonstrated Rogers’s spreadability maxims, which call for a program that’s:

  • better than what exists (both costs and benefits)
  • compatible with beneficiaries’ values, past experiences, and needs
  • simple to use (or do) and understand
  • testable without having to commit to it
  • observable such that others can see the benefit of adopting it

The second principle is to target likely participants. This principle worked in helping to spread cardiopulmonary resuscitation (CPR) techniques. The example shows that it’s not enough to start with a subgroup that can help the program spread; you also have to choose the right segment.

CPR was a true lifesaver for cardiac arrest victims when it was developed, in 1960. For a decade, however, CPR did not advance beyond a small group of medical providers working in medical facilities. So early promoters, including the American Heart Association, looked to scale the technique by training another segment of lifesavers: volunteer firefighters. This group eagerly embraced the practice, but it had limited reach. The real breakthrough came almost by accident, years later when a doctor began training 911 dispatchers to instruct callers to administer CPR. That segment of lifesavers had tremendous reach because those dispatchers trained thousands of callers across the country. Today, more than 18 million people, both health care professionals and laypeople, are trained in CPR each year.

Build sales and marketing capabilities is the third principle. It’s not enough to create a service that people want and target the people most likely to use it. Organizations need to entice people to use that service.

A team of U.S. academic and government researchers confirmed, in 1971 that a mixture of water, salt, and sugar could halt the ravages of cholera-induced diarrhea, a solution called oral rehydration, but the remedy remained largely unused for years. Only when BRAC, a Bangladesh NGO, recruited and deployed thousands of paid workers to teach villagers how to make it out of ingredients in even the humblest of homes did adoption take off, in the early 1980s. In a few years, oral rehydration therapy became the norm for treating cholera and the broader group of diarrheal diseases that are the number one cause of death for children under five in the world’s poorest countries.

Generating demand is unfamiliar territory for most nonprofits. They can get started by answering three questions:

  • How will you ensure your program or service receives high scores from beneficiaries on the five dimensions: better than what’s available, compatible with needs, simple to use, testable, and observable benefits?
  • Which segment of those you hope to serve is aware they have a problem and is seeking a solution?
  • Who will sell your innovative program or service to potential beneficiaries?

Help in answering these questions is available. Acumen, a global nonprofit investor in organizations serving the poor, offers online courses on sales planning. Salesforce.org offers online tools that can help execute sales and marketing efforts. And human-centered design firms, like IDEO.org, can help nonprofits understand the attitudes and desires of their beneficiaries and redesign their programs to satisfy those desires.

These organizations — and, more important, the principles they adhere to — offer nonprofits and their funders a way to meet great human needs with targeted programs that are both needed and wanted.

The science man and innovator, Fernando Fischmann, founder of Crystal Lagoons, recommends this article.


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