In the battle against H1N1, these ads are different strains

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It's like something out of a horror film. A man, coughing and sneezing from the flu, leaves a trail of grimy green fingerprints behind him as he makes his way home from the office. The fingerprints - a bit of poetic filmmaking licence used to illustrate live flu germs - appear on the stop button of his bus and on the front door of his house. Then, after the sickly fellow arrives home and turns off the TV with a remote control, his young son picks up the device, turns the TV back on and - in horrifying slow motion - places a germ-riddled thumb into his tiny mouth.

The creepy moment is from an ad that hit airwaves this week in Britain, where the Department of Health is in the midst of rolling out its mass media campaign to raise awareness of the H1N1 virus, one of many such government efforts around the northern hemisphere to combat the infectious disease.

Most global campaigns - say, for movies, music releases, or software launches - are driven centrally by a single corporation. But the approaches to combatting H1N1 are as varied as the territories themselves. And while the aim of most marketing is to sell a product, ad industry executives admit that changing human behaviour - vital in fighting disease - through conventional advertising presents a far tougher challenge.

Here in Canada, the federal government has been under fire for poor communication, which some say has allowed misinformation to spread. During a press briefing this week, Leona Aglukkaq, the Minister of Health, was pestered by a reporter who insisted the ads weren't reaching the public. Ms. Aglukkaq disagreed.

It may be that the reporter simply didn't notice them. The TV commercial developed by Health Canada is a bland, purely informational spot, featuring a racially diverse array of Canadians behaving cautiously and properly: a mother and daughter washing their hands together, an office worker squirting an alcohol-based sanitizer into his hand, a woman at lunch sneezing into her arm, a man spraying disinfectant on the door handle of his fridge, and a miserable-looking fellow laid out on the couch blowing his nose into a tissue.

Other countries recognize the need to grab a viewing public with entertainment value. In an amateur U.S. spot that won a contest sponsored by the Centers for Disease Control, someone energetically rubs the bristles of a toothbrush against heavily used public surfaces: an ATM, a computer mouse, a handrail, even a cat. The final text solves the mystery of what we're watching: "It's the same as touching your mouth without washing your hands."

Jonathan Hill, business director at DDB London, the agency that developed the spot for Britain's Department of Health, says using advertising to change behaviour is different than using it to sell a product. "If I were trying to convince you to buy one soap over another, I'm trying to give you a reason to believe one is better than another, so when you're in a supermarket, you'll remember that reason and you'll think, 'Oh, I'll give it a go.' You'll either buy it or you won't," he says.

"What we're dealing with here is changing a mindset, changing an attitude; it's a more complex and difficult thing to do, because people's habits around hygiene are formed largely as children." Yesterday, Mr. Hill noted that he could still recall the rhyme he heard in classrooms as a child in postwar Britain: 'Coughs and sneezes spread diseases.'

"There was a reason it was done and targeted around schools, because that was a very fertile area. Kids' minds are open to new ways of doing things much better than adults," he said. With that in mind, theDepartment of Health website offered a short story last year featuring a popular children's character, Dirty Bertie, learning the lessons of proper hygiene.

Still, Mr. Hill added that some product ads have operated in a similar manner to the current flu campaigns. Manufacturers of hybrid cars, for example, tend to emphasize characteristics unique to their category rather than the on-board features and low prices that monopolize other auto pitches. "That operates within a wider context - as this does - because we don't have to go and tell people there's swine flu out there, the media's doing that for us. Everybody else is telling people the reason why they should be doing something, so we have to nuance our message within that context."

The CDC in the United States is currently trying to walk a fine balance between education and overselling. With national vaccine stocks lower than it had hoped, the U.S. cannot afford to drive citizens en masse to flu shot clinics. It will be rolling out the majority of its TV and radio spots, which have been heavily reworked through focus group research, in late November.

But in the meantime, it doesn't want to actively discourage people from seeking the vaccine. When the U.S. ran low on vaccines during the 2004-05 flu season, the non-profit Ad Council rushed a spot on air showing someone visiting a laundromat in a space suit, pointing out that one didn't need to go to extremes to avoid illness. But research years later found that people still remembered the message and believed that washing their hands was as dependable a method to avoid the flu as getting the vaccine.

"We always worry, have we emphasized the hand-washing message too much?" says Kristine Sheedy, the director of communication for CDC's national centre for immunization and respiratory disease.

Another arm of the CDC may be finding an exception to Mr. Hill's belief in the difficulty of changing behaviour. Just as consumer marketers are in thrall these days to the charms of social media, a small unit at the CDC has found success in using social media. One of the CDC's Twitter feeds, which had a base of less than 3,000 followers in April, now boasts more than one million. It has a presence on Facebook and MySpace, and provides numerous widgets that allow bloggers to add CDC content to their websites.

In September, it launched a three-month text-message pilot program for mobile phones. And an e-card initiative that allows people to send personalized notes to loved ones about the importance of everything from breast cancer screening to donating blood boasts a click-through rate of about 80 per cent. Ann Aikin, a social media specialist at the CDC, offers this theory for its success that marketers everywhere are trying to ape: "We think that's because someone you know and trust is sending it to you."