Simply described, social marketing borrows strategies from soft drink, paper towel, and other consumer goods advertising to persuade people to change social behaviors and norms. Successful examples include motivating people to use seat belts, stop smoking, and use designated drivers. But the theories are stretched when the audience includes one of the most vilified groups in society, and the message runs sharply counter to conventional wisdom.

Stop It Now! affiliates in the United States and United Kingdom have been using social marketing concepts for more than ten years to advance two groundbreaking ideas:

• Many people who sexually abuse children want, and will use, treatment to control their impulses.

• All adults are responsible for noticing warning signs and engaging with people at risk of sexually abusing a child, before a child is harmed.

“You have to have a deliberate message and deliver it consistently,” says Michael Stinson, director of Stop It Now! Philadelphia. “You want it to be very specific, so people don't have to guess. Then you've done half the work for them.”

The challenge is finding the precise language to effectively pitch such a controversial message without evoking animosity in a skeptical public.

Stop It Now! was founded in 1992 by Fran Henry, a sexual abuse survivor. She believes that society's solely punitive responses to sexual abusers discourage disclosure. In fact, 88% of those who are abused as children never report it to authorities; 90% of children who are abused already know their abuser—often a family member or family friend, or even another child. When the abuse stays secret, no one gets help.

Stop It Now! staff visited prisons and treatment centers to ask people who had sexually abused children what might have helped them stop. Many believed that an intervention by another adult would have made a difference. That research was the foundation of Stop It Now!'s public health model for abuse prevention, which attracted an endorsement from the Centers for Disease Control and Prevention and funding for community-based pilot programs.

For more than ten years, Stop It Now!'s Web site, www.stopitnow.org, and national Helpline, 1-888-PREVENT, have offered confidential ways to find local information and referrals to get help. Often callers to the Helpline are discussing their concerns and fears out loud for the first time.

Lessons gleaned from Stop It Now!'s first marketing campaign in Vermont in the 1990s have informed subsequent efforts. Recent campaigns have adhered to the core premise—adults are responsible for protecting children from sexual abuse. But choosing a target and crafting a message that avoids stereotypes, while honoring stakeholder expectations and local sensitivities, result in different approaches for each community.

Recent Virginia (figure), Philadelphia, and Georgia campaigns focus on “bystanders”—nonoffending adults in a position to intervene in situations in which abuse could occur. Virginia's effort, including billboard advertising, encourages people to “trust your gut feeling” if some behavior makes them uneasy. Philadelphia's program focuses on warning signs in everyday behaviors. Stop It Now! Georgia has concentrated on interventions with children and adolescents with sexual behavior issues. This past November Stop It Now! Minnesota launched a campaign directly targeting a more challenging population—those having sexual thoughts and feelings about children, but who have not yet acted on them.

Like traditional advertisers, Stop It Now! uses surveys and focus groups to identify existing attitudes and to formulate effective messages to promote its “product.”

“One of the most important things we learned is ‘we are not the target audience,’” explains Yvonne Cournoyer, Stop It Now! Minnesota's director. “We all have our own ideas about the best way to reach our audience. But what we think is not really meaningful. We realized that if we're going to effectively do social marketing, we have to go with what the target audience tells us.”

To that end, researchers working with Stop It Now! Minnesota asked questions to focus groups of people in treatment for sexually abusing children to help formulate the message. After compiling and analyzing the data, they drafted a series of messages and photos for the Minnesota ads. Then new focus groups of recovering offenders assessed the ads for effectiveness at reaching a person on the brink of abusing.

Once a message was developed, Stop It Now! Minnesota ran it by potential critics—supporters, stakeholders, community leaders, the media, and people likely to oppose the message, however it's framed—all in the interest of anticipating reactions that might undercut effective delivery.

“We vetted every word with anyone who would talk to us,” Cournoyer says. “We wanted people to be aware of the ads and to have a context for them.”

Separate focus groups of adult sexual abuse survivors, victim advocates, and law enforcement offered reactions.

“We looked for major red flags of language that would offend,” Cournoyer explains. “We made alterations, changed wording. But it was most important to remember that we would fail if we used a message that was good for adult survivors but no longer reached the target audience.”

When Stop It Now! Minnesota's billboard and transit poster campaign (figure) was launched, local media coverage was widespread and positive and was picked up by the national press. Although the three prominently placed billboards prompted shock and complaints from some in the community, prior contacts with politicians, law enforcement, faith leaders, and social service or mental health professionals helped smooth the way. And the Helpline had an increase in calls from people seeking help to control their own abusive impulses.

Stop It Now! programs all work under the auspices of a sponsoring organization. Decisions about budgets as well as choices for targets and campaign strategies inevitably are influenced by the objectives of the sponsoring organization. Sponsors include:

• treatment providers such as Project Pathfinder in Minnesota and the Joseph J. Peters Institute in Philadelphia

• child advocacy groups such as Prevent Child Abuse Georgia, the Child Abuse Prevention Fund (Wisconsin), and the Children's Trust Fund (Wisconsin)

• state agencies and coalitions including the Virginia Department of Health and the Massachusetts Coalition for Sex Offender Management

The costs, especially for billboards, can be staggering. Unlike retail corporations, social marketers must operate without the benefit of sales revenues. Campaigns in Minnesota, Philadelphia, and Georgia all benefit from crucial alliances with local ad agencies that arranged for donated or cut-rate billboard space.

Whoever the sponsors, whatever the hurdles, Stop It Now! campaigns are all using marketing strategies to promote a new way of looking at child sex abuse prevention—preventing sexual abuse of a child before there's a victim to heal or an offender to punish.