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Public health initiatives increasingly recognize the potential of branding as a strategic tool to influence health behaviors. This comprehensive review explores how health branding has evolved since 2008, highlighting its growing application across diverse domains and the importance of rigorous evaluation methods. Understanding how branding shapes perceptions and actions can inform the development of more effective campaigns, ultimately leading to improved health outcomes. As public health professionals seek innovative ways to engage communities, integrating branding principles rooted in behavioral theory offers promising avenues for behavior change.

Introduction

Branding involves creating meaningful relationships between consumers and entities—whether products, services, or organizations—by establishing identities that resonate psychologically and socially. In commercial markets, brands like Nike or Volkswagen evoke specific lifestyles and aspirations, influencing consumer choices. Similarly, public health campaigns have long employed characters and symbols, such as McGruff the Crime Dog or the Marlboro Man, to personify health-promoting or socially beneficial behaviors.

Despite its long-standing use, the strategic development of health brands—crafted with psychological and behavioral insights—has gained momentum only recently. Early efforts in the 1990s, including condom promotion in Africa and tobacco control initiatives like Florida’s truth campaign, marked the beginning of health branding as a deliberate intervention strategy [ 2 ]. These campaigns drew upon theories like Social Cognitive Theory (SCT) [ 3 ] and the Theory of Planned Behavior (TPB) [ 4 ], providing mechanisms to understand how modeled behaviors and beliefs influence health decisions [ 5 , 6 ].

Health branding applies marketing principles to foster positive health behaviors by establishing associations and beliefs that influence actions [ 7 , 8 ]. Its success hinges on formative research to ensure messages are clear, valuable, and capable of competing with other messages in the crowded health communication marketplace [ 9 ]. Unlike commercial branding, where the product or service is the focus, health branding centers on voluntary behaviors such as quitting smoking or adopting physical activity, with the brand symbol serving as a cue for identity and social acceptance [ 10 , 11 ].

Brands are evaluated based on the associations consumers hold, such as awareness, loyalty, and perceived value [ 12 ]. In health contexts, these associations translate into attitudes, beliefs, and intentions that drive behavior [ 13 ]. For example, campaigns like truth leverage branding to challenge tobacco industry imagery, competing directly for youth’s attention and choices [ 16 ]. This competitive aspect is critical, as health brands often need to counteract more prevalent or powerful commercial brands.

This review extends the foundational work of Evans et al. (2008) [ 2 ], replicating their methodology to identify and categorize recent health branding efforts. It assesses the growth of research, evaluates campaign strategies, and discusses implications for future education and research in public health branding.

Methods

Search Protocol

A systematic search was conducted across major online databases, including PubMed, PsycINFO, Web of Science, and others, following accepted guidelines for systematic reviews [ 17 ]. The focus was on manuscripts discussing branding or specific branded campaigns aimed at promoting health behaviors. Search terms combined concepts like health promotion, social marketing, and health communication with keywords such as brand, campaign, diffusion, and advertising. Additionally, references to prominent health brands like Above the Influence were included to capture the breadth of efforts. To ensure comprehensive coverage, bibliographies of recent meta-analyses on social marketing interventions were also reviewed [ 18 – 20 ].

This search yielded 311 unique references, incorporating prior studies from the 2008 review [ 2 ]. Abstracts were screened to exclude product market research and non-behavioral health promotion efforts, narrowing the pool to 130 articles for full-text review (93 new, plus 37 from 2008).

Inclusion and Exclusion Criteria

Applying rigorous decision rules, articles were included if they reported original research on the development, delivery, or evaluation of branded health campaigns targeting health behaviors. Review articles, commentaries, and campaigns not designed to change behavior were excluded. This process resulted in 69 final articles—32 new since 2008 and 37 from the previous review.

Coding and Quality Assessment

Using a standardized coding form, two reviewers independently assessed each article, extracting information on topic area, brand development, marketing strategies, evaluation design, and outcomes. Variables such as the use of scientific theory, formative research, branding elements, marketing channels, and evaluation metrics were coded. A quality scale (0–11 points) was developed to gauge reporting comprehensiveness, considering factors like theoretical clarity, sample description, and measurement of brand awareness.

Discrepancies were reconciled through group discussions, ensuring consensus in coding. This process facilitated a robust synthesis of the evidence base and identification of methodological strengths and gaps.

Results

Overview of Included Studies

The 69 studies encompass a wide array of public health topics, with tobacco control (28.99%), diet and nutrition (17.39%), physical activity (13.04%), and HIV/AIDS prevention (11.59%) being most prominent (see understanding normal vital signs in adults for related health monitoring concepts). Many campaigns originated from high-resource settings like the U.S., Australia, and Canada, but recent efforts have expanded globally, including Pakistan, Zimbabwe, and Spain.

Brand Development

Most campaigns (77.1%) explicitly reported on the use of scientific or behavioral theories in their development, with marketing and psychological theories being most common. Formative research, such as focus groups and interviews, supported brand design in over half of the campaigns. Key branding elements, including logos, social models, and aspirational imagery, were frequently reported, emphasizing the importance of symbolic communication [ 10 , 11 ].

Marketing Strategies

Nearly all campaigns (95.8%) described their promotional channels, predominantly paid mass media (79.2%), with community outreach also widely used. Audience segmentation and message tailoring were employed to enhance impact, though the use of innovative marketing techniques remains variable. Campaigns often relied on non-oppositional strategies, except in tobacco control efforts, which frequently employed counter-marketing approaches [ 92 ].

Evaluation and Outcomes

Most campaigns (91.7%) conducted evaluations, primarily observational studies, with a smaller subset using experimental or quasi-experimental designs. Common metrics included aided and unaided awareness, brand loyalty, and equity. About 66.7% of studies reported behavioral outcomes, indicating some success in influencing health behaviors. However, the use of validated brand measures and rigorous study designs remains limited, highlighting a need for methodological strengthening [ 25 , 72 ].

Study Quality

Quality assessments showed an average score of 8.0 out of 11, with high-quality studies demonstrating comprehensive reporting of theoretical frameworks, research methods, and outcome measures. Nonetheless, many studies lacked experimental rigor, underscoring the importance of adopting more robust evaluation designs in future research.

Discussion

The expansion of health branding research over the past five years underscores its growing role in public health. Campaigns continue to span multiple health domains, with a notable increase in efforts targeting binge drinking, child care, and reproductive health. The sustained evaluation of major brands like truth and VERB demonstrates ongoing commitment to evidence-based practice, though many efforts still rely on observational data.

The findings reveal that while branding strategies are increasingly sophisticated, evaluation methodologies lag behind, often limited to pre-post or cross-sectional assessments. To establish causal links between branding and behavior change, more experimental studies utilizing validated brand metrics and longitudinal designs are necessary [ 8 , 72 ]. Developing a comprehensive theoretical framework for health branding could guide intervention design, measurement, and interpretation [ 8 , 72 ].

Public health agencies and researchers must enhance capacity through targeted training, such as the Behavioral Brand Builder (B3) initiative, to improve implementation and evaluation skills. This training can facilitate the creation of recognizable, impactful brands that effectively compete with commercial messaging [ 8 ]. Future research should also explore the potential of branding for behaviors requiring single or short-term decisions, such as helmet wearing or smoking cessation, and for complex behaviors involving co-occurring risks.

Limitations of this review include the reliance on keywords that may not capture all relevant campaigns, especially those not explicitly labeled as “branding.” As the field matures, clearer terminology and standardized measures will improve identification and comparison of health branding efforts.

Conclusions

Health branding holds promise as a strategy for promoting sustained health behavior change, but rigorous evidence is still emerging. The current literature suggests that branded campaigns can influence attitudes and intentions, with some demonstrating actual behavioral effects. To advance this field, future studies should employ controlled designs, validated measures of brand equity, and long-term follow-up.

Supporting the integration of branding into public health practice requires dedicated training, theoretical development, and methodological innovation. As health challenges become more complex, leveraging branding principles rooted in behavioral science offers a compelling approach to engage populations and foster healthier behaviors at scale.

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For further insights into health monitoring techniques, see understanding vital signs the foundations of health monitoring.