Background Well-developed social marketing campaigns can shift health-related societal attitudes and behaviours. The purpose of this study was to determine the efficacy of a social marketing campaign to raise awareness, change attitudes and behaviours to reduce the number and severity of injuries among citizens aged 25–54 in BC, Canada.

Methods A 2-year, 2-phase formative evaluation comprised focus groups and on-line survey. Phase I consisted 8 focus groups of 6–8 participants aged 25–54 throughout BC. The goal was to understand perceptions, attitudes, knowledge and behaviours, and to understand potentially effective injury prevention messages and channels. Phase II comprised on-line survey of 300 citizens 25–54 in May 2009. Demographic, knowledge, attitudes and behaviour variables around injuries served as pre-campaign baseline metrics. A multi-year, multi-faceted campaign, using TV, radio, print, signage, guerrilla events and social media launched in June 2009. Data from random samples (n = 700) were gathered at 4-month intervals and used to monitor changes in awareness, attitudes, behaviours, together with changes in injury deaths.

Results Some 50% of BC population (2M) were reached weekly, and over 100 M media impressions were generated during the 6-month launch period. 50,000 visited http://www.preventable.ca. Campaign recall increased 45%; TV ads were considered informative, relevant, credible and generated self-reflection with no advertising fatigue. Positive shifts (5–10%) in attitudes and behaviours were observed, and significant differences persist over 7-years between those who have seen the campaign vs those who have not. Reduction in injury deaths among the target population was associated with the campaign period.

Conclusions A well-developed injury prevention social marketing campaign based upon input from the target audience can result in significant changes in awareness, attitudes and behaviours, which was associated with decreased injury mortality.