Navigating Native Advertising

What are you hearing about native advertising? Here’s what we’ve heard:

“The online ad industry is going native.” “It’s the hottest thing going in advertising” “It’s the savior of the industry.” All of these quotes (found in various stories and blog posts on the topic) might lead you to believe you’re missing out on an advertising revolution. Or they might lead you to ask “what the hell is native advertising?” Either way, as a hospital marketer it’s important to put native advertising in the right context, so you can know whether it makes sense for your marketing goals.

A rose by any other name…

Let’s start with the issue of definition, because it seems advertising professionals themselves can’t define what is meant by “native advertising.” For example, here’s what Wikipedia says:

Native advertising is a web advertising method in which the advertiser attempts to gain attention by providing content in the context of the user’s experience. Native ad formats match both the form and the function of the user experience in which it is placed.

Got it? It’s a little vague, and we would argue, a little limiting, given that many forms of native advertising (as we’ll demonstrate) take place offline. Or how about this gem? Felix Salmon, a Reuters columnist, is quoted in this blog post on Mashable, defining native advertising in this way:

A native ad is something that consumers read, interact with, even share — it fills up their attention space, for a certain period of time, in a way that banner ads never do . . . In that sense, TV ads are truly native; the way you consume a TV ad is the same as the way you consume a TV show. Similarly, long copy print ads are native, for the same reason.

Say again? TV ads are “native” because you consume them in the same way you consume a TV show? Well, yes, that’s true. But what advertising isn’t consumed in the same way the content around it is consumed? Assigning a defining label that applies to an entire universe isn’t much of a defining label. At Interval, here’s how we describe native advertising: advertising with the intent of attracting audiences because of how it mirrors both the form and the value of the content that surrounds it. For example, the classic form of native advertising is the advertorial, a print ad that is designed using a long-copy format to try and replicate the editorial that surrounds it in a magazine or newspaper. That design is intentional: the advertising is hoping the reader will value the content in the ad in the same way they value the content in the magazine, and at some level, hopes the reader doesn’t even notice the shift from editorial to paid content given the similar form of the long copy ad. Not all native advertising works just like an advertorial, but it does share the common trait of intending to draw in readers/viewers/listeners/surfers by blurring the lines between the publisher’s content and the advertiser’s content, both in look and in the content itself. As we delve into later, that “blurriness” can cause problems with native advertising, because it often feels that in some cases advertisers are trying to pull a fast one on audiences by trying to equate their advertising with the content the audience values in the first place. And as marketers of hospitals and health systems, we need to be particularly in tune to any effort that pushes those kinds of boundaries.

Contrasting native with other advertising

To help further clarify the situation, it can help to contrast native advertising with similar (but not identical) marketing concepts. For example, while some native advertising could be considered content marketing (what we define as the strategy of targeting audiences with messages, information, tools or interactions that have value outside of a purchasing need), not all content marketing is native. Native advertising is often confused with “contextual advertising,” which is loosely defined as advertising that takes into account its surroundings to further connect with the audience. For example, a testimonial TV spot featuring famed racecar driver Jeff Gordon for Quaker State Oil that runs during a NASCAR race would be considered contextual advertising. It’s not native advertising, however, because it’s not trying to replicate the form of the content that surrounds it (while it’s on TV like the content that surrounds it, it doesn’t take the same form – a live race). The advertiser also isn’t expecting you to value the ad in the same way as the race, because it’s clear it’s an ad (not the event itself). And finally, some folks might say “isn’t this just PR?” Native advertising is different in two fundamental ways: for one, PR – specifically media relations – lands your product, service or organization in the actual editorial content (like a story on how your emergency department saves lives), not in the advertising that surrounds it. And second, while you spend money on PR efforts, you don’t pay the publisher/resource to cover your product, service or organization. With native advertising, you’re most definitely paying to play.

Now that we have a clear (?) definition of native advertising, how should you leverage it when marketing your hospital or health system? Like any marketing channel or tactic, you need to evaluate how effective this particular approach is given your marketing goal, your budget, your brand, your competitors and everything else that matters. But with native advertising, we think you need to take an extra step to make sure that if you leverage it, you do so within some sort of ethical boundaries. Because as we mentioned, the lines are very blurred and ever moving with native advertising regarding what’s right and what’s wrong, what feels ethical and what doesn’t, and what’s legal and what’s not. For example, go back to the advertorial example. For many people, the more an advertorial attempts to replicate the content around it, the more underhanded it seems. That’s an inherent conundrum with native advertising – the closer an advertiser comes to replicating the form and value of the surrounding content, the more likely they are to cross the line and become misleading. There often seems to be a correlation between the “sneakiness” of such an ad and the advertiser behind it – those products or companies using the more extreme versions of advertorials often come off as less-than-stellar brands, which is the danger of misusing native advertising.

Trust and transparency

At Interval, we believe there are two criteria – “trust” and “transparency” – hospitals and health systems can use to help decide whether your native ad will be effective or prompt a negative reaction. “Trust,” speaks to the level to which an audience member relies on the integrity of the publisher’s actual content to form their own opinions and decisions. And “transparency,” speaks to how obvious it is to the audience member that what they’re experiencing is actually an ad. Many would use transparency alone to judge the ethics of a native ad, but we think both must be used together. For example, consider another classic form of native advertising – product placement in a movie. Showing an Apple laptop in use in a James Bond movie matches the “form” – the product is literally “in” the content – and the hope is that you’ll “value” the product in some way because of it (even just seeing it there builds awareness, whether or not equating Apple to a sexy British spy changes your perception one way or the other of the product). With this type of product placement, however, there’s no transparency whatsoever. You have no explicit indication that it’s a paid product placement. If that were all that mattered, you might storm out of the movie theater, protesting loudly at the disgusting nature of the trickery. But honestly, most of us would say “eh, who cares?” That’s because no trust has really been broken. We expect entertainment from a movie and don’t expect a level of integrity from the movie or its producers as far as helping us form opinions, make decisions or otherwise gain from the content. So the native ad feels ok, and possibly, it improves upon the content. (Notice how this scenario might change dramatically in, say, a documentary film, where a gratuitous product placement might make you question the integrity of the film-makers.) To help you construct boundaries that work for you and your healthcare organization, here are examples that, from Interval’s perspective, lay out in clear “black and white” terms what works and what doesn’t from an ethical standpoint in native advertising. We’ll cover the “gray” area as well.

The Black

When both the trust and transparency criteria fail the sniff test, a native ad could actually illicit negative feelings from the audience, which would then be associated with your brand.

At the bottom of most stories on, you’ll find links to other stories on that would theoretically be of interest to those reading the story itself. Next to those links, labeled “More from CNN,” are links under the subhead “From Around the Web.” Hey, you might say to yourself, CNN has provided me other resources I might enjoy. Until you click on a link and are led to a website for a product or service. Those are actually paid links by advertisers. This fits the definition of native advertising – the links mirror the form and value of the “More from CNN” links next to them. (Also notice these are distinct from the clearly marked “Sponsored Links” below.) But there is nothing indicating these are paid links (unless you count the small “Recommended by” caption that is off to the right, not really attached to the “From Around the Web” links, where it explains these are paid links. Which you shouldn’t, since the caption doesn’t use the word “sponsored” or “paid” or something to imply ad placement.) It’s a transparency fail.

If you trust CNN as a news source, that trust may be broken because you’ve been tricked into thinking these paid links are actually the same as the editorial links next to them. (Note: is not the only news site that leverages such paid “From Around the Web” links.) In both cases, don’t you get a twinge of negativity when you uncover the truth? THAT is the feeling you want to avoid with your native advertising.

The White

When done well, native advertising can bring positive results. According to the same Mashable blog post, BuzzFeed has more than 700 advertisers that use its native advertising offerings, which can reportedly cost anywhere from $5,000 to $25,000. Or that Forbes reports 20% of its revenue comes from its native “BrandVoice” platform. Again, the “trust” and “transparency” criteria might help explain why these examples are successful, let alone ethical. Let’s look at BuzzFeed, the popular entertainment site that has mastered the art of content delivery and, for its advertisers, content marketing. Look at the paid posts – they are clearly marked as advertisements in three different ways: the space behind the post is a beige color, the bottom right-hand corner states “FEATURED PARTNER” and each post includes a “Presented by…” with the advertiser’s logo. “Transparency” – check. In addition, why do you go to BuzzFeed? To be entertained. Just like the actual “editorial” content, the paid ads can be entertaining. More importantly, I’m not expecting much of anything from BuzzFeed from a “trust” standpoint – I’m not relying on their integrity to help me form an opinion or make a decision. I’m just having fun! So no “trust” is broken through native advertising.

Let’s look at another example that is incredibly successful for the publisher and also drives demonstrable results for most advertisers: Google search advertising. While it’s not typically called native advertising, that’s exactly what pay-per-click ads are. If you’re buying a pay-per-click Google ad, you hope someone searching for your search term considers your ad in the same way they would consider the natural search terms, both in how the viewer would value the ad and in how they see the ad (which looks a lot like the natural search results). But Google search ads also pass the “trust” and “transparency” test. Take a look at this search for “cardiologist” in a desktop browser:

The ads at the top and the right are clearly marked as “ads.” The ads at the top have a distinct background color, and the ads on the right are in a clearly defined space separated from the natural search results. This meets the “transparency” criteria, though it’s important to note that these indicators have evolved over time. In the beginning, the distinction between natural search results and paid search ads wasn’t nearly so transparent on Google. (And this separation is not nearly as transparent in many other formats. For example, the ads in a Google search result on a mobile device aren’t nearly as distinct, having only a small “Ad” label in a yellow box and an even smaller “i” icon in the upper right to distinguish them from natural results.) In addition, I “trust” that Google will deliver the best results for my search, regardless of how they’ve been paid by advertisers or any other influence. I expect the most popular/relevant results for my searches, but the accompanying paid search ads don’t breach that trust. Partially this is because they are so clearly “transparent” and distinct. I also know they are a business and need to make money, so I expect advertising here. It doesn’t feel misleading (like the “From Around the Web” links did.).

The Gray

No matter what guidelines you set, in the end, it often comes down to gut feel as to whether native advertising crosses the line between effective and acceptable to misleading or bamboozling. Take for example the “boosted” Facebook post. As the owner of a Facebook page, you have the opportunity to amplify the reach of any post you make, using Facebook’s “Boost” service. Boosting a post can have two benefits: first, you can increase the number of your fans who see the post (only a certain percentage of your fans will ever see the posts you make to start with), and second, you can have your post passed along to your fans’ networks, so a certain percentage of their friends will see the post (this has the advantage of taking your message beyond the circle of fans who know you to those who, theoretically, don’t). The post would show up in the newsfeed of those who have been targeted saying “Joe Public likes XYZ Hospital.” This fits our definition of native advertising – the “advertisement” mirrors the form (it’s a post) and the value (it’s a recommendation from a friend) of the posts that surround it. But here’s where it gets tricky – the only thing designating that this is an advertisement (which at that point it is, because you’ve paid to reach those additional Facebook users) is a small “sponsored” label at the very end of the post. So does that fail the “transparency” test? What about “trust”? Facebook is essentially the world’s largest word-of-mouth generator, and many of us will trust the comments, likes and recommendations of our Facebook friends. By boosting this ad, have you broken that trusted relationship? Well, the post itself isn’t saying anything new or different – Joe Public “liked” XYZ Hospital at some point, so the inherent trusted recommendation is accurate. Facebook is just allowing you to promote that fact in more places (to more users) than normal. Whether or not that feels sketchy to you depends on how you view Facebook and how much you value the content your friends provide through it. In other words, it depends. From Interval’s perspective, there’s nothing shady about using this form of native advertising, but you may decide differently.

So where does that leave you and native advertising?

If and how your healthcare organization leverages native advertising will depend on your comfort level with the above “blurriness” regarding when it feels appropriate/ethical and when it feels sketchy. From our perspective, native advertising isn’t a strategy hospitals and health systems need to employ distinct from other marketing strategies. In other words, you shouldn’t declare “let’s develop a native advertising plan” and start implementing the strategy on its own. (That would be like declaring “let’s develop a billboard plan.”) Native advertising is one of many techniques that could be used to further whatever marketing goals, programs and campaigns you’re pursuing. But no matter how you leverage it, make sure your approach is not only effective in helping you reach your marketing goals but also meets the integrity guidelines that make the most sense for you. That can make the difference between “boosting” your brand or damaging it.

November 4, 2014
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