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Social marketing-based communications to integrate and support the HEALTHY study intervention

International Journal of Obesity volume 33, pages S52–S59 (2009)Cite this article

Abstract

The HEALTHY study was a randomized, controlled, multicenter, middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Participants were a racially, ethnically and geographically diverse cohort from across the United States. Here, we describe the conceptual underpinnings and design of the social marketing-based communications component of the HEALTHY study intervention that combined changes in the school nutrition and physical education (PE) environment with behavior change initiatives. The communications intervention component coordinated multiple elements to deliver campaigns that served to integrate and support all aspects of the HEALTHY intervention. The campaigns unfolded across five semesters of middle school, each targeting a specific theme related to the HEALTHY objectives. Communications campaigns comprised (1) core elements such as branding, posters, banners and visual and verbal messaging, (2) student events supporting the nutrition, PE and behavior intervention components through the application of social marketing and communications strategies, including the incorporation of student-generated media and (3) distribution of premiums and theme enhancers to extend the visibility of the study beyond the intervention environment. Formative research conducted with students, parents and school administrators was used to refine the communications strategy. Student peer communicators selected from the student body were involved to influence the normative student environment. Marketing and creative design experts developed a brand, logo, activities and materials. In the latter half of the study, student-generated messages and media were used to reflect local interests and culture and enhance peer influence. The HEALTHY intervention delivery and impact were strengthened by the communications strategies. The HEALTHY experience provides practical considerations for systematically incorporating a social marketing-based communications approach within future school-based health behavior interventions.

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References

  1. The HEALTHY Study Group. HEALTHY study rationale, design and methods: moderating risk of type 2 diabetes in multi-ethnic middle school students. Int J Obes 2009; 33 (Suppl 4): S4–S20.

    Article  Google Scholar 

  2. McMurray RG, Bassin S, Jago R, Bruecker S, Moe EL, Murray T et al., for the HEALTHY Study Group. Rationale, design and methods of the HEALTHY study physical education intervention component. Int J Obes 2009; 33 (Suppl 4): S37–S43.

    Article  Google Scholar 

  3. Gillis B, Mobley C, Stadler DD, Hartstein J, Virus A, Volpe SL et al., for the HEALTHY Study Group. Rationale, design and methods of the HEALTHY study nutrition intervention component. Int J Obes 2009; 33 (Suppl 4): S29–S36.

    Article  Google Scholar 

  4. Venditti EM, Elliot DL, Faith MS, Firrell LS, Giles CM, Goldberg L et al., for the HEALTHY Study Group. Rationale, design and methods of the HEALTHY study behavior intervention component. Int J Obes 2009; 33 (Suppl 4): S44–S51.

    Article  Google Scholar 

  5. Summerbell CD, Waters E, Edmunds LD, Kelly S, Brown T, Campbell KJ . Interventions for preventing obesity in children. Cochrane Database Syst Rev 2005; 3: CD001871.

    Google Scholar 

  6. Grier S, Bryant CA . Social marketing in public health. Annu Rev Public Health 2005; 26: 319–339.

    Article  Google Scholar 

  7. Andreasen A . Marketing Social Change: Changing Behavior to Promote Health, Social Development, and the Environment. Jossey-Bass Inc: San Francisco, 1995.

    Google Scholar 

  8. Smith DE, Marcus MD, Lewis CE, Fitzgibbon M, Schreiner P . Prevalence of binge eating disorder, obesity, and depression in a biracial cohort of young adults. Ann Behav Med 1998; 20: 227–232.

    Article  CAS  Google Scholar 

  9. Aggleton P . Behavior change communication strategies. AIDS Educ Prev 1997; 9: 111–123.

    CAS  PubMed  Google Scholar 

  10. Institute of Medicine. Food Marketing to Children and Youth: Threat or Opportunity? The National Academies Press: Washington, DC, 2006.

  11. National Health Service. Choosing health: making healthy choices easier. National Health Service 2004. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4094550 (accessed 3 August 2009).

  12. Huhman M, Potter LD, Wong FL, Banspach SW, Duke JC, Heitzler CD . Effects of a mass media campaign to increase physical activity among children: year 1 results of the VERB campaign. Pediatrics 2005; 116: e277–e284.

    Article  Google Scholar 

  13. Wong F, Huhman M, Heitzler C, Asbury L, Bretthauer-Mueller R, McCarthy S et al. VERB—a social marketing campaign to increase physical activity among youth. Prev Chronic Dis 2004; 1: A10.

    PubMed  PubMed Central  Google Scholar 

  14. Maibach EW, Rothschild M, Novelli W . Social Marketing in Health Behavior and Health Education. Mosby: St Louis, MO, 2002.

    Google Scholar 

  15. Bauman A . Precepts and principles of mass media campaign evaluation in Australia. Health Promotion J Aust 2000; 10: 89–92.

    Google Scholar 

  16. Noar SM . A 10-year retrospective of research in health mass media campaigns: where do we go from here? J Health Commun 2006; 11: 21–42.

    Article  Google Scholar 

  17. Janis IL . Effects of fear arousal on attitude change: recent development in theory and experimental research. Adv Exp Soc Psychol 1967; 3: 166–224.

    Google Scholar 

  18. Rosen E . The Anatomy of Buzz. Doubleday: New York, NY, 2002.

    Google Scholar 

  19. Holdford DA . Using buzz marketing to promote ideas, services, and products. J Am Pharm Assoc 2004; 44: 387–395.

    Article  Google Scholar 

  20. Schneider M, Hall WJ, Hernandez AE, Hindes K, Montez G, Pham T et al. for the HEALTHY Study Group. Rationale, design and methods for process evaluation in the HEALTHY study. Int J Obes 2009; 33 (Suppl 4): S60–S67.

    Article  Google Scholar 

  21. Lefebvre RC . The new technology: the consumer as participant rather than target audience. Soc Mark Q 2007; 8: 31–42.

    Article  Google Scholar 

  22. Stead M, Hastings G, McDermott L . The meaning, effectiveness and future of social marketing. Obes Rev 2007; 8: 189–193.

    Article  Google Scholar 

  23. McKenna J, Gutierrez K, McCall K . Strategies for an effective youth counter-marketing program: recommendations from commercial marketing experts. J Public Health Manag Pract 2000; 6: 7–13.

    Article  CAS  Google Scholar 

  24. Abroms LC, Maibach EW . The effectiveness of mass communication to change public behavior. Annu Rev Public Health 2008; 29: 234.

    Article  Google Scholar 

  25. Rogers EM . Diffusion of Innovations, 5th edn. Free Press: New York NY, 2003.

    Google Scholar 

Download references

Acknowledgements

Past and present HEALTHY study group members on the Communications Committee were Lynn DeBar (Chair), Tara Blackshear, Jamie Bowen, Sarah Clayton, Tamara Costello, Kimberly Drews, Eileen Ford, Angela Garcia, Katie Giles, Bonnie Gillis, Heather Murphy Grund, Art Hernandez, Ann Jessup, Megan Krause, Barbara Linder, Jeff McNamee, Esther Moe, Chris Nichols, Margaret Schneider, Brenda Showell, Sara Solomon, Diane Stadler, Mamie White and Alissa Wheeler. The Communications Committee was supported by the creative teams at the Academy for Educational Development and Planit Agency. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during this research.

An online Appendix shows an example poster using student generated media.

Author information

Authors and Affiliations

  1. Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA

    L L DeBar

  2. Department of Planning, Policy and Design, University of California at Irvine, Irvine, CA, USA

    M Schneider

  3. Center for Obesity Research & Education, Temple University, Philadelphia, PA, USA

    E G Ford

  4. College of Education, Texas A&M University, Corpus Christi, TX, USA

    A E Hernandez

  5. Planit Advertising Inc., Baltimore, MD, USA

    B Showell

  6. Biostatistics Center, George Washington University, Rockville, MD, USA

    K L Drews

  7. Division of Health Promotion and Sports Medicine, Oregon Health & Science University, Portland, OR, USA

    E L Moe & D D Stadler

  8. Western Psychiatric Institute and Center, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    B Gillis

  9. School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    A N Jessup

  10. USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA

    M White

Authors
  1. L L DeBar
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  7. E L Moe
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  10. D D Stadler
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  11. M White
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for the HEALTHY Study Group

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Correspondence to L L DeBar.

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Supplementary Information accompanies the paper on International Journal of Obesity website (http://www.nature.com/ijo)

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DeBar, L., Schneider, M., Ford, E. et al. Social marketing-based communications to integrate and support the HEALTHY study intervention. Int J Obes 33 (Suppl 4), S52–S59 (2009). https://doi.org/10.1038/ijo.2009.117

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