Carol A. Bryant

Advances in Segmentation Modeling for Health Communication and Social Marketing Campaigns

Large-scale communication campaigns for health promotion and disease prevention involve analysis of audience demographic and psychographic factors for effective message targeting. A variety of segmentation modeling techniques, including tree-based methods such as Chi-squared Automatic Interaction Detection and logistic regression, are used to identify meaningful target groups within a large sample or population (N = 750-1,000+). Such groups are based on statistically significant combinations of factors (e.g., gender, marital status, and personality predispositions). The identification of groups or clusters facilitates message design in order to address the particular needs, attention patterns, and concerns of audience members within each group. We review current segmentation techniques, their contributions to conceptual development, and cost-effective decision making. Examples from a major study in which these strategies were used are provided from the Texas Women, Infants and Children Programs Comprehensive Social Marketing Program.

Community-Based Prevention Marketing Organizing a Community for Health Behavior Intervention

This article describes the application and refinement of community-based prevention marketing (CBPM), an example of community-based participatory research that blends social marketing theories and techniques and community organization principles to guide voluntary health behavior change. The Florida Prevention Research Center has worked with a community coalition in Sarasota County, Florida to define locally important health problems and issues and to develop responsive health-promotion interventions. The CBPM framework has evolved as academic and community-based researchers have gained experience applying it. Community boards can use marketing principles to design evidence-based strategies for addressing local public health concerns. Based on 6 years of experience with the “Believe in All Your Possibilities” program, lessons learned that have led to revision and improvement of the CBPM framework are described.

Community-Based Prevention Marketing: The Next Steps in Disseminating Behavior Change

OBJECTIVES: To develop and evaluate a new community-based social marketing (CBPM) model. METHODS: CBPM is being piloted to prevent the initiation of smoking and alcohol consumption among middle-school students. The projects impact on behavioral outcomes and the communitys ability to use CBPM to solve public health problems are being evaluated. RESULTS: Community members have demonstrated an unexpected level of interest in learning CBPM and applying its principles to program planning. CONCLUSIONS: Community control of the social marketing process has the potential to enhance program integration into existing community structures, making them more effective and sustainable. (Abstract Adapted from Source: American Journal of Health Behavior, 2000. Copyright

Implementation Evaluation of a Culturally Competent Eye Injury Prevention Program for Citrus Workers in a Florida Migrant Community

Background: The Partnership for Citrus Worker Health (PCWH) is a coalition that connects academic institutions, public health agencies, industry and community-based organizations for implementation of an eye safety pilot project with citrus workers using the Camp Health Aide (CHA) model. Objectives: This project was an implementation evaluation of an eye safety curriculum using modeling and peer-to-peer education among Mexican migrant citrus workers in a southwest Florida community to increase positive perceptions toward the use of safety eyewear and reduce occupational eye injuries. Methods: CHAs have been employed and trained in eye safety and health during harvesting seasons since 2004. Field observations, focus group interviews, and written questionnaires assessed program implementation and initial outcomes. Results: There was an increase in positive perceptions toward use of safety eyewear between 2004 and 2005. Evaluation of training suggested ways to improve the curriculum. The modest literacy level of the CHAs necessitated some redesign of the curriculum and its implementation (e.g., introduction of and more reliance on use of training posters). Conclusions: PCWH benefited by extensive documentation of the training and supervision, a pilot project that demonstrated the potential effectiveness of CHAs, and having a well-defined target population of citrus workers (n = 427). Future research can rigorously test the effectiveness of CHAs in reducing eye injuries among citrus workers.

Promoting Physical Activity Among Youth Through Community‐Based Prevention Marketing

BACKGROUND Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9-13 years of age) called VERB Summer Scorecard. Based on the national VERB media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. METHODS The VERB Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9-step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. RESULTS The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. CONCLUSIONS Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

Impact of a Community-Based Prevention Marketing Intervention to Promote Physical Activity Among Middle-Aged Women

A physical activity intervention applied principles of community-based participatory research, the community-based prevention marketing framework, and social cognitive theory. A nonrandomized design included women ages 35 to 54 in the southeastern United States. Women (n = 430 preprogram, n = 217 postprogram) enrolled in a 24-week behavioral intervention and were exposed to a media campaign. They were compared to cross-sectional survey samples at pre- (n = 245) and postprogram (n = 820) from the media exposed county and a no-intervention county (n = 234 pre, n = 822 post). Women in the behavioral intervention had statistically significant positive changes on physical activity minutes, walking, park and trail use, knowledge of mapped routes and exercise partner, and negative change on exercise self-efficacy. Media exposed women had statistically significant pre- to postprogram differences on knowledge of mapped routes. No-intervention women had significant pre- to postprogram differences on physical activity minutes, walking, and knowledge of mapped routes.

Preventing eye injuries among citrus harvesters: the community health worker model.

OBJECTIVES Although eye injuries are common among citrus harvesters, the proportion of workers using protective eyewear has been negligible. We focused on adoption of worker-tested safety glasses with and without the presence and activities of trained peer-worker role models on harvesting crews. METHODS Observation of 13 citrus harvesting crews established baseline use of safety eyewear. Nine crews subsequently were assigned a peer worker to model use of safety glasses, conduct eye safety education, and treat minor eye injuries. Safety eyewear use by crews was monitored up to 15 weeks into the intervention. RESULTS Intervention crews with peer workers had significantly higher rates of eyewear use than control crews. Intervention exposure time and level of worker use were strongly correlated. Among intervention crews, workers with 1 to 2 years of experience (odds ratio [OR] = 2.89; 95% confidence interval [CI] = 1.11, 7.55) and who received help from their peer worker (OR = 3.73; 95% CI = 1.21, 11.57) were significantly more likely to use glasses than were other intervention crew members. CONCLUSIONS Adaptation of the community health worker model for this setting improved injury prevention practices and may have relevance for similar agricultural settings.

Influences on physical activity participation among Latinas: an ecological perspective.

OBJECTIVES To explore intrapersonal, social environmental, and physical environmental influences that promote or impede total physical activity (TPA) among Latinas in Lee County, Florida. METHODS In-depth interviews (n=41) and face-to-face surveys (n=358). RESULTS Women who worked outside the home, had positive attitudes about activity, perceived themselves to have access to activity facilities, and perceived their neighborhood to be safe reported higher TPA. Women who had more education and whose health information source was radio had lower TPA. CONCLUSIONS Intrapersonal and environmental factors influence TPA levels among Latinas. Segmenting Latina groups using these factors may promote more involvement in physical activity through targeted programs and messages.

Adoption of Safety Eyewear Among Citrus Harvesters in Rural Florida

The community-based prevention marketing program planning framework was used to adapt an evidence-based intervention to address eye injuries among Florida’s migrant citrus harvesters. Participant-observer techniques, other direct observations, and individual and focus group interviews provided data that guided refinement of a safety eyewear intervention. Workers were attracted to the eyewear’s ability to minimize irritation, offer protection from trauma, and enable work without declines in productivity or comfort. Access to safety glasses equipped with worker-designed features reduced the perceived barriers of using them; deployment of trained peer-leaders helped promote adoption. Workers’ use of safety glasses increased from less than 2% to between 28% and 37% in less than two full harvesting seasons. The combination of formative research and program implementation data provided insights for tailoring an existing evidence-based program for this occupational community and increase potential for future dissemination and worker protection.

Adolescent Asthma Self-Management: Patient and Parent-Caregiver Perspectives on Using Social Media to Improve Care.

BACKGROUND Self-management of asthma can now leverage new media technologies. To optimize implementation they must employ a consumer-oriented developmental approach. This study explored benefits of and barriers to improved asthma self-management and identified key elements for the development of a digital media tool to enhance asthma control. METHODS Between August 2010 and January 2011, 18 teens with asthma and 18 parent-caregivers participated in semistructured in-depth interviews to identify mechanisms for improving asthma self-management and propose characteristics for developing a digital media tool to aid such efforts. RESULTS Teens and caregivers enumerated physician-recommended strategies for asthma management as well as currently employed strategies. Both groups thought of a potential digital media solution as positive, but indicated specific design requirements for such a solution to have utility. Whereas most participants perceived mobile platforms to be viable modes to improve asthma self-management, interest in having social networking capabilities was mixed. CONCLUSIONS A digital media product capable of tracking conditions, triggers, and related asthma activities can be a core element of improved asthma control for youth. Improved asthma control will help decrease school absenteeism.