Marian Huhman

The Influence of the VERB Campaign on Children's Physical Activity in 2002 to 2006

OBJECTIVES We evaluated physical activity outcomes for children exposed to VERB, a campaign to encourage physical activity in children, across campaign years 2002 to 2006. METHODS We examined the associations between exposure to VERB and (1) physical activity sessions (free time and organized) and (2) psychosocial outcomes (outcome expectations, self-efficacy, and social influences) for 3 nationally representative cohorts of children. Outcomes among adolescents aged 13 to 17 years (cohort 1, baseline) and children aged 9 to 13 years from cohorts 2 and 3 were analyzed for dose-response effects. Propensity scoring was used to control for confounding influences. RESULTS Awareness of VERB remained high across campaign years. In 2006, reports of children aged 10 to 13 years being active on the day before the survey increased significantly as exposure to the campaign increased. Psychosocial outcomes showed dose-response associations. Effects lessened as children aged out of the campaign target age range (cohort 1, baseline), but dose-response associations persisted in 2006 for outcome expectations and free-time physical activity. CONCLUSIONS VERB positively influenced childrens physical activity outcomes. Campaign effects persisted as children grew into their adolescent years.

Visual and Participatory Research Methods for the Development of Health Messages for Underserved Populations

Mass communication health campaign messages play critical roles in public health, yet studies show mixed effectiveness in reaching and impacting underserved populations. The purpose of this study was to evaluate the benefits of using visual and participatory research techniques toward health message development targeting older Hispanic women. Demographic information and levels of physical activity were first obtained in a sample of older Mexican women (n = 23; ages 71.9 ± 7.6 years) living in the city of Chicago. Perceptions of physical activity were then assessed using a visual research method known as photo-elicitation. Health message concepts promoting physical activity were developed with a subsample of the target population using a participatory approach. Photo-elicitation helped develop a unique understanding into the many factors impacting physical activity among older Mexican women. Follow-up in-depth interviews provided detailed narratives that (a) built upon visual data and (b) identified characteristic differences between physically active and inactive women. Ultimately, these findings were beneficial in constructing new, culturally tailored message concepts. Findings suggest that this method may be a valuable tool in the development of mass communication health messages, extracting rich and meaningful data from target audiences while fostering a sense of partnership between researchers and community members. Tailoring and improving the message design process around the needs of underserved populations is essential in the effort to eliminate the burden of health disparities. This study uses innovative interdisciplinary research techniques to explore new approaches to public health communication in underserved populations.

Exploring the Influence of the VERB™ Brand Using a Brand Equity Framework

The Centers for Disease Control and Preventions Youth Media Campaign designed VERB™ as an aspirational brand to increase physical activity among children aged 9–13 years. In the current study, we explore the influence of the VERB™ brand in the campaign using a brand equity framework. Brand equity responses were collected from 1,007 children from a national cross-sectional telephone survey. Findings indicated that high VERB brand equity was associated with increased positive attitudes toward physical activity and participation in free-time physical activity. The relationship between brand equity and free-time physical activity was partially mediated through attitudes. Brand personality and leadership/popularity constructs were found to be strong predictors in determining physical activity attitudes and behaviors, respectively. As the use of a branding strategy increases in public health, brand equity offers social marketers a framework for evaluating the effectiveness of their efforts. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Impacting Behavior by Integrating Health Communication and Marketing

Without question, social marketing has proven to be a highly useful framework for health communicators to use in tackling critical problems in public health. Although many problems in public health can be successfully addressed with an approach that is largely informational, such as reducing deaths from sudden infant death syndrome (SIDS) with the Back to Sleep campaign, other problems such as poor diet, sedentary lifestyles, and misuse of substances require strategies beyond information. For example, communicating that a desired behavior is an easy, appealing choice requires considering the rewards that the priority audience values (e.g., offering tangible and intangible incentives), making the place to do the behavior pleasant and convenient (e.g., encouraging stair use by having music and interesting art in stairwells), and offering the audience a bundle of benefits that outweigh those of the competition (e.g., socialization when walking with friends). Until the past decade or so, health communicators were skeptical that unhealthy behaviors could be changed with persuasive communications even if they integrated marketing. Now we have years of research and evaluation of initiatives that used marketing with communication to achieve behavior change among multiple and diverse behaviors and audiences. The truth campaign’s countermarketing approach to teen smoking resulted in a 22% reduction of smoking attributable to the campaign (Farrelly, Davis, Haviland, Messeri, & Healton, 2005). Tweens (children aged 9–13 years) who saw the VERB campaign increased their physical activity compared to those who did not see it, and positive effects persisted as the children aged into their teenage years (Huhman et al., 2010). Road Crew, a

Strategies for Identifying Students in Need of School-Based Asthma Services Challenges and Questions That Emerged From a Rapid Evaluation of a School-Based Asthma Program

Charlotte-Mecklenburg Schools (CMS), with assistance from the Centers for Disease Control and Prevention (CDC), conducted an evaluation of the CMS Asthma Program. Data were collected during the 200...

Where Is the Toothpaste? A Systematic Review of the Use of the Product Strategy in Social Marketing

The product strategy is a cornerstone of the product, price, place, and promotion (four Ps) of the marketing mix that has undergone significant scrutiny and critique. This study sought to conduct a systematic review of the peer-reviewed literature to better understand how product has been conceptualized and operationalized over multiple decades. Application of inclusion criteria resulted in a sample of 88 articles published from 1973 to 2015, representing work in 18 different countries in North America, Asia, Africa, Europe, and Oceania. Content analysis showed that authors offering formal definitions of product have placed heavy emphasis on conceptualizing the product P as the prescribed behavior for the target audience in a social marketing initiative. Analysis of the operationalization of product strategies revealed more balance across the literature in thinking about product as beneficial outcomes and tangible goods as well as behaviors. Discussion focuses on consideration of the findings in the context of the call from several thought leaders in recent years to steer away from talking about the product as behavior and concentrate more on goods, services, and product features. The results also inspire discussion about the future utility of conceptualizing product within a three-tiered frame of actual, core, and augmented products.

Community College Students’ Health Insurance Enrollment, Maintenance, and Talking With Parents Intentions: An Application of the Reasoned Action Approach

A primary objective of health care reform is to provide affordable and quality health insurance to individuals. Currently, promotional efforts have been moderately successful in registering older, more mature adults yet comparatively less successful in registering younger adults. With this challenge in mind, we conducted extensive formative research to better understand the attitudes, subjective norms, and perceived behavioral control of community college students. More specifically, we examined how each relates to their intentions to enroll in a health insurance plan, maintain their current health insurance plan, and talk with their parents about their parents having health insurance. In doing so, we relied on the revised reasoned action approach advanced by Fishbein and his associates (Fishbein & Ajzen, 2010; Yzer, 2012, 2013). Results showed that the constructs predicted intentions to enroll in health insurance for those with no insurance and for those with government-sponsored insurance and intentions to maintain insurance for those currently insured. Our study demonstrates the applicability of the revised reasoned action framework within this context and is discussed with an emphasis on the practical and theoretical contributions.

Understanding “Place” in Social Marketing: A Systematic Review

Critiques of the social marketing literature have suggested the place strategy is a key component within the 4 Ps of the marketing mix that simultaneously has been misunderstood and underutilized. This study sought to conduct a systematic review of the peer-reviewed literature to better understand how place has been conceptualized and operationalized over multiple decades. Application of inclusion criteria resulted in a sample of 84 articles published from 1988 to 2015 representing work in 20 different countries in North America, Asia, Africa, Europe, and Oceania. Content analysis showed that almost half (46.4%) of the descriptions of place strategies operationalized the component by including at least one element of placing messages within communication channels or information delivery such as print, interpersonal, traditional broadcast, or digital. The heavy emphasis on communication channels and information delivery contrasts sharply with definitions of place that thought leaders have offered historically. Results revealed that authors from the United States especially have a tendency to operationalize place as message placement. Discussion speculates on why conceptualization and operationalization have diverged and considers the implications for clarity within the field of social marketing as a whole.

Communities Leveraging the Assets of a National Social Marketing Campaign: Experiences with VERB™. It’s What You Do!

The VERB. It’s what you do! social marketing campaign used mass media, school and community promotions, the Internet, and partnerships with national organizations and local communities to encourage children aged 9–13 years (tweens) to be physically active every day. The national presence of VERB through paid advertising on multiple media outlets facilitated the penetration of the campaign into communities where tweens could sample the product of physical activity through multiple school and community promotions, tours, and events. Some communities responded by using the VERB brand to develop their own programs for physical activity, giving the local community activities the cachet and cool factor associated with the images the tweens were seeing in the national marketing campaign. This chapter focuses on the community presence of VERB that developed from the national media platform and through the community-generated programs that leveraged the assets of the VERB brand to bring physical activity opportunities to tweens in their own communities.

Follow-Up of an Elementary School Intervention for Asthma Management: Do Gains Last Into Middle School?

Objective. Albuquerque Public Schools (APS), in collaboration with the Centers for Disease Control and Prevention, conducted an evaluation to examine whether students who were exposed to the APS asthma program in elementary school retained benefits into middle school. Methods. APS middle school students who participated in the APS asthma program in elementary school, including the Open Airways for Schools (OAS) education curriculum, responded to a follow-up questionnaire (N = 121) and participated in student focus groups (N = 40). Asthma management self-efficacy scores from the follow-up questionnaire were compared to scores obtained before and after the OAS education component. Additional items assessed students’ asthma symptoms, management skills, avoidance of asthma triggers, and school impact. Results. Although asthma management self-efficacy scores declined in middle school among students exposed to the asthma program in elementary school, they remained significantly higher than scores obtained during elementary school prior to the OAS intervention. Conclusion. The results indicate that although students benefited from the asthma program delivered in elementary school, they need booster sessions and continued school support in middle school.