Leveraging Industry Efforts to Fight Childhood Obesity: A Multi-Sectored Approach to Communications

Abstract

The issue of childhood obesity in the USA came to the forefront in 2004 following the TIME/ABC News Summit on Obesity, the Time Magazine special issue on child obesity (Lemonick, 2004), and the release of the Institute of Medicine’s (IOM) groundbreaking report on the topic (McGinnis, Gootman, & Kraak, 2006). The report found that obesity rates had doubled among children aged 2–5 and tripled among children aged 6–11 over the past three decades; over nine million children were reported to be overweight or obese.

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Introduction

The issue of childhood obesity in the USA came to the forefront in 2004 following the TIME/ABC News Summit on Obesity, the Time Magazine special issue on child obesity (Lemonick, 2004), and the release of the Institute of Medicine’s (IOM) groundbreaking report on the topic (McGinnis, Gootman, & Kraak, 2006). The report found that obesity rates had doubled among children aged 2–5 and tripled among children aged 6–11 over the past three decades; over nine million children were reported to be overweight or obese.

With a long history of shining a light on the most important issues facing the country, the Ad Council recognized the urgency of this burgeoning crisis and began planning a program that would bring more resources and reach to its traditional public service communications campaigns. The guiding idea behind the collaborative program was to supply a series of consistent, research-based messages that corporations, nonprofits and government agencies could use in their own marketing and communications materials to promote healthy lifestyle habits. Through these collective efforts the program aimed to make parents and their children aware of the importance of leading a healthy lifestyle and to begin to shift entrenched attitudes and behaviors about eating and exercise habits.

By the fall of 2004, the Ad Council had reached out to the companies served by its Board of Directors, the nonprofit and government agencies that sponsor its public service campaigns, the members of its Advisory Committee as well as to the volunteer ad agencies which create the public service campaigns to begin to build a steering committee that could begin to shape this new initiative.

Within months, the Coalition for Healthy Children (CHC) was formed, a literature review was underway and underwriting funds were committed by The Robert Wood Johnson Foundation to begin to build the infrastructure.

Objectives and Guidelines

The first activity of the CHC was to define the audiences and communications objectives for the initiative. The Coalition team spoke with experts in the health and wellness arena, met with academics and researchers and eventually conducted a literature review to understand the most effective measures individuals could take to prevent childhood obesity. The recommendation coming out of these meetings was that it was equally important to address messages to parents (the gatekeepers) and kids (the consumers) in order to achieve maximum impact.

The group also made the distinction between this communications effort and other tactics designed to address childhood obesity (i.e., access to healthy food, poor environments for play and exercise, school lunch, etc.). The CHC would focus its energy on educational messages that would help individuals, as this would be the greatest contribution the Ad Council and its Coalition members could make.

Another critical piece in the development of the program was making sure that guidelines for using the messages with food products and beverage offerings would be adhered to by Coalition members. In keeping with the overall focus of the program, it was decided that Coalition members in these industries could only use the messages on products that met specific nutrition criteria. The guidelines were based on those created by the Alliance for a Healthier Generation, a joint venture between the Clinton Foundation and the American Heart Association, as well as the 2005 U.S. Dietary Guidelines for Americans (HHS & USDA, 2005), which were developed by the U.S. Department of Health and Human Services (HHS) and the U.S. Department of Agriculture (USDA). To join the Coalition, members were asked to sign an agreement that they would help spread the word about the Coalition and its messages within their organizations, that they would report back to the Ad Council the use of Coalition messages and visual assets in their marketing materials, and that they would not use their membership status in the Coalition to deflect any criticism of their products, policies or marketing efforts.

The Ad Council formally launched the Coalition for Healthy Children at a summit meeting with all members in July 2005. At the time, 30 member organizations were in attendance—the Coalition grew to over 50 members in 2009, which included organizations such as the American Heart Association, Boys & Girls Clubs of America, Cartoon Network, Coca Cola Company, DreamWorks Animation, General Mills, Kraft Foods, McDonald’s, National Basketball Association, National Football League, Sears Holding Company, Sesame Workshop, and Univision Communications (see Table 24.1 for a complete list of members).

Table 24.1 Coalition Member Organizations (as of September 2009)

Formative Research and Message Development

Given the wealth of information available on preventing obesity in children, the first step the Coalition team took to begin developing the communications effort was to organize a literature review in order to identify those preventive behaviors that parents and children could easily adopt on their own. We were looking for individual actions that could lead to behavior change. Hundreds of published reports, articles, and existing programs were amassed, and our research team pored through them to find logical groupings that could be developed into message areas. Ultimately, three key areas were identified as the focus of the program:

• Kids getting an hour of exercise each day.

• Knowing the basics of energy balance—calories in/calories out.

• Exerting control when it comes to portion size.

In addition, the importance of parents modeling positive behaviors for their kids, regarding eating and exercise and making better food choices, was also identified as an important factor for consideration.

The Coalition team partnered with Strottman International, a leading kid and family marketing agency to create and test messages in support of these three areas. Strottman was charged with developing a few messages in support of each of these categories, which would then be tested among kids and parents. Four focus groups utilizing proprietary Strottman techniques among parents and four among kids (aged 6–9 and 10–13) were held in early 2005 in Atlanta and Chicago to explore proposed messages for clarity of meaning, relevance, and potential for action. Teachers were included in the parent groups as their influence was also seen as critical in this effort.

This research uncovered a host of insights including:

• Kids feel they already know about and how to make healthy lifestyle choices but choose not to.

• Messages need to be direct and reference food, activity, or exercise to be comprehended.

• Messages that are perceived to be accusatory or guilt-causing are rejected by moms.

• Messages that sound “catchy” are preferred, but still need to deliver on comprehension and content.

• Participants feel that messages about healthy lifestyle don’t belong on unhealthy food and beverage packaging.

• Context, clarity and directness are most important in getting the message across.

The implications from the research also pointed to recommendations for those messages that did not test well:

• Consider taking a positive, partner-like attitude and tone.

• Consider putting messages into the context of the family’s world and use their vernacular.

• Consider messages that create a positive mental image.

• Consider messages that are solution- or action-oriented and attainable without sounding preachy.

Using these guidelines, Strottman and ad agency McCann Erickson reworked and revised the messaging, and then put these revised message concepts through quantitative testing. Over 1,000 demographically representative parents of children aged 6–12 and kids aged 8–12 were exposed to these messages in an online survey and queried on the key measures of message comprehension, newness of message, intent to act, and importance or meaningfulness. While some messages tested well, others did not. See Fig. 24.1 for the complete list of parent- and child-directed messages that were ultimately deemed most effective.

Fig. 24.1

Coalition messages and visuals for parents and children

At this point, the messages and the research were shared with Coalition members and experts in the field of childhood obesity prevention. After a lengthy discussion and feedback period, it was decided that some of the messages needed to be simplified and further refined. Having member input at this point was critical to ensuring that the messages would be fully utilized by member organizations. Based on a request from Coalition members to place messages on collateral materials or product packaging, visual identities for each of the concepts were also created with help from ad agency GSD&M Idea City and students from Brigham Young University’s AdLab.

The Ad Council worked with LightSpeed Research to conduct an online quantitative test of the revised messages and the new visual assets among over 1,100 demographically representative parents and kids during the summer of 2007. Metrics utilized were the same as those in the previous quantitative tests and the results were strong. In this study, half of respondents were shown visual assets without any accompanying message and half of respondents were shown the assets with the accompanying message. Findings indicated that the Energy Balance and Physical Activity messages clearly communicated their intended messages and were motivating and likable among kids and parents. The portion control message fell just short in communicating its message and motivating kids and therefore was subsequently revised before proceeding to the dissemination phase. In all cases, comprehension increased when respondents were shown both stimuli. This suggested that Coalition members would have more success when utilizing both the written and visual elements for each message area.

With this kind of data supporting the saliency of these messages, the Coalition team felt confident that the combined efforts of Coalition members to disseminate these messages would lead to significant impact.

Message Dissemination

The simplicity, clarity, and relevance to their own marketing messages made it easy for members to support the Coalition’s messages. As soon as the messages and visual assets were ready to use.

Coalition members began to incorporate them in their marketing and communications campaigns with guidance and support from the Ad Council team. From packaging and online promotions, to advertising and content development, to fully integrating marketing programs, members brought creativity, innovation, and social purpose to these efforts.

The Ad Council team met with the advertising and marketing departments of member organizations to better understand their needs and to help strategize how to best incorporate the messages. In some cases, the messages enhanced member organizations’ pre-existing efforts. In other situations, the messages were co-branded with members’ branded efforts, and in a few situations, new, fully integrated health and wellness programs were created based on the Coalition messages. The Ad Council team reviewed all proposed uses of the messages and made sure that they followed the suggested guidelines regarding product usage. They also provided support for member organizations when and where appropriate.

During the initial years of the Coalition, member organizations focused primarily on communications promoting the benefits of physical activity and put their resources behind the “Be a Player” message. Over time, a few programs were developed around energy balance and portion control, although not to the extent of the physical activity messages.

The Ad Council also worked with existing public service campaign sponsors like the U.S. Department of Health and Human Services’ (HHS) Obesity Prevention campaign and the U.S. Department of Agriculture’s (USDA) Nutrition Education campaign to create partnerships with other member organizations to jointly promote the messages. Distributed via the Ad Council’s extensive media distribution network, these ads reached over 33,000 media companies across the country.

Meetings with child health advocates, academics, and other experts also built greater awareness for the Coalition’s work among these important constituents. Ad Council Coalition staff have participated as keynote speakers at many national conferences, including the FCC Task Force on Childhood Obesity and the FTC/HHS “Weighing In” workshop. Staff was also asked to speak with the IOM (Institute of Medicine) committee responsible for child obesity prevention and brief the CDC (Centers for Disease Control and Prevention) on Coalition activities. The Coalition team worked closely with CARU (Children’s Advertising Review Unit) to support their Children’s Food and Beverage Advertising Initiative. The effort is designed to shift the mix of advertising messaging to children to encourage healthier dietary choices and healthy lifestyles. As part of this collaboration, the CHC provided messages and visual assets to the marketers participating in the effort, so they could be incorporated into their communications efforts and evaluated accordingly. The Coalition team also developed active relationships with industry groups such as the Grocery Manufacturers of America (GMA), International Food Information Council (IFIC), and the Association of National Advertisers (ANA).

A highpoint of the Coalition’s visibility-building came when Corporate CEO members were invited to a White House Roundtable with former President Bush to talk about their various obesity prevention programs, followed by former HHS Secretary Leavitt’s launch of new HHS sponsored Childhood Obesity Prevention PSAs featuring DreamWorks Animation’s Shrek characters. The press coverage from that campaign launch was done extensively in local and national news.

The following are just a few examples of the ways member organizations utilized the program messages in their marketing and communications programs:

Kraft Foods: Online Games and Cartoon Network Partnership

Kraft Foods teamed up with Cartoon Network to develop a 30-s PSA featuring Cartoon Network characters that reminded kids to be physically active and incorporated the Coalition’s “Be a Player” message and visual asset. Kraft Foods also created a 10-s online game preload targeted toward kids. This mini web cartoon about the importance of being active streamed before visitors played a video game on Kraft Foods’ child-directed websites.

National Football League: NFL PLAY 60—The NFL Movement for an Active Generation

The NFL created its PLAY 60 youth fitness campaign in concert with the Coalition’s physical activity focused communications. The “get up and play an hour a day” message can be seen throughout the Play 60 campaign, which features partnerships with the United Way, American Heart Association, National Dairy Council, U.S. Department of Health and Human Services, and many other corporations, nonprofits, and government agencies. In 2007, the NFL launched PLAY 60, a national youth health and fitness campaign focused on increasing the health and wellness of young fans by encouraging them to be active for at least 60 min a day. In addition to national reach through PSAs and online programs, PLAY 60 is also implemented at the grassroots level by all 32 NFL Clubs through NFL’s in-school, after-school, and team-based programs. The Ad Council/NFL multimedia campaign that was launched in 2007 featured NFL star players Reggie Bush, Antonio Gates, and Jason Witten. More information on NFL PLAY 60 can be found on NFLRUSH.com, which features fitness tips, player recipes, NFL player fitness blogs and videos, and many other activities. Young people visiting the site can pledge their commitment and learn from the pros how to stay healthy and active.

Walt Disney Studios Home Entertainment: Energy Balance Communications from Jungle Book and Pinocchio Characters

Walt Disney Studios Home Entertainment partnered with the Ad Council’s ongoing campaign with USDA to promote healthy lifestyle habits by supporting the energy balance message for kids and families.

TV, radio, and interactive and billboard PSAs featured characters from Disney’s Jungle Book and Pinocchio modeling positive behaviors. In addition, messages promoting energy balance and MyPyramid.gov were featured in Disney parks, on key chains and magnet give-aways, and throughout Radio Disney’s national mobile tours.

Kmart: Retail and Online Promotion

Kmart’s “New Day Kids Way” promotion supported the Coalition’s physical activity message throughout the mega-marketer’s retail environment and online networks. It featured in-store signage, placement in Kmart circulars, online integration, and distribution of brochures at Kmart locations nationwide. Through an online promotion kids were invited to upload photos or videos of themselves enjoying an active lifestyle and the have their family and friends vote for them online.

Ladies Professional Golf Association: PSA’s Featuring Star Golfers

With support from the UPS Foundation, Ladies Professional Golf Association (LPGA) created TV, print, and internet PSAs featuring championship players Lorena Ochoa, Karrie Webb, and Natalie Gulbis, who urged families to “get up and play an hour a day.” The association extended the reach of the physical activity message through partnerships with ESPN and Wegman’s supermarket chains.

McDonald’s: Packaging and Online Message Promotion

McDonald’s promoted the Coalition’s physical activity message by placing the “Be a Player” visual on American Idol and Shrek the Third promotional Happy Meal boxes, along with ideas for kids to get moving. The Coalition’s energy balance message was featured on Happy Meal bags, which encouraged kids and families to take steps to be healthy. McDonald’s also promoted this message on their

http://www.HappyMeal.com web site and linked to the U.S. Department of Health and Human Services health and wellness website, http://www.HealthierUS.gov.

PepsiCo: Advertising, a Wellness Program, and In-Store Displays

PepsiCo’s national promotion featured the Coalition’s “Be a Player” physical activity message in conjunction with their Smart Spot™ line of products. The campaign encouraged families to get more active through America on the Move, a free wellness program. Working with Wal Mart, PepsiCo set up retail point-of-service displays in Wal Mart Super Centers and Discount Stores and sent a http://www.Walmart.com email blast. The company also created a customized “Be a Player” ad for All You magazine.

qubo: PSA Featuring Animated Characters and Olympic Athletes

qubo, the children’s television network, lent their animated characters to star in a new set of public service announcements. Characters from the popular programs, Veggie Tales, Jane and the Dragon and 3-2-1 Penguins! were seen promoting physical activity, energy balance, and portion control messages alongside U.S. 2008 Olympic gold medalists, Shawn Johnson, Sanya Richards, Misty May-Treanor, and Kerri Walsh. qubo Channel is a 24/7 children’s television network currently available on cable, Satellite, Telcos, and over-the-air. qubo programming blocks can also be seen on NBC, ION Television and, Telemundo.

DreamWorks Animation SKG: Shrek Promoting Physical Activity

DreamWorks Animation, SKG brought their popular Shrek property to the issue of childhood obesity to coincide with the launch of the Shrek the Third movie. PSAs featuring Shrek characters were developed to promote physical activity among parents and children across television, outdoor, and Internet media. The Outdoor Advertising Association of America (OAAA) engaged its members, which include CBS Outdoor, Clear Channel Outdoor, and the Lamar Advertising Company, to post the “Be a Player” billboards on all available sites. Nickelodeon also supported the television PSAs in heavy rotation. Inserts featuring the “Be a Player” message were included by DreamWorks Animation in DVD cases for the release of Shrek the Third.

Subway : In-School and Take Home Materials for Kids

SUBWAY^® developed in-school materials featuring the Coalition’s physical activity message in an effort to reach kids and parents with important healthy lifestyle information. Free kits for the classroom were created to encourage teachers and parents to show their kids how staying healthy and active can be FUN. Materials included letters to parents, a teacher’s guide, stickers, classroom posters, and a calendar/planner.

YMCA: Healthy Family Home

Healthy Family Home is a resource to help families make their home environment a place where healthy living is practiced every day. Developed by the YMCA of the USA and made possible by a contribution from the Eli Lilly Company, Healthy Family Home helps families make healthier decisions in three key areas: Play Every Day, Healthy Eating, and Family Time. Healthy Family Home includes a Starter Kit and web resources with ideas and activities to help families maintain healthy lifestyles. YMCAs across the country are incorporating Healthy Family Home into their youth and family programming. More information can be found at http://www.ymca.net or http://www.healthyfamilyhome.org.

Program Results and Evaluation

In just a few years, the Coalition for Healthy Children has provided dozens of organizations with research and strategies to help reduce child obesity via communications. The net impact of this collaborative work is more consistent messages that address the issue of child obesity in American society, and the beginnings of attitude and behavior change among target audiences that are leading to positive health outcomes.

To help understand the entire CHC program in a graphic, easy-to-comprehend model, the Ad Council Coalition team developed and shared with members the Logic Model diagram below (see Fig. 24.2). It visually depicts all program inputs (activities), outputs, and expected outcomes, and it provides a framework for evaluating the overall program impact at each stage of the effort.

Fig. 24.2

Theory of change model for coalition activities

Building membership in the Coalition was critical to the program’s success, and outreach by the Ad Council team began even before the research was conducted and the messages developed. By the time the program launched in 2005, 30 organizations had signed on and that number has grown to over 54 in 2009. Coalition members have been able to develop new partnerships and collaborative projects with other members, as well as with the Ad Council’s U.S. government campaign sponsors working in this area. They also provided much useful feedback and counsel to the Ad Council Coalition team as the messages were developed, tested, and refined. According to an externally conducted program evaluation report from Asibey Consulting, Coalition members cited the opportunities for networking and for access to the research-based messages as a key benefit for them, and they also recognize and respect the important non-partisan, non-political role the Ad Council has played in pulling these sometime competing organizations resources together.

The combined marketing efforts of all Coalition partners have reached millions of Americans in multiple retail, educational, and media environments. All of these efforts could not be captured or included here; however, below is a partial accounting of significant member-generated programs:

• Kmart estimates that the circulars it distributed garnered approximately 40 million impressions, in-store materials received approximately 15 million impressions, and email marketing reached 1.4 million subscribers during the promotional period in 2007.

• Kraft Food’s PSA on physical activity ran in heavy rotation on the Cartoon Network in second and third quarter 2007.

• The LPGA “Get Up and Play” PSAs received over $8.6 million in estimated donated media and public relations support, as well as more than 268 million household impressions.

• Walt Disney’s Pinocchio and Jungle Book PSA effort in support of the USDA Nutrition Education campaign garnered an estimated $47 million in donated media placements and over 600 million household impressions.

• The NFL Play 60 campaign appeared extensively in children’s television programming on NBC, during nationally televised NFL games on FOX and CBS, in Sports Illustrated magazine, and was widely featured during Thanksgiving weekend NFL activities. Initial estimates put the media support for this effort at $54.7 million, with over 645 million household impressions.

• PepsiCo’s Walmart promotion was seen by shoppers in 6,793 stores that receive approximately 140 million customer visits per week. Its email blast reached 20 million households, and the circulation for its ad in “All You” magazine is 700,000. PepsiCo estimates these media garnered an estimated 158 million consumer impressions during the promotion period in 2007.

• qubo’s characters were widely seen in PSAs during NBC’s Saturday morning cartoons. They have generated approximately $3.9 million of donated airtime and public relations, as well as 143 million household impressions.

• DreamWorks Animation’s campaign materials featuring Shrek have received over $16.9 million in estimated donated media, including the value of public relations impressions, and over 792 million household impressions. News coverage highlights included high-profile national segments on The Today Show, CNN, and AP Radio, as well as more than 200 local TV news stories.

In order to measure overall program impact, a quantitative tracking study of parents and their kids was initiated prior to program launch in 2005. The research was conducted by the Futures Company (formerly Yankelovich). Successive research waves were fielded in 2007 and 2009 to measure reported changes in awareness, attitudes, and behaviors regarding physical activity, energy balance, and portion control, as well as a number of related measures. The most recent wave consisted of 1,514 interviews with children aged 6–12 and the same number of interviews with the children’s parents. Oversamples of African-American and Hispanic American participants were taken to ensure accurate representation, including a subset of interviews conducted in Spanish. Interviews were conducted in demographically representative malls across the country where participants took a computer-based survey (self-administered where possible).

One caveat that needs to be stated at this point is that because the research was not conducted using an experimental design with test and control cells, it is impossible to gather whether any shifts in awareness, attitudes, or behaviors were directly caused by the CHC program messages. In addition, this communications effort took place amid other healthy lifestyle marketing and communications programs and concurrently with marketing and advertising campaigns for a host of food, fast food, and less healthy lifestyle products and services. A more detailed content analysis of these external efforts might shed some additional light on the results.

The data present a mixed bag of results. Some measures saw improvement while others declined. What appears to be driving the results is the fact that the physical activity message was the one most heavily promoted by the Ad Council and the one most utilized by member organizations during the 3-year period being measured, especially in kid-targeted media and marketing environments. The good news here is that there have been some significant positive shifts in kids’ attitudes and behaviors regarding the physical activity message and overall healthy lifestyles. Little to no change in other measures is not a surprise to the Ad Council coalition team given the lack of emphasis and adoption of other message areas by member organizations.

One critical finding in both successive waves of the research was disparity between Hispanic respondents and others. On virtually all measures of awareness, attitudes, and behavior, Hispanics lagged significantly behind other groups. Language and cultural differences regarding healthy eating habits appear to be one of the major reasons for these differences, as well as a lack of emphasis by marketers to address this particular population with healthy lifestyle communications at the time. What follows are a few highlighted findings and data points that exemplify the overall learnings.

Awareness of Concepts and Messages

Results from the tracking study suggest that since 2005, awareness of most Coalition message concepts has remained relatively constant among kids and parents; however, there was a significant increase in concept awareness among kids about the importance of being physically active from 2005 to 2007. It was during this time period that many Coalition members were promoting the “Be a Player” message. Consequently, when marketing support declined after 2007, awareness of these messages dropped back down to benchmark levels in 2009 (see Fig. 24.3).

Fig. 24.3

Physical activity messages increased in 2007, but returned to baseline in 2009

Awareness of the three visual assets was not measured in 2005 or 2007; however, in 2009 recognition among kids and parents was fairly strong (see Fig. 24.4). More than 1 out of every 3 children reported that they recognized the “Be a Player” physical activity and “Eat Well, Play Hard” energy balance messages. Significantly fewer kids said they recognized “The Amount Counts” portion control message, which is not surprising because this message has not yet been heavily promoted by Coalition members. Parents were less likely than their children to recognize all three visual assets, but still had a moderate level of awareness. And Hispanic children and their parents were significantly less likely than other parents to say they had seen the visual assets. This discrepancy among Hispanic respondents was to be expected given that most of these messages were not marketed in Spanish. Finally, African American kids had the greatest levels of awareness, with 44 % and 45 % reporting having seen the “Be a Player” and “Eat Well, Play Hard” visuals.

Fig. 24.4

Awareness of coalition message visuals among key audiences

Attitudes and Behavior Regarding Healthy Lifestyles

Since the Coalition began, kids’ attitudes toward healthy eating and exercise have improved (see Fig. 24.5). In 2009, significantly more kids report caring a lot about being healthy, eating healthy, and getting enough physical activity than they did in 2005.

Fig. 24.5

Children were more active indoors and outdoors in 2009

Further, kids increasingly understand the amount of time they need to run around and play everyday to be healthy (see Fig. 24.6). In 2009, 68 % of children reported that they should run around and play at least an hour a day (vs. 62 % in 2007).

Fig. 24.6

Significantly more kids understood the need to be active for over 1-hour each day in 2009

Since 2005, kids better understand that physical activities like playing a game of tag, basketball, or soccer are good for their health. And more kids in 2009 report that they do something active inside and outside than when first measured in 2005 (see Fig. 24.7).

Fig. 24.7

Data showing kid’s attitudes toward healthy habits improved over time

Unfortunately these positive shifts in kid’s attitudes and behaviors regarding physical activity were not replicated in other areas necessary for children to attain a healthy lifestyle. Most kids understand the importance of eating healthy foods, energy balance, and portion control; however, despite this understanding there are significant gaps in their behavior related to these concepts (see Fig. 24.8). This suggests much room for growth, particularly in the areas of portion control and energy balance.

Fig. 24.8

Illustrates the gap between children’s beliefs and actual behavior

In regard to parents’ attitudes about their kids’ healthy lifestyles, the tracking research suggests that they increasingly recognize the importance of eating healthy and being physically active (see Fig. 24.9). In 2009, approximately 3 out of 4 parents reported that it is “very important” that their child has healthy eating habits and/or is physically active on a regular basis; these percentages have significantly increased since the benchmark survey in 2005.

Fig. 24.9

Importance to parents that their kids lead healthy lifestyles

Further, the vast majority of parents in 2009 continued to recognize the role they play in what their child eats or drinks; nearly 9 out of 10 reported that the food and beverages their child consumes reflects on them as parents (see Fig. 24.10). Also, while parents are becoming less confused about what foods are healthy for their families, many continue to feel guilty about their child’s eating habits.

Fig. 24.10

Parents feel responsible for what their kids eat and drink

Overall, the data collected among parents illustrates a similar story to their children. Most parents understand the importance of their children living a healthy lifestyle—through healthy food choices, energy balance, physical activity, and portion control—yet there remains a large gap between these attitudes and their child’s behavior (see Fig. 24.11).

Fig. 24.11

Illustrates the gap between parent’s attitudes and children’s behaviors in 2009

Moving Forward

The Ad Council is proud of the work it has accomplished with the support of Coalition member organizations to begin to change attitudes and behaviors that will ultimately help stem the growing tide of childhood obesity in this country. However, like most major health initiatives, more communications efforts need to be developed and sustained if we are to see continued success. The tracking research, member feedback, and the external evaluation of the program effort have identified opportunities to improve the group’s overall efforts and improve our chances of achieving further success in the years ahead.

Many members utilized Coalition messages to develop mass-audience campaigns that reached millions of Americans and many are continuing their own healthy lifestyle programs. However, some member efforts were short-lived and not incorporated into ongoing marketing programs. The dips seen in tracking data from 2007 to 2009 on key awareness metrics attest to the fact that in order to be successful in changing attitudes and behaviors over time, members need to bang a steady drumbeat on obesity prevention messages. The public still needs constant reminders to take action and to gain new consciousness around energy balance and portion control messages.

In addition, the continued gap between general audience and Latino respondents in the tracking study identified a critical need to better engage this audience in the initiative. In the fall of 2008, the Ad Council hosted an expert panel to understand healthy lifestyle issues-facing Hispanics and determine the most appropriate communications strategies for reaching this audience. The panel included representatives from the American Diabetes Association, American Dietetic Association, Alliance for Healthier Generation, President’s Council on Fitness and Sports, Office of the U.S. Surgeon General, HHS Office of Disease Prevention & Health Promotion, and National Heart, Lung, and Blood Institute. Based on panel input, volunteer ad agency Casanova Pendrill developed a series of messages that were tested through focus groups and other qualitative methods with Hispanic mothers and children. Messages were refined throughout the research process and measures were taken to ensure cultural relevance for the Spanish-speaking population. In addition, Casanova Pendrill developed a series of visual assets to accompany and support the overall messages based on feedback from consumers (see Fig. 24.12). The new Spanish language materials were then quantitatively tested and shared with Coalition members to promote in their own communications channels, ensuring that relevant communications are made available to the underserved Hispanic community.

Fig. 24.12

Hispanic-targeted messages & visuals

The Coalition model has proven that united efforts behind a common program can make a significant difference when sustained over time. With research-based messages as a cornerstone of the Coalition for Healthy Children and sophisticated methods for tracking impact, we have begun to see some shifts in individual beliefs and behaviors among our target audiences. Efforts on the legislative level, school-based initiatives, community interventions, and the combined programs of many corporations, advocacy organizations, and social service agencies are also needed to make headway in reducing child obesity rates. With continued commitment from all the Coalition member organizations, as well as these other environmental activities, there is hope that we are making progress in the fight against this epidemic and are getting one step closer to achieving healthier outcomes for all of our children.