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Communication Strategy – Childhood Obesity & Screen Time
Concordia University
Amber France
Communication Strategy – Childhood Obesity & Screen Time
Exhibit 9.1 – Questions to Guide Communication Strategy Development
Who is the target audience and what are they like? Both socioeconomic status and screen time have been associated with greater rates of obesity among children (Epstein et al., 2008). Therefore, the population of interest for this campaign is parents of children ages 2-5 years on the WIC program, who are enrolled in Fit Families. Fit Families is a behavior change program for families of children, between the ages of 2 and 5 years, in the WIC program. The program has three core messages: move more, watch less, make every bite count, and make every sip count. There is also an overarching message of eat healthy, be active: your kids are watching you. The campaign will be geared towards the parents of the children on the WIC program, but will also be appealing to the children.
What action should they take/what are they doing now? Decreasing screen time is one of the factors to focus on when creating a campaign to decrease childhood obesity. Screen time in relation to fatness and increased television (TV) time is significantly associated with childhood obesity (Gomez et al., 2007). Computer usage and other media, in addition to TV, have also been contributors in sedentary lifestyles among children (Mendoza, Zimmerman, & Christakis, 2007). The American Academy of Pediatrics (2010) recommends that children over the age of 2 years should limit screen time to no more than 1-2 hours per day of quality programming. Screen time of greater than 2 hours per day has been associated with a greater risk of being overweight and higher adiposity rates. Therefore, focusing efforts on limiting screen time can be a helpful factor in decreasing the rates of childhood obesity.
Parental behaviors can influence sedentary behaviors in children. A child is unable to fully understand the importance of healthy behaviors and needs influential factors, such as parents, to help guide those (Karnik & Kanekar, 2012). Intervening with the family is important because they are the origin of health behaviors. In childhood, behaviors are learned from family and if the family is practicing positive behaviors then the child will be influenced to act in this manner. Steffen, Dai, Fulton, & Labarthe (2009) conducted a cross-sectional study with children ages 8, 11, and 14 on the association of parental weight status and hours of screen time on the child’s body composition. The results indicated that children of one or two overweight or obese parents were more likely to watch 22–30 more minutes of television per day than children of normal weight parents. A TV located in a child’s bedroom has also been shown to have a strong increase in the risk of the child becoming overweight (Dennison, Erb, & Jenkins, 2002). This has been found to be especially true in minority and low income children. The lack of parental knowledge regarding the association between screen time and childhood obesity, as well as parental role modeling, indicates that parental behavior patterns may have a negative effect on their child’s behaviors and the child’s BMI. Increasing parental knowledge, as well as positive role modeling, will be the focus of this campaign.
What barriers stand between the audience and the action? Socioeconomic status has an impact on childhood obesity. The CDC (2011) reported that 2007-2010 data indicated that obesity rates among children ages 2-19 decreased with an increase of education in the household. They also found that children ages 6-11 that were living in a household that was below the 400% poverty level were more likely to have more than 2 hours of screen time per day. Socioeconomic status can limit the availability of resources that allow the children to engage in physical activity, as well as parental knowledge. Paternal influence is the most influential factor for behavior choices (Karnik and Kanekar, 2012). The lack of parental knowledge regarding the association between screen time and childhood obesity, as well as positive role modeling, indicates that parental behavior patterns may have a negative effect on their child’s behaviors and the child’s BMI and serves as a barrier to this campaign.
What is the benefit to the audience of engaging in the action? From the survey conducted with Fit Families participants at the Wood County Health Department, results indicated that the top four core values of parenting were happiness, freedom, pride, and love. When asked why they felt these were important core values the most common answers were they felt it was important for their children to feel happiness and love from them as parents, as well as in everyday life. They also felt it was important that they were able to have the freedom to raise their children the way they wanted to without judgment or negative feedback. A sense of pride in raising their children and pride in the decisions they were making with their children was also an important core value to this target audience. The benefit of engaging in the program would fulfill the parent’s core values when it comes to raising their child, which will ultimately result in a healthier child and family. The parents can help shape their child’s physical activity behaviors by setting a positive example and role modeling positive behaviors, taking part in physical activity as a family on a daily basis, providing the resources for the child to be physically active, and making physical activity fun (CDC, 2014). Providing the family with the information as well as the resources through this campaign will allow parents to create behavior changes by decreasing some of the barriers to change. Providing the resources in the community, as well as allowing the parents to set their individual goals will allow the parents to make their own choices on how to go about making the behavior change (freedom), as well as provide opportunities for their child (pride, happiness, and love).
What is the support for the benefit? The support that will be provided to accomplish the goal of increasing physical activity and decreasing screen time is a free 6 month membership to the YMCA with an additional 6 month membership that is paid up to 75% of the rate as long as stipulations are met in the first 6 months. This membership includes parent-child exercise programs, as well as individual adult and child programs, and the ability for the child to participate in YMCA sports teams and lessons. All of these services come with the stipulation that the YMCA must be frequented by the family at least 2 days out of the week. Health coaching through the Fit Families program will also be provided. Parents will receive monthly contact by their health coach and each month a new goal will be set around decreasing screen time and increasing physical activity. When goals are met incentives will be given to help maintain goals. For example, if the goal is to play baseball with their child 2 days out of the week then a bat and ball incentive will be given. The actionable information will be provided during the monthly health coaching session. Guidance on resources in the community and the benefits of engaging the whole family in physical activity will be available to the parents.
What are the best openings for reaching the audience, and are the channels available appropriate for conveying the message? The best openings for reaching this audience would be at a Fit Families appointment with a health coach. The parents are engaged and ready to make a behavior change. Communicating the information at this time would be the most appropriate time and setting for the target audience to be the most receptive and most able to act on the message being sent (Resnick & Siegel, 2013). Since this is a specific audience, mass media channels will not be used for this campaign.
What image should communications convey? The image that should be associated with this program should be powerful and utilized to frame the health issue to position the target audience to take action (Resnick & Siegel, 2013). For this campaign the image should resemble the core values: freedom, pride, happiness, and love.
Behavior Change Theory
The Transtheoretical Model (TTM) of change is a good theory to utilize for behavior change messaging because it is a comprehensive theory that can be applied to a variety of different behaviors, populations, and settings (UMBC, n.d.). The stages of change in the TTM are precontemplation, contemplation, preparation, action, maintenance, and termination. For this campaign, the audience is in the preparation stage. Resnick & Siegel (2013) discuss the importance of selecting a target audience that is interested in making a change, or the program will need to work much harder to make a behavior change. Selecting an audience that is likely to make the behavior change will allow for a more population-wide impact. This target audience is likely to respond to the health messaging, because they have already made the commitment to make a behavior change by enrolling in Fit Families. There are also many resources available to this audience through the Fit Families program and the secondary audiences are already collaborating with this program to assist with the behavior change. The program encourages the audience to restructure their environment, identify barriers and plan solutions, provides health coaching to encourage the audience to maintain their motivation, and increase self-efficacy. Utilizing the TTM allows for the most appropriate and effective type of messaging to ensure the audiences’ needs are being met and behavior change can be facilitated.
Message Appeal
The most effective type of appeal for this campaign would be a combination of rational appeals and emotional appeals. Combining the two types of appeals can be effective because people make decisions based on emotion but want to know the rationale behind their choices (Resnick & Siegel, 2013). The emotional appeal that will be used will be a positive emotional appeal, as this is typically more effective when encouraging behavior change. An emotion appeal would reflect the core values well, as many of the core values indicated by this target audience are emotion: love, happiness, and pride.
Resources
American Academy of Pediatrics. (2010). Children, adolescents, and television. Retrieved from http://aappolicy.aappublications.org/cgi/reprint/pediatrics;107/2/423.pdf
CDC. (2014). Making physical activity a part of a child’s life. Retrieved from http://www.cdc.gov/physicalactivity/everyone/getactive/children.html
CDC. (2011) Health, United States, 2011 with Special Feature on Socioeconomic Status and Health. Retrieved from http://www.cdc.gov/nchs/data/hus/hus11.pdf
Dennison, B. A., Erb, T. A., & Jenkins, P. L. (2002). Television viewing and television in bedroom association with overweight risk among low-income preschool children. Pediatrics, 109(6), 1028-1035. Retrieved from http://pediatrics.aappublications.org/cgi/reprint/109/6/1028?maxtoshow=&hits=25&RES ULTFORMAT=&fulltext=%22screen+time%22+and+%22obesity%22&searchid=1&FI RSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
Epstein, L. H., Roemmich, J. N., Robinson, J. L., Paluch, R. A., Winiewicz, D. D., Fuerch, J. H., & Robinson, T. N. (2008). A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children. Pediatrician Adolescent Medicine, 162(3), 239-245. Retrieved from http://archpedi.amaassn.org/cgi/content/full/162/3/239?maxtoshow=&hits=25&RESULTFORMAT=&fulltext=%22screen+time%22+and+%22obesity%22&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT
Gomez, L. F., Parra, D. C., Lobelo, F., Samper, B, Moreno, J., Jacoby, E., Lucumi, D. I., Matsudo, S., & Borda, C. (2007). Television viewing and its association with overweight in Colombian children: Results from the 2005 national nutrition survey: A cross sectional study. International Journal of Behavioral Nutrition and Physical Activity, 4. Retrieved from http://www.ijbnpa.org/content/4/1/41
Karnik, S. & Kanekar, A. (2012). Childhood obesity: A global public health crisis. International Journal of Preventative Medicine, 3(1), 1-7. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278864/
Mendoza, J. A., Zimmerman, F. J., & Christakis, D. A. (2007). Television viewing, computer use, obesity, and adiposity in US preschool children. International Journal of Behavioral Nutrition and Physical Activity, 4. Retrieved from http://www.ijbnpa.org/content/4/1/44
Resnick, E. A. & Siegel, M. (2013). Marketing public health: Strategies to promote social change (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Steffen, L. M., Dai, S., Fulton, J. E., & Labarthe, D. R. (2009). Overweight in children and adolescents associated with TV viewing and parental weight: Project HeartBeat! American Journal of Preventative Medicine, 37, S50-S55. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/19524156
UMBC. (n.d.). The transtheoretical model of behavior change. Retrieved from http://www.umbc.edu/psyc/habits/content/the_model/