Social Marketing as a Framework for Youth Physical Activity Initiatives: a 10-Year Retrospective on the Legacy of CDC's VERB Campaign

Impact of the Social Marketing-Based Intervention on Preconception Healthy Behaviors of Women With Sickle Cell Disease

INTRODUCTION

A suggested method to improve the outcomes of pregnancy with sickle cell disease (SCD) is to engage more women at reproductive age in preconception healthy behavior (PCHB). Social marketing can be a suitable strategy to achieve this goal. We aimed to assess the impact of the social marketing-based intervention on women's engagement in PCHB.

METHODS

A quasi-experimental study was conducted in Bandar Abbas and Minab (the two largest cities of Hormozgan province in Iran with a high prevalence of SCD) from 2021 to 2022. A social marketing-based intervention with the main components (participation in PCHB as a "product," social media and traditional promotional channels as a "promotion," selecting healthcare centers as a "place" for implementing the intervention, and free access to medical experts and speciality as a "price") was designed based on formative research. The sample size was estimated at 140 participants in each intervention and control group. The study's main outcome was the level of engagement in PCHB, which was assessed according to the health belief model (HBM).

RESULTS

We compared the PCHB scores of both groups. Employing healthy behavior was more dominant in the intervention group. Awareness, perceived severity, perceived susceptibility, perceived benefits, and self-efficacy increased in both groups following intervention, while perceived barriers decreased. An analysis of covariance (ANCOVA) was performed to control and moderate the effect of scores in the pretest. As observed between the adjusted averages, awareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and engagement in the PCHB were significantly different between the control and intervention groups after the intervention. A multivariate linear regression analysis showed that awareness, perceived susceptibility, and self-efficacy were strong predictors of PCHB.

CONCLUSIONS

Social marketing-based intervention successfully increased PCHB among women of reproductive age with SCD.

Implementation models and frameworks used to guide community-based physical activity programs for children: a scoping review

BACKGROUND

The implementation of community-based programs is key to effective, sustainable initiatives that can support population-level changes in children's physical activity. The purpose of this scoping review was to explore the implementation models and frameworks used to develop (process models), explore (determinant frameworks), and/or evaluate (evaluation frameworks) community-based physical activity programs for children. Also, the foundational components of the implementation models and frameworks and practical application in real-world settings were described.

METHODS

The methodological framework developed by Arksey and O'Malley (2005) and the updated recommendations from Levac, Colquhoun and O'Brien (2010) were used to search, identify, and summarize applicable studies. This review also met the requirements in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Reviews Checklist (PRISMA-ScR). A detailed search of six databases and three academic journals was conducted. Information about the article, the program, and the implementation model/framework were extracted and summarized.

RESULTS

The search retrieved 42,202 articles, of which 27 met the inclusion criteria. Eleven process models, one determinant framework, and two evaluation frameworks were identified. Nineteen components were developed from the models and frameworks. Tailoring, situational analysis, and element identification were common components among the identified models and frameworks.

CONCLUSIONS

Since the execution of interventions is vital for creating successful health-promoting initiatives, researchers and program developers should consider using implementation models and frameworks to guide their community-based physical activity programs. Further research examining the application of new and existing implementation models and frameworks in developing, exploring, and evaluating community-level programs is warranted.

Communicating Physical Activity with Adolescents: What works? A scoping review protocol

Background: Worldwide, adolescents are not meeting the minimum recommended physical activity (PA) guidelines to achieve health benefits. Awareness of the guidelines among adolescents is low, only 3.6% can report them correctly. The school is an ideal PA promotion setting, no other institute has the same reach or influence on the adolescent population. There is a need for an effective communication strategy for PA messages for adolescents. The purpose of this review is to explore how, when, who, where and what i.e. the content, context and mode of delivery of PA messages to communicate with adolescents to improve their awareness and understanding of PA that will potentially lead to an increase in PA levels. Methods: A scoping review was selected as the most appropriate methodology due to the broad nature of the research question. The PCC mnemonic (Population, concept, context), recommended by the Joanna Briggs Institute, was used to develop the search strategy and research question. This review will follow the scoping review framework developed by Arksey and O’Malley (2005) which was later updated by Levac et al (2010) to ensure the methods are systematic. It will also follow the PRISMA extension for scoping reviews checklist. Sources include databases (CINAHL, Education Source, Scopus, PubMED), grey literature from the World Health Organisation, Global Index Medicus and the reference lists of extracted articles will be checked from the year 1995 onwards. Results: A PRISMA flow diagram will demonstrate the final articles included and results will be presented and summarised as recurring themes. The results will be discussed in relation to existing literature and future implications for research, policy and practice. Conclusion: This will be the first review to explore the PA messaging context among adolescents and the findings will help inform a strategy for communicating PA to adolescents.

Influential social marketing interventions in physical activity promotion

Purpose

The purpose of this paper is to identify and rank the influential social marketing factors for physical activity promotion.

Design/methodology/approach

A descriptive-survey approach is used in this study. First, the influential social marketing factors for physical activity promotion were determined through the review of theoretical foundations and literature. The factors with a >0.7 content validity index (CVI) value, based on the experts' opinion, were selected. A total of 23 individuals participated in the study, including sports marketing experts and members of physical activity committees of Iranian sports federations, and they were selected purposively. The study data were collected using a pairwise comparison questionnaire and analyzed using the DEMATEL-based analytic network process (DANP) method.

Findings

In this study, a total of 17 influential social marketing factors were identified and categorized in 5 dimensions: product, price, place, promotion and partnership. Based on DEMATEL-based analytic network process (DANP) results, the “promotion” with the weight of 0.212 was the most important dimension and “providing inexpensive sports services” with the weight of 0.096 was the most important social marketing factor influencing the promotion of the physical activity.

Originality/value

The results highlight the importance of sport for all services expenses and costs in promoting physical activity. Thus, the results can be the basis for policies regarding social marketing to promote physical activity.

Developing and Disseminating Physical Activity Messages Targeting Parents: A Systematic Scoping Review

BACKGROUND

Physical activity (PA) messages have demonstrated success in targeting parent support for PA. However, little research exists to inform the development and dissemination of optimally effective PA messages targeting parents. A synthesis of existing literature is necessary to inform message development and dissemination strategies. Unique considerations for parents of children with disabilities (CWD) should be identified given a need for inclusive PA messaging that consider the needs of CWD and their families.

METHODS

Systematic scoping methodologies included a peer-reviewed literature search and expert consultation to identify literature regarding PA messages targeting parents, and considerations for parents of CWD.

RESULTS

Thirty-four articles that met eligibility criteria were included for examination. Twenty-eight studies were identified regarding the PA messages targeting parents; six themes and 12 subthemes emerged from these articles. Six studies were identified regarding unique considerations for parents of CWD; three themes and four subthemes emerged from these articles.

CONCLUSIONS

Through knowledge synthesis, this research can contribute to a knowledge translation process to inform practice guidelines for the development and dissemination of PA messages targeting parents, while also providing unique considerations for PA messages targeting parents of CWD.

The promotion of healthy breakfast and snacks based on the social marketing model: a mixed-methods study

BACKGROUND

Skipping breakfast and replacing it with non-nutritious snacks are progressively increasing among adolescents. This study aimed to develop an educational intervention based on the Social Marketing Model and evaluate its effects on healthy breakfast and snack consumption among female adolescent students.

METHODS

This mixed-methods study was conducted in 2016-2019 in two phases. In the first phase, a qualitative study was conducted through directed content analysis in guidance schools in Khorramabad, Isfahan, and Tehran, Iran, to explore factors affecting breakfast consumption. The results of this phase were set in the benchmarks of the Social Marketing Model. In the second phase, a randomized controlled trial was conducted based on the benchmarks of the Social Marketing Model on 94 students randomly recruited from guidance schools in Khorramabad, Iran.

RESULTS

The findings of the qualitative phase were categorized into the benchmarks of the Social Marketing Model, namely the social marketing mix, the intended behavior, internal and external competing factors for behavior modification, theoretical concepts related to the behavior, and the role of supporters. In the quantitative phase, the univariate analysis showed significant between-group differences concerning the product, price, promotion, and behavior (p < 0.05).

CONCLUSION

Healthy breakfast and snack consumption can be promoted through making acceptable the tastes, costs, preparations, and consumption places of breakfast and snack.

TRIAL REGISTRATION

The trial was registered in the Iranian Registry of Clinical Trials (code: IRCT20170201032347N1 ). The trial was registered in 11/07/2018 and is accessible on the Iranian Clinical Trial Registration website.

Designing an AI Health Coach and Studying Its Utility in Promoting Regular Aerobic Exercise

Our research aims to develop interactive, social agents that can coach people to learn new tasks, skills, and habits. In this article, we focus on coaching sedentary, overweight individuals (i.e., “trainees”) to exercise regularly. We employ adaptive goal setting in which the intelligent health coach generates, tracks, and revises personalized exercise goals for a trainee. The goals become incrementally more difficult as the trainee progresses through the training program. Our approach is model-based—the coach maintains a parameterized model of the trainee’s aerobic capability that drives its expectation of the trainee’s performance. The model is continually revised based on trainee-coach interactions. The coach is embodied in a smartphone application, N utri W alking , which serves as a medium for coach-trainee interaction. We adopt a task-centric evaluation approach for studying the utility of the proposed algorithm in promoting regular aerobic exercise. We show that our approach can adapt the trainee program not only to several trainees with different capabilities but also to how a trainee’s capability improves as they begin to exercise more. Experts rate the goals selected by the coach better than other plausible goals, demonstrating that our approach is consistent with clinical recommendations. Further, in a 6-week observational study with sedentary participants, we show that the proposed approach helps increase exercise volume performed each week.

Increasing Students’ Physical Activity in Function of Social Sustainability: Recommendations from a Social Marketing Perspective

The role of physical activity for social sustainability, as well as potential for social marketing to contribute to increasing the level of physical activity, are already documented in previous literature. Those considerations may gain additional importance in the context of student population, often confronted with the decrease of the level of physical activity, and in a country with scarce similar researches. The purpose of this study is to identify socio-demographic determinants of Serbian students’ physical activity. Physical activity was examined as an ordinal dependent variable (inactive, low-frequency activity, and recommended frequency activity) and an ordered logit model was implemented for examining its relations with students’ gender, age, household size, emotional status, accommodation, year of study, and living standard. The results show that 15.7% of students are inactive, 22.9% have low-frequency activity, while 61.3% met the recommended level of physical activity. The average probability of physical activity is larger for male students in comparison to female students. Students with better living standards are also more physically active. Finally, the average probability of physical activity decreases starting from students who live with their families, followed by those who live in a private accommodation, to students who live in a dormitory. Considering the obtained results, recommendations from a social marketing perspective are provided.

Get the message? A scoping review of physical activity messaging

BACKGROUND

Understanding how to create and deliver effective physical activity (PA) messages for and to various population subgroups may play a role in increasing population PA levels. This scoping review aimed to provide an overview of what is known about PA messaging and highlight key research gaps.

METHODS

We followed a 5-stage protocol proposed by Arksey & O'Malley and the Preferred Reporting Items For Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews checklist. Stage 1: research questions were identified. Stage 2: we identified relevant studies by searching electronic databases, contacting existing networks and hand searching reference lists. Stage 3: studies were screened in Covidence™ software. Stage 4: study data were extracted and charted. Stage 5: findings from included studies were collated, summarised and reported in two ways: (1) a descriptive numerical analysis providing insight into extent, nature and distribution of the included studies, and (2) a narrative summary summarizing the evidence reviewed organised by messaging concepts and by population subgroup.

RESULTS

A total of 9525 references were imported into Covidence™ for screening. Of these, 123 studies were included in final analysis. We found that PA messaging evidence is complex and multidimensional in nature, with numerous concepts to consider when creating or evaluating messages. The extent to which these different PA messaging concepts have been researched is variable. Where research has accumulated and evidence is consistent, it supports the following: (1) PA messages should be framed positively and highlight short-term outcomes specifically relating to social and mental health, (2) message content should be tailored or targeted to intended recipient(s), and (3) when developing messages, formative research, psychological theory and/or social marketing principles should be used.

CONCLUSION

While it is unlikely to address global inactivity on its own, PA messaging may play a valuable role improving population PA levels. However, it is a complex and multidimensional concept and greater understanding is still needed. We present a synthesis of the existing evidence, highlighting key areas where evidence has accumulated and where gaps lie, as well as recommendations for PA messaging to different population subgroups.

Toward optimal implementation of cancer prevention and control programs in public health: a study protocol on mis-implementation

BACKGROUND

Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes.

METHODS

This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation.

DISCUSSION

This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; (3) use agent-based modeling to address cancer control implementation; and (4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to provide replicable computational simulation models that can identify leverage points and public health system dynamics to reduce mis-implementation in cancer control and may be of interest to other health areas.