Awareness of Canada on the Move; Pedometer Campaigns Cora Lynn Craig Adrian Bauman Catrine Tudor-Locke Sue Cragg.

Awareness of Canada on the Move; Pedometer Campaigns

Cora Lynn CraigAdrian Bauman

Catrine Tudor-LockeSue Cragg

Physical Activity in Canada

Early 1970’s First public recognition that Canadians

were sedentary and that the situation would worsen with

technological advances.(Nutrition Survey)

Health Report of Canadians

1974 Lalonde Report recognized lifestyle as one of four areas for improving public health 12 policy initiatives related to physical

activity ParticipACTION launched as a national

social marketing campaign

Need for Awareness Campaigns

The World Health Organization Global Strategy on Diet, Physical Activity and Health identifies education, communication

and public awareness as one of the key roles for government

Mass Media Campaigns ‘purposive attempts to inform, persuade, and

motivate a population (or sub-group of a population) using organised communication activities though specific channels, with or without other supportive community activities.’

Typically (though not exclusively) run by public agencies for social rather than commercial benefit, tend to be run for a defined period of time, and are often not reported in the scientific literature.

Often used as part of a broader community-wide approach, combined with other approaches such as support and self help groups, counselling, screening and education, community events and walking trails. Cavil and Bauman, 2003

Impact of Mass Communication Campaigns

Exposure

Awareness

Knowledge

Attention

Intention

Behaviour

Potential Campaign Effects

Level of Impact ExampleProximal variables – awareness Recognize logo or theme; recall or

awareness of the initiative, prompted or unprompted; understand the meanings of messages

Proximal variables – initial responses to campaign, formation of beliefs, social norms, awareness of resources or programs

Formation of new beliefs and attitudes towards behaviour; perceived personal relevance of being active; perception of personal capability to undertake recommended actions

Distal variables – measures of behavioural intention or physical activity behaviour

Population rates of intending to be more active; actual (short term) changes in physical activity behaviour; long-term maintenance of physical activity (as a habit).

Adapted from Cavil and Bauman

ParticipACTION

One of the most recognized logos in Canada:85% recalled the logo in 1981.

The face of social marketing for two decades.

Effectiveness of Awareness Campaigns

Can Provide an overall framework or umbrella under

which a broader range of health promotion initiatives can take place.

Provide a backdrop for the more detailed community level or interpersonal interventions.

Raise awareness, convey information, help to set agendas and change attitudes.

Cannot be realistically expected to be solely responsible

for reversals in socially and environmentally driven behaviours.

Cavil, 1998

Effectiveness of ParticipACTION High levels of unprompted and prompted recall of

PartcipACTION among adult Canadians across two decades.

Delivered clear messages, enhanced community awareness of physical activity and recreation and fostered community-based partnerships.

Led to the delivery of may programs and events that reached many thousands of Canadians.

Reached both French and English Canadians.

Increases in physical activity among adult Canadians during this time period cannot be causally linked to efforts of ParticipACTION but likely a contributing factor especially since most other developed countries experienced unchanging for even declining rates of physical activity participation during the same period.

Effectiveness of Awareness Campaigns

No major national campaigns since the 1990’s

Current situation

People are aware of the benefits of being active

LTPA has increased (discretionary) Not active enough

Obesity and type 2 diabetes are increasing Total activity (work, leisure, chores)

decreasing?

What is Canada on the Move?

web-based research platform designed to capture self-reported data on steps to evaluate interventions to evaluate programs

(Canadian Institutes for Health Research)

partnership with industry (Kellogg’s) to assess impact of large "natural" experiment of putting pedometers

in cereal boxes social advertising to walk more

Launch December 03 - January 04

Kellogg’s first mass marketing messages to encourage walking aired last week of December

Press release January 8 (Kellogg’s)

800,000 pedometers in cereal boxes on shelves week of January 8 Special K and Special K Red Berries

Launch December 03 - January 04

Press release January 26 launching the COTM website (CIHR)

Media interviews on TV and radio January 26 to February 2

Coverage

January to mid February Kellogg’s provided 3 million messages encouraging

Canadian's to take ‘more steps’.Courtesy of Dr. Ron Plotnikoff U Alberta

8 radio reports (CBC syndication) Length (M = 12.5 minutes) Audience (M = 17,688)

13 TV reports ~ 2 M viewers Length (M = 2.65 minutes) Audience (M = 153,762)

Courtesy of Guy Faulkner & Sara-Jane Finlay

Messages

Campaign brand Canada on the Move

Specific messages Add 2000 steps Donate your steps to health research

Other themes/messages walk more use pedometers to monitor how much you walk “Keep it simple” (Kellogg’s)

Goals

Increase: Campaign awareness Pedometer awareness Pedometer ownership Pedometer usage

Impact of mass communication campaigns

Exposure

Awareness

Knowledge

Attention

Intention

Behaviour

Campaign Awareness

Pedometer

Awareness

Pedometer Ownership

Pedometer Usage

Second Phase: June 2004

Week of June 10 Kellogg’s second mass marketing campaign

aired beginning. 1,500,000 pedometers via cereal boxes

Special K, Special K red berries + 7 other brands

Repeated brand (COTM) and messages “Donate your steps to health research” “Add 2000 steps” plus others

Purpose of campaign evaluation

To assess the short- and intermediate-term impacts of the COTM initiative among adult Canadians attention to and recall of the COTM tagline population rates of ownership and use of

pedometers changes in walking among those who

received pedometers via COTM purchased pedometers elsewhere those who do not own one

Methods

Telephone survey (Physical Activity Monitor) Rolling monthly sample of 750 Canadians

15 years and older Institute for Social Research (York University)

Random digit dialing to select households Individual at random using closest birth date

method Response rate > 50% University graduates and women over-represented

in sample Interviews conducted using CATI

Immediate impact

Recall of campaign (Have you heard of:) Canada on the Move two key messages

Add 2000 steps Donate your steps to health research

two other messages for comparison Stairway to Health (workplace campaign) Walk a Block

Awareness of Canada on the Move

2003 and 2004 Physical Activity Monitors, CFLRI

Recall of the Canada on the Move initiative and the subcomponent messages were at their highest right after each launch and sustained a higher rate recall over time

Recall of the ‘stairway to health’ and the ‘walk a block’ messages remained consistent over the same time period.

Immediate impact

Awareness of pedometersHave you heard of a pedometer or stop counter? (yes/no/don’t know)

Overall 57% of Canadian adults had heard of a pedometer or step counter.

Greatest awareness among women adults aged 45-64 college and university graduates high income earners

Intermediate impact

Pedometer ownership Do you currently own a pedometer or step counter

Obtaining pedometer from cereal box Where did you get it

Bought it From a cereal box Somewhere else

Pedometer use Days pedometer worn in the last 7 days

Special K Red Berries

Intermediate impact

Pedometer ownership Just over one in 10 Canadians reported owning a

pedometer Pedometer ownership more prevalent among

Women College and university graduates High income earners

Pedometer ownership less prevalent among 18-24 year olds

The prevalence of pedometer ownership increased significantly between January and February and between May and July.

Intermediate impact

Obtaining pedometer from cereal box 3.6% of Canadians bought their pedometer and

3.7% obtained it from a cereal box Compared to adults aged 18-24, adults aged 25

and older were 3 to 6 times more likely to have purchased the pedometer and much less likely to have obtained it from a cereal box.

Reporting increased in February and between June and July and then decreased between July and September

Intermediate impact

Pedometer use 2.4 Canadians reported using a

pedometer at least once in the previous week

More likely among Women 44-64 year olds

Intermediate impact

Relationship between recall and pedometer awareness and ownership: Awareness of COTM is associated with having

heard of a pedometer Increased with awareness of sub-message(s)

along with COTM Those who recall one or both specific

messages more likely to own a pedometer Those who heard one specific message were

twice as likely as those who do not to have obtained a pedometer from a cereal box

Intermediate impact

Relationship between recall and pedometer use: Pedometer use was related to

awareness of the COTM campaign; those aware of “Canada on the Move” and both of it s specific messages were almost four times a likely to have worn a pedometer in the past week as those unaware of the campaign.

Longer term impact

Recall of campaign Awareness of pedometers Pedometer ownership Walking behaviour (International

Physical Activity Questionnaire) Number of days walking in the previous

week for at least 10 minutes at a time Total time spent walking in previous week

Impact of mass communication campaigns

Exposure

Awareness

Knowledge

Attention

Intention

Behaviour

Campaign Awareness

Pedometer

Awareness

Pedometer Ownership

WalkingBehaviour

Sufficient walking

Summed across work, chores, transport and leisure time activities

1 hour per day regardless of purpose

Sufficient walking

31% of Canadians reported sufficient walking Lower among women and low income

earners Decreases by age and education

Sufficient walking

31% of Canadians reported sufficient walking Lower among women and low income

earners Decreases by age and education

Longer term impacts - Sufficient walking

A year after its launch, awareness of COTM was associated with a 13% increase in the likelihood of sufficient walking after adjusting for age, sex, income and education.

Higher prevalence of sufficient walking Among those recognizing the campaign brand

COTM and its general message ‘add 2000 steps’ compared with those who were not aware.

Among those recognizing the tagline ‘donate your steps to heath research’ than those aware of COTM and add 2000 steps.

Sufficient walking

Those owning a pedometer were 14% more likely than those who did not own one to engage in sufficient walking.

Those who owned a pedometer and who were aware of the COTM tagline donate your steps to research were 52% more likely to report sufficient walking than others.

Sufficient walking

COTM had a real impact on walking behaviour among Canadians who were aware of the campaign.

Results suggest that combining an easy-to-use tool for self-regulation of the target behaviour with relevant messaging may result in a larger campaign effect than just the message or distribution of the tool alone.

Role of communication campaigns

Targets Evaluation

Impact of mass communication campaigns

Exposure

Awareness

Knowledge

Attention

Intention

Behaviour

References – to be edited

Craig, Cora L, Cragg, Sue E, Tudor-Locke, Catrine and Bauman, Adrian. Proximal Impact of Canada on the Move, Canadian Journal of Public Health, Volume 97, Supplement 1, March-April 2006, pp s21-s27.

Craig, CL, Tudor-Locke, C and Bauman, A, Twelve-month effects of Canada on the Move: a population-wide campaign to promote pedometer use and walking. Health Education Research, Theory & Practice. 2006, Oxford University Press

Cavill, Nick and Bauman, Adrian. Changing the way people think about health-enhancing physical activity: do mass media campaigns have a role? Journal of Sports Sciences, 2004, 22, 771-790

Cavill, Nick. National campaigns to promote physical activity: Can they make a difference? International Journal of Obesity (1988) 22 Suppl 2 s48-s51.Rice, R. and Atkin, C. (eds.) (2001) Public Communication Campaigns, 3rd edn, Thousand Oaks, CA: Sage

Bauman, Adrian, Madill, Judith, Craig, Cora L., Salmon, Art. ParticipACTION: This Mouse Roared but Did it Get the Cheese? CJPH, Volume 95, Supplement 2, May/June 2004.