Engaging Minority Youth in Diabetes Prevention Efforts Through a Participatory, Spoken-Word Social Marketing Campaign

Purpose. To examine the reach, efficacy, and adoption of The Bigger Picture, a type 2 diabetes (T2DM) social marketing campaign that uses spoken-word public service announcements (PSAs) to teach youth about socioenvironmental conditions influencing T2DM risk. Design. A nonexperimental pilot dissemination evaluation through high school assemblies and a Web-based platform were used. Setting. The study took place in San Francisco Bay Area high schools during 2013. Subjects. In the study, 885 students were sampled from 13 high schools. Intervention. A 1-hour assembly provided data, poet performances, video PSAs, and Web-based platform information. A Web-based platform featured the campaign Web site and social media. Measures. Student surveys preassembly and postassembly (knowledge, attitudes), assembly observations, school demographics, counts of Web-based utilization, and adoption were measured. Analysis. Descriptive statistics, McNemar’s χ2 test, and mixed modeling accounting for clustering were used to analyze data. Results. The campaign included 23 youth poet–created PSAs. It reached >2400 students (93% self-identified non-white) through school assemblies and has garnered >1,000,000 views of Web-based video PSAs. School participants demonstrated increased short-term knowledge of T2DM as preventable, with risk driven by socioenvironmental factors (34% preassembly identified environmental causes as influencing T2DM risk compared to 83% postassembly), and perceived greater personal salience of T2DM risk reduction (p < .001 for all). The campaign has been adopted by regional public health departments. Conclusion. The Bigger Picture campaign showed its potential for reaching and engaging diverse youth. Campaign messaging is being adopted by stakeholders.

[1]  E. Mayer-Davis,et al.  The Many Faces of Diabetes in American Youth: Type 1 and Type 2 Diabetes in Five Race and Ethnic Populations: The SEARCH for Diabetes in Youth Study , 2009, Diabetes Care.

[2]  June A. Flora,et al.  Social Marketing and Public Health Intervention , 1988, Health education quarterly.

[3]  R. Glasgow,et al.  Evaluating the public health impact of health promotion interventions: the RE-AIM framework. , 1999, American journal of public health.

[4]  P. Yoon,et al.  Prevalence of Cardiovascular Disease Risk Factors Among US Adolescents, 1999−2008 , 2012, Pediatrics.

[5]  Darcy A. Freedman,et al.  Public health literacy defined. , 2009, American journal of preventive medicine.

[6]  M. Tulder,et al.  Go 4 it ; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2 , 2009 .

[7]  S. Howard,et al.  A systematic examination of the use of Online social networking sites for sexual health promotion , 2011, BMC public health.

[8]  B. Haller,et al.  A cluster randomised school-based lifestyle intervention programme for the prevention of childhood obesity and related early cardiovascular disease (JuvenTUM 3) , 2011, BMC public health.

[9]  Dean Schillinger,et al.  Development and Early Implementation of The Bigger Picture, a Youth-Targeted Public Health Literacy Campaign to Prevent Type 2 Diabetes , 2014, Journal of health communication.

[10]  Jasmin Divers,et al.  Prevalence of Diabetes in U.S. Youth in 2009: The SEARCH for Diabetes in Youth Study , 2014, Diabetes Care.

[11]  E. Rogers,et al.  Entertainment-Education: A Communication Strategy for Social Change , 1999 .

[12]  T. Baranowski,et al.  HEALTHY study rationale, design and methods: moderating risk of type 2 diabetes in multi-ethnic middle school students , 2009, International Journal of Obesity.

[13]  H. Delemarre-van de Waal,et al.  Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2 , 2008, BMC public health.

[14]  W. Dietz,et al.  Childhood obesity: the new tobacco. , 2010, Health affairs.

[15]  P. Briss,et al.  Integrating evidence-based clinical and community strategies to improve health. , 2007, American journal of preventive medicine.