1. Harvard Forum June 11, 2003 A community campaign using paid media to encourage walking among sedentary older adults Bill Reger, EdDAdrian Bauman,PhD Linda Cooper, MSWBess Marcus, PhD Steven Booth-Butterfield, EdD Susan Middlestadt, PhD Holli Smith, MA, MSWFelicia Greer, PhD

2. Harvard Forum June 11, 2003 WORLD HEALTH ORGANIZATION 1 st International Conference on Health Promotion November 21, 1986 Ottawa, CANADA OTTAWA CHARTER FOR HEALTH PROMOTION “Health promotion is the process of enabling people to increase control over, and to improve, their health…People cannot achieve their fullest health potential unless they are able to take control of those things which determine their health.”

3. Harvard Forum June 11, 2003 Initial STEERING COMMITTEE 12-week CHPP Mass media-based CAMPAIGN WHEELING WALKS Task Force Policy and Environmental / INFRASTRUCTURE changes PHASES: On-going POLICY & ENVIRONMEN TAL work INTERVENTIO N COMMUNITY EMPOWERME NT PROJECT MODEL

4. Harvard Forum June 11, 2003 HOW? By delivering: a targeted public health physical activity message: 30 minutes or more of moderate-intensity walking almost every day. to a targeted audience: Insufficiently active adults, ages 50-65, in a West Virginia community

5. Harvard Forum June 11, 2003 Standard Model for Communication Theory of Reasoned Action and Planned Behavior Transtheoretical Model Social Marketing METHODOLOGY

6. Harvard Forum June 11, 2003 TIME ENERGY

7. Harvard Forum June 11, 2003 Print ad: man

8. Harvard Forum June 11, 2003 PAID ADVERTISING - 8 weeks --Two 30-second television ads that run 683 times (5100 GRP) on network-affiliated stations and 1,164 times on cable television stations --Two 60-second radio ads that run 1,988 times (3450 GRP) --2 different 1/4-page newspaper ads that run 14 times

9. Harvard Forum June 11, 2003 PUBLIC RELATIONS included: WEEK 1--campaign KICK-OFF press conference WEEK 3--press conference with physicians WEEK 4--a mid-campaign progress report press event WEEK 6--1st Mayor’s Walking Cup –noon-time walk WEEK 7--Intergenerational Walk WEEK 8--campaign finale press conference

10. Harvard Forum June 11, 2003 COMMUNITY EDUCATIONAL / PUBLIC HEALTH Activities Campaign Website Worksite, Faith-based programs and challenges Physicians’ “Prescription for WALKING”

11. Harvard Forum June 11, 2003 EVALUATION PLAN 1. A telephone survey questionnaire of 1,472. --Baseline --Immediately post-intervention 2. Earned media 3. Environmental and Policy Change

12. Harvard Forum June 11, 2003 RESULTS –EARNED MEDIA 76 -- TV news stories 48 -- Radio news stories 49 -- Newspaper articles (23--Front Page) 107 -- TV / Radio interviews / promotions 2 -- USA Today article w/ pix 76 -- TV news stories 48 -- Radio news stories 49 -- Newspaper articles (23--Front Page) 107 -- TV / Radio interviews / promotions 2 -- USA Today article w/ pix 76 -- TV news stories 48 -- Radio news stories 49 -- Newspaper articles (23--Front Page) 107 -- TV / Radio interviews / promotions 2 -- USA Today article w/ pix

13. Harvard Forum June 11, 2003 RESULTS — TELEPHONE QUESTIONNAIRES Immediate Post Knew about campaign------------92% Saw TV ads---------------------------76% Heard Radio ads--------------------35% Saw or heard news stories------82% Heard about campaign: at worksite------------------------ 5% via faith-based programs----- 4% via speakers--------------------- 4% Self-report

14. Harvard Forum June 11, 2003 RESULTS— TELEPHONE QUESTIONNAIRES SELF-REPORT --Baseline to Immediate-post Percent Increase 32% 18% 14% difference

15. Harvard Forum June 11, 2003 RESULTS-- STAGE CHANGES (Transtheoretical Model) Of those reporting to be in precontemplation, contemplation, and preparation at baseline, 50% 62% in in COMPARISON WHEELING reported being at a higher stage immediately post-intervention. (statistically significant at p<.001) 12%

16. Harvard Forum June 11, 2003

17. Engaging city agencies -streets, highways, parks -law enforcement, planning Physicians writing “walking prescriptions” Weekly column in Sunday paper Working with University engineering team  develop walkable community plan

18. Harvard Forum June 11, 2003

19. Isn’t it time you started walking!

20. Harvard Forum June 11, 2003

21. THE STANDARD MODEL Reception Processing Response Behavior behavior beliefs arg quality PLACEMENT elaboration normative intention BEHAVIOR likelihood beliefs to act FREQUENCY cues control beliefs

22. Harvard Forum June 11, 2003 Message Development (Formative Research) -- An Elicitation Survey to identify salient psychosocial factors about moderate-intensity walking. (30 people) -- A Quantitative Survey to identify which psychosocial factors differentiate walkers and non-walkers. (150 people) -- A Qualitative Pretesting of ad storyboards to guide final ad production. (80 people)

23. Harvard Forum June 11, 2003 Treatment Control Intention Walking Status Best “Predicted” Model, Chi-square[3] = 39.73; p <.00001 GFI =.973; RMS =.132.18.57.15 All paths with coefficients are significant at.01 or better