Focusing on public health: a different look at translating research to practice.

ABSTRACT The Centers for Disease Control and Prevention (CDC) is committed to achieving true improvements in people's health. In chronic disease prevention and health promotion, we have a good deal of evidence about which intervention strategies work in clinics and in communities to improve health, but we need to accelerate translating that evidence into practice. This paper provides an overview of initial efforts of the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) within the CDC to identify and organize the fundamental elements of translation, with the goal of understanding what our constituents need for success and to identify key issues to consider in translation.

The use of surveillance data and market research to promote physical activity.

Using various types of data sources for assessing and monitoring physical activity behaviors on a population level adds to our ability to explain the relationships between individuals and their surrounding social and physical environments. This article presents the findings from part of a panel presentation on available data sets at the 2001 Cooper Conference on Innovative Approaches to Understanding and Influencing Physical Activity. First, an overview of large national epidemiologic and surveillance data sets is offered, followed by a discussion on the use of market segmentation data to complement more traditional sources of data by adding new dimensions to our understanding of target groups and potential intervention strategies. The relative advantages and disadvantages of using each type of data are also given, as well as recommendations for further use.

Public beliefs about breastfeeding policies in various settings.

To understand the public beliefs about breastfeeding policies in various settings and to examine the associations of these beliefs with sociodemographic characteristics, we analyze the data from the 2001 Healthstyles survey, which is an annual national mail survey to US adults. We found that establishing workplace breastfeeding policies and lactation rooms in public places are the most acceptable breastfeeding policies surveyed, especially among African Americans and low-income populations. The overall population appears to approve of breastfeeding in public, but less-educated or older people (aged >/=45 years) are less likely to do so. In general, there is relatively less public support for breastfeeding education in high schools. The results indicate that many Americans, especially African Americans and those with low household income, believe that women who breastfeed need extra support both at work and in public places. A variety of policy strategies would be appropriate to create a favorable environment for breastfeeding.

Public perceptions on breastfeeding constraints.

To describe public perceptions on breastfeeding constraints, the authors studied the responses of 2369 US adults who participated in the Healthstyles 2000 national mail survey (response rate = 75%). Among them, 2351 answered at least 1 of the 12 breastfeeding items. Public perceptions were positive for 8 of the 12 items. Among the other 4, however, almost half of US adults (45%) agreed that a breastfeeding mother has to give up too many lifestyle habits, 31% thought that babies ought to be fed cereal or baby food by age 3 months, 31% said that 1-year-olds should not be breastfed, and 27% considered breastfeeding in public embarrassing. The results revealed more negative perceptions among non-whites, people under 30 or above 65 years, and those who had low income and less education. To promote and support breastfeeding in society as a whole, these messages need to be considered in planning and implementing breastfeeding interventions.

Analysis of physical activity mass media campaign design.

BACKGROUND: Mass media campaigns are a necessary tool for public health practitioners to reach large populations and promote healthy behaviors. Most health scholars have concluded that mass media can significantly influence the health behaviors of populations; however the effects of such campaigns are typically modest and may require significant resources. A recent Community Preventive Services Task Force review on stand-alone mass media campaigns concluded there was insufficient evidence to determine their effectiveness in increasing physical activity, partly due to mixed methods and modest and inconsistent effects on levels of physical activity. METHODS: A secondary analysis was performed on the campaigns evaluated in the Task Force review to determine use of campaign-building principles, channels, and levels of awareness and their impact on campaign outcomes. Each study was analyzed by 2 reviewers for inclusion of campaign building principles. RESULTS: Campaigns that included 5 or more campaign principles were more likely to be successful in achieving physical activity outcomes. CONCLUSION: Campaign success is more likely if the campaign building principles (formative research, audience segmentation, message design, channel placement, process evaluation, and theory-based) are used as part of campaign design and planning.

Mass media health communication campaigns combined with health-related product distribution: a community guide systematic review.

CONTEXT: Health communication campaigns including mass media and health-related product distribution have been used to reduce mortality and morbidity through behavior change. The intervention is defined as having two core components reflecting two social marketing principles: (1) promoting behavior change through multiple communication channels, one being mass media, and (2) distributing a free or reduced-price product that facilitates adoption and maintenance of healthy behavior change, sustains cessation of harmful behaviors, or protects against behavior-related disease or injury. EVIDENCE ACQUISITION: Using methods previously developed for the Community Guide, a systematic review (search period, January 1980-December 2009) was conducted to evaluate the effectiveness of health communication campaigns that use multiple channels, including mass media, and distribute health-related products. The primary outcome of interest was use of distributed health-related products. EVIDENCE SYNTHESIS: Twenty-two studies that met Community Guide quality criteria were analyzed in 2010. Most studies showed favorable behavior change effects on health-related product use (a median increase of 8.4 percentage points). By product category, median increases in desired behaviors ranged from 4.0 percentage points for condom promotion and distribution campaigns to 10.0 percentage points for smoking-cessation campaigns. CONCLUSIONS: Health communication campaigns that combine mass media and other communication channels with distribution of free or reduced-price health-related products are effective in improving healthy behaviors. This intervention is expected to be applicable across U.S. demographic groups, with appropriate population targeting. The ability to draw more specific conclusions about other important social marketing practices is constrained by limited reporting of intervention components and characteristics.