The Influence of the VERB campaign on children's physical activity in 2002 to 2006.

OBJECTIVES: We evaluated physical activity outcomes for children exposed to VERB, a campaign to encourage physical activity in children, across campaign years 2002 to 2006. METHODS: We examined the associations between exposure to VERB and (1) physical activity sessions (free time and organized) and (2) psychosocial outcomes (outcome expectations, self-efficacy, and social influences) for 3 nationally representative cohorts of children. Outcomes among adolescents aged 13 to 17 years (cohort 1, baseline) and children aged 9 to 13 years from cohorts 2 and 3 were analyzed for dose-response effects. Propensity scoring was used to control for confounding influences. RESULTS: Awareness of VERB remained high across campaign years. In 2006, reports of children aged 10 to 13 years being active on the day before the survey increased significantly as exposure to the campaign increased. Psychosocial outcomes showed dose-response associations. Effects lessened as children aged out of the campaign target age range (cohort 1, baseline), but dose-response associations persisted in 2006 for outcome expectations and free-time physical activity. CONCLUSIONS: VERB positively influenced children's physical activity outcomes. Campaign effects persisted as children grew into their adolescent years.

Did augmenting the VERB campaign advertising in select communities have an effect on awareness, attitudes, and physical activity?

BACKGROUND: Although VERB was designed as a national media campaign, funding and donated media time enabled more-intensive advertising and marketing in certain communities. To investigate the effect of increased advertising on physical activity outcomes, six "high-dose" communities were selected to receive more hours of advertising and additional promotional activities. DESIGN: Longitudinal quasi-experimental design comparing outcomes in six communities that received additional VERB marketing activities with outcomes in a comparison group that received only the national dose of advertising. SETTING/PARTICIPANTS: Two cohorts of dyads of youth aged 9-13 years (tweens) and one parent at baseline (2002), followed for 2 years. INTERVENTION: During the first year of the VERB campaign, each of the six high-dose communities received 50% more advertising and conducted special campaign activities. During the second year, only four of the six communities received the larger dose of advertising and additional promotional activities because of reduced funding. MAIN OUTCOME MEASURES: Awareness and understanding of VERB messages; attitudes about physical activity (self-efficacy, social influences, and outcome expectations); and physical activity behaviors. RESULTS: After 1 year, tweens in the high-dose communities reported higher levels of awareness and understanding of VERB and scored higher on the social influences scale than did tweens in a comparison group in areas that received only the national dose of advertising. After 2 years, tweens in the high-dose communities reported higher awareness and understanding of VERB, greater self-efficacy, more sessions of free-time physical activity per week, and were more active on the day before being surveyed than tweens in the comparison group who received the average national dose. CONCLUSIONS: Providing communities with a higher dose of marketing activities and sustaining those activities over time yields more positive outcomes.

The VERB campaign: applying a branding strategy in public health.

A branding strategy was an integral component of the VERB Youth Media Campaign. Branding has a long history in commercial marketing, and recently it has also been applied to public health campaigns. This article describes the process that the CDC undertook to develop a physical activity brand that would resonate with children aged 9-13 years (tweens), to launch an unknown brand nationally, to build the brand's equity, and to protect and maintain the brand's integrity. Considerations for branding other public health campaigns are also discussed.

Methodology of the outcome evaluation of the VERB campaign.

This article summarizes the methods used in the outcome evaluation of the VERB campaign. The outcome evaluation was designed to measure the awareness and understanding of VERB among the target audience of children aged 9-13 years (tweens) and to determine the effect of VERB awareness on psychosocial and behavioral outcomes. Cohorts of tweens and parents were interviewed annually via a telephone survey (Youth Media Campaign Longitudinal Survey). The first cohort (baseline) was surveyed in 2002 prior to VERB advertising and was repeated annually through 2006. A second cohort was surveyed in 2004-2006. A third, cross-sectional sample was surveyed in 2006. Each cohort consisted of a nationally representative sample of tweens to enable generalizability to the nation as a whole. Propensity scoring was used to control for confounding influences. The outcomes were analyzed for dose-response effects (i.e., whether higher levels of awareness led to stronger effects) and overall awareness effects (i.e., the difference between tweens unaware of VERB and all tweens in the U.S.). Secular trends in tweens' physical activity during the life of the campaign were also examined. This article also discusses weighting and imputation, alternative analyses used to assess the adequacy of the propensity methods, and the challenges involved in media campaign evaluations.

Overview of formative, process, and outcome evaluation methods used in the VERB campaign.

Evaluation was an integral part of the VERB campaign. This paper describes the array of evaluation methods used to support the development, implementation, and assessment of campaign activities. The evaluation of VERB consisted of formative, process, and outcome evaluations and involved both qualitative and quantitative methods. Formative evaluation allowed staff to test ideas for messages and to gauge their appropriateness for the intended audiences. Process evaluation allowed staff to test and monitor the fidelity of the campaign's implementation to objectives and to make changes while the campaign was under way. Outcome evaluation allowed staff to determine the campaign's effects on the target audience. Because a comprehensive approach was used, which included formative and process evaluation, the VERB team's ability to interpret the results of the outcome evaluation was enhanced.