The Effect of a Communications Campaign on Middle School Students' Nutrition and Physical Activity: Results of the HEALTHY Study

Abstract

The HEALTHY Study was a 3-year school-based intervention designed to change the behaviors of middle school students to reduce their risk for developing type 2 diabetes mellitus. This report examines the relation between exposure to communications campaign materials and behavior change among students in the HEALTHY intervention schools. Using data from campaign tracking logs and student interviews, the authors examined communications campaign implementation and exposure to the communications campaign as well as health behavior change. Campaign tracking documents revealed variability across schools in the quantity of communications materials disseminated. Student interviews confirmed that there was variability in the proportion of students who reported receiving information from the communication campaign elements. Correlations and regression analysis controlling for semester examined the association between campaign exposure and behavior change across schools. There was a significant association between the proportion of students exposed to the campaign and the proportion of students who made changes in health behavior commensurate with study goals. The results suggest that, in the context of a multifaceted school-based health promotion intervention, schools that achieve a higher rate of exposure to communication campaign materials among the students may stimulate greater health behavior change.

Acknowledgments

The authors thank the administration, faculty, staff, students, and their families at the middle schools and school districts that participated in the HEALTHY study. This work was completed with funding from National Institute of Diabetes and Digestive and Kidney Diseases/National Institutes of Health (NIDDK/NIH) grant numbers U01-DK61230, U01-DK61249, U01-DK61231, and U01-DK61223 to the STOPP-T2D collaborative group.

The following individuals and institutions constitute the HEALTHY Study Group (*indicates principal investigator or director): Study Chair: Children's Hospital Los Angeles: F.R. Kaufman. Field Centers: Baylor College of Medicine: T. Baranowski,* L. Adams, J. Baranowski, A. Canada, K.T. Carter, K.W. Cullen, M.H. Dobbins, R. Jago, A. Oceguera, A.X. Rodriguez, C. Speich, L.T. Tatum, D. Thompson, M.A. White, C.G. Williams; Oregon Health & Science University: L. Goldberg,* D. Cusimano, L. DeBar, D. Elliot, H.M. Grund, S. McCormick, E. Moe, J.B. Roullet, D. Stadler; Temple University: G. Foster* (Steering Committee Chair), J. Brown, B. Creighton, M. Faith, E.G. Ford, H. Glick, S. Kumanyika, J. Nachmani, L. Rosen, S. Sherman, S. Solomon, A. Virus, S. Volpe, S. Willi; University of California at Irvine: D. Cooper,* S. Bassin, S. Bruecker, D. Ford, P. Galassetti, S. Greenfield, J. Hartstein, M. Krause, N. Opgrand, Y. Rodriguez, M. Schneider; University of North Carolina at Chapel Hill: J. Harrell,* A. Anderson, T. Blackshear, J. Buse, J. Caveness, A. Gerstel, C. Giles, A. Jessup, P. Kennel, R. McMurray, A-M. Siega-Riz, M. Smith, A. Steckler, A. Zeveloff; University of Pittsburgh: M.D. Marcus,* M. Carter, S. Clayton, B. Gillis, K. Hindes, J. Jakicic, R. Meehan, R. Noll, J. Vanucci, E. Venditti; University of Texas Health Science Center at San Antonio: R. Treviño,* A. Garcia, D. Hale, A. Hernandez, I. Hernandez, C. Mobley, T. Murray, J. Stavinoha, K. Surapiboonchai, Z. Yin. Coordinating Center: George Washington University: K. Hirst,* K. Drews, S. Edelstein, L. El Ghormli, S. Firrell, M. Huang, P. Kolinjivadi, S. Mazzuto, T. Pham, A. Wheeler. Project Office: National Institute of Diabetes and Digestive and Kidney Diseases: B. Linder,* C. Hunter, M. Staten. Central Biochemistry Laboratory: University of Washington Northwest Lipid Metabolism and Diabetes Research Laboratories: S.M. Marcovina.* HEALTHY intervention materials are available for download at http://www.healthystudy.org/.

Past and present HEALTHY study group members on the social-marketing based communications committee on whose work this report was based were: Lynn DeBar (Chair), Tara Blackshear, Jamie Bowen, Sarah Clayton, Tamara Costello, Kimberly Drews, Eileen Ford, Angela Garcia, Katie Giles, Bonnie Gillis, Healthy Murphy Grund, Art Hernandez, Ann Jessup, Megan Krause, Barbara Linder, Jeff McNamee, Esther Moe, Chris Nichols, Margaret Schneider, Brenda Showell, Sara Solomon, Diane Stadler, Mamie White, and Alissa Wheeler. The committee was supported by the creative teams at the Academy for Educational Development and Planit Agency.

All parties that contributed significantly to this research have been included in the above acknowledgements.

Notes

^a Recognizing the wide variability in setting characteristics across schools, the study protocol mandated a minimum number of campaign elements to be implemented at each school; sites were permitted to exceed that minimum to accommodate to specific school sizes, layouts, and/or policies.

N/A = not applicable; these elements were introduced later in the intervention.

Note. Eating refers to changes in dietary practices consistent with study goals, exercise refers to increased exercise participation, less TV refers to reduced time spent watching TV and/or sitting around, water refers to increased water intake, and soda refers to decreased soda intake.

Note. Eating refers to changes in dietary practices consistent with study goals, exercise refers to increased exercise participation, less TV refers to reduced time spent watching TV and/or sitting around, water refers to increased water intake, and soda refers to decreased soda intake. All regression analyses are significant at p < .001.

*p < .05; **p < .01; ***p < .001.

^†Remained statistically significant using the Bonferroni correction for multiple tests.