Development and Early Implementation of The Bigger Picture, a Youth-Targeted Public Health Literacy Campaign to Prevent Type 2 Diabetes

Abstract

The prevalence of type 2 diabetes is rapidly rising, especially among minority and low-income youth. There is an unmet need to engage youth in identifying solutions to reverse this trajectory. Social marketing campaigns and entertainment education are effective forms of health communication for engaging populations in health-promoting behaviors. Critical to curbing the epidemic is moving the diabetes conversation away from individual behavior alone and toward a socioecologic perspective using a public health literacy framework. The authors developed an academic-community partnership to develop, implement, and evaluate a type 2 diabetes prevention campaign targeting minority and low-income youth. The Bigger Picture campaign uses hard-hitting, youth-generated spoken-word messages around key environmental and social drivers of the type 2 diabetes epidemic. Campaign goals included promoting health capacity and civic engagement. This article focuses on the development and implementation of the campaign, including (a) rationale and theoretical underpinnings, (b) steps in campaign creation, (c) testing the campaign messaging, and (d) campaign dissemination and evaluation planning. A youth-created health communication campaign using a public health literacy framework with targeted, relevant, and compelling messaging appears to be a promising vehicle for reaching at-risk youth to increase knowledge of and attitudes about preventing type 2 diabetes, change social norms, and motivate participation in health-promoting initiatives.

Acknowledgments

Data collection for this project occurred while the first author was a general medicine research fellow at the University of California San Francisco. This research is the result of a close partnership between the University of California San Francisco Center for Vulnerable Populations at San Francisco General Hospital and Trauma Center, and the staff of Youth Speaks, whose wisdom, expertise, and candid feedback made this collaboration possible. The energy, creativity, and deep commitment to racial, social, and environmental justice of the youth poets are at the heart of this campaign, and without them, this campaign would not exist. The authors also thank their main videographer, Jamie DeWolf, for his incredible artistry and passion in creating the PSAs. Sarah Fine is Project Director of The Bigger Picture, and Hodari Davis is Creative Director for The Bigger Picture. The study team thanks their funders, listed below.

Notes

Note. Adapted from Freedman et al. (2009). PSA = public service announcement.

Note. N = 334 respondents (convenience sample). Stakeholders included regional health professionals, leaders from youth- and/or health-related nonprofits, high school teachers, and target community members and advocates. PSA = public service announcement.

*p < .001 for McNemar's chi-square test.