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Volume 1:
No. 3, July 2004
COMMENTARY
Commentary on the VERB™
Campaign — Perspectives on Social Marketing to Encourage Physical Activity
Among Youth
Adrian Bauman, PhD
Suggested citation for this article: Bauman A.
Commentary on the VERB™ campaign — perspectives on social marketing to
encourage physical activity among youth. Prev Chronic Dis [serial
online] 2004 Jul [date cited]. Available from: URL: http://www.cdc.gov/pcd/issues/2004/
jul/04_0054.htm.
The VERB™ campaign is a serious public health investment that aims to tackle the
societal and health problems of inactivity and increasing obesity among
young Americans (1,2). Worrisome trends in risk factors among young people
throughout the developed world reflect the lack of clearly effective public
health approaches. Effecting population-level change is difficult, given the
ingrained societal acceptability of sedentary behaviors and over-nutrition.
VERB is an innovative and expansive effort to improve the current state of
affairs, commencing with a national paid mass media campaign designed to
reframe beliefs and norms about being active among tweens —
children aged nine to 13 years. Secondary campaign objectives are to identify
and influence key stakeholders, such as parents and teachers, and to work
within communities to support opportunities for youth physical
activity (1).
A campaign to influence physical activity should
focus first on affecting social norms (3). Short-term goals should include
documentation of changes in proximal variables (i.e., awareness, beliefs,
and attitudes). But media alone cannot change behavior, because it provides
only a preliminary cue for action. Behavior
change should be the long-term goal of a sustained campaign. Long-term change is likely to take
place only after translating and disseminating programs developed to support
the mass communication components (3,4).
Previous youth media campaigns have targeted tobacco use, illicit drugs,
and sexual health (5-7). These campaigns have had some success in increasing
awareness of an issue, changing social norms toward substance use or the
risk of sexually transmitted diseases, and offering
solutions for young people to prevent tobacco uptake, call or ask for help
in reducing drug use, or practice safe sexual behavior (8). VERB is the
first substantial youth campaign, however, to increase youth activity and encourage a
healthy lifestyle. VERB targets proximal outcomes, such as beliefs about
inactivity, and encourages tweens to “find their verbs” — activities
they might try and enjoy. VERB promotes the notion that not only can
activity be enjoyable but it also can foster friendships with peers, enhance
curiosity, and generate positive feelings of autonomy. Creating and
maintaining these values are essential prerequisites to adopting and
maintaining physical activity throughout adolescence.
VERB is highly intense for a public sector campaign, but it remains
modest amid the plethora of marketing messages targeting tweens. Public
health campaigns that use paid media messages, including campaigns that
promote physical activity, are often reported outside the United States
(9-11), but within the United States, the costs of paid media generally
prohibit their use for public health messages, and public service
announcements (PSAs) are instead typically used. Although local media
campaigns might rely on PSAs for effect or on local-level media, which is
less expensive (12), national initiatives require
a much greater investment to achieve recognition. Any amount invested,
however, remains miniscule compared to the health and social costs of
inactivity and obesity, or indeed to the amount spent on commercial
marketing to tweens. Thus, VERB represents a strong commitment to improving
youth health because it requires a large investment in paid media.
The public health challenge is to penetrate the commercial-marketing
media morass with well-designed messages that reach their target population.
Inducing change in beliefs and norms is only the first step, however.
Subsequent challenges are to create physical environments and spaces for
tweens to move, play, and be active. The challenge involves advocacy,
support, and policy change at the local and state levels to provide
resources to construct or redevelop activity-friendly environments, such as
schools, parks, trails, and neighborhoods. VERB extends beyond a media
campaign and emphasizes the need to form community partnerships and
coalitions to reinforce the media component and initiate community events
(1). Community commitment poses the greatest challenge: VERB sustainability
will be determined not only by continued efforts to influence youth beliefs
but also by persuading decision makers to deploy long-term resources at the
community level.
VERB employs elements of a social marketing framework: it applies
marketing techniques, including promotional strategies utilizing place
(i.e., multiple channels and venues), with a clearly defined and branded product
(i.e., encouraging youths to find their “verbs”) (1). Consistent with any social
marketing effort (13), VERB proposes a voluntary exchange: tweens who take
up activity, presumably in place of watching television or just sitting around, will
derive the benefits of fun and social engagement. VERB clearly segments its
audience; although mainstream VERB messages target all tweens,
ethno-specific VERB messages target minority youth. If long-term
sustainability of VERB is to be ensured, the initiative has the potential to
develop into a formal social marketing campaign, which would require
implementation of the environmental, policy, and regulatory supports suggested
as essential elements of effective social marketing (13).
Comprehensive evaluation is an essential component of a mass media
campaign. The first stages of evaluation include understanding the needs and
motivations of the target audience and developing clear messages for them
(4,14). This process results in a defined brand that is recognizable, seen
across different initiatives, and deemed relevant by the target group. VERB
evaluation commenced with a logic model to provide a conceptual framework
for the intervention (2). Most importantly, VERB carried out substantial
formative evaluation to develop relevant and acceptable messages for tweens
(http://www.cdc.gov/youthcampaign/research/formative.htm).
Often neglected in campaign development, formative research helps in
producing messages and brands more likely to be acted upon by the target
population. Then, evaluators seek short-term impact on campaign awareness,
beliefs about being active, and social norms among tweens, while looking for
long-term impact on physical activity behavior (2). VERB
assesses these proximal and explanatory variables, as well as physical
activity itself. Multiple measures of reported physical activity are
required to overcome the methodological problems of self-report or parental
report of physical activity in this age group. Campaign literature seldom
explores dose-response relationships, but VERB developed high-dose media
communities and compares their results with those of standard-dose
communities.
The prevention of chronic disease cannot be modeled in a causal
relationship to youth media campaigns, because the reduced risk of chronic
conditions may not appear for decades. We can consider the VERB initiative a
public health policy success if trends in childhood inactivity and obesity
are reversed within a decade, consistent with Healthy People 2010
objectives. VERB-commissioned population surveys track proximal impact data;
longer-term monitoring could occur through routine youth health surveys such
as the Centers for Disease Control and Prevention’s Youth Risk Behavior
Surveillance System (15). Process evaluation determines levels of VERB
uptake by communities and minority populations in addition to measuring its
impact on changing local policies and developing supportive community
partnerships and sustainable physical environments.
Increases in rates of childhood obesity are not new, and declines in
physical activity during adolescence are also well recognized in the
scientific literature. Hence, it is timely that VERB was developed in an
attempt to tackle these problems. VERB campaign efforts are not the end of
the process but merely a well-resourced beginning upon which other efforts
should build, synergize, and extend in partnership with community and state
agencies to achieve population-level change. At the start of any such
initiative, large-scale investment may be required as the spark plug
to catalyze the first steps towards more active, healthier teenagers who
have “found their verbs.”
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Author Information
Author: Adrian Bauman, PhD, Center for Physical Activity and Health, Level 2,
Medical Foundation Building, Sydney University, Sydney, Australia 2006.
Telephone: 61 2 9036 3247. E-mail: adrianb@health.usyd.edu.au.
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References
- Wong F, Huhman M, Heitzler C, Asbury L, Bretthauer-Mueller
R, McCarthy S, et al. VERB™ — a social marketing campaign to increase
physical activity among youth. Prev Chronic Dis [serial
online] 2004 Jul. Available from: URL:
http://www.cdc.gov/pcd/issues/2004/jul/04_0043.htm.
- Huhman M, Heitzler C, Wong F. The VERB™ campaign logic model: a tool
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http://www.cdc.gov/pcd/issues/2004/jul/04_0033.htm.
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