Awareness of Canada on the Move; Pedometer Campaigns

1. Awareness of Canada on the Move; Pedometer Campaigns Cora Lynn Craig Adrian Bauman Catrine Tudor-Locke Sue Cragg

2. Physical Activity in Canada Early 1970’s • First public recognition that Canadians were sedentary • and that the situation would worsen with technological advances. (Nutrition Survey)

3. Health Report of Canadians • 1974 Lalonde Report recognized lifestyle as one of four areas for improving public health • 12 policy initiatives related to physical activity • ParticipACTION launched as a national social marketing campaign

4. Need for Awareness Campaigns • The World Health Organization Global Strategy on Diet, Physical Activity and Health • identifies education, communication and public awareness as one of the key roles for government

5. Mass Media Campaigns • ‘purposive attempts to inform, persuade, and motivate a population (or sub-group of a population) using organised communication activities though specific channels, with or without other supportive community activities.’ • Typically (though not exclusively) run by public agencies for social rather than commercial benefit, tend to be run for a defined period of time, and are often not reported in the scientific literature. • Often used as part of a broader community-wide approach, combined with other approaches such as support and self help groups, counselling, screening and education, community events and walking trails. Cavil and Bauman, 2003

6. Impact of Mass Communication Campaigns Exposure Awareness Knowledge Attention Intention Behaviour

7. Potential Campaign Effects Adapted from Cavil and Bauman

8. ParticipACTION One of the most recognized logos in Canada: 85% recalled the logo in 1981. The face of social marketing for two decades.

9. Effectiveness of Awareness Campaigns • Can • Provide an overall framework or umbrella under which a broader range of health promotion initiatives can take place. • Provide a backdrop for the more detailed community level or interpersonal interventions. • Raise awareness, convey information, help to set agendas and change attitudes. • Cannot • be realistically expected to be solely responsible for reversals in socially and environmentally driven behaviours. Cavil, 1998

10. Effectiveness of ParticipACTION • High levels of unprompted and prompted recall of PartcipACTION among adult Canadians across two decades. • Delivered clear messages, enhanced community awareness of physical activity and recreation and fostered community-based partnerships. • Led to the delivery of may programs and events that reached many thousands of Canadians. • Reached both French and English Canadians. • Increases in physical activity among adult Canadians during this time period cannot be causally linked to efforts of ParticipACTION but likely a contributing factor especially since most other developed countries experienced unchanging for even declining rates of physical activity participation during the same period.

11. Effectiveness of Awareness Campaigns • No major national campaigns since the 1990’s

12. Current situation • People are aware of the benefits of being active • LTPA has increased (discretionary) • Not active enough • Obesity and type 2 diabetes are increasing • Total activity (work, leisure, chores) decreasing?

13. What is Canada on the Move? • web-based research platform designed • to capture self-reported data on steps • to evaluate interventions • to evaluate programs (Canadian Institutes for Health Research) • partnership with industry (Kellogg’s) to assess impact of • large "natural" experiment of putting pedometers in cereal boxes • social advertising to walk more

14. Launch December 03 - January 04 • Kellogg’s first mass marketing messages to encourage walking aired last week of December • Press release January 8 (Kellogg’s) • 800,000 pedometers in cereal boxes on shelves week of January 8 • Special K and Special K Red Berries

15. Launch December 03 - January 04 • Press release January 26 launching the COTM website (CIHR) • Media interviews on TV and radio January 26 to February 2

16. Coverage January to mid February • Kellogg’s provided 3 million messages encouraging Canadian's to take ‘more steps’. Courtesy of Dr. Ron Plotnikoff U Alberta • 8 radio reports (CBC syndication) • Length (M = 12.5 minutes) • Audience (M = 17,688) • 13 TV reports ~ 2 M viewers • Length (M = 2.65 minutes) • Audience (M = 153,762) Courtesy of Guy Faulkner & Sara-Jane Finlay

17. Messages • Campaign brand • Canada on the Move • Specific messages • Add 2000 steps • Donate your steps to health research • Other themes/messages • walk more • use pedometers to monitor how much you walk • “Keep it simple” (Kellogg’s)

18. Goals • Increase: • Campaign awareness • Pedometer awareness • Pedometer ownership • Pedometer usage

19. Impact of mass communication campaigns Campaign Awareness Exposure Awareness Pedometer Awareness Knowledge Attention Pedometer Ownership Intention Pedometer Usage Behaviour

20. Second Phase: June 2004 • Week of June 10 • Kellogg’s second mass marketing campaign aired beginning. • 1,500,000 pedometers via cereal boxes • Special K, Special K red berries • + 7 other brands • Repeated brand (COTM) and messages • “Donate your steps to health research” • “Add 2000 steps” • plus others

21. Purpose of campaign evaluation • To assess the short- and intermediate-term impacts of the COTM initiative among adult Canadians • attention to and recall of the COTM tagline • population rates of ownership and use of pedometers • changes in walking among those who • received pedometers via COTM • purchased pedometers elsewhere • those who do not own one

22. Methods • Telephone survey (Physical Activity Monitor) • Rolling monthly sample of 750 Canadians 15 years and older • Institute for Social Research (York University) • Random digit dialing to select households • Individual at random using closest birth date method • Response rate > 50% • University graduates and women over-represented in sample • Interviews conducted using CATI

23. Immediate impact Recall of campaign (Have you heard of:) • Canada on the Move • two key messages • Add 2000 steps • Donate your steps to health research • two other messages for comparison • Stairway to Health (workplace campaign) • Walk a Block

24. Awareness of Canada on the Move • Recall of the Canada on the Move initiative and the subcomponent messages were at their highest right after each launch and sustained a higher rate recall over time • Recall of the ‘stairway to health’ and the ‘walk a block’ messages remained consistent over the same time period. 2003 and 2004 Physical Activity Monitors, CFLRI

25. Immediate impact • Awareness of pedometers Have you heard of a pedometer or stop counter? (yes/no/don’t know) • Overall 57% of Canadian adults had heard of a pedometer or step counter. • Greatest awareness among • women • adults aged 45-64 • college and university graduates • high income earners

26. Intermediate impact • Pedometer ownership • Do you currently own a pedometer or step counter • Obtaining pedometer from cereal box • Where did you get it • Bought it • From a cereal box • Somewhere else • Pedometer use • Days pedometer worn in the last 7 days

27. Special K Red Berries

28. Intermediate impact • Pedometer ownership • Just over one in 10 Canadians reported owning a pedometer • Pedometer ownership more prevalent among • Women • College and university graduates • High income earners • Pedometer ownership less prevalent among • 18-24 year olds • The prevalence of pedometer ownership increased significantly between January and February and between May and July.

29. Intermediate impact • Obtaining pedometer from cereal box • 3.6% of Canadians bought their pedometer and 3.7% obtained it from a cereal box • Compared to adults aged 18-24, adults aged 25 and older were 3 to 6 times more likely to have purchased the pedometer and much less likely to have obtained it from a cereal box. • Reporting increased in February and between June and July and then decreased between July and September

30. Intermediate impact • Pedometer use • 2.4 Canadians reported using a pedometer at least once in the previous week • More likely among • Women • 44-64 year olds

31. Intermediate impact • Relationship between recall and pedometer awareness and ownership: • Awareness of COTM is associated with having heard of a pedometer • Increased with awareness of sub-message(s) along with COTM • Those who recall one or both specific messages more likely to own a pedometer • Those who heard one specific message were twice as likely as those who do not to have obtained a pedometer from a cereal box

32. Intermediate impact • Relationship between recall and pedometer use: • Pedometer use was related to awareness of the COTM campaign; those aware of “Canada on the Move” and both of it s specific messages were almost four times a likely to have worn a pedometer in the past week as those unaware of the campaign.

33. Longer term impact • Recall of campaign • Awareness of pedometers • Pedometer ownership • Walking behaviour (International Physical Activity Questionnaire) • Number of days walking in the previous week for at least 10 minutes at a time • Total time spent walking in previous week

34. Impact of mass communication campaigns Campaign Awareness Exposure Awareness Pedometer Awareness Knowledge Attention Pedometer Ownership Intention Walking Behaviour Behaviour

35. Sufficient walking • Summed across work, chores, transport and leisure time activities • 1 hour per day regardless of purpose

36. Sufficient walking • 31% of Canadians reported sufficient walking • Lower among women and low income earners • Decreases by age and education

37. Sufficient walking • 31% of Canadians reported sufficient walking • Lower among women and low income earners • Decreases by age and education

38. Longer term impacts - Sufficient walking • A year after its launch, awareness of COTM was associated with a 13% increase in the likelihood of sufficient walking after adjusting for age, sex, income and education. • Higher prevalence of sufficient walking • Among those recognizing the campaign brand COTM and its general message ‘add 2000 steps’ compared with those who were not aware. • Among those recognizing the tagline ‘donate your steps to heath research’ than those aware of COTM and add 2000 steps.

39. Sufficient walking • Those owning a pedometer were 14% more likely than those who did not own one to engage in sufficient walking. • Those who owned a pedometer and who were aware of the COTM tagline donate your steps to research were 52% more likely to report sufficient walking than others.

40. Sufficient walking • COTM had a real impact on walking behaviour among Canadians who were aware of the campaign. • Results suggest that combining an easy-to-use tool for self-regulation of the target behaviour with relevant messaging may result in a larger campaign effect than just the message or distribution of the tool alone.

41. Role of communication campaigns • Targets • Evaluation

42. Impact of mass communication campaigns Exposure Awareness Knowledge Attention Intention Behaviour

43. References – to be edited • Craig, Cora L, Cragg, Sue E, Tudor-Locke, Catrine and Bauman, Adrian. Proximal Impact of Canada on the Move, Canadian Journal of Public Health, Volume 97, Supplement 1, March-April 2006, pp s21-s27. • Craig, CL, Tudor-Locke, C and Bauman, A, Twelve-month effects of Canada on the Move: a population-wide campaign to promote pedometer use and walking. Health Education Research, Theory & Practice. 2006, Oxford University Press • Cavill, Nick and Bauman, Adrian. Changing the way people think about health-enhancing physical activity: do mass media campaigns have a role? Journal of Sports Sciences, 2004, 22, 771-790 • Cavill, Nick. National campaigns to promote physical activity: Can they make a difference? International Journal of Obesity (1988) 22 Suppl 2 s48-s51.Rice, R. and Atkin, C. (eds.) (2001) Public Communication Campaigns, 3rd edn, Thousand Oaks, CA: Sage • Bauman, Adrian, Madill, Judith, Craig, Cora L., Salmon, Art. ParticipACTION: This Mouse Roared but Did it Get the Cheese? CJPH, Volume 95, Supplement 2, May/June 2004.