Transcript Material Development for the June 5, 2000

Material Development for the
June 5, 2000
Evolution of Project
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Identify core issue: CSFII data indicates
calcium consumption is low in some age
groups
Promote chocolate milk as a means to
increase calcium consumption
Target audience parents, teachers, WIC
providers, food service workers, etc.
Dispel sugar-hyperactivity myth
Target audience food service workers
Social Marketing Concepts
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Based on consumer needs
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Population based
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Relies on mass media
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Pre-testing or pilot testing of the
program
Social Marketing Process
Model
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Market analysis
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Conduct focus groups
Establish clear goals
Define geographical scope
Identify distribution outlets
Assess market trends
Identify resources
Assess competition
Social Marketing Process
Model
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Planning
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Define program structure/organization
Establish specific objectives
Segment target market
Determine strategy
Define marketing mix
Develop action plan
Social Marketing Process
Model
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Develop, test & refine planning
elements
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Implement program
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Assess effectiveness
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Analyze effectiveness
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Refine intervention accordingly
Evidence Based Knowledge
The Problem:
back in 1980, Prinz et al. published a
paper reporting an association between
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amount of sugar products consumed
ratio of sugar products to nutritional foods
ratio of carbohydrates to protein
and
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amount of destructive-aggressive
restless behaviors observed during free play
of hyperactive children but not in controls
Evidence Based Knowledge
Since then, numerous studies
(including every study we examined)
have not found the same association…
Evidence Based Knowledge
“Acute sugar loading did not increase
aggression or activity in preschool
children.”
Kruesi MJ, Rapoport IL, Cummings EM, Berg CJ, Ismond DR, Flament M, Yarrow M,
Zahn-Waxler C. Effects of sugar and aspartame on aggression and activity in
children. American Journal of Psychiatry. 1987;144:1487-90.
Evidence Based Knowledge
“...neither dietary sucrose nor
aspartame affects children's
behavior or cognitive function.”
Wolraich ML, Lindren SD, Stumbo PJ, Stegink LD, Appelbaum MI, Kiritsy MC. Effects
of diets high in sucrose or aspartame on the behavior and cognitive
performance of children. New England Journal of Medicine. 1994;330:301-307.
Evidence Based Knowledge
“… it {sugar} clearly is not a major
cause of hyperactivity or other
behavioral problems.”
Does sugar or aspartame cause hyperactivity in children? Nutrition Reviews;
Washington; May 1994; start page: 173.
Evidence Based Knowledge
“...the studies to date found that
sugar does not affect the behavior
or cognitive performance of
children. The strong belief of
parents may be due to expectancy
and common association.”
Wolraich ML, Wilson DB, White JW. The effect of sugar on behavior or cognition in
children. Journal of the American Medical Association. 1995;274:1617-21.
Evidence Based Knowledge
“Although sugar is widely believed by
the public to cause hyperactive
behavior, this has not been
scientifically substantiated.”
Krummel DA, Seligson FH, Guthrie HA. Hyperactivity: is candy causal? Critical
Reviews of Food Science Nutrition. 1996;36:31-47.
Evidence Based Knowledge
“The majority of experimental studies
do not support the idea that sugar
consumption leads to an increase
in activity or hyperactivity.”
Bellisle F, Blundell JE, Dye L, Fantino M, Fern E, Fletcher RJ, Lambert J, Roberfroid
M, Specter S, Westenhofer J, Westerterp-Plantenga MS. Functional food science
and behavior and psychological functions. British Journal of Nutrition. 1998;80,
suppl. 1:S173-S193.
Social Marketing Approach to
Material Development
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Complete market analysis
Assess scientific basis & identify key
points
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Develop handout
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Pilot test
Social Marketing Approach to
Material Development
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Implement use of handout
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Assess effectiveness of handout
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Continue to refine intervention
The Development of a Handout
Chocolate Milk...
What’s in it for kids?
Sugar  Hyperactivity
So where does it fit in a healthy diet?
Test, Market & Evaluate
Sugar & Hyperactivity
Test, Market & Evaluate
Sugar & Hyperactivity
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PTA focus groups
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Poll attitude, introduce handout, discuss,
poll
Food service orientation meetings
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Poll employees at beginning
Introduce handout
Poll at end of meeting
Test, Market & Evaluate
Sugar & Hyperactivity
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According to test results, modify
handout
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Content
Format
Distribution method
Need for reinforcement, linking agents
Test, Market & Evaluate
Sugar & Hyperactivity
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Handout mailed with school lunch menu
and newsletter
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Sent to parents, food service workers &
linking agents
Cover letter about nutrition concerns
Controls do not receive handout
Provide info for linking agents
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MDs, DDSs, PH reps, school psychologists
Health info hot line through newspaper
Test, Market & Evaluate
Sugar & Hyperactivity
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Implement marketing
Follow up with telephone interviews of
key informants +/- intervention
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Food service workers
Parents
Test, Market & Evaluate
Sugar & Hyperactivity
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Baseline & 6 months
Schools with & without intervention
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Attitudes about sugar & hyperactivity
Availability of beverages
Consumption of beverages
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Milk
Fruit juice
Soft drinks
Test, Market & Evaluate
Sugar & Hyperactivity
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Outcome
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Increase knowledge & attitudes by 10% to
more closely reflect evidence based data
regarding sugar and hyperactivity
Test, Market & Evaluate
Chocolate Milk
Test, Market & Evaluate
Chocolate Milk
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Pilot chocolate milk handout
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Parents
Teachers
Food service professionals
WIC service providers
Linking agents
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MD, DDS, school psychologist and nurse
Content, format, readability, clarity,
distribution
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modify handout based upon feedback
Test, Market & Evaluate
Chocolate Milk
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Mail cover letter & chocolate milk
handout to intervention schools
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Parents
Teachers
Food service professionals
WIC service providers
Linking agents
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MD, DDS, school psychologist and nurse
Test, Market & Evaluate
Chocolate Milk
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Print media in intervention schools
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Promotional events
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bulletin boards
menus
local grocery stores, health fares
PSA
Broadcast media
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Bill Nye the Science Guy
Test, Market & Evaluate
Chocolate Milk
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Baseline & 6 month follow-up
Schools with & without intervention
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Survey knowledge & attitudes
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nutritional content as compared to white milk
chocolate milk, sugar & hyperactivity
caffeine
dental health
Purchase & consumption patterns
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white & chocolate milk, soft drinks, juice
Test, Market & Evaluate
Chocolate Milk
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Purchase & Consumption
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Increase milk purchase & consumption per
capita by 10% over 6 months
Knowledge & Attitudes
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Increase knowledge & attitudes by 10% to
more closely reflect evidence based data
regarding chocolate milk
Looking Forward . . .
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Focus groups and key informants to
determine prevalence of beliefs
Sugar & hyperactivity handout bridges
the gap between calcium crisis &
chocolate milk
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Stepping stone
Highest risk groups
Calcium Intake
Food and Nutrient Intakes by Children 1994-1996
Gender &
age (years)
Recommended
daily intake of
calcium (mg)
Mean daily
intake of
calcium (mg)
Mean intake as
percentage of RDI
Percentage of
kids who meet
100% RDI
Boys & girls
3-5
500-800
865
108
48.4
Boys 6-11
800
984
116
57.2
Boys 12-19
1300
1145
95
36.2
Girls 6-11
800
865
102
43.2
Girls 12-19
1300
773
64
13.4
http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm
Questions or Comments?