Direct mail marketing--a new way to empower moms: The Champions for Change Grassroots Initiative

The Network for a Healthy California is the largest Food Stamp nutrition education (FSNE) program in the nation, combining social marketing with direct education to promote healthy eating and physical activity (PA) among Californians with incomes < 185% of the Federal Poverty Level (FSNE-eligible). Formative research conducted with eight focus groups of low-income women was used to identify a “motivating context” to inform development of a multi-component, innovative direct mail (DM) intervention. Goals were for the recipient to open the package, read/use the materials promoting family healthy eating and PA behaviors, perceive that other moms like her were leading their families and communities to these behaviors, feel she could do so also, identify with the “Champions for Change” brand, and take action. The four-item DM kit, combining bilingual low and high technology materials, was sent to over 500,000 FSNE-eligible households in five California counties during July 2007. It included a mom-oriented DVD and mini-magazine with empowerment and motivational messaging, as well as basic education on eating healthfully and PA and an action plan. A “low-tech” assessment tool enabled moms to see how many cups of fruit and vegetables each family member needs daily. Finally, a set of success cards presented real mothers offering concrete suggestions to specific barriers and a reply card to receive more tips and recipes. A quasi-experimental longitudinal design was used to evaluate the kit in two treatment counties against similar control areas not receiving it. A 15-minute telephone survey was administered in either English or Spanish to 400 each randomly selected treatment and control households immediately before and six weeks after the DM package was mailed. Survey topics included package recall, reading/use of materials, rating of materials, information and support seeking behavior, effectiveness of materials in increasing saliency and knowledge of related issues, and effectiveness of materials changing social normative and self-efficacy beliefs and health behavior. Over 80% of respondents found the contents “very” or “extremely” interesting. Treatment effects were seen for three of six self-efficacy and two of six social normative measures. As of 12/31/07, 5,650 information requests had been received. Well-designed direct mail marketing may be an effective strategy for reaching targeted low-income consumers for public health education.