Effects of social marketing for obesity prevention among low-income mothers

Evidence of effects from social marketing campaigns has been difficult to establish, specifically among those using mass media targeted at improving healthy eating behaviors. California's SNAP-Ed (Supplemental Nutrition Assistance Program- Education) campaign from the Network for a Healthy California at the California Department of Public Health uses TV, radio and outdoor advertising to promote self-efficacy and positive social norms to low-income mothers of school-aged children. Obesity prevention messages are designed using formative research and are tested among the target audience prior to release. An annual evaluation survey is conducted to collect recall of the ads, fruit and vegetable consumption, physical activity, attitudes and beliefs. Healthy behaviors are measured at the individual and family level. Samples from 2009-2010 were aggregated over consistent measures for the time-frame of the campaign for a sample size of 4,879 that included 2,016 SNAP recipients, 1,961 of those eligible for SNAP benefits but not participating, and 902 of those just over eligibility for SNAP, but qualifying for WIC (Women, Infants and Children). Telephone surveys were conducted with recipients and mall surveys in low-income census tracts for those not participating. Findings suggest significant positive associations among respondents with high recall for personal and family change behaviors for fruit and vegetable consumption, self-efficacy to consume fruits and vegetables and be physically active, and normative beliefs when controlling for demographics. Results show promise for campaigns to potentially influence low-income audiences and support those with existing healthy behaviors.