Kids across the nation are finding their "verb" and getting physically active, thanks to an innovative national marketing campaign and the power of mass media. The federal, multi-million dollar investment to prevent childhood obesity, known as Verb, is reaping better results than expected, which is leaving some wondering why the campaign has landed on the budgetary chopping block.
Officially launched in 2002 by the Centers for Disease Control and Prevention, the "Verb: It's What You Do" Youth Media Campaign uses modern media marketing techniques to appeal to 9- to 13-year-olds, encouraging them to become more physically active - and the strategy has worked. First-year results from the media campaign, published in the August issue of Pediatrics, show that as kids' awareness of Verb increased, so did their levels of physical activity. In fact, Verb achieved 74 percent awareness among its target audience in its first year, the study reported.
"It's the only federal program aimed at childhood obesity that's been evaluated and found effective," said John Porter, a Washington, D.C., lobbyist who served as a U.S. representative from Illinois for more than 20 years. As chairman of the House Appropriations Subcommittee on Labor, Health and Human Services and Education in 2000, Porter earmarked funding for what would become Verb.
With an estimated 9 million U.S. children considered obese and physical activity levels on the decline, Verb was created as a way to instill habits in children that would lead to lifelong healthy behavior. Federal funding for Verb was $125 million in 2001, $68 million in 2002, $51 million in 2003, $36 million in 2004 and $59 million in 2005. At press time, the House had proposed $11.2 million for Verb in the fiscal year 2006 budget, while the U.S. Senate had proposed no funding at all. According to the 2006 budget justification released by the U.S. Department of Health and Human Services, the "budget request reflects the elimination" of Verb, noting that the program was originally authorized for five years in 2001. However, Congress can reauthorize Verb funding if it desires or simply continue appropriating funds for the program.
"I think it's very short-sighted (to eliminate Verb)," Porter told The Nation's Health. "Are we going to pay the price down the line for not making investments to make kids more active? Of course we are."
Using television, radio, online and print mediums, Verb targets 21 million kids ages 9 to 13, also known as "tweens," with a "surround" strategy - "wherever kids go, they run into Verb," said Faye Wong, MPH, director of the Youth Media Campaign at CDC. Verb's success is tied to smart marketing and branding techniques that speak directly to tweens' motivating factors. Tweens are a prime audience because while they're still influenced by their parents, they're also becoming more independent in their decision-making, Wong said. Verb organizers also want to reach kids before they enter high school, at which point physical activity levels decline steeply.
"We consistently send a positive message that physical activity is about fun, being social with friends...we never use the word exercise," said Marian Huhman, PhD, team leader for evaluation of the Verb campaign. "Now, we can hardly find a tween anymore that hasn't heard of the Verb campaign."
Working with multiple advertising agencies experienced in youth marketing, Wong, Huhman and colleagues created a highly recognizable brand that kids automatically associate with physical activity. In addition to mass media advertising on television and radio, Verb is also promoted via "gorilla marketing," Huhman told The Nation's Health. While television makes kids aware of Verb, such marketing allows kids to experience Verb, she said. To help Verb "come alive," Huhman said, college-age street teams set up booths and organize activities at sites where kids gather, encouraging kids to "find their Verb" and try new physical activities. Verb organizers also work with advertising agencies to develop culturally sensitive physical activity messages aimed toward Hispanic, black, Asian, American Indian and Alaska Native tweens.
"It's not just counteracting obesity, as physical activity is in some ways the closest thing we have to a silver bullet for general health," Huhman noted.
Demonstrating behavioral changes from a media campaign is quite difficult, Wong said, so when positive results began surfacing, "we were just ecstatic." The first-year results were even better than expected and so far, second-year results are even better, she said.
"If you talk to scientists, the fact that we had any behavior change, quite honestly, was a pleasant surprise for us," Wong told The Nation's Health. "It's clear that advertising and marketing work."
According to the August Pediatrics study on Verb's first-year results, 90 percent of children aware of Verb also understood its messages. Awareness among white and Hispanic children was 78 percent and 70 percent, respectively, and 63 percent among black children. Higher awareness of Verb was associated with higher free-time physical activity levels among tweens, including subgroups such as girls, children living in both high-density and rural areas and children in low-income families. While local communities were instrumental in offering tweens the opportunity to "find their Verb," the substantial national investment to secure the brand and break through the cluttered landscape of child advertising made the difference, Huhman said.
In fact, the amount spent on Verb pales in comparison to the billions the food industry spends targeting children, Wong noted. With a target audience of 21 million, Verb's first-year funding of $125 million works out to about $6 per child per year, she said. However, if funding is dramatically decreased, there would be a significant change in what Verb is able to do.
"When people look at a single campaign with a large price tag, it may be difficult to understand," Wong said. "Prevention takes more time, but it doesn't mean there's no pay-off."
Communities finding their "Verb"
While CDC is able to reach tweens on a national level, it is communities that provide children with opportunities to be physically active. Such is the case in Winchester, Ky., where the Clark County Health Department offered the Verb Summer Scorecard program for the first time this past summer.
With backing from a coalition of physical activity partners - such as the local YMCA, local Parks and Recreation Department, libraries, schools and the fire department - health workers began promoting the program in April, reaching about 2,000 kids ages 9 to 13, of whom 350 signed up, according to Kristian Wagner, clinical nutritionist with the Clark County Health Department.
"Kids see (Verb) over and over and over," Wagner told The Nation's Health. "When we asked kids what Verb was, all of them already knew."
Children who participated in the summer program were given a scorecard with 24 squares of physical activities to fill out, with each square representing about an hour of activity, Wagner said. Community partners offered free activities to scorecard participants, such as free swimming at the YMCA and open gym hosted by the Parks and Recreation Department. Also, parents could initial up to 18 scorecard squares for activities such as bike riding, frisbee, playing with hula hoops and skateboarding. The grand finale took place at a YMCA swim party, where kids could turn in completed scorecards for a prize. Although organizers are still analyzing data, the summer scorecard program was "definitely a success," Wagner said.
"Being in public health, we know a lot of the background of why physical activity is so important," she said. "I think we were able to convey that in an understandable way."
While Clark County plans on continuing the Verb Summer Scorecard program regardless of the national campaign's future, Wagner said Verb's strong branding made it easier to bring kids into the fold.
"Kids are bombarded with other types of really well-done advertising, so it's nice to have something like (Verb) competing with that," she said.
Clark County based its Verb program on the success of nearby Lexington, Ky., which created the scorecard concept a few years ago, according to Carol Bryant, PhD, professor and co-director of the Florida Prevention Research Center at the University of South Florida. As part of the center's work developing community-based prevention marketing, Bryant began working with the Lexington-Fayette County Health Department as well as a community-wide childhood obesity coalition, teaching members "to think like a marketer would." After organizers chose physical activity as one of their target behaviors, Bryant suggested they look toward Verb.
"The fell in love with Verb and realized the power of marketing data in making their decision," Bryant told The Nation's Health.
Building on Verb's national brand awareness, Lexington workers created the Verb Summer Scorecard program, which was first offered in 2004. During the program's second run this past summer, about 15,000 scorecards were distributed, 880 complete scorecards were returned and more than 1,000 people attended the program's grand finale event, Bryant said. After the program's debut in 2004, the Verb brand had reached 88 percent awareness in Lexington, she noted.
Lexington-Fayette County organizers are now developing a year-round scorecard program, and communities around the nation - from Florida to Texas to Colorado - are picking up the program as well, Bryant reported.
"If (CDC) loses funding for Verb, we're very concerned about what will happen," she said. "I believe a community could still promote physical activity...but I just can't think it'll be seen as important or as cool without that national campaign behind it."
Verb's national marketing data has generated insights into the motivating factors for tweens that "open your eyes as to how to position physical activity so that it fits into tweens' lives," Bryant noted. Verb marketers really understand how important it is for a tween to feel a sense of belonging, spend time with friends and fit in, she said, and have incorporated such findings into a campaign that doesn't turn tweens off. It will be a huge missed opportunity if national policy-makers deny Verb the money it needs to continue and build on the brand equity, Bryant said.
"I can't believe that the administration at the national level would look at the facts - look at the 74 percent brand awareness - and conclude from that that we no longer need the program," she said. "In business, they would look at that success and say 'let's capitalize on it.'"
For more information on CDC's Verb campaign, visit www.cdc.gov/youthcampaign. For more news from The Nation's Health, visit www.thenationshealth.org.
Nations Health. 2005;35(8) © 2005 American Public Health Association
Cite this: Successful CDC Verb Campaign in Danger of Losing Funding: Budget Cuts Likely - Medscape - Oct 01, 2005.