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Purpose Community coalitions are an important part of the public milieu and subject to similar external pressures as other publicly funded organizations – including changes in required strategic orientation. Many US government agencies that fund efforts such as community-based social marketing initiatives have shifted their funding agenda from program development to policy development. The Florida Prevention Research Center at the University of South Florida (Tampa, Florida, USA) created community-based prevention marketing (CBPM) for policy development framework to teach community coalitions how to apply social marketing to policy development. This paper aims to explicate the framework’s theory of change. Design/methodology/approach The research question was: “How does implementing the CBPM for Policy Development framework improve coalition performance over time?” The authors implemented a case study design, with the “case” being a normative community coalition. The study adhered to a well-developed series of steps for system dynamics modeling. Findings Results from computer model simulations show that gains in community coalition performance depend on a coalition’s initial culture and initial efficiency, and that only the most efficient coalitions’ performance might improve from implementing the CBPM framework. Originality/value Practical implications for CBPM’s developers and users are discussed, namely, the importance of managing the early expectations of academic-community partnerships seeking to shift their orientation from downstream (e.g. program development) to upstream social marketing strategies (e.g. policy change).

In the United States, community coalitions are an important part of the public health milieu, and thus, subject to many of the same external pressures as other organizations—including changes in required strategic orientation. Many funding agencies have shifted their funding agenda from program development to policy change. Thus, the Florida Prevention Research Center created the Community-Based Prevention Marketing (CBPM) for Policy Development framework to teach community coalitions how to apply social marketing to policy change. The research reported here was designed to explicate the framework’s theory of change. We describe and demonstrate a hybrid evaluation approach: utilization-focused developmental evaluation. The research question was “What are the linkages and connections among CBPM inputs, activities, immediate outcomes, intermediate outcomes, and ultimate impacts?” We implemented a case study design, with the case being a normative community coalition. The study adhered to a well-developed series of steps for system dynamics modeling. Community coalition leaders may expect CBPM to provide immediate gains in coalition performance. Results from causal diagramming show how gains in performance are delayed and follow an initial decline in performance. We discuss the practical implications for CBPM’s developers—for example, importance of managing coalition expectations—and other social marketers—for example, expansion of the evaluation toolkit.

Community-based prevention marketing (CBPM) is a community-driven framework for program planning, which applies social marketing concepts and techniques to the development of health behavior interventions. Whereas community members who comprise an action committee or coalition set the goals and make programmatic decisions, social marketing provides the planning framework to guide program design, implementation, and evaluation. CBPM has guided successful initiatives to promote physical activity in both youth and adults, to increase safety eyewear use in agricultural settings, and to delay alcohol and tobacco initiation among youth. However, the emergence of evidence-based policy has fostered renewed interest in “upstream” approaches to health behavior change that, in the United States, have included community partnerships as an important tool for policy development. Unfortunately, these community partnerships have had variable success because of the lack of a systematic framework for identifying, selecting, tailoring, and promoting evidence-based policies. We describe the adaptation and application of CBPM to improve community capacity for identifying and promoting evidence-based policies. The resulting framework, CBPM for Policy Development, is comprised of the following eight steps: (1) build a strong foundation for success; (2) review evidence-based policy options; (3) select a policy to promote; (4) identify priority audiences among beneficiaries, stakeholders, and policy makers; (5) conduct formative research with priority audiences; (6) develop a marketing plan for promoting the policy; (7) develop a plan for monitoring implementation and evaluating impact; and (8) advocate for policy change. We provide a description of each step and an examination of the experiences and lessons learned in applying it to youth obesity prevention.

OBJECTIVE We assessed changes in the frequency of self-reported physical activity (PA) among tween girls exposed and not exposed to the VERB™ Summer Scorecard (VSS) intervention in Lexington, Kentucky, during 2004, 2006, and 2007. METHODS Girls who reported 0-1 day per week of PA were classified as having little or no PA. Girls who reported 2-3 days of PA were classified as low PA performers; 4-5 days of PA were labeled as moderate performers; and 6-7 days of PA were identified as high performers. Logit regression analysis of survey data from girls identified trends in PA frequency across time. RESULTS In 2004, participant girls were more likely than girls unfamiliar with VSS (reference group girls) to report high frequency of PA (OR = 1.44, CI = 1.18, 1.70). In 2006, participants were statistically less likely than reference group girls to report low frequency of PA (OR = 1.75, CI = 1.33, 2.21). In 2007, VSS participants were consistently more likely to report moderate frequency (OR = 1.56, CI = 1.35, 1.77) and high frequency of PA (OR = 1.44, CI = 1.24, 1.64) than reference group girls. CONCLUSION An innovative, community-driven intervention demonstrated promise for increasing PA among tween girls. VSS may have transportability to other communities to help reverse the secular trend of declining PA for this population segment.

Interventions which facilitate physical activity of youth are vital for promoting community health and reducing obesity. This study assessed the results of a community-driven program, VERB™ Summer Scorecard, as knowledge of exposure to and awareness of community-based interventions for physical activity among youth could inform design and implementation of such interventions. A total of 2,215 youth ages 8 to 12 years responded to a survey about physical activity. Ordinal logistic regression suggested that youth who participated in this program were 1.73 times (95% CI = 1.41, 2.11) more likely to report high physical activity than nonparticipating youth 9 mo. after the intervention's first full-scale application. The program appeared to appeal more to girls than boys. Such results are encouraging for use in communities.

BACKGROUND: Community-based prevention marketing (CBPM) is a program planning framework that blends community-organizing principles with a social marketing mind-set to design, implement, and evaluate public health interventions. A community coalition used CBPM to create a physical activity promotion program for tweens (youth 9 -1 3 years of age) called VERB ™ Summer Scorecard. Based on the national VERB ™ media campaign, the program offered opportunities for tweens to try new types of physical activity during the summer months. METHODS: The VERB TM Summer Scorecard was implemented and monitored between 2004 and 2007 using the 9 -step CBPM framework. Program performance was assessed through in-depth interviews and a school-based survey of youth. RESULTS: The CBPM process and principles used by school and community personnel to promote physical activity among tweens are presented. Observed declines may become less steep if school officials adopt a marketing mind-set to encourage youth physical activity: deemphasizing health benefits but promoting activity as something fun that fosters spending time with friends while trying and mastering new skills. CONCLUSIONS: Community-based programs can augment and provide continuity to school-based prevention programs to increase physical activity among tweens.

Background: Participation in free-time play, including individual and group activities, is important during youth as patterns of physical activity established then persist into adulthood. The VERB Summer Scorecard (VSS) intervention is an innovative physical activity promotion initiative that offers tweens (8-13 year-olds) opportunities to be active during the summer months when increased sedentariness can occur, leading to weight gain and a predisposition for further inactivity. Purpose: This study identified factors associated with intentions to participate in VSS among tweens previously exposed to the intervention. Methods: We conducted a cross-sectional study of 1,063 middle school youth using a 39-item survey and performed a multi-level analysis. Results: Being female (OR=1.43), having tried a new physical activity (OR=1.59), not currently participating in out-of-school activities but wanting to (OR=2.60), and self-monitoring of physical activity (OR=4.42 to 7.50) were associated with future...

The VERB ™ campaign used a social marketing approach to deliver its message through the mass media, school and community promotions, and partnerships to encourage children aged 9–13 years (tweens) to be physically active every day. This paper presents the VERB campaign's community and national partnership strategy, highlights three successful partnerships, and discusses challenges associated with the efforts. The national advertising generated awareness of and affinity for the product's brand and motivated the primary audience to seek out the product. The campaign's national and community partners were engaged to facilitate a product-distribution channel. The campaign developed a three-pronged partnership strategy to integrate the promotion with the placement of the campaign's product (physical activity): (1) reframe the way physical activity is positioned and delivered; (2) connect the brand to the point-of-purchase; and (3) refer (or drive) the audience to the action outlets, opportunities, places, spaces and programs to purchase the product. The VERB campaign provided partners with marketing training and resources to assist them as they leveraged tweens' brand awareness and supported regular physical activity among tweens. The method of technical assistance and the types of marketing tools were provided in relationship to four characteristics of the partner: (1) partner's network, (2) leaders and champions in the network, (3) partner's financial resources for community campaigns; and (4) partner's understanding of the marketing mindset. Coordinated, collaborative, and strong mass-media and community-based interventions within a national social marketing campaign can sustain the immediate effects of such campaigns.

Breast cancer is one of the leading types of preventable cancer among women in the United States. Despite improvements in mammography and early detection techniques for breast cancer, special population groups within the United States continue to experience high incidence and mortality rates. This paper focuses on Kentucky's underserved populations. The research objectives were to: 1) identify the factors that motivate women at risk to be screened for breast cancer; and, 2) identify the factors that deter women at risk from being screened for breast cancer. A combination of quantitative (survey n=407) and qualitative (focus groups=19; in-depth interviews=58) research methods were used to examine factors that influence mammography use. Factors that motivate women to have mammograms include: physician referral; the belief that early detection will improve breast cancer outcomes; and, the belief that a mammogram is an effective test. Factors deterring women from having mammograms include: lack of physician referral; cost; and, the belief that mammography is dangerous. Research findings point to the need for a comprehensive, integrated approach to increasing utilization rates. This approach includes recommendations for increasing physician referrals, modifying service delivery, training staff, and development of client education materials and a public information campaign. These recommendations have been incorporated into a social marketing plan to increase utilization of mammography services in the state of Kentucky.

Daily breakfast consumption has been associated with maintenance of healthful weight in youth and improved cognitive performance in the classroom. In one study, less than 50% of middle school youth reported eating breakfast daily. The United States Department of Agriculture (USDA) suggests ‘‘Grab ‘N’ Go’’ as a strategy for increasing school breakfast program participation. Grab ‘N’ Go is a school-based meal delivery concept that enables children and youth to select healthful food options quickly, easily, and economically. In 2004, a Grab ‘N’ Go breakfast program founded on USDA suggestions was developed by a Kentucky-based public health coalition, with input from coalition members, a youth board, school nutrition management and staff, and the school principal, as well as data obtained from 11 focus groups with parents and 9to 13-year-olds.

The VERB campaign used a social marketing approach to deliver its message through the mass media, school and community promotions, and partnerships to encourage children aged 9-13 years (tweens) to be physically active every day. This paper presents the VERB campaign's community and national partnership strategy, highlights three successful partnerships, and discusses challenges associated with the efforts. The national advertising generated awareness of and affinity for the product's brand and motivated the primary audience to seek out the product. The campaign's national and community partners were engaged to facilitate a product-distribution channel. The campaign developed a three-pronged partnership strategy to integrate the promotion with the placement of the campaign's product (physical activity): (1) reframe the way physical activity is positioned and delivered; (2) connect the brand to the point-of-purchase; and (3) refer (or drive) the audience to the action outlets, opportunities, places, spaces and programs to purchase the product. The VERB campaign provided partners with marketing training and resources to assist them as they leveraged tweens' brand awareness and supported regular physical activity among tweens. The method of technical assistance and the types of marketing tools were provided in relationship to four characteristics of the partner: (1) partner's network, (2) leaders and champions in the network, (3) partner's financial resources for community campaigns; and (4) partner's understanding of the marketing mindset. Coordinated, collaborative, and strong mass-media and community-based interventions within a national social marketing campaign can sustain the immediate effects of such campaigns.

The goal of our project is to encourage our 320 co-workers to improve their nutrition and fitness behaviors so they can enhance their own health and become more effective health educators. Because our co-workers make thousands of health-related contacts a month, they are an important and influential group to reach. Health-care professionals who practice good nutrition and fitness habits are likely to be more credible and dynamic when conveying this information to clients. The majority of health department employees know the principles of nutrition

Summary The in vivo consumption of oxygen and glucose was studied in relation to growth in Walker Carcinoma 256, Hepatoma 5123, and Fibrosarcoma 4956 transplanted in rats. Glucose not eliminated as lactate or carbon dioxide in the efferent blood was presumed to be retained by the tumor. The retention was so high that growth alone could not account for it. As an alternative, the elimination of glucose by the tumors in some unknown manner is suggested. The weight-doubling times of the tumors were independent of oxygen consumption and lactate production. The tumors needed oxygen to survive; there was no indication, however, that in vivo tumor metabolism shifted from respiration to glycolysis when the supply of oxygen was deficient. The opposite was found to be true: glucose consumption and lactate elimination were in direct proportion to the oxygen utilized and a lack of oxygen blocked both of them. The fraction of glucose transformed into lactate was maximal during insulin-induced hypoglycemia. These glucose-starved tumors did not produce lactate during glucose refeeding despite a large glucose utilization. Neither lack of oxygen nor large glucose consumption appeared to be the dominant causes of in vivo lactate production by tumors. Experimental increases in the lactate content of subcutaneous tissue could be obtained in the absence of any tumor. The possibility that glycolysis is related to changes of cellular components not necessarily involved in the neoplastic process is suggested.