Physical Activity: Stand-Alone Mass Media Campaigns

The CPSTF finding is based on evidence from a Community Guide systematic review published in 2002 (3 studies, search period 1980-2000) combined with more recent evidence (13 studies, search period 2000-2009). This finding updates and replaces the 2001 CPSTF finding on Mass Media Campaigns.

Sixteen studies qualified for the review. Study duration ranged from 1 week to 4 years.

• Proportion of people who reported being physically active (as defined within each study):
  • Median absolute increase of 3.4 percentage points (Interquartile interval [IQI]: -0.6 to 5.7 percentage points; 10 studies)
  • Median relative increase of 6.7% (IQI: -1.6% to 14.1%; 10 studies)
• In three studies, people reported spending more time engaging in physical activity: median relative increase of 4.4% (range of 3.1% to 18.2%).
• Three additional studies found people reported being more active as a result of a campaign, though increases were modest.

While no studies were identified that evaluated the cost-effectiveness of mass media interventions, several studies reported costs of mass media campaigns, which ranged from $191,000 for a 1-year campaign to $339 million for a 4-year campaign.

Applicability of this intervention across different settings and populations was not assessed because CPSTF did not have enough information to determine if the intervention works.

CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

• Future studies should use standard measures to document campaign dose, intensity, duration, and reach, as these variables influence message awareness and can affect other distal outcomes.
• Data for proximal outcomes other than awareness listed in the analytic framework were reported rarely. Six studies provided information about knowledge, intentions, or attitudes and beliefs related to physical activity.
• Studies should also measure proximal outcomes of mass media campaigns (e.g., knowledge, intentions, or attitudes and beliefs) to better determine success or failure of interventions.
• Future research, at a minimum, should use valid and reliable self-report measures, but ideally, more objective measures of physical activity if feasible and appropriate for the research questions being asked.
• More research is needed on the harms and benefits associated with physical activity interventions (mass media as well as other types of interventions) to evaluate their safety, and also to evaluate cost effectiveness that includes benefits gained and adverse events encountered.
• Future research should evaluate the relationship between campaign dose and costs per media channel by outcomes among the target audience(s).
• More research is needed to understand what specific dose and channels of a media campaign (e.g., Internet, billboards) are most effective for specific target audiences.
• Audience segmentation and tailoring should be considered when planning multicomponent mass media campaigns and evaluated to advance knowledge in this field.

• The studies included three controlled trials, five cohort studies, five cross-sectional studies, and three single-group studies using before after designs.
• Three studies summarized results from the longitudinal, national mass media campaign, brand-named VERB (www.cdc.gov/youthcampaign/), conducted from 2002 to 2006 to increase physical activity among “tweens,” who were aged 9-13 years at baseline.

Brown DR, Soares J, Epping JM, et al. Stand-alone mass media campaigns to increase physical activity. A Community Guide updated review. American Journal of Preventive Medicine 2012;43(5):551–61.

Community Preventive Services Task Force. Stand-alone mass media campaigns to increase physical activity. Updated findings from the Community Preventive Services Task Force. American Journal of Preventive Medicine 2012;43(5):562–4.

Effectiveness Review

Analytic Framework see Figure 2 on page 553

When starting an effectiveness review, the systematic review team develops an analytic framework. The analytic framework illustrates how the intervention approach is thought to affect public health. It guides the search for evidence and may be used to summarize the evidence collected. The analytic framework often includes intermediate outcomes, potential effect modifiers, potential harms, and potential additional benefits.

Effectiveness Review

Summary Evidence Table

The number of studies and publications do not always correspond (e.g., a publication may include several studies or one study may be explained in several publications).

Effectiveness Review

Bauman AE, Bellew B, Owen N, Vita P. Impact of an Australian mass media campaign targeting physical activity in 1998. Am J Prev Med 2001;21(1):41-7.

Bauman A, McLean G, Hurdle D, et al. Evaluation of the national ‘Push Play’ campaign in New Zealand–creating population awareness of physical activity. N Z Med J 2003;116(1179):U535.

Beaudoin CE, Fernandez C, Wall JL, Farley TA. Promoting healthy eating and physical activity short-term effects of a mass media campaign. Am J Prev Med 2007;32(3):217-23.

Berkowitz JM, Huhman M, Nolin MJ. Did augmenting the VERB campaign advertising in select communities have an effect on awareness, attitudes, and physical activity? Am J Prev Med 2008;34(6 Suppl):S257-66.

Booth M, Bauman A, Oldenburg B, Owen N, Magnus P. Effects of a national mass-media campaign on physical activity participation. Health Promot Int 1992;7(4):241-7.

Craig CL, Tudor-Locke C, Bauman A. Twelve-month effects of Canada on the Move: a population-wide campaign to promote pedometer use and walking. Health Educ Res 2007;22(3):406-13.

Hillsdon M, Cavill N, Nanchahal K, Diamond A, White IR. National level promotion of physical activity: Results from England’s ACTIVE for LIFE campaign. J Epidemiol Community Health 2001;55(10):755-61.

Huhman ME, Potter LD, Nolin MJ, et al. The Influence of the VERB campaign on children’s physical activity in 2002 to 2006. Am J Public Health 2010;100(4):638-45.

Jason LA, Greiner BJ, Naylor K, Johnson SP, Van EL. A large-scale, short-term, media-based weight loss program. Am J Health Promot 1991;5(6):432-37.

John-Leader F, van Beurden E, Barnett L, et al. Multimedia campaign on a shoestring: promoting ‘Stay Active – Stay Independent’ among seniors. Health Promot J Austr 2008;19(1):22-8.

Merom D, Rissel C, Mahmic A, Bauman A. Process evaluation of the New South Wales Walk Safely to School Day. Health Promot J Austr 2005;16(2):100-6.

Meyer AJ, Nash JD, McAlister AL, Maccoby N, Farquhar JW. Skills training in a cardiovascular health education campaign. J Consult Clin Psychol 1980;48(2):129-42.

Miles A, Rapoport L, Wardle J, Afuape T, Duman M. Using the mass-media to target obesity: An analysis of the characteristics and reported behaviour change of participants in the BBC’s ‘Fighting Fat, Fighting Fit’ campaign. Health Educ Res 2001;16(3):357-72.

Peterson M, Chandlee M, Abraham A. Cost-effectiveness analysis of a statewide media campaign to promote adolescent physical activity. Health Promot Pract 2008;9(4):426-33.

Price SM, Huhman M, Potter LD. Influencing the parents of children aged 9-13 yrs: findings from the VERB campaign. Am J Prev Med 2008;34(6 Suppl):S267-74.

Renger R, Steinfelt V, Lazarus S. Assessing the effectiveness of a community-based media campaign targeting physical inactivity. Fam Community Health 2002;25(3):18-30.

Electronic literature searches were conducted in MEDLINE (Ovid), Embase, CINAHL, SPORTDiscus, PsycINFO, Campbell, Cochrane, NICE, Sociological Abstracts, AMED, and Enviroline databases. Also reviewed were references listed in all retrieved articles, as well as other identified review articles.

Only articles published in peer-reviewed scientific journals were included. To be included in this review, studies were required to

1. Be published from 1998 through 2011
2. Present findings of original research published in English
3. Be conducted in a high-income economy
4. Be consistent with the systematic review development team’s definition for a stand-alone mass media campaign
5. Provide information on one or more outcomes related to the analytic framework that included a measure of physical activity
6. Compare a group or population exposed to the intervention with a group not exposed or less exposed (comparisons could be concurrent or in the same group over a period of time).

Two abstractors independently read and collected information on each article using an electronic abstraction form. Any disagreements between the reviewers were reconciled by consensus of the two lead scientists of this systematic review.

CPSTF did not have enough evidence to determine whether the intervention is or is not effective. This does not mean that the intervention does not work, but rather that additional research is needed to determine whether or not the intervention is effective.

Evidence-Based Cancer Control Programs (EBCCP)

Find programs from the EBCCP website that align with this systematic review. (What is EBCCP?)