Columbus Targets Messaging, Technology and Talk

June 13, 2013
By Julie Eisen

Ohio Healthy Weight Message

Through a partnership with Ohio State University’s Department of Communication, the team was able to work with students in a class focused on developing campaign messages. “We wanted to make sure the students understood that the message needed to cross all age barriers,” recalls team member Debbie Seastone. “We wanted a message that kids and parents would catch on to regardless of literacy or age level.”

 

43205, 43206, 43207. In these three zip codes in Columbus, Ohio, 47 percent of fifth graders are overweight or obese, a figure that is well over the national average of 33 percent.

“This is a predominantly low-income area with a lot of need,” says Dr. Ihuoma Eneli, leader of the Ohio Healthy Weight Outcomes (OHWO) team in the Healthy Weight Collaborative, and Medical Director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital. “We want to reduce this rate to 38 percent over the next five years.”

One way that the team is tackling this goal is by using innovative communication strategies to increase awareness, knowledge, and dialogue around nutrition and physical activity. But the team knows that to make the most effective impact, they need to work with the community. Whether they are creating a campaign message, a text-based tips program, or a school health form, Eneli and the Ohio team are taking the time to gather feedback from residents in order to produce materials that are uniquely tailored to the needs of Columbus’ most at-risk children and their families.

Developing a New Message: eat. live. be WELL.
The first order of business was to create a message that was simple, original, and would resonate with their target population. Through a partnership with Ohio State University’s Department of Communication, the team was able to work with students in a class focused on developing campaign messages. “We wanted to make sure the students understood that the message needed to cross all age barriers,” recalls team member Debbie Seastone. “We wanted a message that kids and parents would catch on to regardless of literacy or age level.” Other than that, the class was given free rein.

After the class submitted six proposed messages, the team narrowed the options down to two and tested them in various focus groups with kids ages 8-16, parents, and pediatricians. “The input was invaluable because they gave us a different angle on the message,” says Eneli. “We were able to look at it from the child’s perspective, the parent’s perspective, and from the perspective of the health care provider who will be working with families around the message.”

After tallying scores and tweaking the message according to the feedback received, the final message was announced: “eat. live. be WELL.” Eneli notes that the “WELL” portion of the message is a mnemonic for Walking, running, and play; Eating fruits and vegetables; Limiting sugary drinks; and Limiting screen time.

With the new messaging established, the team has printed flyers and sent them home with every student in the three target zip codes, and they have used the flyers at Columbus Public Health department early child care programs and events. Additionally, the posters have been hung in exam rooms at the Center for Healthy Weight and Nationwide Children’s Hospital affiliated primary care clinics. Over the next year, OHWO plans to use the posters at school events like parent-teacher conferences, carnivals, health fairs, and open houses. Finally, the team also plans to garner additional feedback on the message from their target population to assess and enhance the effectiveness of the message as well as improve the dissemination process. At this point, Eneli estimates that more than 8,000 people have seen the message.

Technology and Education: Feeding Your Kids
In another innovative partnership, the Ohio team’s parent institution, Nationwide Children’s Hospital worked with the Feeding Your Kids Foundation. The Foundation offers a program where participants can sign up to receive a text message or an email containing nutrition tips for parents about feeding their kids.

Eneli’s team, along with a group from the University of Michigan, revised the text and email program to fit their community’s needs. “The material had to be tweaked a little to speak more to our low-income populations in Columbus, and it had to blend well with the existing messages that individuals hear when they come into our clinics and programs,” she says. Some of the revisions included simplifying language, highlighting eating on a budget, and adding pictures and videos. The team piloted the new program in November with approximately 100 Columbus residents. The results of a post-pilot survey indicate that the program improved many participants’ knowledge on healthy food choices and helped them make better food decisions.

For now, promotion of the new Feeding Your Kids program has taken place primarily at clinic visits through the distribution of cards with the program’s website, as well as through Nationwide Children’s Hospital website. When the new school year begins, the team plans to promote the program in conjunction with the “eat. live. be WELL.” message.

“Our strategy is to partner our healthy weight message with our other initiatives such as our school-based body mass index screening effort, the feeding your kids program or our healthy lifestyle plan.” says Eneli.

Bridging Communication Between Schools, Families, and Providers
In addition to building a message and using new technology to educate parents about nutrition, the Ohio team has also looked at how routine materials like school health forms can be altered to better facilitate communication between schools, families, and providers.

In one case, school nurses learned that parents were not taking their children’s yearly Body Mass Index (BMI) referral letters to their children’s doctors, as the letter requests. Debbie Seastone, who is the wellness coordinator for the Columbus City Schools saw this as an opportunity to make a quick fix that could result in a big change.

To gain insight, team members held focus groups with parents and discovered that the language in the letter did not create a clear urgency for the letter to go to the doctor. With feedback from the parents, the new form now includes a line explicitly instructing parents to take the form to their child’s doctor, in addition to a new box for physician comments and recommendations. “The main goal,” says Seastone, “is that the letters make their way to the physician so that a conversation can be started about health, wellness, nutrition, fitness, and lifelong behavioral change to keep kids healthy for many years to come.”

Reflecting on the Ohio team’s overall strategy, every step of the way, Eneli says, “we want to make sure that our materials meet the needs of our residents. A message or form can look great to us, but if it doesn’t work for our kids, parents, or doctors, then we won’t see the change that we need.”