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Material Development for the

Material Development for the. June 5, 2000. Evolution of Project. Identify core issue: CSFII data indicates calcium consumption is low in some age groups Promote chocolate milk as a means to increase calcium consumption

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Material Development for the

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  1. Material Development for the June 5, 2000

  2. Evolution of Project • Identify core issue: CSFII data indicates calcium consumption is low in some age groups • Promote chocolate milk as a means to increase calcium consumption • Target audience parents, teachers, WIC providers, food service workers, etc. • Dispel sugar-hyperactivity myth • Target audience food service workers

  3. Social Marketing Concepts • Based on consumer needs • Population based • Relies on mass media • Pre-testing or pilot testing of the program

  4. Social Marketing Process Model • Market analysis • Conduct focus groups • Establish clear goals • Define geographical scope • Identify distribution outlets • Assess market trends • Identify resources • Assess competition

  5. Social Marketing Process Model • Planning • Define program structure/organization • Establish specific objectives • Segment target market • Determine strategy • Define marketing mix • Develop action plan

  6. Social Marketing Process Model • Develop, test & refine planning elements • Implement program • Assess effectiveness • Analyze effectiveness • Refine intervention accordingly

  7. Evidence Based Knowledge The Problem: back in 1980, Prinz et al. published a paper reporting an association between • amount of sugar products consumed • ratio of sugar products to nutritional foods • ratio of carbohydrates to protein and • amount of destructive-aggressive • restless behaviors observed during free play of hyperactive children but not in controls

  8. Evidence Based Knowledge Since then, numerous studies (including every study we examined) have not found the same association…

  9. Evidence Based Knowledge “Acute sugar loading did not increase aggression or activity in preschool children.” Kruesi MJ, Rapoport IL, Cummings EM, Berg CJ, Ismond DR, Flament M, Yarrow M, Zahn-Waxler C. Effects of sugar and aspartame on aggression and activity in children. American Journal of Psychiatry. 1987;144:1487-90.

  10. Evidence Based Knowledge “...neither dietary sucrose nor aspartame affects children's behavior or cognitive function.” Wolraich ML, Lindren SD, Stumbo PJ, Stegink LD, Appelbaum MI, Kiritsy MC. Effects of diets high in sucrose or aspartame on the behavior and cognitive performance of children. New England Journal of Medicine. 1994;330:301-307.

  11. Evidence Based Knowledge “… it {sugar} clearly is not a major cause of hyperactivity or other behavioral problems.” Does sugar or aspartame cause hyperactivity in children? Nutrition Reviews; Washington; May 1994; start page: 173.

  12. Evidence Based Knowledge “...the studies to date found that sugar does not affect the behavior or cognitive performance of children. The strong belief of parents may be due to expectancy and common association.” Wolraich ML, Wilson DB, White JW. The effect of sugar on behavior or cognition in children. Journal of the American Medical Association. 1995;274:1617-21.

  13. Evidence Based Knowledge “Although sugar is widely believed by the public to cause hyperactive behavior, this has not been scientifically substantiated.” Krummel DA, Seligson FH, Guthrie HA. Hyperactivity: is candy causal? Critical Reviews of Food Science Nutrition. 1996;36:31-47.

  14. Evidence Based Knowledge “The majority of experimental studies do not support the idea that sugar consumption leads to an increase in activity or hyperactivity.” Bellisle F, Blundell JE, Dye L, Fantino M, Fern E, Fletcher RJ, Lambert J, Roberfroid M, Specter S, Westenhofer J, Westerterp-Plantenga MS. Functional food science and behavior and psychological functions. British Journal of Nutrition. 1998;80, suppl. 1:S173-S193.

  15. Social Marketing Approach toMaterial Development • Complete market analysis • Assess scientific basis & identify key points • Develop handout • Pilot test

  16. Social Marketing Approach toMaterial Development • Implement use of handout • Assess effectiveness of handout • Continue to refine intervention

  17. The Development of a Handout

  18. Chocolate Milk... What’s in it for kids?

  19. Sugar Sugar  Hyperactivity So where does it fit in a healthy diet?

  20. Test, Market & Evaluate Sugar & Hyperactivity

  21. Test, Market & EvaluateSugar & Hyperactivity • PTA focus groups • Poll attitude, introduce handout, discuss, poll • Food service orientation meetings • Poll employees at beginning • Introduce handout • Poll at end of meeting

  22. Test, Market & EvaluateSugar & Hyperactivity • According to test results, modify handout • Content • Format • Distribution method • Need for reinforcement, linking agents

  23. Test, Market & EvaluateSugar & Hyperactivity • Handout mailed with school lunch menu and newsletter • Sent to parents, food service workers & linking agents • Cover letter about nutrition concerns • Controls do not receive handout • Provide info for linking agents • MDs, DDSs, PH reps, school psychologists • Health info hot line through newspaper

  24. Test, Market & EvaluateSugar & Hyperactivity • Implement marketing • Follow up with telephone interviews of key informants +/- intervention • Food service workers • Parents

  25. Test, Market& EvaluateSugar & Hyperactivity • Baseline & 6 months • Schools with & without intervention • Attitudes about sugar & hyperactivity • Availability of beverages • Consumption of beverages • Milk • Fruit juice • Soft drinks

  26. Test, Market& EvaluateSugar & Hyperactivity • Outcome • Increase knowledge & attitudes by 10% to more closely reflect evidence based data regarding sugar and hyperactivity

  27. Test, Market & Evaluate Chocolate Milk

  28. Test, Market & EvaluateChocolate Milk • Pilot chocolate milk handout • Parents • Teachers • Food service professionals • WIC service providers • Linking agents • MD, DDS, school psychologist and nurse • Content, format, readability, clarity, distribution • modify handout based upon feedback

  29. Test, Market & EvaluateChocolate Milk • Mail cover letter & chocolate milk handout to intervention schools • Parents • Teachers • Food service professionals • WIC service providers • Linking agents • MD, DDS, school psychologist and nurse

  30. Test, Market & EvaluateChocolate Milk • Print media in intervention schools • bulletin boards • menus • Promotional events • local grocery stores, health fares • PSA • Broadcast media • Bill Nye the Science Guy

  31. Test, Market & EvaluateChocolate Milk • Baseline & 6 month follow-up • Schools with & without intervention • Survey knowledge & attitudes • nutritional content as compared to white milk • chocolate milk, sugar & hyperactivity • caffeine • dental health • Purchase & consumption patterns • white & chocolate milk, soft drinks, juice

  32. Test, Market & EvaluateChocolate Milk • Purchase & Consumption • Increase milk purchase & consumption per capita by 10% over 6 months • Knowledge & Attitudes • Increase knowledge & attitudes by 10% to more closely reflect evidence based data regarding chocolate milk

  33. Looking Forward . . . • Focus groups and key informants to determine prevalence of beliefs • Sugar & hyperactivity handout bridges the gap between calcium crisis & chocolate milk • Stepping stone • Highest risk groups

  34. Calcium Intake Food and Nutrient Intakes by Children 1994-1996 http://www.barc.usda.gov/bhnrc/foodsurvey/home.htm

  35. Questions or Comments?

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